Thursday, October 26, 2006

Code Brown

Every now and then you start thinking about shit. No, not stuff…shit.

Having a past career in medicine both in hospitals and on ambulances, I have encountered more than my fair share of shit. Here are a few of the more memorable moments:

While working in geriatrics, I walked into a patient’s room and was nearly suffocated by the stench. I knew that the patient needed some serious bath time but it wasn’t until I actually reached the bed that I realized the extent of the situation. This little lady literally had shit from the top of her head to the tips of her toes and everywhere in between. Never before or since have I encountered a situation such as this. I cannot begin to imagine how it happened. We washed her hair and had to scrub her scalp to get it clean. Shit was clinging to each strand as if it were bubblegum. It was in the crevasses behind her ears, in clumps underneath her arms, completely coating her front and back, and wedged between her toes. I believe every patient on the floor took a crap in her bed in some elderly gang hazing incident.

While working on the general medicine floor, we had three separate patients who were taking bowel preps for procedures the following day. All three patients were teetering on the edge of dementia. All three patients walked out into the hallway that evening and proceeded to shit all over the floor. There is a reason hospitals use shit brown carpeting.

One lady, who was well on her way down the road to dementia, used to lock herself in the bathroom and paint the walls with feces. We used to call this “going gorilla”. On the rare occasion when we caught her before she got into full artistic fury, we would gently take her by the hand and try to lead her back to her room. Being African American, we were never aware until we were already holding her hand that she had a fistful of shit.

One patient who was suffering from a bowel obstruction had endured every form of laxative short of dynamite to no avail. This poor guy was about middle age and undoubtedly not used to a bunch of women barging in on him to demand a fecal play by play. On the day that he finally was able to go, I believe he emptied the entire contents of his bowels in one continuous masterpiece. We were a group of professional women standing around the toilet going “WOW! Would you look at that???” We then tried to flush the toilet and discovered that it wasn’t going anywhere. We ended up calling the maintenance department who took one look into the bowl and said “that’s not my job…” We decided to let things ferment for an hour or so and then things flushed far easier.

I’ll never forget the look on the face of the elderly gentleman with colon cancer as he sat on the bedside commode with his wife nearby. This man had been the patient from hell. He treated his wife like dirt and you could tell that this had been the tenor of their relationship for 40 or 50 years. She was flitting around him doing everything in her power to make the situation better but he sniped and baited her to no end.

I had put my foot down several days earlier with this man and let him know that I would treat him with competence and respect but I would also demand respect in return. I recall walking out of his room the first day after he swore at me with my airy fairy comment that “I don’t put up with that tone of voice and I will be back when you’re ready to be civil.” (That’s always a dangerous line to walk as a health care professional. Your employer might back you up or you may have just screwed yourself unto the lord.) I stood outside his room for about a minute, collected my composure, and then walked back in as if nothing had happened. He was amazingly kind to me after that, a fact that blew all the other staff’s mind. (This was a patient that would ring his bell and the nurses at the desk would scatter like cockroaches.)

As he sat there on the bedside commode and his wife flitted around him and reassured him that he would be going home soon and everything would be fine, yadda, yadda, yadda, he began to hemorrhage from his intestines. He looked at me and I looked at him and it was as if his wife was moving in some other dimension. He knew he had reached the end and in that one instant, I could see a lifetime of regret and sorrow in his eyes. He was dead within a few hours.

Yeah. Sometimes shit happens.

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