When I was little, several of my aunts were in nursing homes. When my family and I would go for a visit, I was always surprised at how happy the other residents were to see a child. I can remember going around and hugging many of them; I assumed that they just didn’t have grandkids. Of course, I later learned that their grandkids and kids just couldn’t be bothered to visit…
Well, I’m not a medical type person any more, but I have been a cop and an EMT in the past.
From my EMT days…I worked for a private ambulance company. We did predominantly patient transfers to/from nursing homes. One day, we were supposed to pick up a patient from Ben Taub hospital in Houston. Taub is also an outstanding trauma center; if I ever get squashed by a meteor or something, I want them working on me.
Anyway, we’re standing around waiting for our patient to be brought down when in comes Houston EMS. They’ve got an older looking guy on the stretcher screaming bloody murder. He gets run to the back real quick. A while later, the EMS guys come out and we start talking. Seems this fellow was in his 60s, went cruising around and picked up some young hottie and took her home for some fun and games. He apparently was unable to function and she started teasing him about it. He tried a couple of drinks, which obviously didn’t help, but which diminished his judgement enough to think that inserting a fever thermometer up his urethra would give him sufficient rigidity.
And it broke…
When we heard this, my partner and I both crossed our legs in sympathy and then chorused, “Oral or rectal?”. Great minds swim in the same sewers, I guess.
What’s the difference between and oral and a rectal thermometer?
Taste!
/rimshot/ I’ll be here all week
I work ER so occasionally I get to see something really neat (or gross. They’re really pretty much the same to a nurse). A few years back I was at work when in comes this very nice, sixtysomething year old lady with an 18 inch piece of steel rebar sticking out of her leg! She and her husband had been working in the yard and he apparently ran over the rebar with the lawn mower. It went flying through the air and penetrated her right calf. For someone with that kind of injury, she was pretty calm. We didn’t even try to mess with it; we just shipped her off to surgery.
Oh yeah, and there was the time a homeless diabetic came in with “foot pain”. No wonder it was hurting; when I removed his shoe and sock there were maggots crawling all over it!
The medical term is toxic socks.
This is funny/sad/scary. You pick.
I was charge one night in a community hospital 14 bed surgical ICU
One of the nurses working that night, was a 6’4" ex-marine medic. The kind of nurse I’d want if I was in a big car wreck, but not if I had my gall bladder removed. He did a great job of keeping is patients alive, but hardly ever gave a bath or changed a sheet.
On this particular night, his patient was a fresh post-op AAA (Abdominal Aortic Anurism) repair that had ruptured on the way to OR.
Because of a very long cross-clamp time, he was putting out very little urine and requiring tons of fluids. so he was swollen up like a toad.
Day shift had had the fore thought of putting him on a sand bed (one that air is pumped through the “sand” so it feels like lying on a cloud.)
The action from the bed causes the patient to have a slight continious movement.
I was charting at the desk where we had small B/W video monitors from each room. His room was around the corner. I heard a small male voice call my name. I looked up at the monitor, and could understand what I was seeing. I headed into the room and the first words out of my mouth, after “Oh s***” were “turn off the bed!” The patient’s abdominal wound had opened, and his smal intestine was leaping around the bed.
The big strong, “I’ve seen it all” ex-marine nurse, was frozen in place, looking as white as the sheets used to be.
we got the bed turned off called the on call surgeon, and shipped the patient back to OR.
After he was gone, we sat down to talk about what happened. His response was, “I knew he didn’t need a bath!”
Obs/Gyn and Paeds always have sad things.
Late third trimester intra uterine foetal death diagnosed a routine appointment is the worst. It’s when you wish that outpatient consulting rooms were soundproof, and that you have all the time in the world to deal with the poor woman concerned…and all the other pregnant women who have listened to her crys of anguish.
My worst day in OB clinic there were two of them- one at 36 weeks, one at 39. Both unexpected and unexplained, both gut wrenchingly sad.
My week in the NICU, one of “my” baby girls didn’t make it (severe Intrauterine growth retardation, she was less than 700g at 30 weeks and she had a chromasomal abnormality), her death wasn’t completely unexpected, but it was still a blow.
Another day that sticks in my mind was a quiet Monday (which is a rare thing) in the Emergency department. There were all the usual minor injuries, acopias (literally, elderly people who cannot cope, or whose families cannot cope), MIs, Strokes and alcoholics with acute pancreatitis after a weekend bender.
But there were also two patients I will never forget, because both of them presented with lethal conditions with apparently minor symptoms (a painless lump on the chest wall, and a red face and cough).
The first was a father of four in his 30s, presenting with a painless lump on the chest who turned out to have high-grade lymphoma.
The second was a lovely man in his 60s, who had gone from a cough on the Friday, to a chest Xray on the Saturday, to Superior Vena Caval Obstruction (where the major vein draining blood from the head and neck is blocked) on the Monday. He only came to the Emergency department because his wife insisted, he wanted to wait until the Thursday and his scheduled appointment with his GP for the Xray results. He was dead within weeks.
Looking back at the three years I’ve been on the wards, it is scary to think how many patients I’ve talked to will have died by now.
On a slightly lighter (but more gross) note- did you know that some testicular tumours, when they become necrotic, can literally explode at orchidectomy? The textbooks strangely fail to mention this, but I’ve experienced it first-hand.
Also, I’ve seen a paravertebral TB cold abcess drained in a rather rudimentary hospital in rural India. The patient was given a large dose of ketamine, a local anaestheic was injected into the skin of the back and the incision was made. My job was to hold a bucket (not a kidney dish or a fancy disposable emesis basin, but a big plastic yellow bucket, that had recently been separated from the mop used to clean the floor of the operating room) underneath the incision to catch the pus. By the end of the procedure, the surgeon had run her hand all the way down the psoas muscle into the patient’s pelvis, and my bucket was almost half full. May I add that this was in August, during Monsoon season, when it was 100% humidity, 30 degrees centigrade, and there was no aircon?
On a lighter note, I did my surgical clinical exam today, and it went as well as can be expected, i.e. I wasn’t called for a viva, so I’ve definitely passed. One down, one (medicine) to go, tomorrow…then I’m a doctor (woohoo).
Let’s see. How about things that I’ve actually been grossed out by? Just off the top of my head, I’ve
- Had a bit of infarcted large bowel rupture in my face, spraying me with its contents during surgery.
- Had amniotic fluid and necrotic tissue from a stillbirth pour into my sneakers (with me in them).
- Slipped and fell on a liquidy spot left by a gangrenous foot.
- Palpated a lump on an abdomen, which suddenly ruptured, revealing itself to be a fistula to the large colon which leaked all over with wild abandon.
- Got hit in the forehead by a large thrombus expressed from an external hemorrhoid.
Congradulations Irishgirl!!!
Todays story, I’m feeling warm and fuzzy,
PICU dayshift, I’ve picked up a little Hispanic baby that had RSV (a resp virus, adults=cold, small kids=good and sick, ex/premies=life threatening). Kid had been intubated for a couple of days but less than a week, he’d turned the corner, and they had extubated him last night. Now we usually plan on an empty stomach for extubation, 'cuz it’s way bad juju if they vomit and get stomach acid into their lungs, this is true for everyone, but worse, of couse for a resp illness. Therefore pts are made NPO (non per os[mouth]), for a few hours before extubation, and kept that way until we’re reasonably sure their going to fly, and not buy themselves another tube.
So Mom’s there, asking when can we feed the baby and the docs give me the green light when they make rounds. I tried a little pedialyte or formula first, can’t remember which, but the baby latched on without difficulty and Mom asked if she could nurse, so we gave it a go.
Now I’ve seen some great artwork in my time, but any painting of Madonna and Child is a pale immitation of the light this woman put out as she nursed this baby that had been on a breathing machine yesterday. I swear to Og, I warmed my soul by that fire.
