Take A Picture

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

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

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

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

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

So, so pretty.

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

Well, thank you fellas.

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

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

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

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

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

So, so classy.

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

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

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

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

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

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

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

I was never less proud to be an American.

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

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

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

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

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

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

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

A Third Look

I sometimes wonder what the commotion of our emergency department must look like through the eyes of a patient or their family. Imagine walking down the hallway to visit Aunt Lucy only to have a half-naked patient, his gown loosely-tied and his junk hanging out, walking at you from the other direction. Or seeing an unresponsive patient on a cot being rushed into a room with a paramedic sitting on top of him, performing CPR. Or hearing the drunk patient in the next room violently vomiting and gagging while filling-in the space between with obscenities.

The imagery and sounds that come from our busy shifts must haunt some of these visitors not familiar with the day-to-day workings of an ER.

Better yet, I wonder what these same patients and their families think when they see our staff's occasional blase' attitude. It has to be something pretty remarkable and out of the ordinary to get us to cringe or flinch or react, it seems. Which, I'm sure, comes across as uncaring to some. Trust me, though, it's not that the staff doesn't care, it's just that with the constant bombardment of these scenes, we have become somewhat immune to being caught off-guard.

When was the last time I did a double-take, you ask? Easy. It was two weeks ago. I had been standing at a counter in the nurses' station, finishing a chart, when I looked up to find one of our male techs helping a female patient stand from her cot. She had needed to go the bathroom and had insisted on using the hallway bathroom. She was a short but heavy woman, mid-forties, frosted blond hair, wearing a gown and nothing else. I presumed it had been tied up in the back.

Wrong.

As the tech helped this woman out of her room and down the hallway, away from me, I glanced to make sure she was steady on her feet. She was. But after what I saw, I wasn't. This woman's very robust ass was hanging out of her gown. Evidently, her gown hadn't been tied correctly. Now, I can handle the robust ass part. That's not a problem. If I've seen one robust ass in my career, I've seen a hundred. But what made me look twice at this one was the very tiny triangular patch of bright orange at the small of this patient's back.

"Noooooo," I thought to myself, "that can't be a thong. Can it?" A small part of me, although not a fan of them, hoped it was a "tramp stamp," a tattoo. For some reason, I would have accepted this a little better. As much as I hate tramp stamps, I hate thongs even that much more.

So, what did I do next? Heck yeah--I looked a third time. And disappointingly, I realized that the itsy-bitsy patch of orange was fabric. No tramp stamp for this classy patient. Straining my eyes, I couldn't see the rest of the thong, though, as it seemed to disappear among the fleshy cheeks.

With my mouth gaping, I watched the tech and the patient arrive at the bathroom, where he helped the patient in before stepping out and giving her some privacy. Afterwards, I looked behind where I was standing, only to find one nurse, one radiology tech, and two family members from another room (they had been asked to step into the hallway while a portable chest x-ray was being taken) standing in the hallway, watching the same scene I had just witnessed.

Their mouths were gaping, too.

I walked to the tech waiting outside the bathroom for this patient. "Hey, Mike," I said, "you have to cover up this patient when she comes out. Her backside and thong are hanging out for everybody to see."

"A thong?" he asked, "No way." I understood his amazement--this patient wasn't our typical, narcissistic thong wearer. "Trust me," I answered, pointing down to the family members looking our way, "they got a free show."

Mike ran and got one of our scratchy hospital-issued blankets and tried to cover up this patient's backside as she exited the bathroom, but she refused. "Get that thing off me," she yelled, "I don't care who sees me!" Good for her for being proud of her robust ass. If only we could all be that confident.

Mike earned his paycheck that day. As the patient walked back to her room, Mike grasped her elbow for support while using his other hand to hold the back edges of her gown together. No easy feat on his part, but he handled it like a champ. Single-handedly, he got this movie's rating reduced from an "R" to "PG.

