Giggles

Giggles.

I have had many responses to doing a rectal exam, but this one took the cake.

OK, I know I have tried to stay away from describing in graphic detail those fun little invasive exams I have to do on a regular basis, but I’ll make an exception here. This was an older gent with a history of, um, a little constipation. So I ask him all kinds of questions that would get me into trouble at my mum’s dinner table, do an exam, and decide I need to do a rectal exam. He seemed ok (‘Whatever you think you need to do, doc’), so I gloved up, lubed up, and started to spread his cheeks.

At this point he starts to giggle. He then tells me he is ticklish.

Have you *ever* heard of a guy who is ticklish when he is about to get a finger up his rump??

And it gets worse! I start to, uh, check his prostate and he raises both hands with an ‘Aw Lawdy’, a bunch of giggling, and asks if I am almost done. Now, I have had a lot of reactions to this kind of exam; from patients deferring to one accusing me of trying to touch their tonsils with a log. But I have *never* had someone giggle.

Maybe my technique is getting better….

Anyway, it’s the end of my term and I have learned a lot in the emergency room at the WORLD FAMOUS CLEVELAND CLINIC. Some things are different in emergency medicine in the States, but one thing is the same: a lot of patients come in for no good reason. OK: Chest pain – come in. Sudden, excruciating headache? Hurry in; maybe even run a few red lights. Sudden loss of vision? Have someone *else* run a few red lights. But a boil on your buttocks? Run out of your regular medications? An ingrown toenail? A sore ankle for 3 months that is worse after you are on your feet all day at work? Somehow, I don’t think the word ‘Emergency’ applies. (A certain medical student – who shall remain nameless – didn’t run into the ER when he used the ‘loo after chopping a hot pepper. He ended up very, um, warm and fidgety for about 4 hours. Not that he didn’t think about it, mind you. But can you imagine the fight between all the nurses and doctors on who would have to put the burn cream on? But I digress.) Sometimes, you wonder what folks are thinking when they come into the emergency room.

Not that I turned the cheerleader with the sore ankle away, mind you…

OK, everyone get out your playbill; there is a change in the second act of this little performance. The part of ‘Bryan in Orthopedic Surgery’ has been changed to ‘Bryan in Emergency Research’. This is my way of letting all of you know that instead of doing Ortho Surg for the next 4 weeks, I have changed and doing a research project in the ED here at the WORLD FAMOUS CLEVELAND CLINIC for the next four weeks. And while I would like to say things about the opportunity for research and expanding the knowledge base, it really comes down to one thing:

I’m tired of washing my hands for surgery.

And with that, it’s the weekend. I’m working on some Brown’s tickets, and trying to get to OSU for a game while I am in the state, and in general having some fun. I have this huge binder of research papers I need to read through. Not to mention trying to get the burning to stop…

As always, Love to All and keep working on your 101 List!
Bryan

Cleveland Rocks!

Boy, was I confused.

Not that Bryan being confused is anything new or unusual. In fact, it seems – most days, anyway – to be typical. But this was different. This was in the emergency room of the WORLD FAMOUS CLEVELAND CLINIC, and I had just finished talking to a patient with chest pain. The attending physician, who is my boss, walked in and introduced herself to the patient, gestured in my direction and said she was working with Dr. Canterbury.

I turned around to see if this mythical ‘Dr. Canterbury’ was standing behind me…

It may be a bit late, but welcome to Cleveland, home of the WORLD FAMOUS CLEVELAND CLINIC. (I am required by contract to capitalize that whenever I type it. Something to do with trademarks and reputation. But I figure if the reputation is so great, they never would have let me through the front door as a patient – never mind as a student. But I digress.) Even though I am about 40 minutes form Mom and Dad, it seems really weird to be ‘home’. I still can’t get used to Ohio State hats and the Cleveland Indians on TV – not to mention the Browns! Of course, after 3.5 years in Australia the parental units, are happy to have me so close.

I’m sure that’ll wear off with all the dirty laundry I’m bringing home this weekend…

But I am back in the emergency room and having a blast. The doctors are a lot of fun, and the patient mix is pretty interesting. I saw as many traumas in the first two days in Cleveland as I saw in my whole month at Harlem. I had one patient drive from two hours away with chest pain because he wanted to be seen at the WORLD FAMOUS CLEVELAND CLINIC in case he had heart problems (he didn’t – it was only gas). This has been in addition to the usual stuff of sore backs, weird skin rashes, patients hearing voices and a slew of sore tummies, the last of which was a kid who swallowed something that showed up on x-ray. We weren’t sure what it was, so we started a betting pool on what it might be. We had to return everyone’s money in the end, though:

No one wanted to dig through the, uh, ‘collection’ he left us to find out what it was…

And with that, it’s the weekend. I’ll be at home with the family this weekend doing laundry and celebrating my sister’s 40th, er, 37th, um, 33rd birthday. Not to mention trying to track down this mysterious Dr. Canterbury…

As always, Love to All and keep working on your 101 List!
Bryan