SO I'VE BEEN AWAY.

SORRY

So, it's been awhile, hasn't it? I have not put a new post on the site in quite a few days - for this I apologize. I do not apologize for my devilish good looks - that is a curse that I must carry with me as I flirt my way through life's problems. Nonetheless, I can make a million excuses about why I was lackadaisical in my posting (does beating a new video game count?), but instead, I will tell you a brief story. 

The other day, a woman cried because the bathroom was dirty. Yup. She came in for abdominal pain, it was determined that she was having a miscarriage, but she didn't care. "I wasn't keeping this one NEWAYZZZZ."  Aside from being annoyed at the fact that medicine has not progressed to the point where she could be triaged, seen by a nurse, seen by a doctor, diagnosed and treated, and discharged all within a span of 1 minute/never having to leave her house, she seemed as though she was pretty level headed. 

But then she cried. Because there was toilet paper on the bathroom floor - balling her eyes out. People are the worst. 

Anyway - I've got a new stable of stories, and I'll be sure to release one every few days so that I can cater to my thousands of fans, who are all clamoring for more. Or just for my mom and my best friend's mom. Two... thousands... same thing, right?

*for those of you who may think that she was releasing some pent up emotion over the news... just stop. 

POOP WARS, VOLUME 2.

THAT'S THE SPOT

Bodily fluids. If you're coming into the ER, the likelihood is that we're going to be dealing with some of yours - that's just the way it goes.  Everybody has those fluids that they hate more, like less, whatever you want to call it. If you're working in the hospital, you're not that sensitive.

My order of preference?  I'll take brown over green, poop over vomit. That's just me - so I guess I was asking for it. It's not as if its a One Doctor One Cup scenario, but if I'm forced to choose, I'm Team Mr. Hanky.

One night in the ED, I had the pleasure of taking care of the sweetest old lady in the world - 85 years old, and approximately 75% hairspray by volume. The poor thing had been through so much, but she still made sure to take care of herself. She had a fresh manicure, a new perm, and I know she meant for the best when she layered on her 9 coats of makeup that day. Fighting a recent diagnosis of cancer that left her in terrible pain, she was on a high dose of opiate painkillers.  And hey - do you know what side effect they have? Constipation. Horrendous constipation. And tonight, it was a constipation that would have conquered the world. Don't worry, though - I played the role of hero. A hero in a brown cape.

It's called a disimpaction. It's not the most glamorous thing that we do, but its not all double rainbows and kittens. Sometimes you have to get your hands dirty... Your double gloved hands.

A typical rectal exam consists of one finger. Most people have trouble with this... Not my cute old lady. I got started. 

Dr. Z: Well, I can certainly see why you haven't been able to go to the bathroom. There's a very large ball of stool down here that's acting as an obstruction, backing everything up. I'm going to try to solve this for you...
BlueHairLady: You've already started?

Game. On. Two finger MacGruber, in action. 

As I began to form the world's worst triple scoop waffle cone, the conversation became ever more interesting.

BlueHairLady: Oh, yes. Oh, yes!
Dr. Z: Are you ok?
BlueHairLady: That's the spot. Oh yes that's it right there. Oh my god, yes.
Dr. Z: Ma'am? Should I stop?
BlueHairLady: Am I pooping? Oh my god, am I pooping? Oh, yes this is working. It feels so good. Don't stop, don't stop. Please, don't stop. YES!

As I had a chaperone in the room, I didn't really have to worry about what the people outside of the room were thinking. That fact didn't make it any easier to keep a straight face, though. It took everything that I had to keep from falling over backwards in a fit of laughter.  By the time I had finished, I half expected to look up and see her smoking a cigarette - nope.  She didn't seem embarrassed at all - this was all perfectly normal for her.

And, since this is my life, I guess this was perfectly normal for me as well. Satisfying women around the world, one rectal exam at a time. 

LOST AT SEA.

FLOATING IN A PUDDLE OF INCOMPETENCE

Kids are stupid. 

Back when times were awesome, you would get married at 13 years old, and start to play the "let's have sex" game way earlier than is now socially acceptable.  It seems that today, even though we're waiting longer to have sex, we're not much better at it. Add in all of the 'extras' that we now have, and there exists a greater opportunity for things to go wrong. Horribly, horribly wrong. 

Working a relatively slow overnight shift, everyone nearly lost their minds when one of the interns said, "Wow, it's been 9 hours and we haven't had a single vaginal complaint yet!" You don't talk about a no hitter during a no hitter. Everybody knows this, except when somebody doesn't know this. Sure enough, the floodgates opened, and all of the city's itchy and smelly females decided to come into the hospital at the same time. My encounter that night was particularly awful. 

I walked into the room of an 18 year old female, and the moment I opened the door, I took a step back. I never do this. My poker face is world famous, and that was the first time I ever showed my cards. This time was different; it was as if I had walked into an invisible wall of ungodly odor.  I regrouped, walked through the door again, and did the only thing possible to make it through the encounter - I started breathing through my mouth. Surprisingly, the patient I encountered was a pleasant female, 18 years old, and seemed pretty normal.  What was even MORE surprising was the fact that her boyfriend was sitting in a chair at her bedside, just relaxing and playing with his phone while being completely immersed in the most putrid odor known to man. Like he didn't notice a thing. If we had wallpaper in the ER, it would have been peeling 2 minutes after she got into the room. Nevertheless, Boyfriend of the Year sat at her side, loving her in all of her smelly glory. 