They were doing an ACDF (anterior cervical discectomy and fusion–they go in through the front of your neck and fix your spine) in the OR, and I knew they were about done, so I was strolling up there to get ready to do the final x-ray. As I approached the OR, the door flew open and the nurse shouted, “We need the C-arm, stat!”
(Normally, we just used a portable x-ray machine to take a picture of the “finished product” after a spinal fusion. A C-arm is a different machine used when the doctor needs live action x-ray pictures.)
So, I dash to bring in a C-arm, and I find the OR crowded as hell. It seems the neuro docs were just finishing up the fusion and went to clean up a bit, but they “nicked” an artery just off the carotid.
Talk about blood. Anaethesia was squeezing it in one place while it flowed out of the gentleman’s neck. The floor all around the table was covered. (I’m not used to that. We’re not a trauma hospital.) Anyway, The neuro docs backed out and the vascular docs were doing a cut down on the pt’s right arm so that they could get a catheter in place. They did a great job and the bleeding was stopped very quickly.
Later on the neuro resident was talking about the experience. One of the other residents asked him about the blood loss following the slice. He asked, “Did it fountain?” The answer came, “Fountain? It fucking geysered!”
By the way, the patient came out of it just fine.
Hi,
Non medical person, did two years as an inspector in an abattoir, these stories bring back memories!
But - medical gross out.
Last year my daughter (then 6 y/o) had a tiny Impetigo lesion - fine, antibiotics from the doc. The next day she has thin watery blisters all over her face neck & chest WTF? Back to the doctor, who says it’s just a reaction to the medicine, prescribes different anitbiotic.
That night she looks so bad, I am on the phone with NZ’s 24hour medi advice line, she says wait and see. Kid’s temp is no worse than when the doctor saw her - everyone says wait and see, but I feel like I am saying goodbye instead of goodnight.
Morning, not very responsive, the blisters are now huge, her nightie is stuck to her back and her arms stuck to her sides where they have burst.
Back to the doctor, who sends us to the hospital, who keep us waiting for hours before they find the one nurse in the building who has seen “Scalded skin syndrome.” My daughter has had an asymptomatic strep infection for perhaps weeks. Her throat is pus filled and causes the attending doctor to flich, even though my daughter insists that it doesn’t hurt.
They realise that her nightgown will have to be cut off her (taking all the skin off her back with it). Within 1.3 seconds I am alone on the ward holding scissors and a saline bag with my kid screaming in my face.
Everywhere that she has been touched, even lightly, her skin has blistered. If a blister gets touched, it bursts. I have to lift her on and off the bed pan when she needs it, finding a new place to lift each time. She screams if anyone but me comes near her - all I can see is that I am hurting my baby every time I touch her.
IV fluids and for the next few days she is treated as a burns victim. She looked like that Iconic photo from Vietnam, where the girl has been hit by Napalm.
We become a tourist attraction for medical staff - and get sent home as soon as she stops forming new blisters and the old ones scab up.
She has faint scarring on her chest where she scratched herself while sleeping, other than that it’s been a total recovery.
Still makes me shaky, just thinking about it.
irishgirl, I, for one, had no doubt 
Congrats. You’ll do well on the last one, I’m sure.
No more stories tonight. I’m going to bed early. (Early for me, 10:30 PM.)
Good night.
My husband works intake at the state prison. A lot of the inmates come from the various county jails. Some of them are just awaiting trial or doing short ‘jail time’, but if they become a problem for county, they get sent there. The county jails rarely want to take the time or spend the money required to give the inmates the medical treatment they need. So they just let the state deal with it.
One time, my husband walked into the intake area and wondered why all the unprocessed inmates were huddled up on one side of the room. There was moaning comming from the other side. This guy was sitting there bent over and holding his stomach. There was blood on the floor and it had soaked his clothes. He had been stabbed in jail, and was trying to keep his intestines from sliding out of the gash in his belly. He had come there on the bus with the other inmates.
Here is an interesting but difficult case I had some role in recently.
During routine early ultrasound, a fetus was found to be clearly abnormal. Over the next few weeks, the mom/baby received a diagnosis of massive cystic hygroma of the fetus- a condition where the lymphatic system doesn’t connect or drain and the lymphatic fluid simply accumulates in cysts. These babies, especially ones so severely affected, usually demise and deliver in short order.
