Sunday, May 28, 2006

Poo and Dog Bites

Hello Loved Ones,

I was originally preparing for another ranting monologue about 18hour days and the emotional pain of perpetual stupidity, but I think all of that (including the 100 or so boring constipated people I’ve seen in the last couple days) takes a backseat to the following anecdote: Also, it is a relatively short story and I (having just returned from the hosp) am not long for this world.

Tonight I was in the emerg department looking at hard, poo-filled bellies. My boss stopped by, but had dinner plans with some friends he hadn’t seen in a very long time, so he left me with the last poo lady, and told me to page him with the dets. It took me a while, but I got her story, called him up and told him I thought she needed to be admitted for a possible bowel obstruction. He agreed that she should be admitted, but said he thought she might have diverticulitis of the right colon. WTF? This guy is a diagnostic machine. I had barely relayed any information. I scoffed in my head and thought he was out to lunch. After all, I’d seen the xray.

Twenty minutes after I hung up the phone, the patient in question had a humungous bowel movement. Actually, she shat the bed big time. Obviously, not a bowel obstruction – probably diverticulitis! Fuuuukkkkkk. I try so hard! I want my boss to like me and think I am smart. Just to make things worse I think I forgot the pink consult sheets that he needs in order to be paid somewhere in the ED. I hope to Christ I can track them down tomorrow morning…..

Anyway, I’ve digressed. My boss said to admit the patient and told me what orders he wanted on the chart. He said that after I was done with “le paper work”, I could go home and he would come in later tonight and co-sign. Fair enough.

However, as I was wrapping up my business, a man came in with his right nard fully hanging out of his scrotum, precariously dangling in mid air. His penis was also in fairly rough shape. Despite the fact that I am not currently doing an emerge rotation, I could not help but implicate myself in this case.

According to the patient, his son’s dog bit the nard off for no reason. I found the man’s story, and his demeanor, suspicious. The facts, and some of the evidence, did not add up. Nevertheless, whatever the dickens this man was up to tonight, he definitely paid the price. I thought he was gonna punch me in the face as I began injecting 10cc’s of Xylocaine directly into his purple, shredded ball sack! The pain must've been unreal. I was as gentle as possible, but he was screaming. Poor fucker. I left before the stitching started. Even busted testicles couldn’t keep me from my flannel heaven right now.

Goodnight - T

ps - good luck to Pesto and Shakes the Cat who will be taking part in the full and half marathons respectively tomorrow!


Blogger The One and Only said...

God Damn! This is another example that supports my theory that every man should wear a titanium protective cup at all times!! I would have loved to get the "real" story out of the "poor fucker" ;)

Have things gotten any better with your boss? Don't worry, you too will become a diagnostic soon as you find your niche you can begin to customize your own way of doing things. Hope you had a nice sleep.


4:29 PM  
Anonymous Pesto said...

I'm making you dinner tonight. You coming? Come for 7ish. Bring nothing but a left nard.

11:00 AM  
Blogger telltale tabby said...

sweet pesto,

thing is, i really need to study tonight. i can't come over for a couple of hours to eat. i am heading straight for the depths of despair.

you know i would be there in a heart beat for some of your red pasta and salad.

i'll need a raincheck. i love you to pieces.


11:06 AM  
Anonymous Pesto said...

NOOOOO!!!!! But you have to come! Just come. I'll feed you. You don't even need to socialize. Bring your books and study there... or just come for dins. you need to replenish your nutrients or electrolytes or whatever we replenish with food. You'll probably eat something devoid of balance like toast and Stilton at home. I'll feed your soul and your belly. Reconsider.

11:29 AM  
Blogger telltale tabby said...


you know i won't get any work done there. plus, dinner at 7 really means dinner at 8:30. i love this about you, but i can't afford the time committment tonight. i know it's dyfunctional and you're right, i will be eating dirty food here. for the last 3 days, it's been only rice krispy squares bascially (extra-chewy ones at least). i'm a pathetic mess. the sad part is, i am not even getting any work done - just floundering in an emotional dead space.

11:35 AM  
Anonymous Pesto said...

Ok. Well if you change your mind let me know. You know that the food I make multiplies like JC's fish and bread when the destitute arrive.

