The Reverse Peeper

It is 7:30 a.m. A weekday. Imagine that you walk up the two-lane driveway that leads to the brown-sided, two-story home, accented by shaker shingles and maroon shutters. You gingerly approach the burgundy front door, the morning sun warmly glowing against the house's reflective, cross-hatched windows as it bathes comfort to your posterior neck. You deeply inhale the passing autumn breeze, saturated with the smells of change. Slowly, you open the front door, turning the gold-plated handle down while pushing inward. You step forward, off the brick-lined stairs, into a foyer entrance.

You step onto warm, beige tiles as you gently close the door behind you. Facing you, a winding staircase embraces a wall completely covered in a variety of frames, their contained pictures telling a story of past and present family, from grinning babies with sprouting hair to formally-dressed young couples in love during the depression era. You glance to your left, noticing the wide, oak-framed doorway that leads into the formal room. A mahogany piano with glittering white keys sits in the corner, sheet music scattered across its front.

To your right, you see a glass-paned door invitingly open, leading into a home office. You casually peer in, noticing the filled mahogany bookcase, the L-shaped desk with a pile of paperwork off to one side, and the cozy, hunter green leather chair, draped by a matching green afghan and ottoman, in the far corner. You notice shelves of collectibles, more frames of family, and hung diplomas and artwork on the coffee-colored walls. The room looks comfortable and lived-in, a room you can accomplish paper-work in.

Finally, you notice the two oversized, side-by-side windows that dominate one entire wall. They face the front yard, watchful of the path from you which you just arrived.

And watchful of the path that leads away.

In front of those windows, on most mornings, stands a father watching his children walk away from their protective, comfortable home to their bus stop. He stands there in his pajama bottoms and a white cotton t-shirt, holding a steaming cup of coffee. His forehead and nose press against the pane, hoping his children will turn around to give him one last wave, one last acknowledgement, before they will soon round the bend of their cul-de-sac and no longer be in view.

He watches his oldest child, as tall as her mother, walk beside his middle child, his only son. They walk alongside one another, occasionally stopping to shift the heavy backpacks they carry. They nudge each other frequently, bumping into one another with the familiarity that only family knows. Their faces turn frequently to one another, and the father can see clearly the smiles and laughter privately shared between his two children. It makes him proud. Soon after, though, they separate, she going with a friend who met up with her and he chasing after two friends waiting for him further down the road.

They round the bend and disappear from sight. They are growing up too fast, the father thinks, wishing to himself that he could rewind time and slow down the hectic pace of life. He exhales, turning to face his quiet office, wondering if today will be the day he finally attacks the pile of paperwork waiting for him. He sits in his office chair and pulls up to the desktop computer. He is reflective, sitting there thinking about the stillness of the house. It seems too quiet. Perhaps, he thinks, he will write about this moment.

Within five minutes, thankfully, the stillness of the house is interrupted. A young, sweet, girlish voice, the voice of his youngest child, greets him. "Good morning, Daddy." She walks down the winding stairs with her bed's comforter wrapped tightly around her. He pauses at his computer, returns her greeting with a hug, and lets her begin her day. Her mother waits for her in the kitchen.

By 8:30, she too is ready for the school day. She stands at the front door yelling her last goodbyes, hooking the straps of her backpack around her strong shoulders. As she pulls the door shut, the house's canyon of stillness that just an hour earlier had haunted the father reemerges.

He resumes his position at the office windows. He watches his little girl traipse across the front lawn, her foot steps temporarily etched in the morning dew. She marches directly across the street, her blond ponytail swaying with her enthusiastic steps, where her bus stop awaits the queen's arrival. There are nine kids, ranging in age from kindergarten to fourth grade, and four hovering parents each morning. The father sadly shakes his head, thinking back to the days when he stood in line waiting with this daughter, a proud hoverer himself. Since those days, however, he and his wife had been dismissed from the job. "I'm too old to have you walk me out anymore," their independent daughter had explained.

The parents greet his daughter and look to the window, waving to the father, knowing he stands there on his days off. He returns their wave. The youngest of the children rush his daughter, their small arms quickly jumbled around her waist. She drops her book bag and kneels down onto one knee to return the hugs. Smiles and giggles and endless circles of running fill the next five minutes, until the screeching bus rounds the corner and stops to pick them up.

Through the bus windows, the father sees shades of his daughter's body as she walks the bus's main aisle until the last seat. She plops down her book bag before sitting herself down. On some days, she remembers to wave to her parents from her window as the bus pulls away, but this was not to be one of those days. The father waves eagerly anyway.

As the bus rounds the bend and leaves his sight, the father, once again, turns to face his quiet office and the stillness of the house. He had grown accustomed to a summer of chatter, of laughter, of arguing, and of simple daily moments--moments now stolen back from the eight-hour school day.

The father sits at his computer and stares at the blank screen. He misses his kids already. He is, however, not that naive to think that his pain is isolated. Parents everyday walk this path he is on. How they cope, however, may not be the same way he does.

He writes.

And so he pulls himself up to his desktop and begins. It is 7:30 a.m. A weekday...

Big thanks, as always, for reading. I hope you have a great weekend. This piece was an interesting one to write. I hope you enjoyed the peek in and "the father's" unique perspective.
See you next week!

The Damaged Eyes of Alcoholism

I walked into the dimly lit treatment room, Room 31, to find my next patient quietly and calmly lying in her cot. She had curly graying hair which, when added with the deeply creased wrinkles of her face, made her look much older than her stated age. Despite her attempts to welcome me with a warm smile, her greeting seemed forced. Her smile was but a thready, thin blanket failing to cover the the cold of her pain.

The pain of an alcoholic.

Standing in the corner, huddled together as a unified front, stood two teenagers. A boy and girl. Unlike their mother, they made no attempt to cover their worry. Their appearances were youthful--Converse Chuck Taylor sneakers, straight-legged jeans, graphic t-shirts, and hip stylish haircuts. But their eyes, those pained and aching eyes, bore an unfortunate truth to the years of sadness they had endured. Of their lost innocence.

I introduced myself to the patient before focusing my attention a little more closely on her children. Despite their worry, they were gracious in returning my hellos, introducing themselves.
I turned back to the patient. "Ms. Smith," I asked, "what happened that brought you to our ER this evening?"

Ms. Smith looked at me blankly, a confused haze slowly overtaking her face. I spoke again. "Do you know why you are here this evening?" She continued to stare at me, worrying me with her silence, before eventually nodding her head "no." She spoke. "I have no idea what happened."

I turned to her children. "Can either of you tell me what happened with your mother?"

The son stared down at his feet in response to my question. The daughter, however, connected with my eye contact and spoke up as she nervously tucked her wispy, blondish curls behind her ears. "I think she had a seizure." She got quiet then, her eyes getting more glassy as we continued to hold one another's gaze.

"Please, go on," I encouraged her and she bravely continued her story. She and her brother had been out and, upon returning home, had found their mother lying on the kitchen floor, unresponsive. An abrasion on their mother's forehead and a bleeding tongue greeted them upon closer inspection. After finding a pulse but failing to arouse their mother with yelling and shaking her flaccid body, they called 911. They all rode in the ambulance to the ER. They later put together, with the help of the paramedics, that their mother had probably had an alcohol withdrawal seizure. "She tried to quit cold turkey a few days ago," the daughter continued, shaking her head, "and I told her she needed to go somewhere to get some help."

The mother, intently witnessing her children struggling, started crying as she spoke. "I haven't had a drink for two weeks, honey."

With her words, the son looked up from his feet. "No, Mom, that's not true. You were drunk just over the weekend." The mother offered no excuses to his words.

Just then, the room's curtain pulled open and in walked a middle-aged man, his face strongly resembling the children's faces in both looks and worry.

"Daddy," the girl exclaimed, jumping away from her brother and into her father's arms. "Hi Dad," the son added shyly, giving his father a brief smile before turning his eyes downward again. His pain was palpable.

"Hello, sir," I said, introducing myself, "you must be Mr. Smith."

"I am," he replied, thanking me for taking care of his ex-wife. He turned from me back to his children. "Are you both okay?" he asked, pulling them into his chest for a hug. I caught my breath at his genuine display of love and concern for his kids. It was just what they needed at just the right time.

The kids smiled and looked up into their father's eyes, nodding their heads "yes." Their worried eyes relaxed and I was able to see some small sparkles mirror off their reflection as they continued gazing at their father.

Before turning to a physical exam, I asked a few more questions. It turns out that this patient had an extensive alcohol abuse history. Eight years prior, she had successfully completed an alcohol rehabilitation program and had remained sober for six years, before succumbing to alcohol's temptations again just two years earlier. According to her children and ex-husband, the past few years had been "hell" and had affected all of their lives in a very gloomy, detrimental way. They were just nearing the point of giving up on her, I'm afraid, when two weeks back, the patient announced to her family that she was done with alcohol "for good."

"That didn't last long, though," the son added, "because she got drunk that very night and passed out."

On exam, this woman appeared very fatigued, both mentally and physically. She did have the forehead abrasion that the kids had noticed on their kitchen floor, her eyes nervously flittered horizontally (known medically as nystagmus) within their reddened borders, and her tongue, on the left side, was bitten. Her vital signs were stable and the rest of her exam was unremarkable. It was evident that she had had some type of seizure, most likely an alcohol withdrawal seizure.

We did a full work-up. Her head CT was negative, her labs reflected dangerously low levels of both magnesium and potassium (which we began immediately replacing via her IV), and her alcohol level was zero. Besides addressing her electrolyte imbalances, we also gave her IV multivitamins, hydration, and thiamine to protect her damaged body.

