Got A Light?

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Birdstrike

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I walk into the ED for the 7:00am shift. I’m 24 hours post-night shift so my body thinks it’s 3:00am and my brain feels like it’s been embalmed for 3 days. I take my last swig of triple dark-roast Starbucks and sign up for my first patient.

Chief complaint: “Lost light”

Is that a misprint? Maybe it’ll be a quick and easy one to start the day, I think to myself. That’s just what I need, so my coffee will have some time to kick in. I’ll just send this guy off the Lowe’s or Home Depot, I laugh to myself, so he can get a new light. I walk into room 13 and there’s a man laying in a fetal position on a stretcher, with the bed sheet over his head. I walk up to the side of the bed and say, “Hello sir, I’m Dr. Bird, what can I help you with today?”

“Well, doc, I’m in a bad spot. I was holding on to a light bulb, and it just popped right in,” he says with a whimper, avoiding eye contact. Looking at his face, I notice he is as white as the bed sheet. He’s pale and looks like death.

“What are you talking about?” I ask him.

“Lift up the bed sheet,” he says, looking behind himself.

I lift the bed sheet and he is lying in a pool of blood. The back of his gown is soaked. I glance up at the blood pressure monitor and the automatic cuff had just rechecked his blood pressure: 88/58. “Sir, are you having rectal bleeding?” I ask.

“I guess you could say that. The light bulb just popped right in,” he says again.

“What? Oh…I get it. You mean…you, put it up your rectum?” I ask, now knowing exactly what happened. For an ER doctor, things like this are not shocking. In fact, they are part of the portrait painted for us every day; the bell curve of the ER doctor’s experience.

“And it popped!”

Ouch, I think to myself. O U C H ! “It broke?”

“It exploded in there,” he cries.



2 IVs, bang!

Fluid bags hang.

Time to call the OR gang.

KUB ordered,

Let’s see the x-ray.

“Am I dying, Doc?

Is this my last day?”



There it is on the x-ray: one homicidal light bulb clearly visible inside one rectum cut to ribbons, with its countless shattered glass shards, doing their best to bleed the life out of a man.

“Am I gonna make it doc?” he asks me again.

“You’re going to make it,” I answer. “You got yourself here quickly. If you had waited any longer, you might not have.”

“Doc, can you please tell my wife…”

Wife?” I interrupt, surprised.

“And my kids…”

Kids?” I ask.

“Yes, doc, we’re here on vacation. It’s our first family trip to Disneyland. You wouldn’t understand,” he says, as he pulls the bed sheet over his head, as if to crawl under a rock to hide and never come out.

Just then the OR team barges in the room commanding, “We’re ready for him. Let’s go!”

“What do you want me to tell your wife?” I ask him.

“Doc, please, a hemorrhoid. Just tell her it’s a little hemorrhoid.”

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You're a fantastic SDN member Birdstrike... thanks for the post. :)
 
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Legitimate question: What did you (or would you) tell his wife? I haven't had to deal with this aspect of patient care yet (just applying for residency now), and I don't know how I would handle having a patient asking me to lie to his wife. I wouldn't lie to her, but I also don't know what I'd say.
 
Legitimate question: What did you (or would you) tell his wife? I haven't had to deal with this aspect of patient care yet (just applying for residency now), and I don't know how I would handle having a patient asking me to lie to his wife. I wouldn't lie to her, but I also don't know what I'd say.
I would probably be as vague as possible but make the husband tell her after the operation if it's that big of a deal. He has the right to withhold information from her.
 
Legitimate question: What did you (or would you) tell his wife? I haven't had to deal with this aspect of patient care yet (just applying for residency now), and I don't know how I would handle having a patient asking me to lie to his wife. I wouldn't lie to her, but I also don't know what I'd say.

"I'm sorry M'am. Federal law prevents me from disclosing health information. Even to a spouse, would you believe that! Darn government/politicians. We'll get someone to take you to the Family Room and we'll take you to see your husband as soon as it's safe to do so."
 
Okay... so you've got some fetishes you dont want the wife knowing about. Fine. I could care less.

But why... why... WHY does it have to involve the risk of exsanguination?
 
Okay... so you've got some fetishes you dont want the wife knowing about. Fine. I could care less.

But why... why... WHY does it have to involve the risk of exsanguination?
And why the F*#$ would you do it while you were on vacation with your family at Disneyland.
 
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