Dr.Z: So what brings you into the emergency department today?
Princess Unclean (PU): I've been having a really weird discharge lately.  It's been going on for about three weeks, but it's been getting a lot worse lately. I've had STDs before, but this doesn't look the same.
Dr.Z: Okay, that's no problem. Have you noticed any weird odor associated with your discharge?
PU: Not really. Kinda like a normal discharge smell. 

Through no personal experience of my own, I've come to understand that you can't really appreciate your own smelliness.  You truly need an outside presence to judge your smell. That explains her, but what about him? Also, I don't know what a normal discharge smell is, and for that I thank every female that I have ever known. 

Dr.Z: Let me ask you a few more questions. I take it that you're sexually active?
PU: Yes.
Dr.Z: And how many partners do you currently have?
PU: Just one, my boyfriend.
Dr.Z: Do you use protection?
PU: No, I don't like how condoms feel. 
Dr.Z: Okay. Well let's do a physical examination and we'll see if that yields any more information. 

At this point, it's full on spacesuit, ET level HazMat. I'm talking double gloves, face mask with splash shield, and a disposable gown. As I get into my pelvic examination, everything appears to be normal. Until I see it. I'm not sure what it is at first... but it's floating in there... floating on the surface of a sea of terrible infection... taunting me... just out of my grasp... and then I have it. But I don't know what I have. I turn it over, hold it close to my plastic shield, a lightbulb flickers, and then I know. It's a piece of condom, complete with reservoir tip. I'm like a vaginal Columbo.

Dr.Z: I thought you told me that you don't use condoms? 
PU: I don't. Well, I don't use them anymore. The last time I used one was 6 months ago, with my old boyfriend. 

And there it is. Not only has Boyfriend of the Year been putting up with the smell of the century - it doesn't even belong to him. Six months of this condom life raft surviving all alone in the Pelvic Ocean . It's the Tom Hanks of pelvic debris. Should I have gone back in and looked for a volleyball named Wilson? Meh, not my business. Besides, if there's anything else in there, we'll get it next time. 

Saving lives. One pelvic exam at a time.

FAMILY VIRTUES.

LIKE MOTHER, LIKE DAUGHTER 

Most of the time, patients in the emergency department are alone, and without family or friends at the bedside to provide love and support.  We usually appreciate this in the ER - it is widely known that any kind of family/friend showing up immediately creates a more dependent and whiny patient. Moderate pain becomes severe and debilitating, hunger turns into starvation, and a 5 minute wait develops into a month long lesson in patience that should be rewarded with a prize. 

That being said, the interaction between patient and family can, at times, be a heartwarming experience.  The job itself is very stressful - throw in the long hours, bland paint, no windows, constant complaining, and we need a little pick me up here and there. That's why this particular mother-daughter team lit up my heart. The young girl (16) came in after a sports injury, and was diagnosed with a rib injury. 

Dr. Z: This is an incentive spirometer, sweetheart. I'm going to give this to you to go home with, but I want to make sure that you understand how to use it. Okay? 
... I proceeded to explain to her the correct way to use an incentive spirometer, and even threw in my amazing acting skills to solidify the training... 
Patient16: Like this? (she proceeds to prove to me she listened to absolutely nothing that I said)
Mom: No no, baby. Like this. (Mom, surprisingly, is a quick study, and demonstrates perfect form)
Patient16: How did you do that, mom? 
Mom: You don't blow on it, baby. You inhale. Like a joint. Nice and deep. 

Lit up my heart. And once they left, I'm sure they lit up something of their own. 

THINGS YOU DO THAT WE HATE.

HATE HATE HATE​

You do a bunch of things that we hate, all the time. Most of the time you don't even know that you're doing it, but that doesn't make us hate you any less. Here are five things we all hate about you. Sometimes coming together for a common hatred is just as powerful as love. And more violent. ​

1. Stand outside your room and stare at us.

Really? What do you think that this accomplishes? I understand you've been waiting four hours, but that's because you came in for a runny nose and I have actual sick people that I'm caring for. You're the worst. 

2. You're upset when you find out that nothing is wrong with you.

Really? Can I punch you in the face, immediately? I know it's disappointing to find out that your cough isn't life threatening pneumonia, but I'm not treating you on a World War II battlefield you mindless twit. Be happy that you're not sick. JUST BE HAPPY.

3. Never remember anything about yourself.

How do you not know your doctor's name? You're 50 - you see him more often than you see your kids. How can you forget which surgeries you've had? How is it possible that you can't remember if you're a diabetic, but you can remember that the game starts at 7 and you need to be discharged RIGHT NOW? Get bent. 

4. Ask me for food. Over and over. 

You're a real 'Richard.' How can you come to the ER complaining about abdominal pain and vomiting, and then rape me for hours with your, "when can I eat?????" I'm not here to serve you your damn food. Sometimes I think that I should be, though, because all of those godforsaken satisfaction surveys always come down to how often you were fed. "Yes, I had a cardiac arrest and the team of doctors, nurses, and techs did an incredible job bringing me back to life... But they didn't feed me until the next day. And the bathroom in my room smelled weird. 3/5 stars." I hate you.

5. You urinate on yourself. ​

I JUST SAW YOU WALK INTO YOUR ROOM. You just got up and walked to the vending machine. How is it that when a nurse doesn't immediately bring you a urinal or bedpan, you have to piss all over yourself. You deserve a huge snowjob. Other than the fact that its probably a little too cool in your room, and pissing yourself warms you up for a minute, there's no excuse. Peeing yourself does not make you Miles Davis. ​

I pretty much hate everyone. This will be a running column, obviously. ​