We admitted this patient, much to her family's appreciation. She needed specific medical attention for her alcohol abuse and withdrawal seizure. After arranging all of this, I went back into her room to find this patient and her family much as I had left them, with much love being shared between the children and their father and their mother quietly sitting in the cot observing her children. There was much sadness, for me, from the many facets of this scenario.

"Maam," I said, after reviewing her work-up and disposition, "do you want to stop drinking? Will you accept some help for your problem with alcohol?"

Her answer was music to my ears, and it came without hesitation. "I have to stop drinking," she said. "If not for me, I need to do this for my kids." She paused and looked at her kids, who were now watching her intently. "I love you both too much to continue on this path anymore." With those words, both kids gingerly walked over and wrapped their arms around their mother, the daughter now openly weeping.

How do I know this patient was sincere about wanting help? As I spoke to them about their options for several available in-patient rehabilitation programs, she seemed to be intimately familiar with most of the options. This mother had done her research and had begun taking her own steps toward sobering up and becoming the mother she could be to her children again. She appeared very sincere in wanting nothing more.

I looked at both children hunched over the railings on either side of the treatment cot as they hugged their mother. Despite the daughter's weeping and the son's hesitancy, I could see that their eyes, despite their sparkling and youthfulness just minutes earlier as their father had hugged them, had become edgy, wistful, and nervous again. Old and young and, unfortunately, back to old again, reflecting their aged, hurt souls.

I am not naive. I know it is going to take a lot regained trust and renewed love to keep these children's eyes permanently young. To erase the damage caused by their mother's alcoholism.

Then again, maybe I am naive, because a large part of me thinks that this mother can succeed. For her children's sakes, I can hope for nothing more.

As always, big thanks for reading. I hope your holiday weekend is a good one. Next posting will be Monday, July 5. See you then...

This Father's Daughter

She was 50. Prior to being transported to our ER, her only complaint had been for non-traumatic elbow pain over the past two weeks. She was on no medications and had no significant medical history.

She was at home, preparing to visit her doctor for a scheduled visit, when she collapsed. Because she didn't drive, her elderly father had planned on swinging by to pick her up. He had just called and spoken to her minutes earlier to let her know he would be there shortly.

He arrived at her front door and knocked. No answer. He rang the doorbell. Again, no answer. Panic set in. This was not like his daughter to not greet him when she was expecting him. He knocked again, harder. Nothing. He kept his finger pressed to the doorbell, hoping his daughter would hear its continuous ringing and come to the door. She didn't. He tried turning the doorknob, but it was locked. He banged his aging shoulder against the door. It didn't budge.

He remembered the spare key she had given him months ago. "I'll never need this," he had said, trying to give it back, but his daughter had insisted he put it in his glove compartment. He stepped off the concrete porch pad and ran down the sidewalk, back to his pickup truck to retrieve the key. He found it, hidden under a pile of napkins.

Returning to the door, he struggled to fit the key into the lock. As a father, he knew something was wrong, very wrong. With trembling fingers, he finally succeeded in properly jamming the key into the door's lock. He turned the doorknob, barely breathing now, his mind racing of the possibilities he would encounter.

The door opened. He stepped into the small kitchen and yelled his daughter's name. No response. He listened to hear if the shower was running, but it wasn't. He strained his ears for anything, any sound of activity that would reassure him he was overreacting.

That's when he heard the moan. It was garbled and low, guttural almost. He followed the sound into his daughter's bedroom. That's where he found her, lying on the floor, beside the telephone nightstand.

He tried to rouse her, but he couldn't. Knowing something was terribly wrong, he dialed 911. Waiting for the prehospital team to arrive, he sat down on the floor beside her, caressing her head. Talking quietly to his daughter, he filled her ear with the promises that everything would be okay. It had to be, since they were all each other had.

The ambulance team arrived. After briefly interviewing her father and performing an exam, they prepared the daughter for transport to our emergency department. They were concerned that this patient may have had a stroke. They offered the elderly father a ride in the ambulance, with his daughter, but he decided to follow them in his pickup.

In the ER, the prehospital radio went off. They reported that a 50 year-old woman with a sudden onset of right-sided weakness and garbled speech was being transported to our facility. There had been no signs of trauma. Confirming that the time frame was adequate, a stroke alert was called in preparation of this patient's arrival. She would be a perfect candidate for tPA therapy if she did indeed suffer a stroke that was not hemorrhagic.

I, with the rest of our ER team, waited for this patient's arrival in Room 26. In three short minutes, she was being wheeled through our ambulance bay doors and down our hallway. Quickly, we were able to slide the patient from the prehospital stretcher to our hospital cot, all the while listening to the medical report given by one of the paramedics.

Her vital signs revealed that her blood pressure was quite high. She had no fever, her respirations were slow and erratic, and her pulse was normal. On exam, she had a flaccid right side, was nonverbal except for her occasional moaning, and teetered between some minimal form of consciousness and being unresponsive. It appeared that this patient had suffered some catastrophic brain event.

We emergently intubated this patient, both to protect her airway as well as ensure adequate oxygenation to her ill body. After a repeated exam by the neurology team, the patient was hurried to the CT scanner to determine the extent of her stroke.

While she was out of our department, escorted to CT by our nurse, the respiratory therapist, and a neurology resident, I went to the family room to speak to this patient's father. I was accompanied by our social worker and nursing supervisor.

I knocked on the door, opening it slowly to reveal a gentleman in his mid-seventies, tearful and distraught, running his hands through thin wisps of graying hair as he sat in the corner wing-backed chair. He had the look of a hard-working, honest man, dressed in a pressed flannel shirt and brown Dickie pants. He was alone.

"Sir," I said quietly, after introducing myself and my team, "I'm so sorry about what you are going through. Can you tell me what happened or anything that might help us with your daughter's care?"

With great detail, he told me about their plans to visit her family doctor that morning regarding her elbow. He was not aware that she had any medical problems. "She's a hard worker, that one. Never had time to be sick, really." He shared how he went to pick her up, only to find her collapsed beside her bed prior to his calling the ambulance. I listened intently, watching this father struggle to be stoic in his misery.

After maybe five minutes, a faint knock on the family room door preceded one of our nurses stepping in and interrupting our conversation. "Dr. Jim," she said, "can you come here, please."

I excused myself, leaving the father with our social worker and nursing supervisor. I stepped into the hall. "What is it?" I asked the nurse, herself wearing a worried look on her face.

"The CT scan, it's bad. The radiologist wanted me to get you."

I rushed to our physician work space, pulling up the patient's head CT images on the computer panel while I dialed the radiologist's number. What I saw saddened me. This patient had a significant brain hemorrhage, one that was shifting her brain from its midline and filling her ventricles with blood. The radiologist confirmed what I was looking at--that this patient most likely had a ruptured brain aneurysm. I called neurosurgery and the OR stat, since this patient needed emergent decompression of her brain's swelling and bleeding. Her problems were life-threatening.

I went back to the family room, where I sat down opposite the father. His expectant eyes bore into me. Slowly and deliberately, I explained all of the results to him. He unabashedly cried, his shoulder's shaking. "She's all I have left," he muttered. I was affected by his emotions and, looking at the tearful social worker and nursing supervisor, I knew that I wasn't alone.

We escorted the patient's father back to Room 26, where he was able to sit with his daughter as we awaited the go-ahead from the OR. I hovered in the room with several techs, the patient's primary nurse, and a respiratory therapist, overseeing the quick preparations of getting his daughter ready for surgery. I continued to watch the father, unable to turn away from the deep grief and ache that enveloped him.

This patient was taken to the OR. Thankfully, she made it through her emergent neurosurgery. She remained far from a successful outcome, however, since her following few days after surgery would be fragile and tenuous.

Usually, I follow-up with these types of emergent cases, the types that pull at my heartstrings. But, for this case, I didn't. I couldn't. I thought of this patient and her father frequently, yes, but I couldn't bear to think of this father losing his adult-daughter. I was willing to risk not learning of a possible successful outcome if it meant I also didn't learn of a sad, heartbreaking one.

I recognize what I am doing. I am protecting myself, adding another cement block to that protective shell that surrounds my heart. Building it up. Tearing it down. It is a constant but necessary struggle for each of us in the medical field.

I hope and pray, though, that this patient did well. After all, this father's daughter was all he had left.

As always, big thanks for reading. Next post will be Monday, April 19. I hope you have a great weekend...

A Memorable Ride

Undoubtedly, part of the charm of Hilton Head Island is her fondness of bicycling. Riding paths weave throughout her landscape, the warm and welcoming wrinkles of her proud face. They meander through her plantations, along her roadways, and frame her edges. They are her "laugh-lines," proof to the years of living she has witnessed, of the families she has embraced.

Like the two previous years, five rental bikes, complete with handlebar-baskets, awaited our family's arrival last Saturday, chained together outside of our beachfront condo, eager to shed their shackles and reacquaint us with Ms. HHI. Barely finished with carrying in our suitcases and supplies, the kids could hardly contain their enthusiasm to go for a bike ride. My wife, despite her sniffles and cough, led the charges.

"Come on, Jim," she said, froggy-voiced, "we have to go. Look at your children!"

Oh, I was looking, alright. Their excitement, their joy, their anticipation--how could a father not jump on that band wagon of happiness. Isn't this what family vacations are all about?

I teased them a bit, plopping myself into a lumpy, over-sized reading chair. "Hey kids," I said, lazily, "why don't we just grab a bite to eat somewhere and, afterwards, come back to the condo. Relax a little. Take a nap. The bikes will be here all week for us." Their collective "noooooooo," moaned with much exaggerated anguish (I'll admit, their flair for drama is my fault), was anticipated. Still, kids, well done.

