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with Rod Moser, PA, PhD

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Monday, July 31, 2006

Dirty Places, Part 10: Dirty Jobs

The world is filled with dirty places, but I am starting to run out of places that I have identified. I watched a few episodes of a series called “Dirty Jobs” today, so it reminded me of some of my own past (and present) dirty jobs.

While in high school, I worked at a game farm in Farmington, Pennsylvania. My job was to raise quail for the hunting reserve; ten thousand per year to be exact. That many quail, as small as they are, produce an impressive amount of quail poop that needed to be cleaned.

We also had a small zoo on the property, so I quickly developed more than a casual relationship to the excrement of bears, raccoons, opossums, porcupines, deer, elk, rabbits, bobcats, and dingo dogs. My job, of course, was to feed the animals and clean their cages. Although this job may sound disgusting for some people, it really wasn’t a bad job, once you get used to the smell.

When I entered the medical profession, I graduated from animal droppings to the fine art of dealing with human poop, from performing rectal examinations (someone has to do it), to examining stool specimens for ova and parasites. Medical people have to deal with many of the more disgusting human afflictions, like perirectal abscesses, embedded foreign bodies, horrible infections, squirting blood, and the shear joy of removing an impacted tampon (that happens quite often — read on).

Every medical provider has their tasteless stories, mostly told around the dinner table much to the horror of our non-medical guests.

In a past Blog, I talked about my experience of teaching a mother how to insert a rectal suppository in her ill child. Just a little warning to put down your sandwich before reading it: The child also had diarrhea.

Until Hepatitis B, HIV, and other blood-borne pathogens took front page, most medical professionals did not give much thought to getting blood all over our hands. Not any more. We glove up and protect our clothes and eyes when dealing with blood now.

One evening in the Urgent Care, a man was brought in with a chain saw injury on his lower leg and foot. High on the list of Stupid Human tricks, this man decided to duct tape his chain saw (turned on, of course) to a long pole in order to cut a branch out of his reach. When the saw vibrated out of his duct tape, it landed on his leg and foot.

He told me that he quickly decided not to catch it, but thought he could at least break its fall by sticking out his leg. This frightened man must have missed that high school lecture where people are told to put PRESSURE on a bleeding wound. He decided to wrap a black, garbage can liner around his foot and leg to catch the blood. Catch it, it did. By the time he arrived at the Urgent Care, the bag was full. As we were lifting him onto the examination table, the bag broke. A tsunami of blood flooded the exam room. Once the bleeding site was identified, it only took a few minutes to patch the hole. The amount of blood did not justify the relatively small laceration the saw caused. It could have been much less work.

A year or so later, we saw yet another chain saw injury. This time the guy dropped the saw in his lap. Fearing that he had cut off both Frank and the Beans, I announced that he only nicked his leg. His penis, assuming it was the same size as before the incident, was miraculously intact.

Draining an abscess is another of our dirty medical jobs. Abscess does NOT make the heart grow fonder! Perirectal and pilonidal abscesses have got to be the stinkiest. Many seasoned medical professionals have gagged when opening and draining these little gifts of nature. It takes quite a while to air out the office after these procedures.

The removal of an impacted tampon is yet another stinky task for medical provider in primary care. In the busy bustle of daily life, it is not uncommon for women to insert a second tampon sometime during their menses, forgetting that another one is in place.

Soon, their menstrual period will end, but days or even weeks later, they will begin having a very smelly vaginal discharge — one that cannot be improved by showering or other hygiene measures. Believing that they have a monster of an infection, they present to our office.

As soon as an experienced medical provider enters the examination room, this relatively-common scenario is suspected. A pelvic examination will quickly reveal the malodorous culprit. It then will be extracted, quickly wrapped in inside-out examination gloves, a plastic bag, and disposed of in a sealed container…outside. Case and problem solved for the embarrassed woman.

The care of human afflictions can be viewed as a dirty job to some, but this is the profession we chose. Human beings are vulnerable to disease, subject to the ravages of nature, and unbelievable lapses in judgment. I would much rather enjoy the glamorous practice medicine than clean another quail pen.

Related Topics: First Aid and Emergencies, 7 Key Traits of the Ideal Doctor

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Posted by: Rod Moser, PA, PhD at 7:45 am

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