Sometimes, the noise can be just as disturbing. Just a few days ago, we had a pleasantly demented elderly woman sent to us from a local nursing home for a variety of medical complaints. Usually, if we can, we place this type of patient near the nursing station to keep a closer watch on them (in the event they try to climb out of their beds). Unfortunately, though, this patient was prone to frequently screaming out "Help me!" Every few minutes. In a loud, high-pitched, shrilly voice. For three full hours. Behind her partially-closed glass doors.

Imagine being one of the patients or families who bore witness to these screams. After a few minutes, the staff easily got used to them (although I'm sure most of them would have preferred a little more quiet). I'll bet, though, that it was probably somewhat disconcerting for several families to think a patient was screaming out for help and not finding the staff reacting.

Unbelievably, about forty-five minutes before Ms. "Help me!" was discharged back to her nursing home, an elderly demented man was brought to our ER and placed in a parallel hallway near the same nursing station. And can you guess what he was prone to yelling out? "Owww!" Yes, "owww!" Drawn out in a raspy, deep, masculine voice.

Suddenly, we had these two patients prompting each other. "Help me!" was followed by "Owww!" "Owww!" was followed by "Help me!" This duo had impeccable, precise timing in their forty-five minutes of togetherness.

We all shook our heads. The hilarity of the moment, unfortunately, was tinged with some sadness to the reality of their situations. In another thirty years, I thought, that could be me uncontrollably yelling out something. Something suave, I can only hope.

After the woman was discharged, the elderly man continued with his "Owww"s for a few more minutes before tapering off completely. Maybe he realized, through his dementia, that he was Simon without his Garfunkel. Or Hall without his Oates. Better yet, Ike without his Tina.

As for the patients and families that heard this duo's chorus, we offered several reassurances that these patients were okay and not in any pain. Hopefully, the families we didn't get a chance to offer an explanation to won't be scared off from returning the next time they need emergency care.

The families that saw the orange thong, though? I don't expect we'll ever see them again...

As always, big thanks for reading. Any of you have a funny story to share? I hope you have a great weekend...

The Thong Expert

I had no idea that I, a small-town, naive, aah-shucks kid, would become a thong expert. For better or worse, though, thanks to my job as an ER physician, that's exactly what I've become. Just don't look for that entry on my resume!

I was attending medical school, in Philadelphia, the first time I walked into a Victoria's Secret. I was with two of my buddies and we were on the hunt for something sexy, something hot, something that would tell our girlfriends that yeah, we might be medical students, but we were hip medical students. Good luck trying to find the nerd in us that Valentine's Day!

I had never been in a Victoria's Secret before but, because my buddies seemed real comfortable about the whole thing, I tailed them through the front door. "The secret," they confided, "is not to touch anything."

I lasted less than five minutes. Okay, I'm lying. It was more like five seconds.

I felt like I should have paid a cover charge, my bobble-head taking in all the life-like mannequins modeling the newest underwear trends. I could have sworn one of them winked at me as I was checking out the intricacies of her lace borders. Easily my lowest point ever on the wishful thinking scale.

Not paying attention to where I was walking, I knocked into a table loaded with skimpy undergarments. Luckily, though, I was able to catch myself and right the table before we both hit the ground. Like a klutz, I tried to straighten a few piles of panties before giving up, realizing that never again would I hold ten thongs in my hands at one time.

My face felt flush. Ebbs of desperate sweat trickled down my back. I took a deep breath and recovered slightly. Keeping it cool, I continued walking down the aisle, pausing here and glancing there, sure that I was looking more and more at home.

My confidence, however, was short-lived. Directly in front of me, approaching, was a pretty girl with a Victoria's Secret pin on her lapel. Brandy, it said. I turned and looked behind me, hoping I wasn't the one in Brandy's line of fire. No such luck.

"Hello, sir, what can I help you with today?"

"Um, well, I um, well--I'm looking for a Valentine's Day gift for my girlfriend," I stammered.

"That's easy enough," Brandy said enthusiastically. "What size is she?"

What size is she? What size is she? WHAT SIZE IS SHE? Shit, I had no idea.

