Believe it or not weekend mornings are when I have seen some of the strangest patients in the ER. People usually think of the weekend nights as being the time when all the crazies are out, but this isn't always the case.
I was working one Saturday morning when a woman in her late 20's came in for evaluation. She was accompanied by her fiance' who waited in the waiting room. The fiance' waiting in the waiting room is always a sign that something interesting is about to transpire. If it wasn't weird or interesting, the fiance' would be in the exam room with his wife-to-be, not in the waiting room. This rule of the ER would remain in place that day.
"Hello, what brings you to the ER today?", I said.
"Well, every time my fiance' and I have sex, after we're done and I go to wash up ( she pronounced it "woorsh-up"), I notice these little blue tubules coming out of my privates." the patient says.
Maybe it's just been my white-bread conservative up-bringing, but I've never felt the need to wash-up after having sex. Maybe I'm doing something wrong. Maybe I'm not doing it right. Should you need to wash-up after having sex? These were some of the thoughts going through my mind at that moment, not to mention the thought of "What the hell is she talking about?..... blue tubules!?" "Where do these people come from?" "Ok, there's a hidden camera somewhere and someone is filming this for some type of TV show".
Anyway she proceeds to describe the blue tubules. "They are about the size of a pencil lead and about a quarter of an inch long. I usually find a few of them when I clean up. It's always after we have sex. I don't know where they are coming from." "Have you seen anyone about this before today? Do you have a gynecologist you see?" I ask. Of course, she hasn't seen anyone about this. That's what the ER is for. She doesn't enen know what a gynecologist is. The nurse and I go do her pelvic exam, which to no one's surprise is completely normal. "Are you sure you don't see anything?", she says. "Pretty sure. I can see the entire inside of your vagina and I don't see any little blue tubules." "Well I wonder where they could be coming from", she says. "Maybe we could give you a specimen container to take home with you so the next time you see them, you could collect them. I'll give you the name of our gynecologist on-call that you can follow-up with." That was the most important part. Giving her somewhere else to follow-up other than coming back to the ER.
As the nurse and I were walking out of the exam room, it suddenly dawned on me that the patient had said she only found these tubules after she and her fiance' had sex. I had no idea when the last time they had sex was, and frankly I didn't want to know. Maybe the source of the tubules was his semen. I describe this thought to the nurse. "She said she only saw the tubules after they had sex, right? There was nothing that you or I saw during her pelvic exam, right? Maybe the tubules are in his baby batter! Nurse we need to have her fiance' go to the restroom and wack-off so we can check his jizz for the tubules!" "Are you serious?!", said the nurse. "No way! I don't think I want that guy wacking-off in the bathroom. I was just kidding, but do give her the specimen container to take home with her. She seemed to like that idea."
So, the patient left happy with her evaluation and the plan for follow-up. I never heard anything about her again, so the source of the blue tubules remains a mystery.
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