Monday, January 10, 2011

Take A Picture

Like anyone else who works in the ER, I wish I could take pictures and videotape some of our more absurd, inebriated patients. Of course, though, I can't--patient confidentiality and all that blah-blah stuff. But how great would it be to sit a patient down, after they sobered up, and show them how ridiculous their behavior was while in our care? Maybe, even, send a copy to their proud parents or spouse.

Personally, if I ever had twelve beers and ten shots of tequila before proceeding to crap and vomit all over myself, I would like a picture or two to convince me it really happened.

It was 2 am and I was standing at the counter of our nursing station nearest the ambulance bay doors, finishing a chart while dreaming about going home within the next hour, when the doors suddenly swung open and a prehospital team proceeded to wheel a disheveled patient into our ER hallway. Usually, the team contacts us by radio to alert us of their pending arrival with a patient, so their unannounced visit was a surprise to all of us.

The chief paramedic shrugged. "Sorry," he said, "but we picked her up at a bar just a few blocks away and didn't have time to call."

On their cot, obviously intoxicated, sat a peroxide-blond female, in her mid-twenties, with her head slumped to her right side and her breasts barely contained by her skimpy halter. Her hair was messed, the hairspray she spritzed earlier in the evening unintentionally spiking clumps in all directions. Her face was streaked with tears, darkened trails of waterproof-less mascara collecting at her chin. Drool gathered at her mouth's angles.

So, so pretty.

Of course, I was intrigued. "She was at the bar," the paramedic continued, "drinking for the past three hours, when her friends got concerned because she wasn't 'acting right.' Remembering she had diabetes, they called us to come 'check her out.' When we got there, she was passed out on a bench in front of the tavern, a puddle of vomit at her feet. Her finger stick was 87, so we decided to bring her in. She doesn't have any signs of trauma, doc."

Well, thank you fellas.

As the paramedic was speaking, as if on cue, the patient cocked her one eye open and, realizing she had an audience, started wailing and shrieking, her cry alternating between forced hiccups and gasping sobs. The hallway filled with various heads poking out of the treatment rooms, wondering how a hyena ended up in our ER.

"Room 23," the charge nurse said. The paramedics hurried off with their patient.

A few minutes later, walking back to my computer station, I passed Room 23, slowing down to check-out what was going on with our new patient (yes, I was nibshitting). I'm glad I did, though, if for no other reason than to find the paramedic holding this patient in both arms, a hero carrying his damsel-in-distress, while transferring her dead-weight from his cot to ours. I stopped and waved to him, laughing, and he shook his head in disgust. "Sometimes I hate my job," he muttered with a smile.

I stopped in and did a brief primary exam, listening to the patient's heart and lungs, confirming her stable vitals, and making sure she had no evidence of trauma. She didn't. All the while, she kept asking for the bouncer from the bar. Over and over and over. "Maam," I finally said, "nobody came with you. I'm sure the bouncer had to stay to finish out his shift."

"Ahh," she slurred, "screw him. He has a small penis, anyway." As she spoke, she pinched her thumb and index finger an inch apart from one another, giggling to herself while amusing us. "How do you know that?" her nurse, Barb, asked. "Well, duh," the patient replied, "I can hardly feel him when we have sex." I almost threw up in my mouth from her sharing so much (or so little) information.

So, so classy.

As the nurse removed this patient's clothing to put her in a gown, we discovered that the patient had on three layers of compression garments around her middle--a spanx, a girdle, followed by another spanx. For those of you not familiar with spanx (and I wasn't, so the nursing staff kindly informed me), it is a stretchy, spandex-type piece that, after you hold your breath and squeeze yourself into it, acts like a casing to your sausage body. Miraculously, you look thinner and more fit. Without going to the gym or watching your diet. Your difficulty breathing, profuse sweating, and pinched-up, cyanotic face, though, might just be dead-giveaways that you are wearing one.

"Why in God's name," Barb continued, not learning her lesson about asking questions from before, "are you wearing three of these? I've never seen anything like this."

"Well, duh," the patient answered again, "maybe so I can get laid by a guy who likes skinny girls." I get it--three layers tripled her chances.

I'm assuming that she was assuming that she looked more attractive all squished into her itty-bitty jeans and shirt with the help of her garments, but really? Did she think this situation through? What guy, one who was probably out drinking at the same bar as her, would be able to remove three of these things? Would the effort be worth it? Would his spanx-removal talent have a big payoff? Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have? Besides the fumbling, frustrated fingers of her date? Failure, through and through.