BTW, I have a major beef with Blogger. They make those word verification tests increasingly more difficult to decipher. Half the time I can't understand what letters I'm looking at and I am forced to re-type them 10 times! Arrghhh!!!

11:57 AM  
Blogger telltale tabby said...

okay. thanks. i wish wish wish i could come. i'm hungry right now. abnormal vaginal bleeding is not as interesting as you might think.

i frequently screw up the word verifications too. don't take it personally.

12:03 PM  
Blogger bbctchr,M.D. said...

Often when the emerg doc tells the consultant the story over the phone, the consultant will ask a few key questions in order to prioritize which patient is seen first and to come to a working diagnosis. That is probably what happened - he already knew the diagnosis before he even sent you to see the patient. I do it all the time! You should have asked him what it was about the story that allowed him to make the leap to diverticulitis.

Do not fret, since you admitted the patient, the pink sheet is irrelevant for billing.

You are so lucky that you got to see a ball; I've never seen a ball and I've got a few!

Take it back, vaginal bleeding is fascinating!

7:28 PM  
Blogger telltale tabby said...

Vaginal bleeding is a mystery to unfold. So many potential causes, so little time to study....

The ball was great. Kind of like the literal definition of a blue ball.

I don't think he really had gotten much info from the ER doc, because the person was transferred from a rural hospital for possibile appendicitis. When I called him, he said, "so, do you think she has appendicitis?" I said "no, I do not since Dr. D. (a different surgeon at our hospital) took out this woman's appendix in 2004. I'm not sure how he figured out it was diverticulitis, but he is one smart clinical cookie that's for sure.

I found the pink sheets in my lab coat pocket on Monday morning (phewf).

Inside, I am dying right now from lack of motivation. Bbctchr, this is my last rotation at our hospital. We will never see each other again, unless I am able to do an elective with you next December, which I think is unlikely for a number of reasons.

Right now, I have bigger problems. There are gigantic ants in my house (like the biggest I've ever seen). I have no idea where they are coming from, but I fear that if I have seen 5, there are an additional 5000 lurking somewhere else. I will either vomit, or have a massive MI if I stumble across them.

cheerio - T

8:30 PM  
Blogger The One and Only said...

T - you sound like a general of the finest army with your comment regarding the ants. They are the ones that are taking all the nutritious food away from you house!! As you nuts and vaginal bleeding - continue with your hard work will get through. As for Pesto's invite for dinner, if I were invited "S" and I would be out the door before I finished reading her post!!

12:05 PM  
Anonymous Pesto said...

My darling TOAO,
Next time you come to town you'd better inform me. I would like nothing more than to feed you and "S" all the pasta and other Italian goodnesses my little worker hands could cook up. And once that little TOAO cub arrives and is ready to ingest solid foods, I'm gonna get him hooked on pasta like no non-Italian has ever been! Watch out, the pasta train is coming your way!


3:15 PM  
Blogger The One and Only said...

Thanks Pesto!!

Is it wrong that you and I have hijacked Tabby's comment section on her blog?? I don't she would mind though....LOL.


8:41 AM  
Anonymous Pesto said...

On the contrary TOAO! I think she should feel proud for having fostered this reunion and for having provided a forum for such profound and heartfelt communicaish. Three cheers for Tabby for being the virtual glue that binds.

Hey, TOAO. Any chance you'll be in TO this weekend?

9:27 AM  
Blogger The One and Only said...

PESTO!!! I was in T.O. last Friday and this Monday!!!

You visiting family? Check out my blog will ya....


P.S. - Tabby rocks...if it wasn't for "The Law" she would be catching my slippery baby in August!!

10:19 PM  
Blogger telltale tabby said...

you guys are the best. only you could pull me from the depths of despair.

i have a real problem here with academic side of this med school gig.


10:23 PM  
Anonymous pesto said...

TOAO, I am making a day trip to Waterloo. I want to come see you. What is your number? What is the name of your school. I'm coming tomorrow, ie friday.

12:44 AM  
Blogger The One and Only said...

Hey Pesto...nice to talk to you on the phone today.

Tabby - I am glad that you appreciate our support. Sorry, I can't directly help you with your medical school studies - I know that you rock but I will cross my fingers for you anyway.

12:02 PM  

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