We went for our first bike ride of the season. And, believe me, it didn't disappoint. There is a bike path along Mooring Buoy in Palmetto Dunes that is, if I may quote my eleven year-old, "Awesome!" No boring trail, this path winds around trees, through neighborhoods, over bridges, and, occasionally, offers up a small puddle or mound of wind-blown sand that must be plowed through. Hairpin turns and S-curves are included. If I was needing to unwind a little bit on this vacation, it was accomplished that first day. I was ten again--a smiling, innocent, fast-pedaling, wheelie-popping kid trapped in a grown man's body.

By Tuesday morning, after conquering most of the bike paths in our area, we decided to bike on the beach. Hard-packed sandy paths, a rising sun, and playful dolphins just yards from the coast beckoned us. No, you didn't have to twist my rubber arm to get me to go along with this plan.

We walked our bikes from our condo, through some loose, white sand, a work-out unto itself, until we arrived to the ocean's edge. The whispering breezes were westbound, and we decided to take them head-on. Just as we expected, the biking was superb. Starfish served as orange caution cones, and we maneuvered around them expertly. As pelicans regally swooped off the shore for their breakfast, new morning shells enticed us to slow-down and inspect their states of imperfection. Morning waves lapped at our tires, their white crests dispensing infinite prisms within foamy bubbles. Yes, life was good, despite having the back tire kick sand and water into the crack of my shorts.

We weren't biking on the beach for all of ten minutes when we noticed something peculiar in the distance ahead. Approaching, we were able to make out yellow tape, scant crowds, and the police. And...a small plane lying on its belly, facing the water.

Say what? A plane? Yes, a plane. Crashed on the shore. An obvious emergency landing. Appearing intact but for the propeller lying near it's front and, from what my non-expert eye could see, some right wing damage. Anchored to the dry shore by its tail, probably to keep it from being swept away. Saving it from drowning itself.

We approached the wreckage site cautiously, my kids asking whispered questions that my wife and I had no answers to. "What happened?" "Did anybody die?" "Where are the people from the plane?" The plane's nose bobbed with each incoming wave and, suddenly, all the recently observed glories were forgotten.

It was a heartbreaking scene to happen upon. Even though I didn't know specific details, a few minutes of scene-watching made it evident that this plane crash didn't just happen. No smoke from the wreckage, no EMS services, no panic. Just an eerie calm blanketing our disbelief.

The who, what, where, when and whys would have to wait--I didn't want to hang around and listen to any of the speculative chit-chat or idle gossip. All I wanted to do was turn my family around and get back to the safety of our condo, to our vacation life. We pedaled hard, the wind at our back, and returned within minutes.

We were all quiet walking into our place. We turned on the news and surprisingly, couldn't find any news-breaks explaining anything. We accessed our computer and, low and behold, my first breaking news of the recent events was from a very cool reader, Jacqueline. Just checking to make sure, via email, that my family was okay. Big thanks, Jac. She had heard on her news reports that a jogger was killed on Hilton Head Island Monday night.

So now, here we are, on vacation, and a jogger has been killed and an airplane has crashed. Hardly the stuff that helps one unwind. After several googled news reports, we found the answer that tied all the facts together. As reported, a 38 y.o. man, here for business, was jogging on the beach Monday evening, listening to his iPod. A single-engine plane had "oil problems," had lost its power, and was attempting an emergency landing at the local airport. The plane never made it. Essentially, by news reports, the pilot, struggling to see through an oil-splashed window, glided the plane in along the shore and, unfortunately, landed his plane on this unknowing jogger. Dead instantly. A father of two. A daughter's third birthday to celebrate this week. A family to support. To love. To grow old with.

Gone.

I work in an ER. I know how suddenly fate can change one's life. I came down here to get away from all of that. And yet, for all the misery and heartaches I've witnessed, this story struck a nerve. We walk this beach, we bike this beach, we hang in the same spot for hours on this beach. Why this guy jogging? Why not one of us? Or, for that matter, anyone else down here? Why the beach? Why couldn't the fates just let this father, this husband, this son have his casual jog while listening to some favorite music? Why? As with so many other tragedies in life, this seems so senseless.

We don't know this man or his family. But that won't keep our family from sending well-wishes, heartfelt prayers, and good energy their way. We can only hope that their lives will someday recover from this tragedy.

Back to the biking. As you might have suspected, we have given up beach biking for the remainder of this trip and are back to Ms. HHI's trusted, familiar bike paths. And after a couple S-curves and some wheelie-popping, I am once again a ten year-old trapped in a grown-man's body. Relaxed and ready to head home and face my everyday life and job with renewed vigor. A new appreciation of sorts.

Ms. HHI, I thank you--you didn't disappoint. Although I'll be taking one sad memory home with me, it will be tucked within a bundle of amazingly happy ones.

As always, big thanks for reading. Next post will be Monday, March 22. Have a great weekend and I'll see you then...

My John Deere Cap

I am a small-town boy now living in a big town. I graduated high school with 92 friends and, although I enjoy my big town, I miss the values and ways that accompany small-town living. Apparently, I'm not alone in my thinking, since four of my six siblings still live in our small town, all within a few miles of my parents' home.

Part of being small-town is that the work and entertainment varies greatly. Work, besides the obvious, may also include mill and factory work, forestry, and farming. Entertainment may include cow-tipping, four-wheeling, snowmobiling, hiking, fishing and hunting. And sports. How did I almost forget about our small-town sports?

Most recently, after visiting my family, I brought one of my dad's baseball caps home to big-town with me. It was a bright-green John Deere hat, one I had borrowed to wear outside for an afternoon while visiting. Besides breaking-in easily, it fit well.

Now, how many of you are familiar with farming? And forestry? John Deere is a stellar company, one that has stood up through the worst of our economy. My father's business relies on the excellence of their heavy-machinery products, especially their skidders and bulldozers. The people who don their John Deere hats are typically farmers and industrial sorts, salt-of-the-earth types. In my small-town hometown, when you wear a John Deere cap, you wear it with pride.

Returning home to big town, it didn't take long for me to learn that wearing a John Deere hat in a suburban area seems to make certain people assume that you are "slow" or "a hick." Or that you are a country-music lover. Or that you pick your nose freely in a big crowd.

That assumption would be wrong. Completely off-base, actually. Frankly, though, I couldn't care less what other people want to assume, but I find it surprising that this assumption actually exists. Anybody who is familiar with farming or knows a farming family is aware that these are some of the most intelligent, brilliant, and hard-working people you will ever come across. What one assumes might be a simple mind could actually be quiet confidence, introspective intelligence, and humility. I'll take this person over a dim-witted owner of a suit and European car any day.

My father and my brothers? Kind and humble, intelligent and easy-going. After obtaining their college degrees, my brothers chose to follow in my father's successful forestry footsteps. If someone chooses to judge them based on the cap they're wearing or their Carhartt overalls, it won't take that person long to realize that their judgment was premature. And it will only take minutes for my brothers to intellectually bulldoze through those wrong assumptions.

Anyway, back to the John Deere cap. I returned to my big town and proudly started wearing my green baseball cap everywhere--to hockey games, the local mall, my children's sporting events, and restaurants. About the only place I didn't wear my cap was at work in the ER. Don't think, though, that I didn't give that some thought.

The first time I noticed that I was being treated differently, for lack of a better word, was in an up-scale department store check-out line. The cashier spoke freely, easily, to the people ahead of me. Then it was my turn. And it was as if the cashier had a control switch to slow down her voice. And s..l..o..w.. down she did, even going so far as to raise her slowed-down voice while she gave me my change back.

"H..e..r..e.. i..s.. y..o..u..r.. c..h..a..n..g..e.., s..i..r..," she shouted, nearly exhausting herself.

I thanked her and walked away scratching my head, puzzled, and not quite connecting that it was all about my John Deere cap.

Next, I was at a local hockey game and the beer caller--you know, the one walking up and down the aisle with a tray of beers to sell--kept stopping beside me and asking if I was ready for a beer yet. Why, I wondered, was he just stopping to ask me? And again, he talked slower. And louder. I would have given him the benefit of the doubt, except I had heard him talk in regular voice to the people across the aisle from me. As bad as I wanted that damn beer, though, I passed each and every time.

More scenarios followed and by then, I knew the reason. My green John Deere cap. Each time, I walked away not knowing whether to smile at these sporadic ignorances or just brush off them off. I do have to say, though, that it was enlightening, this social experiment for one that I was conducting, to see how certain people responded to my cap.

Most recently, I was at my eleven year-old son's basketball game. I, with another father, had run the clock and kept the score during the home games all season. Before the start of this particular game, the referee approached our table to review some last-minute rules. Of course, he talked in normal voice to the other father before turning to me.

"D..o..n..'t.. f..o..r..g..e..t.. t..o.. s..e..t.. t..h..e.. c..l..o..c..k.. f..o..r... ." You get the idea.

After the ref finished and walked away to start the game, the other father turned to me and asked "What was that?" I pointed to my hat and he looked up, read it, and said "You're kidding, right?" He must have been a small-town boy himself. But no, I assured him, I wasn't kidding.

Well, I'm still wearing my hat. Only now, I don't give much thought to the occasional slow-talker whom I may encounter. This experience has enlightened my perceptions of how quickly others can judge you without knowing you. It's not only my John Deere cap, either. It can be cowboy boots, a certain hairstyle, the car you drive, where you're from, your accent, and how you're dressed, among many other things. That list is l..o..n..g.. .

If anything, now I'm a bit more guarded about my first impressions when I walk into a patient's ER room. Heck yeah, first impressions matter. I'm not denying that. But we should give the person an opportunity to show their true colors before we label them as a simpleton, or otherwise. In fact, why do we even need to label them? And what's wrong with being a simpleton? The medical field seems to be filled with them.