"Um, I think, well, um...I'm not sure," I said, now definitely feeling a little woozy.

Sliding her hands down her hips, Brandy asked innocently, "Is she my size?"

What??? Was this an open invitation to check her out? Did I need a coupon for this?

I passed on Brandy's invitation. "Yeah, well, I think she is," I said, eyes downward, feet pacing side-to-side. "I'm not feeling all that great, though," I mumbled, trying to escape, "so I'm going to go out in the hallway and sit down for a minute. I'll be right back." Yeah, right. Liar.

Thus, my history with Victoria's Secret. Needless to say, Karen (my eventual wife) did not get a VS outfit. I'm good for chocolate and jewelry and wine, but if she wanted a guy to buy her those skimpy outfits, she married the wrong one.

How does this relate to my life in the ER? Well, with as many thongs as I have seen in the ER, sometimes I wish I had been born in a Victoria's Secret. Then I wouldn't be so caught off guard, so queasy, each time I saw one.

Especially on a guy!

Recently, after hearing a trauma alert called for Room 29, I ran into the room to find a very belligerent middle-aged male, quite intoxicated, with multiple contusions and abrasions to his face. A victim of a barroom assault, per the paramedics. He was being both verbally and physically abusive to our staff, aggressively swinging his fists and kicking his legs at several of us. Another drunk tough guy talking big and hitting low.

We were unable to calm him down, despite our best efforts. Not knowing if he had any life-threatening injuries, we chemically sedated and paralyzed him before emergently intubating him, hooking him up to a ventilator. This ensured our safety from his flagrant behavior while we got a more thorough physical exam and ran the appropriate tests, all in a calmer manner.

After stabilizing this gentleman, one of our newly-hired aides began removing this patient's clothes so we could do a fully-exposed physical exam.

Now, picture it. Balding, middle-aged man. Scruffy, ruddy face. Gold-plated incisor. Carhartt jacket. Flannel shirt. Wrangler jeans. Steel-toe boots. All coming off.

The aide cleared his throat. I looked up to find him blushing. "Does this come off, too?"

Everybody stopped what they were doing and our eyes followed his. Oh no! This patient had on one of the skimpiest candy-apple red thongs that any of us had ever seen, frilly-lace included. And although I didn't know what size this patient wore, I would bet the thong was too small, evident by both of his testicles hanging out on either side of its sparse fabric.

I know, fricking gross. That's what I thought, too. I imagined connecting a cable between them so they could catch up with one another. Can you imagine that conversation?

"Hey, Leftie," his right testicle would say, "can you believe this asshole? Packing and suffocating us in this thin, red snatch of flimsy fabric! I'm pissed!"

"Hell, yeah. This better be the last time or I'm outta here. It's nice to breathe again. That damn thing was pressing me right low to the brown hole."

Needless to say, after the appropriate gawking was done, we cut the dainty, delicate undergarment off this patient and placed it in its own clear plastic garment bag to give to his family. The nurse placed it smack on top of his pile of possessions, no less. Accidentally, I'll assume. (Side note here--always be kind to your nurse and never, ever spit at them!)

Based on his wife's expression when the nurse handed over his clothes, this patient had some serious explaining to do. I could only imagine his testicles' flagrant screaming for mercy when she got done with them. At least, to this guy's credit, he didn't have a matching "tramp stamp" tattoo in the small of his back.

Soon after that day, I was at our local mall and passed by Victoria's Secret. Sadly, despite all the skimpily clad mannequins, all I could picture was a near-naked guy in a red thong sitting on a rickety bar stool guzzling Budweisers and slamming back shots of Jim Beam.

And they wonder how we in the medical field get jaded!

As for my wife, well, she'll just keep getting chocolate. And jewelry. And wine. And a pair of Hanes granny panties. Again.

As always, thanks for reading. Next post will be Wednesday, February 24. See you then. Big thanks for all your support and votes in the recent Medgadget Medical Blog Awards!