People often come to the ER if they see, or think they see, blood in their stool after a bowel movement.
They are most afraid they have cancer or some other terrible disease. So, it's not uncommon to have to do a rectal exam on people almost every shift I work. I'm always amazed when people start acting all weird about this exam. "Oh my! This is embarrassing! I wish I didn't have to have this done!" All the while I'm thinking to myself, "You know, when I woke up this morning I was hoping I was going to get to stick my finger in someone's butt-hole!" This isn't exactly the high-light of my day either, I assure you.
It's late morning. I go see a middle-aged professional man dressed in a nice blue business suit.
"How can I help you today?", I said.
"Well, I went to use the bathroom this morning and I noticed blood in the stool." , he said.
He proceeds to describe to me in much too much detail the caliber of the stool, the amount of blood, the color of the blood, etc. What happened next was the big surprise. He opens his briefcase and pulls out a Zip-lok plastic bag which appeared to contain a rather decent sized turd! I could not believe this. All I could think to myself was that this man was at a business meeting this morning with a plastic bag of shit in his briefcase! I wonder if he would have sealed-the-deal or acquired the new account, if those in the meeting with him new what a little treat he had in his suitcase. They probably thought to themselves, "Does this contract smell a little funny?" or "There seems to be a brown smudge on your draft proposal. Must be something wrong with your copier. Maybe it needs a new toner cartridge."
So he hands me his bag of excrement for me to examine. I obviously did not want to do this, but he seemed eager and proud, so I obliged his request. As I began to take a closer look at his goodie bag, I noticed he appeared to be getting plenty of fiber! I also noticed what looked like several watermelon seeds along with streaks of red. The red appeared to be the pulp of the watermelon. I also noticed many kernels of corn. "You must have been at a picnic or a cookout?" "I was. How did you know that?", he asked. I described how I came to the conclusion by the contents of his plastic bag. Now I'm a forensic stool examiner I think to myself. I did a chemical test on the stool called hemoccult which tests for blood. The test was negative, no blood. As it turned out, the red he was noticing was the undigested pulp of all the watermelon he had recently eaten.
He was very relieved to hear the good news that he didn't have cancer or some other terrible illness. I think maybe he was a little embarrassed, as well.
And for me..... It was just another day in the ER!
Monday, May 16, 2011
Wednesday, May 4, 2011
A Phrenologist's Dream
Working one Saturday night, I walk in to see a man whose face and chest is covered in blood. I could see he was bleeding from multiple lacerations to his scalp and he was obviously intoxicated. Drunk people tend to fall into two classes; the happy drunk or the angry, belligerent drunk. Luckily for me, this was a happy drunk.
"Wow, what happened to you?", I said.
"My wife caught me with my girlfriend tonight and hit me with a hammer", he said.
"Wives are funny that way, aren't they? Most just don't like it when you have a girlfriend too. Did you get knocked out or are you hurt anywhere else?", I said.
"Nope. Just my head." he said.
As I examine the man I'll call Leon, I find that he has a total of twelve lacerations to various places on his scalp. Each laceration was about two centimeters long. His head was a large tangle of hair, blood and large knots on his scalp.
"Man, a phrenologist would go crazy with you", I said to Leon.
"A what?"
"A phrenologist. It's a person who is supposed to be able to tell you what kind of person you are, or what your future may hold, by reading the bumps on your scalp."
"That's funny doc! Am I gonna be ok?"
"Yeah", I said. "We just need to clean up your wounds and repair your lacerations. You'll be fine."
In order to repair his lacerations, I had to try to wash all the blood out of his hair and then trim a little of the hair away from the edges of the lacerations. After this was accomplished, the wounds were repaired. Each wound was closed with two metallic skin staples. After I had repaired his lacerations, the nurse took the patient to a decontamination shower in the ER so he could finish washing his hair and getting all the blood off himself.
We keep a closet full of donated clothing for people to wear if their clothes are ruined from blood, urine, excrement or whatever. Leon went to the clothes closet and, of his own free-will, chose a stunning blue polyester leisure suit to wear home. His clothes were completely ruined by his own blood and beer. Leon slept off his alcohol in the ER for a few hours. When he awoke, it was Sunday morning.
I will never forget the sight of Leon walking past me as he left the ER that Sunday morning. He was quite a sight in his polyester powder blue suit with twelve small bald spots on his scalp; each one containing two metallic skin staples. He could be off to church with Jim Jones or to some zombie prom.
"Wow, what happened to you?", I said.
"My wife caught me with my girlfriend tonight and hit me with a hammer", he said.
"Wives are funny that way, aren't they? Most just don't like it when you have a girlfriend too. Did you get knocked out or are you hurt anywhere else?", I said.
"Nope. Just my head." he said.
As I examine the man I'll call Leon, I find that he has a total of twelve lacerations to various places on his scalp. Each laceration was about two centimeters long. His head was a large tangle of hair, blood and large knots on his scalp.
"Man, a phrenologist would go crazy with you", I said to Leon.
"A what?"
"A phrenologist. It's a person who is supposed to be able to tell you what kind of person you are, or what your future may hold, by reading the bumps on your scalp."
"That's funny doc! Am I gonna be ok?"
"Yeah", I said. "We just need to clean up your wounds and repair your lacerations. You'll be fine."
In order to repair his lacerations, I had to try to wash all the blood out of his hair and then trim a little of the hair away from the edges of the lacerations. After this was accomplished, the wounds were repaired. Each wound was closed with two metallic skin staples. After I had repaired his lacerations, the nurse took the patient to a decontamination shower in the ER so he could finish washing his hair and getting all the blood off himself.
We keep a closet full of donated clothing for people to wear if their clothes are ruined from blood, urine, excrement or whatever. Leon went to the clothes closet and, of his own free-will, chose a stunning blue polyester leisure suit to wear home. His clothes were completely ruined by his own blood and beer. Leon slept off his alcohol in the ER for a few hours. When he awoke, it was Sunday morning.
I will never forget the sight of Leon walking past me as he left the ER that Sunday morning. He was quite a sight in his polyester powder blue suit with twelve small bald spots on his scalp; each one containing two metallic skin staples. He could be off to church with Jim Jones or to some zombie prom.
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