So, if you own a John Deere hat, wear it with pride. Let me hear you yell, "Hell, yeah!" Or, better yet, yell "H..e..l..l.. y..e..a..h!"

And if any of you know a good place to purchase some Yosemite Sam mud-flaps, I would be anxious to hear from you. I've been looking for a set to put on my European car.

As always, big thanks for reading. Next post will be Friday, March 5. See you then...

A Love Story

Before today's post, some quick business to take care of...

To my awesome readers, to Medgadget, and to Epocrates...I am truly appreciative and honored to have won the 2009 Medgadget Best Literary Medical Blog Award. Hell, I was tickled to just be nominated and ecstatic to have been chosen as a finalist. But to win? This is a very cool and distinguished award that has been bestowed upon my blog, and I thank all of you. Congratulations to the other finalists, as well. You all rock! I am humbled by the attention.

Big thanks, all, for also supporting my blog as a finalist in the 2009 Medgadget Best New Medical Blog category. The competition was fierce and I feel fortunate to have been included within that fine group of weblogs. Congratulations to the winner, SCOPE! Well done!

A special thanks to several people for my early nominations...Mike from Life In The Fast Lane, Ramona from Suture For A Living, Sunil, and Chrysalis Angel. Continued thanks to my (intelligent, faithful, and funny) readers for always being supportive of my blog, from your personal emails to your insightful comments, from your blogrolls to your tweets. You guys make me feel like I've accomplished something special. Thank you, my friends...

Finally, this Thursday, February 25, 2010, at 9 p.m., I will be a guest on the Dr. Anonymous Show, a live internet "BlogTalkRadio" show produced by a heck of a cool guy, Dr. Mike. This will be a new adventure for me and I look forward to the experience. If you have a chance to tune in, please do. And thank you, Dr. Mike, for the opportunity. I just hope I don't screw up...

The post that follows describes a gifted moment that I was fortunate to witness last week in our ER. I proudly share the story with you...

A Love Story

I noticed the two of them shortly after I arrived for my shift. I was standing at the counter, immersed in a chart, when out of the corner of my eye, I saw them walk out of their treatment room. Together.

Slowly, they walked into the hallway, looking first to their left and then to their right, wondering which way to go. One of them pointed down the hallway, grabbed the other's pale hand, and they began to walk toward their destination.

They were obviously in-sync and comfortable with one another, leaning into one another with each step. They continued to hold each other's hand as they approached me, and my eyes locked onto their steadfast grip. As they neared where I was standing, I smiled at the both of them and was rewarded with a return smile from each, doubling my investment.

"Can I help either of you?" I asked, studying their faces as they gave me their attention. Faces etched with contentment.

"No, thank you." It was said in unison. "We're just heading to the bathroom," added the one.

They passed me at a slow pace, and I continued to watch the caring that was quite evident between the two. It was my privilege, really, to observe and absorb their abounding love and obvious comfort with one another, something I don't see nearly enough in my job.

The bathroom was just thirty or so feet past me and, with no pressing patient concerns, I decided to continue watching. Their entwined hands, which had mesmerized me on their approach, looked even more beautiful and innocent, swinging in unison, as they passed and continued down the hallway, away from me. They were talking, hushed, and I noticed how their conversation was steady. Occasionally, one would steal a glance at the other.

They made it to the bathroom. The one gingerly pushed the door open for the other, helping him into the room before stepping back out into the hallway and shutting the door. Several minutes later, after some brief privacy and a few loving knocks, the door opened and they reunited. Hands were reclasped. Smiles were exchanged. Gingerly, they made their way back down the hallway, towards me and their room. Passing by me again, they both nodded.

We exchanged pleasantries. "Have a nice day" was met with "And the same to you." I wanted to say so much more, but decided to just enjoy this moment.

They passed me and I turned to watch their final few steps. Ginger steps that were unhurried and conscious. Again, hands were swung, bodies were leaned into, and familiarity enveloped their every move. I basked in their uniqueness, their special bond, hopeful that they realized just how blessed they were to have one another.

They arrived at their door and, just like with the bathroom, the older gentleman walked into the room first. Helped by the other, who followed.

How blessed was I to witness this true love story. Between...

An elderly father and his grown son.

As always, thanks for reading. Next post will be Friday, February 26. See you then...

No Love For A Father

The nurse hung up the phone, shaking her head.

"I can't believe the nerve of some people," she said, clearly aggravated by the phone call. The phone call, she explained, was from a gentleman inquiring about where he should check-in when he brings his father to our ER in a few weeks.

"In a few weeks?" the nurse asked, making sure she heard right. She did.

The gentleman explained that they were moving their father from the West Coast back to our side of the country, to be closer to family, after the father's third wife recently died. The caller had heard that it would be a much quicker process for their father to get into an assisted-living facility if he came through the ER.

"Honestly, sir, that is not a reasonable expectation, unless your father is ill and needing treatment. We are an Emergency Department," she said, enunciating Emergency, "not a place to bring your healthy father for placement."

Her words fell on deaf ears. Around 1 a.m., almost two weeks to the day of that phone call, another one of our nurses walked into the nurses' station, looking incredulous.

"Get this," she said, "this family in Room 22 brought their father directly from the airport to our Emergency Room to have him placed in an assisted-living facility. And," she continued, "they're pissed that they had to wait three hours to get called back from the waiting room."

It was a busy night but, eventually, I was able to make my way to their room. Their story was somewhat familiar with me, but I wanted to learn more.

"Hello, folks," I said, introducing myself to the patient and his family, consisting of two sons and a daughter. All local folks. All dressed in sophisticated clothes and very well-kept. I tried not to be judgmental as I continued. "What brings you to our emergency room tonight?"

"How many times do we need to repeat this?" asked the one son, the obvious spokesman. And obviously obnoxious. "We need you guys to get Dad a place to live here in town."

"At this hour?" I asked, looking at my watch. "It's 2 a.m., I don't think that's going to happen, sir."

"Well," said the son, "we've been waiting since 10 p.m. It's not our fault that it's now 2."

"Even at 10, sir," I said, staring at the spokesman, "I doubt we would have been able to accommodate you." Turning my attention to the patient, I continued. "Sir, are you hurting anywhere? Do you have any injuries or health problems that seem worse to you tonight? Anything that warrants you coming to our ER?"

The patient shook his head no. It was obvious that this was not his planning. I looked back to the son and cocked my eye. He just shrugged his shoulders. After obtaining more history from the patient, I performed a thorough physical. It was stone-cold normal. Clearly, this patient was mentally and physically stable and the family was simply seeking a short-cut to finding a place for their father to live. Heck, he could even live on his own if he wanted to.

"So, just to clarify this," I said, looking at his three grown children, "you picked your father up at the airport and drove him straight to our ER, at this hour, to be placed in a living facility? Am I correct?"

They all nodded. "But all three of you live locally," I continued, "why aren't one of you opening your home to your father until you can get him into a local facility?"

"We were told by several people, including my family doctor," the son spoke, "that this was the easiest way to have Dad placed." Shame on that family doctor, I thought. "And if you can't get him in a place tonight," the son continued, "then just admit Dad until you can get him in somewhere."

It's hard to get a rise out of me, but these people were doing a darn good job. I took a deep breath and tried to clean up my thoughts of these people.

"Well," I said, looking between the patient and his ungrateful children, "unfortunately, your information is wrong. I'll call our case management team down to discuss the available options for your family, but your father has no medical emergency and I won't admit him for the reasons you want. What your father does have, though," I said, "are three children who live locally that could easily provide for him until an assisted-living facility is available."

The family just looked at me. And I stared right back, alternating between them. I wasn't going to blink first.

"Well, then," the spokesman said, "can you call the case manager down to talk to us?"

I walked out of the room, disappointed in this family's dynamics. I'm sure there was more history between this father and his three kids than I was aware of, but still...to pick-up your father from the airport and bring him right to the local ER to dump him off? I would be ashamed of myself. Why even bother bringing him back here to live if this is how it was going to be?

Our case management team came down and, sure enough, were unable to place this patient directly into an assisted-living facility. The soonest they could arrange for his placement was in three days. Three days? People waited months for placement into a facility, and this patient would be there in three days. I guess it was a good shortcut for this family, after all.

"Three days?" said the son, "what kind of system is this? We can't wait that long. Do we have any other options?" No other options, said case management. No other options, said the nurse. No other options, I said.

The patient got dressed while his family grimaced and glared in our hallway. I seriously think they entertained the idea of leaving quickly without their father, but I kept my eye on them. I was ready to chase them down if they tried such a thing. I knew, just from observation, that they weren't above such a thought.

I have three kids of my own, and I shudder to think where a man could have gone wrong to get this kind of treatment from his own children. Did he spoil them? Did he wrong them so significantly that their refusal to take him in was justified? Or were his kids so caught up in their own lives that they had little time left for their father?

Regardless, the patient went to live with the spokesman son for three days. Three long days, per the son. I could only imagine, though, just how long those days would be for a father who felt no love from his family.

As always, thanks for reading. The next post will be Friday, February 5. Until then, if you haven't yet voted, go to Medgadget Medical Weblog Awards and vote for StorytellERdoc in both of his nominated categories. Your support and votes are appreciated! Big thanks!

Antisocial & Cynical Me

Recently, while in the middle of a conversation with an old high school classmate at a family gathering, a middle-aged woman who I had never met before ran up to me.

"Are you a doctor?" she blurted abrasively, stepping between my friend and me.

"Pardon me?"

"I said, 'Are you a doctor?' That man over there (she pointed to my father, who was in the middle of his own conversation) says that you are and that you'd be able to help me."

Ughhh! I've had several conversations with my father about not referring me "consults," especially when I'm holding a beer in my hand at a party.

