Saturday, January 08, 2005

Lessons Learned: Week One

It is now Saturday afternoon of my first week in McPherson. I am on call, so I find myself tied to staying here at the hospital, in case some dire emergency or large disaster necessitates my "assistance." Rather than reading any mroe about the colon, I decided to go ahead and reflect on the lessons I have learned so far.

Lesson One: Do Not Swallow Toothpicks
Tuesday morning brought an interesting case to the Emergency Room. A man was complaining of intense abdominal pain and fever since the night before. An emergency exploratory surgery was arranged, and the list of possible diagnoses was long. It could be appendicitis, diverticulitis, gall stones, and the list went on.
Shortly after opening up the fellow, it became clear that the problem was in his small intestine. This became clear as about half a toothpick was poking through the intestinal wall, into the gut cavity.
The surgeon removed about 5 inches of the small intestine around the toothpick, placed the segment on a tray, and we began to examine it. He made a lengthwise cut, and opened it up, to find the other half of the toothpick. It was perfectly intact, sticking there like some kind of strange cocktail weenie gone bad. There was much speculation as to how this could have happened. Did the guy know he had swallowed a toothpick and was just to embarassed to admit it, even under the threat of major invasive surgery? Had he fallen asleep with it in his mouth and just forgotten?
Turns out, when it was explained to him after the operation, the man was just as puzzled as every one else. He continues to claim that he doesn't even use toothpicks, and that he can't think of anything he might have eaten that could have possibly contained a toothpick. So, the mystery continues as he heals from his incision.

Lesson Two: Stand Clear the Line of Fire
Wednesday morning I got to see the first of what I know will be many colonoscopies. The colonoscopy is that treat that everyone is supposed to have at the age of 50...a 5 foot long hose stuck up your butt to examine the health of your colon.
At this hospital, they very kindly give patients IV sedatives, essentially knocking them out for the procedure.
In order to get a good look at the walls of the colon, the patients have to "prepare" the colon by only taking clear liquids the day before, and also ingesting certain drinks that essentially cause a lot of diarrhea. During the actual colonoscopy, something that I can really only decrsibe as a small hose with a camera on the end of it, is inserted into the anus and advanced the length of the colon. Since it is empty, the colon is kind of like an empty ballon, which we need to slightly inflate. This is done by blowing air from the end of the hose ahead of the camera's path. Needless to say, quite a bit of air get blown up their asses.
Usually after a colonoscopy, the patient is brought to a recovery area, and allowed to deflate.
This patient, though, was also set to have a hemorrhoid removal after the colonoscopy, which made it all the more interesting.
After the camera/hose was removed, the nursing staff got the patient into the proper position for the next procedure. This means having her lay face down on a bed, with pillows beneath her lower abdomen to prop up that part of the body we are again going to invade. The bed is then tilted so the head goes down, which means that the butt goes up. Everything except the patient's butt is covered with sheets and drapes, so there is, essentially, an ass flaoting in the middle of the room.
For our little old lady, this turned out to be the perfect position for deflation.
As soon as she was flipped over, she began expelling large quantities of air, to the effect of someone having sat on a whoopie cushion.
Now, I realize that at my age and with my planned profession, I should not find anything amusing or remotely interesting about farts. Fortunately, I was wearing a surgical mask, so my facial expressions were mostly disguised. Soon, though, even the nursing staff could not hold it together, and we all giggled a bit at the next 30 second expulsion of air.
It was all fun and games until more than air began flying out of the butt. Soon enough, bits of lovely, watery stool began flying with enough propulsion to send them 6 feet from their exit. Everyone was a bit taken aback.
Except, it seems, me. Despite the "warning shots" that were sent in my direction, I did not take it upon myself to move even slightly to the left or right, and at the next expulsion, found it difficult to dodge the barrage headed my way. Despite my efforts, I was hit.
It was a small hit, and it only landed on the outside of my scrub top. It was a hit nonetheless. I was totally grossed out, wondering how I was going to remove the top, which can only come off by being pulled over the head, without getting any of the "material" onto any other parts of my body. Somehow, I managed to squirm out of it though.
I am happy to say that roughly 7 showers with lots of soap later, I am feeling almost clean again.

Hmmm. I thought I had more lessons to share, but my mind has suddenly gone blank.
So, I am going to have to leave everyone with these tales to ponder for a few days while I try to learn a few more lessons and come up with a few more interesting tales.


abby said...

i don't think toots will ever cease to be funny. but maybe that's just me... anyhoo, keep the lessons coming! do you want to come over tonight to watch wilco and bright eyes on austin city limits? i'm making brownies and you can like the spatula.

abby said...

um, that was supposed to be lick the spatula..

Anonymous said...

I am so glad you are back to writing! I thought you had quit on us.