The mom progressed to 23+ weeks before the demise but then made no progress toward delivery. At this point the fetus should have been between a pound and a pound and a half, but this baby was huge. The Doc wanted to reduce the size of the fetus to allow a vaginal delivery, so we began a series of amniocentesis-like procedures to reduce the size of the fetus. I have never seen so many abnormalities on one ultrasound. There was absolutely nothing ‘normal’ looking on the screen. The brain, the limbs, the still heart, the pockets of fluid everywhere. It seemed each hygroma itself was larger than the fetal head.
Several times, for as long as the mom could tolerate it, we used spinal needles and evacuated containers to withdraw the extra fluid. We removed well over 4000 cc’s of fluid (which I think is about 8 1/2 lbs of fluid) and began the induction.
Unfortunately, the baby was still to large to pass through her fully dilated cervix and needed some instrumentation to effect the removal. The mom wanted to hold her baby following delivery but the baby needed some repair prior to being handed over. The Doctor handled the baby very kindly and delicately, but the whole thing was an ugly mess from beginning to end.
I have EMT buddies. They tell stories.
One that particularly stayed with me was about a guy who had had a motorcycle accident. When the motorcycle stopped, he didn’t and was thrown over the handlebars. On the way, he lost something; namely, his jeans and his scrotum. Yes, you read that right, his scrotum was missing. His testicles were still intact, they were just out there, skinless and hanging in the breeze as it were. Oddly, most of his other injuries were pretty minor.
No other story I’ve told gets more crossed-legs reactions than that one. I thought of it just about every time I got on my motorcycle for the year or so when it was my only form of transportation.
Not a medical person here.
My foster brother was working at a local hospital while he was training to be a nurse. He came down with something nasty, and before long it was clear it was much more severe than just the flu. First, the doctors said it might be West Nile virus, which was big in the news at the time. Then they said no, it’s not West Nile, we think it’s mono. Then they said no, it’s not mono, we don’t know what it is. Some mutant monster bug lurking around the hospital.
First he became weak and developed a fever. Then his liver swole up. The doctors said something about how his marrow wasn’t working correctly, but I’m not sure what the exact terminology was. His throat swelled shut and they had to put a tube down his throat to feed him. He went completely delirious for about three days. We’re all in hysterics, the doctors plainly told us, “Don’t get your hopes up.” Fortunately, the swelling abated and the fever dropped and after a few days he was well again, but weak as a kitten. Never did get an answer as to what made him so sick.
Btw, this same foster brother of mine went to work at a psychiatric facility about a year later. He worked in, well, the crazy ward. One of his best buddies there was a patient, a gigantic black man about thirty-years-old, who he said if you were hanging around him you’d have no idea he was crazy. He talked and laughed and carried on just like any normal person.
Anyway, my FB was escorting his buddy to his room one evening, they’re strolling along, chatting, when all of a sudden his buddy freezes. He goes silent, staring off into space at something my FB can’t see. He seems as though he’s listening to someone. “No,” he says out loud to no one at all, “no, I wouldn’t do that to him.” And then he walks right past FB as though nothing happened.
My FB was never quite the same around this guy afterwards. Creeped him out good.
Three weeks ago my mother started having psychotic episodes, she has up and downs since then.
Last week she seemed to be OK and came back home from the mental institution. On Sunday night she started to loose it, she tried to break things, walked on all fours, laughted maniacally and at some point started to try to poke my eyes out, and then her own eyes. I had to physically restrain her for nearly two hours while she kept repeating that she loved me so much and that she wanted to stab me to death with a pair of scissors because “it would be fun”.
That make at least one grown man to cry.
Ale, you have my sympathies. I know what it’s like to see someone you love go descend into the abyss. How old is she?
58, I hope it´s not a permanent situation; I can´t think she won´t get better.
I hope they find the right meds for her. You and your mom will be in my thoughts.
Thank you, you´re very kind. 