Unfortunately, my father likes to play by his own rules. And when you're nearing eighty, there's only one rule--"I'll do whatever I want." He's even had friends run up to the house to "ask me something" or "take a look at this" while I'm in town visiting. As I said before, ughhh!

After I realized that this was not a joke, I had no choice but to listen this woman out.

"Anyway, I got bit by a bug last week, right here," she spoke, sweeping her forearm in front of me, revealing a small pimple, "and it won't go away. What can you do?"

Well, I knew what I could do. It involved my steel-toe boots and this woman's ass. I was at a party, for God's sake! Or, I guess I could have set down my beer and grab the defibrillator paddles for this life-threatening emergency.

Instead, I decided to take another long sip of my draft beer. A perfectly chilled beer that was hitting the spot. Hmm--decisions, decisions. I knew this would make me look extra attentive and reflective about her question, me there dragging out that sip and pondering her illness. I mean, I wanted to look like I cared, right?

Unfortunately, I spilled some beer on my shirt during my pondering. Make that attentive, reflective, and clumsy.

She continued waving her arm in my face, anticipating my diagnosis.

"Well," I started, "if you had come to the ER while I was working, I might have tried to lance it, but I doubt there would be any drainage. Since it's small and hardly red or swollen, though, I think you will be alright just to use warm soaks on it and give it time to heal itself."

She started to open her mouth but I cut her off.

"No, it doesn't need antibiotics," I said.

"How did you know?" she asked, surprised.

You know how I know? I'll tell you how I know. Everybody wants antibiotics when they have a problem. Heck, President Obama should have just sent each family a four-pack prescription of amoxicillin instead of tax relief money. The economy would be kicking like no tomorrow, all problems solved.

She looked down at her arm again, my eyes following her's back to the minuscule bump. I hope she didn't expect me to pop that menacing pimple with my own gloveless fingers! Give me one more beer, though, and just maybe...I think I could do it, using the same technique we all used when popping our face pimples in puberty. Thankfully, though, I was of clear mind.

I was hopeful that we were done, but oh no.

"Hey," she continued, "look at this." She pulled her short-sleeve shirt from her left shoulder to expose her bra strap, her bra, and unfortunately, her boob. She was hardly fazed. Did I mention I was at a party with a lot of people around?

"Oops," she said, pulling up her bra but still exposing a shiny new scar on her anterior shoulder.

"Wow," I said, taking another long, reflective sip of what was left of my beer.

"Shoulder replacement," she said, a proud smile creeping onto her face.

"Wow," I repeated again, now making a mental list of how I could possibly repay my father for this referral. Would it be wrong or considered rude to give your eighty year-old father a wedgie? Could adult services come after me for that?

"Yeah," this woman continued, "my doctor said I was the best patient to ever have this done."

I nodded my head. The old "you're my best patient" line, successful once again.

Actually, I must admit, this woman was very nice and pleasant, in her own way, but I really didn't want to go down that road with her of all her past medical problems. I can spot that trap ten miles away. And I was at a party holding a beer, not working in the ER. I'm sure I would have enjoyed her company if not for her forearm pimple and shoulder scar.

I'm sure of it. Almost sure. Pretty sure. Okay, not sure at all. Actually, probably not. Alright, nope, I wouldn't have enjoyed her company regardless.

After she finally left, I got back to my classmate, who was flabbergasted.

"Does that happen often?"

"Yes, unfortunately, it does," I said, keeping my answer short. I really wanted to whine and complain about just how often this does happen, whether my father is around or not, but I reminded myself that nobody really wants to hear about someone else's problems.

"That's cool," said my classmate, "because I've been meaning to ask you about this toenail..."

Needless to say, I haven't been to a party since. Well, okay, maybe just one or two...

As always, thanks for reading. Sincere gratitude to all who have recently blogrolled or twittered my posts--I appreciate your support. Next post will be Monday, January 18.

Meeting Candy

It was early morning, 4 a.m., the first time I met Candy. I had been on the job for about a year. Not having any idea what I was walking into, I slid Candy's curtain to the side to enter her treatment room. What I walked into was better than a shot of espresso.

Candy was running her fingers through her nurse's long blond hair.

"Honey, what I could do with your hair if you let me," she was saying to Mo, who was being an awfully good sport about it. I'm not sure I could let some stranger caress my scalp and hair in this manner.

"Yeah, yeah. Thanks, Candy," Mo answered, "that's what you told me last time, too."

So, Mo already knew Candy. I later learned that everyone who works in our ER knew Candy.

Candy, as it turns out, is a transgender male-to-female. These terms can be confusing, but transgender simply means that a person is living cross-gendered without sexual reassignment surgery.

Candy was known for handing out brutally honest fashion advice to our staff during her treatment time. I was only too happy to watch her interaction with Mo play out.

"Yes, honey," Candy continued as she held tight to Mo's hair, "you need to cut it a little shorter, get some highlights, and have it frame your face better."

"Um, okay, thanks Candy. I'll get right on that," Mo answered, still the good sport. "You do remember, though, that it's four in the morning, right? I'm sure not getting gussied up for an overnight shift."

"Ugghhh," Candy continued, ignoring Mo's defense, "and your split ends! Girlfriend, how could you? Go get me some scissors and I'll take care of this mess right now."

Mo extracted herself and her hair from Candy's grip. And then noticed me standing by the entrance.

"Oh, Candy, look who we have here! One of our doctors is waiting to see you." I do believe that Mo had just thrown me under the bus!

I stepped forward with my hand extended and introduced myself to Candy, feeling her eyes bore into my every fiber.

"Well, well, well," she said thoughtfully, "what do we have here?"

Nope. I'm first. Let me describe Candy to you. First, her outfit. She was in a white with black polka-dot mini-skirt with white tights, humongous red heels capping the ends of her lower extremities. Her shirt was sheer, white and black zebra-striped, hanging loosely over her skirt. She had a five o'clock shadow, a prominent Adam's apple, and thin scraggly hair that hung limply to her shoulders. Her makeup was very loud, despite the facial contusions and abrasions from the assault that brought her to us this night. She was sitting upright comfortably in her cot, one leg bent under her thin frame.

Okay, now your turn, Candy.

"Hair, good. Body, good. Nice eyes. Nice lips. Wow, look at those cheekbones!" Yes, I was really liking this Candy character, but made a mental note to myself that I should probably check her vision on this visit. Mo, who I thought was leaving the room, decided to hover to see what advice I would be receiving. She was leaning against the wall, arms crossed, smirking at me, thoroughly enjoying me being in the hot seat. She must have known it was going to get ugly soon.

"Wait. Oh yes," Candy exclaimed, pointing at my mouth, "look at that tooth!"

Shoot. I can't believe she narrowed in on my tooth. I think I have pretty nice teeth, barring one slightly off-colored one on my right upper front. And even this tooth isn't so bad. I had gotten knocked in the mouth playing basketball a few years ago, resulting in this tooth turning slightly off-white. My dentist had thought it would die and I would ultimately need to get it pulled, posted, and replaced. However, the darn thing didn't die off completely, and now I was stuck with a half-living tooth. Kind of like tooth purgatory.

Eventually, I knew I would have to get the tooth addressed, but it didn't bother me, and you had to look really hard to see it. At least I thought so. Thanks, Candy, for looking hard.

"Yeah, sugar," Candy continued, Mo now in a full-bloom smile, "get that thing taken care of, would you? Jesus H. Christ! Why would you walk around looking like that?"

How can you not smile? I started laughing, but Candy was just getting warmed up.

"Honey, can you spell manicure? Because you need one bad. Look at those bitten-up nails!"

I looked down at my hands, appreciating my nails, actually thinking that they looked pretty good to me. Now, though, I was feeling the need to apologize. "I'm sorry, Candy, I can't help it."

"Well, help it. You're a doctor, right? There's no reason you shouldn't be getting yourself some manicures (she said it like "man-neeeee-cures") and pedicures." She shuddered and continued. "I can only imagine what your feet look like!"

"Do you want to see them, Candy?" I asked, now enjoying this immensely. I had on hospital clogs, it would be easy to accommodate her.

"Ugghhh," she said, "find somebody else with a foot fetish. That ain't me, honey."

Ouch! She was tough. Clinton and Stacey from "What Not To Wear" held nothing on Candy.

Well, I'm happy to say that Candy turned out alright that night. Just some bumps and bruises. Interestingly, she had been working a corner in one of our less-desirable neighborhoods and had been picked up by four college boys for her services (this was her version). Less than a mile later, when they found out her true gender, they assaulted her and threw her out of their barely stopped car.

I'd like to think it wasn't her gender that bothered them as much as her fashion critiques. Can you even imagine? "Honey," she'd start out as she bent to get into the car, "what's up with all those pimples on your face? And you," she'd continue, looking at another one, "what's up with that greasy haircut you're sporting?" Yep, out the door she went.

I've seen Candy in the ER a few more times since then and always enjoy her wisdom and our conversations. Most recently, I was out to a dinner party at a local restaurant that was having a simultaneous gathering of transgender/transsexual localites. As my party followed the waitress to our table, we passed the gathering and there was Candy, sitting at a table with three other members, laughing and smiling and being quite animated.

Her hair is still scraggly. My tooth still isn't fixed.

You go, Candy!

Thanks for reading, as always, and have a great weekend. Next post will be Monday, December 21.

What Do I Know?

One of the hardest parts of being a physician is that people expect you to know everything about everything. And I have to be brutally honest here. That ain't me. But, thanks to a great residency and medical school, I do know my medicine.

Heck, though, I'll be the first to admit that I've never known much about plumbing. Or electrical work. Or car engines. Or how to cut an onion without crying. Or rectal foreign bodies.

Whoa, back up! What did I just say?

Yes, you heard me right. Rectal foreign bodies. As in having something in your behind that shouldn't be there. If you need to squat over a mirror to look, then chances are something is wrong back there. Seriously wrong.

So, imagine my surprise when, in my first year of residency, I discovered that our hospital's ER, being centrally located among several prisons, got it's fair share of rectal foreign bodies.

"Wait a second, people," I wanted to scream out, "I didn't sign up for this part of the job!" As long as I was making a list, I didn't sign up to do internal pelvic exams on eighty year-old ladies with blue hair, either. Unfortunately, though, in the ER you simply don't have a choice. Besides, I was a first-year resident. That's about as low as you go on the medical totem pole. Who would have listened to my concerns?

I remember well my first "something's stuck back there" patient. One of my favorite teaching physicians, Dr. Z., held a chart out for me. "Hey, K.," he said, "there's a patient in Room 12 I'd like you to see." Looking back now, I should have known his snicker was not all that innocent.

I walked into the room to find a regular Joe sitting on his cot, his feet and legs dangling off the side, looking a little uncomfortable.

Hmmm, not a prisoner. So far, so good.

"Hello, sir. I'm Dr. K. What can I do to help you today?"

"Well," the patient stammered, "I had an accident."

"What kind of accident?"

"Well," he started, his eyeballs almost rolling up into his brain to recite his rehearsed story, "I was at the gym and after working out, I got a shower. After I was done, I walked back to my locker wrapped in a towel and as I went to sit down on the bench, the guy next to me put his hairspray bottle down and I sat on it. It was an accident."

I promise you, he did not even crack a smile. It's amazing how distracting ass pain can be, I guess. Even as a first-year resident, I knew a good story when I heard one. The storyteller in me wanted more.

"So," I said, "did the bottle scratch your skin? Leave you with a bruise? What happened to it?" I, in some twisted way, wanted to hear him admit to me that as we were talking, a Clairol hairspray bottle was still missing.

He looked at me incredulously. "Look," he said, "you're new here, right?"

"Actually, yes, I am. Why?"

"Because, I've been...," he blew out an exasperated breath before continuing, "let's just say that this isn't the first time this happened to me." That explains Dr. Z.'s smile. And what gym has multiple hairspray bottle accidents in their men's locker room?

It turns out this guy had several "accidents" in his past that brought him to the ER. And, of course, they didn't really happen at the gym. He was a local celebrity of sorts. It was my privilege to finally meet someone famous, although a few years prior, I had met Cyndi Lauper. That should count, right?

I listened to the patient's heart and lungs with my stethoscope for way too long, hoping against hope that my shift would end before I had to do the rectal exam. No such luck. After feeling his abdomen, it was time "to look back there." I stepped out of the room to bring Dr. Z. in with me. After all, he was my teaching physician for the shift (plus, he dragged me into this case).

Dr. Z. walked in. "So, Joe, I see you met Dr. K., one of our new residents. He treating you okay?"

Great, Dr. Z. and Joe were buddies. "Yeah," Joe said, eyeing me up, "he'll do."

This is where my learning curve took off.

"Okay, Joe," Dr. Z. said, "you know the routine." Dr. Z. had Joe get on all fours on his cot (yes, my mouth was gaping open, too) and, after several layers of gloves, we inspected Joe's backside poking out of his gown. No scratches. No bruises. Then we tried to manually (unfortunately, "manually" meant using my fingers, not Dr. Z.'s) grasp and remove the hair spray bottle. Although I could feel the bottom of the bottle, I was unsuccessful.

I was filled with shame from my failed attempt. I had wanted this story to have an ending where I saved the day, where all the nurses would cheer for me, a measly first-year resident, and my unlimited brilliance as I walked out of Joe's room holding up the Clairol bottle like it was some sort of treasure trophy.

Dr. Z. tried his best to cheer me up. "It's okay, K. Really. This is what residency is for--to learn how to successfully pull a hair spray bottle from a patient's ass. There'll be more." Funny guy, that Dr. Z.

We sent Joe to x-ray. Abdominal films revealed to us that, just as Joe had said, there was a stuck hair spray bottle. Just beyond our reach. I blacked out Joe's name on the x-ray and made myself a copy to frame and hang over our fireplace, but my wife refused. "Don't you even think of taking down our wedding picture!" Sometimes I wish she could be a better sport about this stuff.

Unfortunately for Joe, the bottle would have to be removed in the OR. We tried one last hurrah by using a special rectal speculum and graspers, but no such luck. Yep, Joe was heading to the OR.

While under anesthesia and completely relaxed, the GI team was able to use a scope to retrieve the missing bottle from Joe's backside. I can only hope that they got the round of applause that I had dreamed about.

I often wondered what Joe told his family and friends about his hospital visits. I mean, really, what if one of them wanted to send flowers? What do you write on that card? Please let me know if you have an idea about that--I'm blanking out.

I still don't know much about plumbing or electrical work or peeling an onion without crying. However, I'm proud to say that so many years later, I know all I need to know about rectal foreign bodies.


Thanks for reading...and enjoy your day. The next post will be Wednesday, December 16.

The Half-Load Predicament

My family does a lot of swimming in the summer, both recreational and competitive. And because of the amount of time we spend at the pool, we go through a lot of swimsuits.

This summer, while at a local department store, my wife took the girls and went looking for some extra suits while my son and I searched out swim trunks in the men's department.

While my son was looking at the boy's rack, I thumbed through the available men's options. I passed right by the tiny Speedos rack, since I'm neither European nor obese, and found a rack of board shorts, my favorites.

The designs were current and hip and I just knew I was going to look 20 again at the poolside.

Finding a pair I really liked, I peeked at the tag to confirm the size was the same as what the hanger read.

What I saw next was nothing less than disgusting. And hysterical. I could not believe what I was looking at.

There, inside the swim trunks I had planned on purchasing, was half a load of crap clinging to the inseam!

Obviously, someone had tried these trunks on underwearless, which is gross enough. But to actually leave this mess and put the shorts back? I was incredulous. It either had to be a teenager playing a vile prank or someone who simply failed to hold their wet fart. Either way, I couldn't even imagine what their crack looked like if this is how the shorts turned out.

Since my kids have fantastic senses of humor, I decided to have a little fun. "Hey," I called to my eleven year-old son, "can you come here?"

He came up to me as I stood in front of the trunks. "Yeah, Dad?"

"I really like these trunks but I can't read the size on the tag. Can you?"

"Sure." My son grabbed the clean waistband and pulled it back to read the tag. "Dad, it says thirty...OH MY GOSH!" He had spotted the mess.

He released his grip on the waistband and could barely get his words out. "There's...there's a load of...of...it's brown...OH MY GOSH! GROSS!"

I sometimes wish my humor wasn't so twisted from working in the ER, but there you go. I could hardly keep a straight face.

"Look, Dad, I'm not kidding!" I took a look to appease him. "Well," I said reflectively, fingers on chin, "I don't think that should be there."

"We have to go tell Mom and the girls!" he exclaimed, running away from me before I could stop him.

I followed him to the girls section, where he was already in the middle of the story by the time I arrived. My wife and daughters looked incredulous. In unison, when he finished, they exclaimed "NO WAY!"

My wife and girls looked at me to confirm the story. "Really?" they asked. "Really," I said.

As my son rushed off with the girls to show them this remarkable find, my wife asked me again. "This is for real?"

"Yes," I said again, "no lie. I promise. And it's disgusting."

She caught me off-guard with her next question. "Aren't you going to take them up to the front counter?"

What? I didn't even think of that. I wasn't the one who took a dump in some new board shorts in the dressing room. And, I didn't ask for this to happen. Why should I have to take them up to the front?

"Because," my wife said, "that's the right thing to do. You don't want someone buying them and taking them home, do you?" Ugh, sometimes her reasonable thinking annoyed me. "Besides," she continued, "what if someone throws them in their cart and they have food or, even worse, a toddler playing in the cart. Then what?"

I pictured a little child, blond spiral curls, pulling those board shorts playfully over her head.

Nope, it still wasn't enough for me.

"Listen," I pleaded with my wife, "if I take them to the front counter, they'll think I did it. Who's going to believe that I 'just found them on the rack?' They'll be laughing at me the minute I walk away. Security will probably follow me on hidden cameras the rest of this shopping visit."

I could only imagine. "Hey, Nancy," the security guard would yell to the lady I handed the shorts to, "there's 'the shitter' looking at tennis balls in the sporting section. Why isn't he in the toilet paper aisle?" Then they would burst into fits of laughter, all at my expense.

No, I wasn't handing the swim trunks in. No way, no how.

My wife and I walked over to the men's section to find our kids playfully pushing one another close to the stained shorts.

"Hey, kids," my wife admonished, "be careful! And don't touch them! I don't want you getting someone else's poop on yourself!" Yes, I thought, but it's okay to have your own poop on you? Since she was somewhat annoyed with me, however, I decided not to question her on that point.

She hesitantly stepped towards the shorts and peeled back the waistband. The kids and I held our breath. "Well," she said, cracking a smile at the absurdity, "that sure is something, isn't it?"

Um, yeah, it is something. Something disgusting. Something filthy. Something funny. Something hysterical. Something unexpected. Something unbelievable. Yeah, it was something alright.

"Are you going to take them to the front? Or am I going to have to?" she asked.

I held my ground. "I can't, hon'. Seriously. I just can't do it."

She huffed. "Well, whatever then." I expected her to keep her threat and grab the shorts and take them up to the front herself, but she didn't.

She grabbed the cart handle and pushed it away from the rotten, stinking shorts. "Come on, kids. Let's get out of here and get some cookies." They had earned that much. As long as they washed their hands first.

"Wait," I challenged, "I thought if I didn't take these to the front, you were."

"I changed my mind. Let's go." Good--maybe she was seeing the light of my way.

I walked away from those shorts with a heavy heart. Why I felt so responsible for a load of feces that wasn't mine, I don't know. Darn that deviant culprit for making me feel guilty for his defecation.

On our way out, my eyes searched for anyone close to having a 33w. Or a shuffle to their walk. Or brown-stained pants. No one...

Driving home, I ended up calling in the problem anonymously from my cell phone. Okay, not really. But I do wish I had thought of that at the time. It's just that, for being a level-headed guy, I was a bit flustered.

When we share this story with friends, family, and coworkers (and trust me, we got a lot of mileage out of this one), they seem to be split on what they would have done. Do you know what you would have done?

One of my coworkers, Bill, said it best. "That sure was a shitty predicament."

Yeah, you think?


My next post, an ER story, will be Monday, December 7. I assure you that my kids are very happy and well-adjusted and carry no ill-effects from this shopping trip. Thanks, as always, for reading and have a great weekend.

Big Stuff, Big Words

I have become quite good at reading people within the first few minutes of meeting them. It comes with the job, actually. Thirty patients (and their families) a shift and rest assured, after 16 years in the ER, I have been exposed to many different personalities. I am a poker player of sorts, keeping my personal feelings hidden behind my smile while I measure up the alpha male, the needy daughter, and the nosy neighbor, all begging for more attention than the actual patient.

With all the family dynamics swirling around a patient's room, it is important for me to swiftly figure out the who, what, when, where and how so that I can attend to the patient's illness. You would be amazed how just one person can affect the entire ER experience, either positively or negatively.

And in Room 12, that one person happened to be a father of two boy, ages 10 and 12.

I walked into the room to find the ten year-old boy lying on the treatment cot, his forearm bent in the shape of an "L", obviously broken. The nurse was starting an IV to give him some morphine. Sitting in the corner of the room was this patient's twelve year-old brother, his face tear-stained and agonized, looking as hurt if not more than his younger brother. Pacing nervously alongside the patient's cot was their father.

Nothing really too much out of the ordinary.

Except the tension in the room was explosive. Something wasn't adding up.

And then Dad opened his mouth to speak to the son in the corner and it all made sense.

"I hope you're happy, damn it. Just look at your brother's arm. What the hell is wrong with you?"

Whoa, back up here. As the nurse was starting the IV, she looked up in the middle of Dad's rant to give me "the look," a warning that all was not good in this room. I interrupted Dad to introduce myself.

Dad bit his tongue during the introduction, but as soon as I asked what happened, Dad jumped right back in where he left off.

"He's always causing problems...pain in my ass...doesn't care about anyone but himself..."

His rant against his older son continued and the more he spoke, the more his son's shoulders shook from silent sobbing. The younger son with the broken arm sat silent, his pained expression speaking volumes.

The story played out that the two brothers were in the front yard playing soccer. Soon after, bored from kicking the ball, they started tackling one another. It was then that the older brother tackled his younger brother and, in the midst of the tackle, broke his younger brother's arm.

An accident, pure and simple. I could see it, the nurse could see it, and I know as you read this you see it.

Dad didn't see it. And I was finding it difficult to give him some benefit of doubt during his family's stressful crisis.

After several more hurtful insults, I had had enough.

"Come outside into the hallway with me, Dad. We need to talk."

In the hallway, Dad tried to start all over again with how his older son was a "problem child" and always created conflict in their family, but I halted him. Rarely have I met a "problem child" that didn't have a "problem adult" in his life.

I took a deep breath, not wanting to be anything but professional during this conversation. Deep down, though, my insides were screaming. I wanted to grab this guy and shake him, make him take an outside look at what he was doing to his older son.

"Listen, sir, I understand you're upset. But you have the power to make this a better experience for both of your sons right now. As things stand, your words are only making the situation worse."

"But damn it, he's got..."

I stopped him. "I've heard you already. And so has the nurse. And so have both of your sons. What I am asking of you is to go back in the room, find something nice to say to your older son, and then sit on the cot with your younger son and help him get through this visit. I don't want any more negative talk from you while we help your family, okay?"

I stared at him and he was silent. "Okay?" I asked again, more loudly.

He shook his head yes.

We walked back into the room. I looked at Dad. He was ready to talk to the son in the corner.

"See," the father said, "now you got me in trouble. I hope you're happy with yourself."

I was shocked. And angry. And frustrated with this man who, I felt, was clearly not appreciating the blessings of having children.

He looked at my face and, for once, I failed to hide my emotions. He did not say another word while we fixed his son's fracture.

After successfully reducing the broken arm, we sent the younger son to X-Ray for post-reduction films. We had Dad accompany him. I hung back with the older son.

Over popsicles, we got better acquainted. He shared that his dad said "a lot of mean things" to him. Words "that hurt sometimes." He assured me, though, that this was the extent of his father's unkindness. "He treats me okay most of the time," he added.

"You know this isn't your fault, right?"

He thought I meant his brother's broken arm. "But it is. I shouldn't have tackled him so hard."

"No, but that's not your fault, either. Things like this happen between brothers. I'm talking about the angry words you hear from your dad. Some parents love their kids very much but just don't know how to pick the right words to tell them."

He nodded while he looked down at his sneakers. I continued. "I have no doubt that you are a good son and brother." We talked a few more minutes that culminated with a smile from him.

Dad had calmed down before his son was discharged. Prior to leaving, I had an instinct that he wanted to say something to me--something apologetic, by his expression. But he didn't. A part of me, though, could only hope that he had looked in the mirror and didn't like what he had seen.

The nurse planned to arrange follow-up with this family.

Sometimes, despite our best efforts and resources in the ER, life and fate will continue to play out the way they were destined to.

Darn it all.


Next post will be Friday, December 4. See you then...and hats off to the caring nurse who provided more than just good medical care for this family.

Cheetos and Painkillers

We pretty much went paperless in our ER several years ago. In paper's place, I now have a computer that lists all of the patients in the ER, their complaints, their vital signs, and their medical histories.

All at my disposal with the click of a mouse. Yes, mine is a powerful finger!

The nurses enter most of this medical information in triage or at a bedside computer in the patient's room. Occasionally, they will enter little tidbits of information that are quite funny. I live for these innocent commentaries.

"Patient's toupee keeps shifting on his head."
"Patient had smelly flatus during interview." (Is there any other kind?)
"Patient refused to put on gown but did adjust her halter top."
"Patient getting long lingering hugs from her 'brother'."
"Patient did not wash his hands after showing me his hernia."
"Patient used to smoke but quit three hours ago."
"Patient is constipated and tried to disimpact himself in our bathroom."

Yes, it's these little subtle comments that sometime tell me the most about a patient. And sometime warn me to shake the patient's hand with a glove on when I introduce myself!

So, after clicking to treat the patient in Room 29, directly across the hall from the nurses' station, I scanned the computer screen for the patient's information.

She was 24, complaining of abdominal pain for three days, and had no entertaining nursing comments charted. Another serious, legitimate patient.

Wrong.

As I walked into the room, I was surprised to find a young woman sitting comfortably on the bed, just finishing a small bag of Cheetos. In the corner of the room, accompanying her, was her husband, his hands dipped into a small bag of Doritos. Both had orange fingers. They must have been snacking for a while.

Now, if you had significant enough abdominal pain that brought you to the ER, don't you think you would pass on the Cheetos? I know I would. And trust me--nothing comes between me and my Cheetos!

I introduced myself to the patient and her husband but skipped my customary handshake. I didn't want orange fingers, too.

"What brings you here today, maam?"

The patient mumbled something that I couldn't understand.

"I'm sorry, can you say that again?"

The patient held up her finger to me, her way of telling me to wait. She nimbly jumped from the bed, went to the counter in the room, picked up a 20 oz. Pepsi that was nearly full, and proceeded to chug it down to within an inch of the bottom. As she put the Pepsi back down, I noticed that there was a second, though empty, bag of Cheetos sitting on the counter.

She spoke a little more clearly now, thanks to the Pepsi washout, although I could still see the orange crumbs clinging to her chin and orange saliva building up in the creases of her lips.

"You're the doctor, right?" I nodded yes to her question. She grabbed her left abdomen. "Oh," she started moaning, "oh my God! Help me, Doctor! My stomach hurts so bad." I think I actually saw her suppress a smile.

She was serious. Seriously a bad actress. She could have at least practiced in front of a mirror.

And maam, I'm so sorry, but Julia Roberts just called. She wants her Oscar back.

I asked this patient some specific, in-depth questions and got only the sketchiest of responses.

"Well," I said, after finishing my interview and performing a stone-cold normal physical exam, "I'm happy to say that you have a good exam. And your blood and urine work that the nurse ordered in triage came back normal, too."

"What?" she shrieked. "You mean to tell me I just waited four hours to have you tell me I'm okay?"

"Maam," I gently pointed out, "your vital signs are good, your exam is unremarkable, and frankly, you ate two bags of Cheetos and chugged a 20 oz. Pepsi. I think whatever was hurting your belly is already passing you by."

She looked very unhappy while she nervously glanced over to the corner at her husband.

"Umm," she said, "I need some pain pills."

"Pardon me?" I asked.

Now, I am a very compassionate doctor and rarely hesitate to provide pain relief with strong medications when needed. In fact, I sometimes get teased by our nurses for being a "candy man." So I promise you, I was not taking this patient's complaints lightly. It's just that between her complaints, her actions, her exam and her test results, my suspicions of her having a serious illness were so low that all she was going to get from me was Tylenol.

