During my family medicine rotation, my very important role amongst the "team" of healthcare providers is to merely shadow a resident around as he sees patients with the usual holy trinity of diseases - diabetes mellitus, hyperlipidemia, and hypertension. It gets really boring after a while, and I keep myself from gouging my eyes out by looking up sports statistics on my iPhone surreptitiously as the adults talk about boring stuff. Sometimes, though, God hands you a little gift by making life interesting.
A few weeks ago, I was following around this Indian resident. A young girl came in to follow up on her gluteal abscess - i.e. butt ulcer. She exposed the affected area, and the ordeal, I mean, exam began. Firstly, there was this strange yellow discharge coming from her buttocks. Then the doctor proceeded to clean the wound and "pack" it with new gauze. The patient screamed her head off and tried to grab the resident's hand mid-procedure, which really annoyed him. She would yell, "NOOOOOOOOOOOOOOOO WAIT!!!!!" while the nurse told her to just hang in there and let the doctor do his work so the ordeal could be over and done with, but the girl continued to protest and yell. The whole thing was grueling because the girls' screams reverberated through the office walls as if she had just come back from the trenches of Flanders Field in World War I and had a horrible case of trench foot. I, too, was getting annoyed with the patient's dramatics and thought unsympathetically, "Geez some people have such low pain thresholds" I smiled at myself smugly and proceeded to condescend down to the patient, "It's okay! It'll be over so soon!"
After the wound cleaning, screaming, and general torturing was over, the girl asked how she had gotten this gluteal abscess. And this, dear readers, was the resident's explanation (insert New Delhi accent here):
"Vell, you see, this is how you get this butt abscess. It is wery common. If you are overweight, the hips, you see, they are rubbing together more. And then there is also hair there in that butt area. And then the hips of the overweight person are rubbing together, and then you are also sweating a lot there. And then there is the hair, and it gets infected. And then you are in a car for 6 hours, and your butt cheeks are rubbing against each other, and then with the hair and the sweat, you get that infection and then the abscess." So, the basic medical pathophysiology of a butt ulcer was this:
Overweight sedentary person with large hips + hair + sweat = Gluteal abscess
I tried not to laugh as he explained this in layman's terms to the patient, but I couldn't help it. I literally started to laugh in front of the patient. In order to remain the ever-neutral professional, who never judges a patient's problems, I tried to compose myself by ordering myself to think of the tragic day my grandmother died. But the above equation was too much, and I laughed despite forcefully recalling the hard, unfunny times I had experienced. The resident left the room and merely said to me, "That was funny how I explained it." I wasn't sure if it was a rhetorical question or a statement, so I just nodded and wished I could have appropriately memorexed the moment with a tape recorder or video camera.
--By Mariam, who is glad that the hellish experience of family medicine will finally be over.
The BackRow Ballers are no longer lowly medical students, blogging about the daily grind. They are now doctors, who will continue to bring light, joy, sunshine to their readers' lives with their blogs. You're welcome.
Sunday, December 14, 2008
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5 comments:
The image of you laughing in this situation is the funniest part of the story!
If you ever see this resident again, I want you to make sure you are wearing a wire. See if your iphone has recording capabilities.
your iphone can record things! you need to capture these moments!!
Also, did she want him to wait to lidocaine that up? I am guessing that would have made this process much easier.
Hands down, the funniest blog post I have ever read.
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