The Smell. My God, The Smell
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“I recently had a patient that had an operation on his lower back. It was a rather easy procedure and it should’ve been a pretty routine healing process, changing dressings every day.
Except this person was in the care of a nursing home, and bad things happened.
The nursing staff allowed the back wound, plus two other wounds, to become infected and necrotic. My partner and I were livid, and the nurses couldn’t figure out why it made us so angry to find out that they only changed the dressings once a week.
Here’s the kicker though: we didn’t know about all three wounds, just about the one on his back and another on his ankle. We didn’t find out about the third until we brought the man to the ER.
We had transferred care, and I was cleaning the stretcher. My partner was out talking to the hospital nurses. I was just scrubbing away when I glanced back into my patient’s room, and I saw him leaning over the side of the railing and not moving. I panicked for a second because I thought this guy just keeled over. I ran back in and ask him what he’s doing. ‘Oh, I’m just trying to get comfy. My rash is burning.’
Rash? This is the first we had heard of it. So I investigated.
I swear to God. The smell was worse than a GI bleed. This wasn’t a rash. It was a hole in this man’s hip, literally the size of a softball. I guarantee I could fit both my fists in, and it was necrotic and stuffed with week-old gauze.”
Seven Months Is A Little To Long
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“I had a patient who over-wore her soft contact lenses for over seven months straight without removing them.
The contact lenses deprived the cornea of oxygen and tiny blood vessels started to grow from her eye into the contact lens. By the time I saw her, the contact lenses had been fused onto the front surface of her eyes.
Her eyes were bloodshot and she was in a great deal of pain. The contact lenses could not be removed. Our corneal specialist had to bring her into the operating room and sever all off the blood vessels to peel off each of the contact lenses.”
“I Thought Dogs’ Tongues Clean Wounds…”
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“I had a patient in a rural location who had severe diabetes and resulting neuropathy (numbness) in his feet. He took horrible care of himself and had low health literacy. Anyways, he had noticed his big toe was ‘stinking’ for several days. His dog had started licking it the day before, but he didn’t come in to see me until the dog LICKED HIS TOE OFF.
I ordered x-rays just for the formality of it (although he clearly had no toe) and yup, the dog licked it clean off.
He generally smelled pretty icky at baseline, but I unwrapped the gauze while wearing a mask with Vick’s smeared in it so I luckily don’t have a memory of a specific odor. It looked exactly how you’d imagine it would…think gnawed-off hotdog.
Turns out he had osteomyelitis (an infection that sinks into the bone) in the toe for a while, and the licking was just the nail in the coffin for the toe. We referred to the incident as ‘zombie toe’ for years.”
Kids Do The Darnedest Things
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“A few of my moments in pediatrics:
A young girl managed to jam a candlestick into her eye socket and skull. She tripped and fell while carrying it like a baton and jammed it into her head. She pulled it out, saw blood on it and passed out, fell backwards and hit her head on the floor and had a seizure. Not a good day for her. She actually did pretty well, it mostly missed her eye (just damaged the bone around the eye) and her vision was fine. There was a small piece of the eye socket that got pushed into her brain but it would have been riskier to take it out so we just left it. I watched her in the ICU for a couple days, no further seizures or signs of brain swelling. Not sure what happened after discharge but nothing to suggest she wouldn’t be fine.”
A toddler somehow ended up with carpet nails embedded in her skull. We had to get DCF involved with that one because no one had a good answer as to how that happened. DCF let her go home with her family and then she came back a couple weeks later after being hit by a car when she was playing outside minimally supervised. She was mostly fine, just a couple of broken bones. But she did not go home with her family after that.
A teenage boy wore cargo shorts to bed and had a zipper accident when he got up to pee overnight. We had to glue a large laceration down the center of his junk. Felt bad that he had to be attended to by two female doctors and a female nurse (plus his mom), but that’s all who was there in the ER at 3 am.
A teenage boy got in a bike accident and got flung over the handlebars. His junk got snagged on the handlebars and got degloved. I think the urologist was able to salvage some of it.
A young boy liked to stick rubber strings up his urethra. No idea why. It didn’t seem to be related to any kind of abuse (he swore no one taught him to do this or made him do it). He’d put them in for a few minutes, then take them out. One day, one got lost up there and he didn’t tell anyone for a week until he started peeing blood.
Brushing Could Have Prevented All Of This
“In a free medical clinic, I had to tell a mother that she should be brushing her 4-year-old’s teeth. The daughter came because her throat hurt. After opening her mouth and using a tongue depressor to see her throat, the daughter squirmed like 4-year-olds are prone to do and the tongue depressor hit her gums. Pus flowed everywhere and the child wound up having to be put on penicillin before having every tooth pulled due to severe infection.
This occurred in Nicaragua quite far from any major city and wasn’t reported because the mother did follow-up and kept the appointment for extractions. The thought of brushing her daughter’s teeth simply never arose.
I always tell people that they should start brushing their infant’s teeth as soon as they start teething and do a gentle gum massage with a baby toothbrush before that. Use safe to swallow toothpaste before the child is 10. Let the child brush their own teeth as soon as they are able (for practice) and then have an adult brush them at a 45-degree angle towards the gums in small circles. Children should be supervised brushing their teeth until they’re at least 12 or longer if necessary.”
This Catholic Hospital Was A Host To Horrors
“There was a full-term baby that died in utero. It had polycystic kidney disease and accordingly had massive, oversized kidneys. They tried to deliver the baby’s body the traditional way, but the kidneys were so big it couldn’t pass through. The OB must have been really pulling to get the baby out because its head came off. We did the autopsy and our morgue workers did the most amazing job of sewing it back on and arranging the blanket just so for the photos.
I can’t imagine how the OBs explained what happened to the mom. I don’t understand how they didn’t know that the baby was that large, or why they didn’t just do a C-section. But, it was a Catholic teaching hospital, who knows – all bets are off.
Another time, this doctor was doing a second-trimester abortion and perforated the uterus during the procedure. This is unfortunate but not unheard of. What was unfortunate is that the fetus was already partially dismembered and the head escaped through the hole in the uterus and was free floating in the abdominal cavity.”
Still The Worst After All These Years
“Years ago, while working in the operating room, I was assisting on a laparoscopy when the surgeon decided to have the nurse clean the woman’s belly button. It turned out her belly button was much deeper than normal and appeared to have NEVER been cleaned. It took the nurses at least 15 minutes to extract a ‘concretion:’ aka many years worth of dirt, dead skin, and other pieces of matter that had been there so long it had hardened like a rock about the size of a pecan. I’ve seen lots of horrific things but this one has stuck with me more than 30 years later.”
There’s A What In Her What?
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“I didn’t witness it personally, but back when I worked as a psychologist, we had a female patient with a history of chronic depression. From her file, it seemed that she was in state care most of her life. This apparently stemmed from an incident when she was a child where she was presented to the hospital with a yeast infection stemming from a foreign body being stuck inside her womanly parts. It was a memory card of some kind containing indecent images of the girl in question.
It was awful. Without going into too much detail, how the item in question got where it was inside of her wasn’t clear, although her mother and father were both in prison on child abuse/neglect and other charges by the time I spoke with her. The logical suspicion was that one of her parents decided that it was a good place to stash the card, then panicked when it became apparent that cling film does not belong in the place in question, let alone objects containing metal.
There is some happiness to be had, however. I only stayed in that job for four years, but at the time I left she was out of counseling and was looking promising for a medical instructor role for the British military, where I was working as a psychologist. Given the talk at the time, the odds are strong that she got the job.
It kind of makes sense of why she had a lifetime of mental issues.”
It Started With A Slight Pain And Got Worse. Much, Much Worse
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“When I was on my ER rotation during medical school, I would get sent in to see patients and then present them to the attending physician.
One time, I went to check on my next patient, a 50-year-old guy with rectal pain. The guy reported that he had been having blood on the toilet paper when he wiped and pain when going to the bathroom. This had been going on for years at this point, as he said he had always been too embarrassed to have it checked out. Finally, he was forced to come in as it was too painful for him to sit down.
I figured it was going to be bad and pulled back his gown to look, check for hemorrhoids, and check for rectal bleeding. Where his butt should have been there was a warty mass the size of a baseball. I could not find/examine his rectum through it. Possibly due to poor hygiene, possibly due to malignancy, he also had massive multiple abscesses with likely fistulas between them leaking pus on both of his buttocks.
I couldn’t figure out where one abscess ended and another started, the entire cheek was inflamed and fluctuant.
In short, the man’s rear end was a nightmarish plane of wart, infection, blood, and pus.
Flustered, I proceeded to make a sloppy presentation to the ER attending, recommending a CT scan and surgery.”
They Had To Dive Into The Folds To Discover The Source Of The Stench
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“My buddy was a resident at this hospital where this extremely obese woman came in because there was this unbelievable stench about her. She’d tried showering and everything possible to get it off with no luck. After a full inspection, lifting up and checking all of her extra flab, they found the source in her belly button.
There was a freaking mushroom growing in there from all of the grime from months of not seeing the sunlight. They removed and cleaned out the area and the smell cleared up. But dear god, man.”