"Tried that. It doesn't work."

"Well, I'm sorry. You won't be getting any pain medication with your visit today."

She eyed me, I eyed her, she eyed her husband, he eyed me, I eyed him.

I was eyed out.

"You sure I can't have any pain pills? Just a couple. I'm hurting so bad." She was now holding the other side of her belly, not remembering it was the left side that was hurting before.

And then, in the midst of her drama, she did something unexpected and glorious.

She burped.

A big, nasty, bullfrog burp.

I think after that, she knew it was over. I shook my head no to her request, wished her good luck, and advised her to return if she got a fever or her symptoms worsened or changed.

"Yeah, whatever," she mumbled as she easily jumped up from the bed to get dressed.

I went back to my computer screen to get her discharge instructions ready and noticed that she had another page that I hadn't scrolled down on.

There, on page two, sat my warning from her nurse.

"Patient's 19th visit this year."

Maybe she just likes the Cheetos from our waiting room vending machine.


I hope everyone had a great Thanksgiving weekend. Thanks for reading. Next post will be Wednesday, December 2. See you then.

Pass The Clicker

In the spirit of this Thanksgiving holiday, a humorous peek into my home life...

I'm a typical guy who, if given the chance, will sit on my leather sofa with TV remote in hand and slowly meld into the cushion, oblivious to the fact that I am watching for the third time the same episode of "Trading Spaces" or that I may not have changed my underwear in two days. With this in mind, my wife and I made a decision about four years ago to cancel all but our most basic cable channels.

Who am I kidding! If I'm going to be honest here, she made the decision. I had no say. I still get teary-eyed thinking back to that awful day.

To complicate matters, the cable company screwed up our cancellation. Yes, they lowered our bill from $50 to $16, but they kept forgetting to reduce our cable plan to the basic package. As a result, we continued to get all the big package channels. All for the fantastic price of $16! Can you imagine how frustrating it was for me to hear my wife call the cable company ten times, requesting them to come and "fix the problem."

I saw no problem. We were getting a hundred channels for $16. Where's the problem?

"The problem is that it's dishonest," she replied.

I think her honesty may be the death of me.

Now, though, with the kids growing older and outgrowing PBS (our only kid-friendly channel among our huge selection of 12 channels), we were faced with another dilemma. What could they watch? We were stuck between "SpongeBob SquarePants" and "CSI." There was no gray zone of good television for our kids.

Low and behold, we discovered our favorite television series on DVD. We made trips to Walmart, Target, and Best Buy and were frequent visitors on Amazon.com. We snatched up "Little House on the Prairie," "The Waltons," "Happy Days," "Laverne and Shirley," "Leave It To Beaver," "Gilligan's Island," and "The Brady Bunch." There's more, but these were the shows that made the biggest impact.

Our kids were in heaven. If they liked Season 1 of something, we moved on to Season 2. And Season 3. And Season 4. I'm going to be honest here--I thoroughly enjoyed revisiting these classics. Probably more than the kids.

I discovered that I did not attain much personal growth traveling from my childhood into adulthood. I still liked Mary more than Laura. I rooted for Jan over Marcia, Marcia, Marcia. Laverne made me laugh, but Shirley held my heart in her hand. Did I really think Richie Cunningham was cool? And Mary Ann versus Ginger? Let me tell you, if you put your hair in pigtails and wear a red-checkered shirt and tie the bottom in a knot around your waist, I'll eat the scraps from your plate.

Mrs. Cleaver remained my fantasy mother. Just once I wanted to wake up and find my own mother, awesome though she was, serving me breakfast in full makeup and an evening gown! I remember Mom rolling her eyes when I asked her to play along with me on that. Nope, it didn't happen.

And how could I not mention Eddie Haskell, my idol? I got tired of my friends and family mentioning that I was his twin, but he did teach me that good manners and sincere politeness could take you far. Thank you very much. And by the way, did I mention how nice you look today?

I could not let this moment pass without mentioning how much I still love Grandma Walton. Not for the physical reasons, mind you, but just for the fact that I had never known someone who was so moody and sour. It was a new experience to watch such a crotchety character. I was so thankful she wasn't my grandma. I can only imagine what kind of mood Grandma Walton would be in the first time her bladder didn't hold out. Can you even imagine her shrilling voice? "John Boy, get over here right now and change my diaper!" Ugh. Keep writing, John Boy, and get yourself out of that house. Because up on those mountains, my friend, you wash the diapers by hand. In the cold creek.

The biggest hit for my kids, though, was and still is "I Love Lucy." Although I didn't see this one coming, my wife did. My daughters, 13 and 8, love everything about Lucy. And my son, 11, cheers right along with the girls. The candy factory line, the grape-stomping, the vitameatavegamin commercial--you know what I'm talking about. We all have our favorites--are you thinking of yours right now? Just hearing my kids gut-busting laughter from a show that is 50+ years old is a miracle in and of itself. It's hard to believe, but the episodes only seem to have gotten funnier.

We recently traveled to Hilton Head and instead of playing music overhead in the car, my wife and I listened to the episodes that the kids were watching. Better than music, I tell you, better than music.

And I know what you are thinking--NO, we are not pathetic!

I think a visit to Lucy's museum in her hometown of Jamestown, N.Y. is going to happen someday soon. I just need someone to promise me that it won't be a bust.

Okay, so maybe that's a little pathetic. But they just might have a picture of Lucy in pigtails wearing a red-checkered tied-at-the-waist shirt. Then who's going to have the last laugh?

Now, pass me my clicker. Peter's just about to say "Porkchops...and applesauce."


Thanks for reading...next post will be Monday, November 30.

Ssshhh

Ssshhh.

What do you hear? Silence? Commotion?

During yet another crazy, bustling ER shift, I squeezed into a sliver of unused counter space at one of our nurses' stations to finish writing on a chart. I was facing one of my favorite secretaries, Louise, who sat opposite from where I was standing.

"Is it me or is it loud in here tonight?" she asked.

Besides being good at what she does, "Weezie" also was born and bred in our hospital's town and seemed to know everyone. "That's my great aunt's best friend's nephew's son's girlfriend--well, ex-girlfriend, I mean. They broke up last week." Some of my heartiest laughs at work have come from Weezie. You should have heard her three-year rant after turning 50 about still getting her period! The first time she missed her period, I should have bought her a Georgia O'Keefe print to celebrate! There would be one more unclipped Tampax coupon in the Sunday paper that week.

"Way too loud, Weezie," I answered, still writing.

She was right, too. It was deafening. And now that she brought it to my attention, my ears were hurting. The ER seems to be very moody, bipolar almost, in how quickly the atmosphere can change. And judging from the volume tonight, we were in a manic phase. Without looking, I knew there was a full moon.

I stopped writing and looked up from my chart, appreciating the bedlam. Looking down one hallway and into the next, all I could see were patients lying in cots lining the halls, nurses and techs scrambling in and out of rooms, pacing family members, ambulance crews waiting with their patients for a room assignment, and security taking their usual strolls.

"I think this might be one of the worst," she said. Those were big words coming from Weezie.

I went back to finishing my chart, hoping this most recent patient would recover from her stroke symptoms.

And then it happened.

Ssshhh.

Silence.

It was the most momentous, most sudden silence I have ever appreciated at work.

I knew that whatever was going on was huge, HUGE--nothing can silence an ER like this!

Debating whether to look up or not, it was Weezie's voice that convinced me.

"Oh my God," she exclaimed. Weezie exclaiming? This must be colossal!

I looked up at Weezie, her mouth gaping, and I followed her pointing finger.

Staggering down the hallway, towards us, was a middle-aged man. Moving slowly. Passing by patients and their families. He seemed real nice and friendly, nodding to this patient and waving to that one, in a vote-for-me kind of way. I'm quite sure, though, that he wasn't running for public office.

And, oh yeah. I may have forgotten to mention--the guy was butt-naked!!!

There was no gown, no clothes, no shoes even. His pudgy, hairy middle-aged body was there for the world to see. If not the world, at least our lucky ER. Who knew that little Susie was going to have her appendix taken out and see her first naked stranger!

I would like to say that I rushed over to help this gentleman cover up but I, like everyone else, was so completely stunned that I couldn't move. Couldn't budge from my spot. Couldn't shut my gaping mouth, either. I had seen much craziness in my career but nothing that stunned a crowd quite like this. Boy, did I like this guy.

It had been upwards of a minute before security responded to this kind gentleman's wayward stroll. With an armload of blankets, they covered him up and coaxed him back into his room. Right before he stepped back in, he peeked out to give us, his adoring fans, one last wave! Yes, with his hand. I hope for his sake this guy had a lot of alcohol on board.

It turns out this patient, who I'm proud to say wasn't mine, had fallen asleep at a bar counter and had been brought to us by the police to observe and "check out." Somewhere during the ER's chaos, this gentleman, who the nurse had rightfully checked in on many times, was able to climb out of bed, strip off his gown, and take a lovely, relaxing stroll. I think this could qualify in the "memorable stroll" category--mine, not his. He wouldn't remember a thing.

After the guy's last wave to us, we all looked around at one another. Our faces were indistinguishable--we all wore masks of disbelief. It took just one brief smile, one quick laugh from one of the techs, and we all burst out howling at the absurdity of the situation.

"Alright, Weezie," I said, after we had caught our breath, "who was that?"

"Why are you asking me? How would I know?" she asked, incredulously.

This was a first from Weezie. But if you ask me, I'll bet it was her sister's ex-husband's old high school teacher's third cousin, twice-removed.


Next posting will be Friday, November 27. I'd like to wish everyone a blessed Thanksgiving holiday. If you eat too much, tough, I don't want to see you in my ER! Thanks for visiting and reading my posts...