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