PUNCHES TO THE GUT

Violence exists in the world. Lying exists in the world. The emergency department exists in this world - often, all things exist together.

When you grow up watching sitcoms like Full House and Growing Pains, you develop a sense of how family conflicts should be resolved. You learn that familes comes together, problems are discussed calmly and rationally, and a decision is made that solves the problem while providing an important learning opportunity. Then everybody goes to sleep with their sneakers on. Seriously, what is that? Have mercy.

In inner city America, this is not what occurs on a daily basis. Not even close.

I came into the emergency department one afternoon, and encountered a young female with abdominal pain - not terribly complicated. 18 years old, with her mother sitting at the bedside - that's the complicated part. Do you remember being 18? I certainly do, and I would say that approximately 50% of my life would have been met with disapproval by anybody outside of their 20s, let alone my mother. What that means is that everything that this girl says will count for nothing, because she'll be lying through her teeth. Dr. Sherlock Holmes, activated (kind of like Robert Downey Jr., but with less cocaine and more formal education).

Before I even began speaking to the patient, I apologized to her and her mother, and excused myself for a moment. Different smells often permeate the emergency department, but today's was particularly different - and especially pungent. You know that scene in Anchorman where Brian Fantana busts out Sex Panther, by Odion? It was kind of like that. A used diaper, filled with Indian food... and a can of tuna. I thought that perhaps one of the foreign medicine residents had dropped their half eaten lunch into the garbage while walking through the ER... and then a tuna fish magically escaped the ocean and died directly on top of it. A careful inspection of the garbage cans in the ER did not prove that theory to be correct. I tried to forget the smell, and forged ahead.

Dr. Z: Hi there Ms. LiarLiarPantsOnFire (LLPOF). What brings you into the emergency department today?
LLPOF: My stomach hurts a lot. It started two days ago, and hasn't gotten any better.

A careful history taking revealed nothing of worth. Apparently, she had just moved back in with her mother after having been kicked out of her father's house for sneaking out at night. Other than that, she seemed like a pretty normal kid. Except for this.

Dr. Z: Are you sexually active?
LLPOF: Well, with girls. I only date girls now.

Why was this abnormal? Well, it seems as though the girl had a boyfriend last year, that mom hated. He was banned from her daughter, banned from her house, and banned from her life. So, naturally, my patient turned to the most reasonable method of throwing her mom off of the scent (see what I did there?) of her continued love affair - homosexuality. I could see where this case was going, and I'm sure that by now, you can too. Mom, however, was willfully ignorant. But not for long.

As I let the patient know that I needed to conduct a physical examination, she became a little nervous. The emergency department is set up like a casino - air conditioning always blasting, no windows, etc. So it didn't really seem out of the ordinary that my patient was wrapped in two blankets like she was in a cocoon. Until I began to unwrap the blankets...

It all happened very quickly. The first layer of blankets was unwrapped, and mom's brow furrowed. As I began to unwrap the second layer of blankets, and the full wave of nauseating aroma made its way into mom's nostrils, she flipped. Mom smelled the spoiled mayonnaise, and it wasn't something new to her. Fists started flying, daughter rolled off of the bed and attempted to escape, but it was too late. Mom had channeled her 12th grade track team quickness and cornered her, and was punching her daughter in the gut, all while screaming, "I TOLD YOU NOT TO LET THAT BOY INTO MY HOUSE ANYMORE! HOW MANY TIMES DOES HE HAVE TO GIVE YOU AN STD?? ASLKFSDKGFKGFDJHGUEGJF..." Mom went berserk. Daughter was crying. Security was called.

And I had my diagnosis. Just another day at the office. Elementary, my dear Watson. Elementary.