Emergency! (10 page)

“I am so embarrassed, Doc. You see, my boss has been riding my back for the longest time and I just decided I'd had enough. I decided to quit, but I wanted to show him how I really felt about him. So at five o'clock, when everyone had left for the day, I turned the copier back on and made a copy of my hand flipping the bird. I wrote a note at the bottom telling my boss to screw himself, and put it right in the middle of his desk. Then I decided that wasn't good enough. I went back to the copier, checked again to make certain I was alone, dropped my pants, lifted up the cover, and put my manhood on the machine. But when I pushed the button to make the copy, the cover fell down!”

The patient suffered only minor abrasions and contusions, fortunately. I never found out if he had the machine set for enlargements.

NAME WITHHELD AT REQUEST OF AUTHOR

B
ack in the days when IUDs were more common, I had a woman come in asking to have a DC-7 inserted. Another woman told me she used condominiums for birth control.

People come in to the ER for all sorts of strange reasons. I'm sure that my most nonemergent chief complaint will never be topped. A male adolescent came in at 2
A.M.
with a complaint of lint in the belly button.

ER staff deal with difficult families. There was a man who insisted that his mother-in-law be admitted to the hospital so that he could go on a fishing trip. He had his fishing gear on and was obnoxious. The mother-in-law was also obnoxious … but not sick.

Two psychiatric patients had met in our hospital and married. They came in one night insisting that they had been sexually assaulted by aliens and requested an examination.

·    ·    ·

A fifty-year-old woman came in to the ER with multiple problems, most of which were very difficult to solve. She had recently divorced her husband and married her twenty-year-old stepson. Her new husband sucked his thumb and was very weird. The more I inquired about the lady's problems, the more bizarre the story became. I finally asked the lady what I could do to help her. Her answer: “Just sing me some country music.”

SYLVIA SYDOW, M.D.

Denver, Colorado
   

O
ne evening a middle-aged man was brought in via ambulance with severe abdominal pain. He related a history of constipation unrelieved by Fleet enemas or laxatives. Frustrated, he gave himself an enema of his own special concoction—Drano! He went directly to surgery. The surgeons later told me that his entire colon was “charcoaled.” He lived for about two weeks before dying of overwhelming abdominal infection.

DAVID VILABRERA, M.D.

Holliswood, New York

A
n adolescent female came to the Emergency Department with a complaint of lower abdominal pain. The emergency physician took a thorough history and did a complete physical examination, including a pelvic exam. All this was normal. Although the patient denied any sexual activity, the physician had been surprised before, so he sent off a serum pregnancy test. The test came back positive. The physician returned to the young woman's room.

SCOTT OSLUND, M.D.
   

Sunnyvale, California

A
young woman signed in complaining of a purple discharge. I had heard of green, yellow, pink, and other assorted shades, but purple? She was taken back to one of the OB/GYN exam rooms, and the pertinent questions were asked: Are you pregnant? When was your last period? How many times have you been pregnant? And so on. One question drew an interesting response.

“Are you using any type of birth control?” she was asked.

“Yes,” she responded, “a diaphragm.” I was delighted. It seemed so few of our patients did use contraceptives.

“But I've only been using it a few days,” she added. I nodded.

“So tell me about the purple discharge,” I continued.

“Ain't much to tell. I got the prescription filled for the diaphragm that the doctor gave me and the discharge started almost right away. I thought maybe I was allergic to it or something.”

“So the discharge started almost as soon as you began using the diaphragm,” I reiterated. She nodded affirmatively. “And you're using the spermicide jelly with it?” I asked.

“Look. The doctor told me to use the diaphragm and the jelly with it, and I did,” she said.

I nodded understanding, then had a sudden flash of insight.

“What kind of jelly are you using in the diaphragm?”

“I don't remember—I think it was grape.”

BARBARA NUTINI, R.N.
    

Independence, Kentucky

A
ninety-two-year-old woman suffered a full cardiac arrest at home and her family called for an ambulance. The ambulance transported the patient with CPR in progress.

She arrived in our ER and, after thirty minutes, we were unable to resuscitate her. I pronounced her dead and went out to tell her seventy-eight-year-old daughter.

I looked at her gently and said, “I'm sorry, ma'am, but your mother didn't make it.”

Shocked, she looked at me and shouted, “Didn't make it? Where could they be? She left in the ambulance forty-five minutes ago!”

GEORGE R. DREW, D.O.

Rockford, Michigan
  

A
thirty-five-year-old female came to my Emergency Department with a complaint of mild abdominal pain. The patient
had a colostomy from surgery for a previous gunshot wound to the abdomen. While reviewing her social and employment histories, I saw that the patient had stated, “I work the street.” I asked her to clarify what she meant. She replied, “I get money for having sex—twenty-five dollars for a guy to do me [points to her vagina] and ten dollars for a guy to do it [points to her colostomy].”

RICHARD A. OYLER, M.D.

Mobile, Alabama
        

O
ne spring day while at work in the Emergency Department, we received word on the radio of a big-rig accident with serious injuries to the driver. The patient was brought into the department barely alive, and after an hour of attempted resuscitation was pronounced dead. The staff involved dispersed to their other duties, the body was taken to the morgue, and the cleanup crew arrived to restore the trauma room. Exhausted, I went to the physicians' dictation area to complete the chart and notify the next of kin.