All the while, the patient continued talking in a slurring half-whisper, occasionally bursting out in giggles from her self-amusement. Several times, she belched so obnoxiously that it would have made any beer-guzzling, football-watching male proud. And one time, she dug her finger so high up her nose for a booger that I think her elbow was resting on her chin. Needless to say, I was fascinated by her influenced behavior and lack of awareness.

Finally, though, my biggest shock of the evening came from what the nurse shared with me. It seems that as the tech and nurse finished undressing the patient for observation, they were unpleasantly surprised to find this patient and all her southern female parts barely covered by her thong underwear.

Her American flag thong underwear!!! Three square inches of red, white, and blue fabric.

I was never less proud to be an American.

For various reasons, I found this news appalling. And so did the nurse and tech. Never before, in my vast experiences, did I see some skimpy underwear fashioned in this manner. When did a manufacturer start finding it appropriate to place the American flag, our sacred national symbol, on a little triangular patch that covers a woman's privates. Or worse (I'm shuddering here), a man's? I mean, let's reason this out. If our flag touches the ground, out of respect, isn't the protocol to attempt to lift it up from the ground (if possible) and, if not, burn it. Yet, it's perfectly okay for someone to wear our prideful flag pressed against their privates? Something about this thought just didn't sit right with me.

Let's be proactive. I say we gather all the existing American flag thongs out there and have ourselves a big--no, make that huge-- bonfire. Quite honestly, though, that's one bonfire I would probably dread attending.

I did get to eventually leave at my scheduled time, 3 am, after signing out my active patients to the overnight doctor. The patient, who had no sober friends or family available to come take her home, did fine throughout the night's observations, barring the occasional outbursts of swearing, drunk mumbling, and promiscuous suggestions. When she sobered up, however, according to the morning team, she turned out to be a very nice, pleasant young woman who just happened to "have a rough night."

"She could have been your sister or mine," the nurse added.

"Umm, no," I thought to myself, "I don't think so." I wasn't about to picture any of my sisters in an American flag thong, let alone being ridiculously drunk while holding their thumb and index finger an inch apart.

My final thought...maybe I don't need to take a picture or videotape this stuff, after all. Really, the mental image is reminder enough for me. Who needs a timeless picture to document such dread? Or the nightmares that would follow? If anything, I guess you can just take a picture of me, the treating physician. I'll give you permission. Just excuse my gaping mouth, my surprising eyes, and my befuddled expression when you get it printed...

As always, big thanks for reading. If you own a pair of American flag thong underwear, do me a big favor and throw them out. STAT! See you soon...


Holly said...

"wondering how a hyena ended up in our ER."

spew alert! Coffee all over my keyboard!

Anonymous said...

If my friend weren't a diabetic and was still with it enough to talk to me about sex, I would let them pass out on my couch and sleep it off - it would at least save them some ER underwear exposure!

Katie said...

"Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have?" is my favorite line! I've seen women dance to get in and out of a single pair of spanx... I can't imagine three layers!

Excuse me, I have to go throw away a week's worth of new underwear... I got them on sale too! Kidding, of course.

<>< Katie

rnraquel said...

Spanx remind me of TED hose, which I still wrestle with to put on patients. I can't imagine a drunk guy having the dexterity or endurance to get those off! And that poor American flag...What horrors has it been exposed to?

Anonymous said...

LOL, great post today and glad to see your blog's RSS feed working once again. For a while there it was stuck on that which was posted a month ago.

Tanya said...

Heh-I like the idea of videos of drunks to give them as a reminder why they shouldn't drink to excess. I'm thinking-maybe you could do it Disneyland style, like they do after you come off a big roller coaster-so when your drunk patients leave the ED, they walk by a wall with their pictures displayed and they can buy a copy...

Anonymous said...

I think you need a stack of "Is AA for You?" or "20 Questions" fliers handy in your ER. One of the questions is "Have you had to see a doctor because of your drinking?" Clearly, if an ER doc is handing you the flier then the answer is a resounding YES. Who knows, it's possible such a flier could save a life. Call me the optimist but I'm a recovering alcoholic (for more than 27 years) optimist. I know I've beaten the odds. But I'd like to know that maybe someone in your ER could also beat the odds, with your nudge in the right direction.

See question 18.

Anonymous said...

You assume that anyone she was going to pick up to have sex with at the bar was going to remove any more clothing than necessary to get the job done.

Mental101 said...

Is it not a regular occurance to get really drunk people in the ED? Just from drink alone? It is in the UK.

Peter said...

Someone could start up "Funniest Hospital Videos" but it sounds all too sick to me.

