Dude, Where's My Stethoscope?

by Gray, Donovan

  “Perhaps I should be more specific. Do you have any physical health problems?”

  “Nope.”

  “What about mental health problems?”

  “Not really… .”

  “How about in the past?”

  “Um… .”

  Pearl of wisdom from 15 years of clinical practice: When all else fails, check the chart.

  “Do you mind if I quickly review your file?”

  “Er… .”

  I opened it and started leafing through. It didn’t take long to spot certain glaring trends.

  “Gee, it says here you’ve had long-standing issues with panic attacks, substance abuse, alcoholism, obsessive-compulsive disorder and multiple personality disorder.”

  “Really?”

  “It also mentions at least five different admissions to psychiatric hospitals within the past two years.”

  “No way.”

  “Way.”

  “I forgot.”

  “According to the most recent discharge summary, you just got out last week.”

  “Oh.”

  A slightly awkward silence settled over the room. Finally my patient cleared his throat and spoke.

  “Does this mean you won’t be able to sign my form?”

  Ode to a Carrot Juice Enema

  I’m sure there must be some good naturopaths out there, but I’ve yet to run into one. How’s that for an opening salvo?

  Every month a gastroenterologist from a nearby city has an endoscopy clinic at one of the rural hospitals I work at. For colonoscopy the bowels need to be as empty as possible in order to permit a good evaluation of the mucosa. To that end, patients are asked to take two oral Fleet phosphosoda laxatives on the evening prior to their procedure. The Fleets are remarkably effective at evacuating the bowels and cost only $6.99 each.

  Recently a naturopath in the area began offering carrot juice enemas as an alternative to the traditional bowel prep. Carrot juice enemas cost $120. As if that wasn’t bad enough, the damn things don’t work. Instead of inducing the usual 10 or more bowel movements, the carrot juice regimen produces a paltry one or two. One or two BMs aren’t nearly enough to clean out the average person’s colon. Shortly after this new “service” became available, patients started showing up for their colonoscopies with their bowels full of carrot juice and crap. The gastroenterologist would only be able to advance the scope about six inches before running into a solid wall of orange sludge. The procedure would then have to be aborted and rescheduled for a later date. We’d ask people who’d had previous scopes how in the world they figured one or two poops could possibly clear them out when the standard regimen had made them go at least 10 times. “Well, to tell you the truth doc, I was kind of wondering how that was going to work myself… .” