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What I Learned From Crap

June 15, 2007

kr’s note: This post may not be suitable for children under 13, for the faint of heart, or anyone who has just eaten and/or plans on eating for the rest of the day. I hereby exonerate myself from any consequences that may befall a reader upon reading this post. Once again I narrate an account of my day that serves as a background for what I realized later on.

It was a typical day of internal medicine, we had just finished lunch and noon conference and my intern and I were on for admissions during the afternoon. I got back on the floor around 1:15 pm and the floor supervisor said there was an admission waiting and handed me the chart. The chief complaint was abdominal pain for two days on a 95 year old lady, so I figured it was most likely either a bogus admission that her attending did (so as to fill up beds in the hospital and make some money) or this was an easy case to buff-and-turf over to surgery. The concept of buff-and-turf, dear friends, is perhaps the greatest concept ever invented, originating in the famous book “The House of God”, and is worthy of a post in and of itself.

Nevertheless, I looked at the chart and read the ER note that also mentioned that this lady had not had a bowel movement for 7 days. The abdominal x-rays done in the ER (and wow, actually read quickly by those lazy radiologists…) noted that she had accumulations of fecal matter all throughout her bowels. Eh, I figured probably a small bowel obstruction with her extensive history of abdominal operations… we’d just keep her NPO, give her some fluids, and turf the patient to surgery.

In the words of Charlie Murphy: “Wrong… wroooong!”

Alas, if only it were the case. After doing the history and physical, we couldn’t just turf her… she was ours to deal with. But all isn’t lost, I figured–we could just give her an enema or two and she’d be fine.

Twenty minutes later, the enemas haven’t worked, she’s still impacted and her abdominal pain is getting worse. The senior resident looks at us, and wearily smiles, “Looks like you guys are going to have some fun today.” And so there we were, my intern and I, about to partake in what was perhaps the most memorable experience since my peri-rectal abscess story. We were to manually disimpact her. He was nice enough to say that I didn’t have to do this if I didn’t want to, but the look on his face of a man being condemned made me feel bad, and that I should give him company in his misery.

Usually in the hospital, doctors get around the real nasty stuff by getting the nurses to clean up after patients… we’re elitist like that. But apparently this is semi-“procedure” and has to be done by a “trained medical professional”, even though it requires nothing else than sheer will and a strong stomach. And so like the poor souls that we were, we double gowned, double gloved, double masked ourselves and stole a huge can of potpourri air-freshener from the nurse’s station. The intern went first, applying some surgilube on his fingers, and well… getting his finger in there and manually moving it around until he hits gold… or green in this case. He pulled out what can only be described as green stones and chunks of feces (what, did she only eat spinach for a week??) and plopped them on the sheet, gasping through the mask, “Spray the air freshener.” Like an idiot, I said, “How much?” He said, “I don’t care, ALL of it”.

The smell was downright nasty, and the air smelled like someone had just taken a crap in a field of roses–in other words, it didn’t help much, and perhaps ruined the smell of roses for both of us for a while. I felt bad for him, so I said I’ll take over as every smell receptor cell in my olfactory tract threatened to go on strike over what I was about to put them through. I put some lube on, used one hand to move one buttock out the way… and just jammed the other in there. It was awful, I gagged, but a feeling of sympathy for this poor old lady came over me, so I held my breath, told her to push, and began to scoop out fecal balls like gumballs from a broken candy machine. After a while, we couldn’t reach in any further to get more out, so we called it a day. I looked over at our patient, thinking she’d be in a lot of pain from the trauma. She was in mild discomfort, but she looked at us with this look of gratitude, thanking us for what we had just done.

And so as I walked away from the room after having tore off the protective layers, I looked down at my right hand, wondering if I could ever eat with that hand again (I needed my dominant hand to get the stones out… for the record, I did eat dinner tonight with my right hand… after a while you just stop caring about this stuff) and reflecting upon what had just happened. In addition to feeling like I had actually done something good for my patient just by seeing that look in her eyes, I realized that this crappy (no pun intended) event taught me a great deal. For starters, I felt a renewed sense of gratitude that Allah gives us all each day by allowing us to answer the call of nature without difficulty. It’s something that we don’t really think about, we just “go” when we have to, and that’s that. But then as we age, we get weaker, and just as it was difficult for us to control our bodily functions as infants, we’re returned back to that same state when we become old, giving a new level of meaning to the verse, “Allah is He Who shaped you out of weakness, then appointed
after weakness strength, then, after strength, appointed weakness and gray
hair. He createth what He will. He is the Knower, the Mighty
(30:54).” On another level, it was quite humbling as well… you can’t really think much about yourself when you realize where your hand was, and what it had to do. And that doctors are too often underappreciated these days for the things they have to do.

In the end, it’s her gratitude of us alleviating her pain that will remain with me the most. Maybe that was what I was supposed to learn–from crap of all things–that sometimes one has to do crappy things in life–even things that you never thought you could never bring yourself to do–but in doing so, by making that sacrifice, not only does one learn things unknown before, but one might even find the experience rewarding. Or not.

Either way, in the end, just make sure you wash your hands.

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15 Comments
  1. ha, i like the last line…but this really is nothing compared to the peri-rectal abscess story

  2. oh my god, what an experience. i’m pretty sure i would’ve involuntarily thrown up.but you’re right, about being grateful when our bodies work as they are supposed to with no problem.. you really aren’t aware of how smooth it all runs until it fails.

  3. You Want a cookie?

  4. wow good job KR, I’m pretty impressed that you did that… and then learnt a lesson from all that too 🙂

  5. Anonymous permalink

    hey! my bros a radiologist…meh you’re right, what a bunch of lazy fruits

  6. good story. the repeated use of the word crappy made my day

  7. Stephen Colbert said, “Never send in a doctor to do a plumber’s job.”

  8. haha, and doctor’s have the most glamorous job because…? 🙂

  9. Anonymous permalink

    only one prop cause i already heard this story…nigger-ul-haq

  10. Anonymous permalink

    ah, beautiful UIC memories…I miss UIC…I miss all you peeps…

  11. i think ive had to do that to myself a couple of times…im jk…

  12. alhamdulilah, life teachs us many lessons. sometimes even crappy ones, LoL.

  13. Wow, that’s some crazy stuff..

  14. Anonymous permalink

    The best line…Spray the air freshener.” Like an idiot, I said, “How much?” He said, “I don’t care, ALL of it”. Gave me a good laugh 🙂

  15. I agree with the how much air freshner line.. that cracked me up! But otherwise man, it was scary to know that a 95-year old had to go through that much pain with several abdominal surgeries. Seriously, I am so down with one.May Allah keep us in good health always. Aameen!

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