While sitting there, I heard a distorted, metallic-sounding melody coming from the direction of our clerk, seated behind me. It repeated over and over until I finally had to turn and ask, “Pat, what is that sound?” She held up a manila envelope containing the deceased's personal belongings. She looked at me oddly, pointing to the envelope. A tune was coming from inside. She answered, “It's his watch.” She opened the envelope and produced a small novelty watch, capable of playing a selection of three or four tunes. Though the watch
was smashed, it repeatedly chimed the old Beatles tune, “Yesterday … all my troubles seemed so far away.…”

MICHAEL M. KNOTT, M.D.

Tahoe City, California
  

A
newly arrived Mexican immigrant, knowing not a word of English, arrived in the ER indicating pain in his abdomen. He was a handsome and macho young man, with a tight T-shirt to show off his well-muscled body. We tried to develop the young man's story through pointing and gestures. A physical exam showed some low abdominal tenderness. I wanted some lab tests. I pointed to his forearm for a blood test that I would order, and I pointed to his groin for a urine test. I handed him a small plastic bottle and led him to the toilet to produce a urine specimen. After ten minutes, he still had not emerged from the bathroom. One of the nurses needed the bathroom so she knocked on the door. After some rustling, the young man appeared, flushed and sweating, but beaming proudly. He handed the nurse his specimen container. It was filled with semen.

B. TOMKIW, JR., M.D.
  

Fair Oaks, California

T
he man had suffered chest pains for days but had resisted his wife's urging that he seek help. Finally, she drove him to the ambulatory ER entrance. At the curb, we recommended a stretcher, and, when he refused that, a wheelchair. But he was cranky and insisted on walking. At the door he collapsed, unconscious. One of our physicians countershocked the patient, brought him back to life, and quickly stabilized and transferred him to the cardiac unit. Out of the hospital in two weeks, the man sued the ER and the physician because he had broken his nose and cut his lip in the fall.

HUGH F. HILL III, M.D.

Bethesda, Maryland

A
young farmer caught his right leg in a farm implement, severing it above the ankle. He was brought in by ambulance in intense pain and anguish but otherwise was stable.

Meanwhile, back on the farm, the other farmhands thought it prudent to find the severed foot, which they did. It was still in its work boot, still warm. They jumped in the truck and drove off toward the hospital.

In their haste, they crashed the truck. Although no one was injured, the truck was disabled. Desperate to have the body part transported to the hospital, they flagged down the next car, which was driven by a plump woman in hair curlers and a housecoat on her way to the market. The farmers rushed up to her with the bloody stump sticking out of the top of the boot, handed it to her through the window, and pleaded for her to take it to the hospital.

I happened to be in the hallway near the door when she walked in. “Here,” she said with a cigarette in one hand and the foot in the other. “Someone asked me to bring this foot up here.” I thanked her and took the foot up to the OR.

KIRK V. DAHL, M.D.
      

Eau Claire, Wisconsin

A
young male entered the walk-in entrance to our ER one busy Sunday afternoon shift, holding a hand over a bloodstained shirt. When the overwhelmed triage nurse didn't acknowledge him for several minutes, he calmly walked to the registration desk and informed the startled clerk that he had been shot in the chest. After the man was rushed into our trauma room, his unluckiest-ever story unfolded.

It seems that he had been depressed for several weeks, and two days earlier had decided to commit suicide. He took a bottle of Valium and a fifth of vodka and fell asleep in his bed, fully intending to never wake up again. Unfortunately, the combination was not lethal, and he did wake up, albeit thirty-six hours later, with a tremendous hangover. Deciding that something else was needed to complete the job, he filled up the bathtub, got in, and slit both wrists with a razor blade. Alas, the bleeding was all venous and clotted off after several minutes, leaving him sitting in a pink-tinged lukewarm bathtub.

He climbed out of the bathtub and decided to hang himself from the dining-room light fixture using his belt. The light fixture tore from the ceiling and he crashed to the floor with such force that he fell
through
the dining-room floor into the basement. Battered but not beaten, he looked around the basement for something to finish the job. He found a .22 caliber bullet but
no gun
. He decided to hold the bullet with a pair of pliers and, pressing it against his sternum, took several whacks at the compression end of it with a ball-peen hammer. On the third whack the bullet went off. He fell to the floor and looked down to see a bullet hole on the left side of his chest. After lying on the floor for twenty minutes, he decided that maybe he really did not want to die and drove himself to the ER.

Our evaluation showed that the bullet had harmlessly bounced off a rib and was lying in the subcutaneous tissue of the left chest.

JAMES DOUGHERTY, M.D.

Akron, Ohio
                 

A
patient said: “Doc, my wife has a rat in her pussy and every time I do her, my dick hurts.”

“A rat?”

“Yeah, a rat that bites me whenever I get in there.”

I did a pelvic exam and found a needle in her vagina left there by the surgeon who had performed her hysterectomy. Ouch.

A thirty-year-old male in custody has swallowed a bag of cocaine. We give him charcoal and sorbitol to make him poop it out. When it comes out, he tries to grab it and hide it. The police see him and run over and try to get the bag. They start fighting over it. Charcoal, cocaine, and shit go flying everywhere. What a mess.

A thirty-five-year-old male comes in with a deformed right forearm that is swollen and extremely tender. He says he just fell off a ladder.

“Doc, this is killing me, can I get some pain meds before I get an X ray?” I say, “Sure.” When I have a chance, I look at his X ray. There's a fracture, but it's at least a year old—well healed, but at an angle. I walk back from X-ray to discuss this with him and he's gone. Outsmarted by a drug addict.

A forty-year-old female came in after jumping into a tree from the third-story window of a burning house. She was obviously high on
something, but she said she felt fine. She had a normal physical exam, with the exception of a nick to her left flank and a small bump on the right side of her chest. I asked her how long the bump had been there. She replied, “I ain't got no bump on my side.”