He Didn’t Understand The Scope Of The Problem At First
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“It was a quiet day at my optometrist clinic when a man phoned up for advice on what he should do. He said he got a nail in his eye and asked if he should come and see me or go directly to the hospital. I asked if he could give me an approximate size of the nail because if it was a little clipping he could come to me, but if it was an entire big toenail then he should go to the ER
His answer? ‘It’s about a three-inch-long nail.’
What?
I’d been thinking like a fingernail. No. It turns out, he’d been shooting nails while working on a home improvement project. It worked happily about half a dozen times, then suddenly it didn’t. He pressed it a few times, nothing happened, so then he turned it to face him and pressed it again whilst looking at it so he could see why it wasn’t working. He never got an answer, it worked that time.
He went to the hospital because there is nothing in my repertoire that could help him.”
“Every Day Is A Delight”
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“I did work for a journal specializing in medical case reports. Two stories spring out:
1) A guy was impaled on a construction site by a big metal tube. Think a giant, metal apple corer. Inexplicably, it managed to miss all his vital organs, instead just sort of pushed them out of the way, but the pipe was right through him ‘Looney Tunes’ style. He survived surgery to remove it and far as I know, he was OK in the end.
2) Labial fusion. It’s relatively common and is basically a condition where your labia fuse together unless kept separate – by proper treatment, but sometimes by romantic activity. In this particular case, the issue was that the woman had accidentally gotten pregnant. Her boyfriend had released on her, and by a million to one shot, some made it through what little gaps there were down there and took root. However as she lived in a country where that kind of romantic freedom wasn’t exactly widespread, she was terrified about going to the hospital. So by the time she saw the doctor, who submitted the case file to us, she was seven months pregnant, but the baby literally had no way to get out. They had to surgically separate her labia and do an emergency operation to get the baby out. Fun times!
Every day is a delight in that job.”
Well, That Explains It
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“I admitted a guy for pneumonia, which was odd because he was young and strapping, had no other medical issues, but the x-ray didn’t look quite right. The pieces just didn’t add up, and so I started questioning him more closely.
Me: ‘Do you use any substance?
Patient: ‘No! That’s disgusting. I’m no junkie! I’ve never touched that stuff in my life.’
I move on to other questions and suddenly:
Patient: ‘Look, doc, I just want you to know I may have used coke once or twice years and years ago. I just snorted it though. That wouldn’t cause this, right?’
Me: ‘How long ago?’
Patient: ‘Like ten years, maybe longer.’
Me: ‘It shouldn’t be affecting you after this long.’
Patient: ‘More like five.’
Me: ‘Years?’
Patient: ‘Uh, like five months ago.’
This goes on forever until he admitted he just got off a massive crack binge the day before, where he spent the past three days in a hotel with some ‘loose women’ smoking crack non-stop. He finishes with: ‘But I don’t want you to think I’m one of those dirty junkies.’
No, I think you’re the idiot who lied and was getting treated for pneumonia instead of getting the proper treatment for crack lung, which is what he had.
Here’s a tip: I genuinely don’t care. I’m not your mom, your spouse, or your priest. Don’t waste my time and endanger your health spewing crap. Whatever horrible twisted thing you think is too shameful to talk about, I promise you, I’ve seen worse.”
He Won’t Be Dribbling This Basketball Any Time Soon
“My sister’s friend is a nurse and told the story of a man who came into the ER clutching his abdomen and complaining of severe abdominal pain.
He was acting suspicious and kept changing his story, symptoms, and the site of the pain. My sister’s friend and a few other nurses suspected something wasn’t right and after maybe an hour or so, he confessed the true cause of his pain.
He had inserted a deflated full-size basketball into his butt and pumped it up. Amazingly, he somehow managed to pump the ball up to the point where it popped inside him.
The popping is what had caused his pain, but the kicker was this: he hadn’t come to the ER to treat the pain.
The basketball was still inside his butt, and after the pop, a combination of pain, presumably swelling, and it still being semi-inflated meant he was unable to retrieve it himself.
She didn’t go into detail as to how the basketball was retrieved, but I can’t imagine it was pleasant.”
“Free Hotel Room For The Night”
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“I had a lecturer who told me about a homeless guy who regularly presented to ED claiming stomach pain. He would get an abdomen x-ray which showed a bunch of wire inside his abdomen.
He would be added to the next day’s emergency theatre list, get a hot meal and a bed for the night before hooking it the next morning, and self-discharging before surgery.
He had purposefully pierced his belly with a wire coat hanger and fed the thing inside himself so he could go around to hospitals and score a ‘free hotel room for the night.’
This is somewhere with universal healthcare so even though he was a regular and the hospital staff knew him by name, they couldn’t refuse treatment and couldn’t force him to have the coat hanger removed either.”