Take Care,

thatsit said...

Contrary to popular belief-Bud does not make you wiser.

coulrophobic agnostic said...

I actually do own American flag underwear. Boxer shorts. Thrift store find that made me go "did they really seriously actually make something this ridiculously awful?!" so, naturally, had to have 'em.

Anonymous said...

Hyena - coffee - ditto!

That has to be one of your best lines ever.

There are lots of boxers with American flags on them - you'd better brace yourself.

tracy said...

Sad, really, in a way. No one gets that drunk with out a reason.

Have Myelin? said...

Guess her mom didn't tell her to wear "good underwear in case you have an accident and go to the hospital".

Good story but very sad on many levels.

I hope someone recommended AA for her.

Cara in Canada said...

To the agnostic in the corner ... There is only one thing worse than American flag undies and that is ... Admitting that you bought them USED at a thrift store. LOL.
I've seen so many girls humiliated when drunk. I'm embarrassed for them since they don't have the sense left to be embarrassed for themselves. Sad - entertaining but sad.

Kristina said...

OMG! this is so hilarious! Hollywood stars use Spanx! Beyonce is known to be one.

Amber said...

I have a friend who wears 2 layers of spanx and is always so uncomfortable but says she wants her stomach to look flat. I dont get it.

Anonymous said...

You know, it's the turnaround that amazes me...foul language, combative, the whole drill, but once sober, they may be sweet and nice, maybe even contrite. I looked after one young girl who had to be placed in restraints she was so combative, and spent hours spitting to the point her face and hair were soaked (as was the bed and floor around her) but once sober she was quite sweet and apologetic.

On another note, my daughter had to have some tests for repeated UTI's when she was 4yo, and she was given midazolam for sedation, which only succeeded in turning her into the 4yo equivalent of a belligerent drunk. I laugh now, but at the time I was horrified! My generally good-natured little girl turned nasty! Pointing at the nurses, screaming "stay away from my vagina!" and "I'm goin' home, and YOU can't stop me!" with all the vile contempt a 4yo could muster. Thankfully, she had no memory of the experience afterward.

SR said...

"Sober, I doubt any guy would be able to succeed in getting this patient out of her spanx, but throw some drinks into the equation and what do you have? Besides the fumbling, frustrated fingers of her date? Failure, through and through."

I think this is what we like to call natural selection, or reproductive incompetence.

Karen said...

First, poor, poor girl. Second, I have only one question. WTF is nibshitting????

terri c said...

I had driven a sick friend to a city hospital ED and was staying with said friend in her cubicle when an intoxicated visitor in a nearby room was told he could not go home yet; this visitor was so irate he began yelling about false imprisonment and injustice and announced he was going to telephone a well-known radio talk show host with his tale of woe. I wanted to go dial the number for him just for entertainment value...

Anonymous said...

yes, I don't know what nib shitting is either....

Anonymous said...

Empress Bee (of the High Sea) said...

well okay doc but i still wouldn't mind seeing an assback!

smiles, bee

Anonymous said...

Seriously, you work in an ER and this is shocking to you?

Maybe you get less drunks in the US, but in the UK I wouldn't even consider that to be terribly surprising. And frankly, even if you were shocked I think your attitude is very judgemental. You have no idea what was happening in that girl's life, what caused her to go drink like that, what made her need to reach for that oblivion. Yeah, fair enough if it amuses you, but maybe some compassion would be nice too.

Have Myelin? said...

I started to say something but I didn't.

My daughter WAS an alcoholic. Yes, WAS. She died from multiple-organ failure brought on by alcoholism. She was only 34. Three weeks later my girlfriend (who attended my daughter's wake) lost her son to the same thing.

I sat by her side for 10 days then she died.

My daughter's story is hard. She saw her grandfather die (she thought of him as her real dad) then our Uncle died of pancreatic cancer, then his wife died of the same thing. Another Aunt died as well plus our cousin's baby was born dead.

Then my grandmother dies in front of my her grandmother whom she adored had Lups and RA and was truly suffering.

I have MS, her father has chronic leukemia (it's under good control)

She couldn't cope. Alcohol was her solace.

I have NOT talked about this on my blog due to family reasons. Too much pain.

That was her life, her story.

timmygirldoubledouble said...

Drunks are an every weekend occurrence for us. We diaper them and let them sleep it off. We mash their vomit and poo encrusted clothes into a plastic bag for safekeeping. When they leave they leave in a johnny and diaper, with a blanket wrapped around them, and we never, ever see them again.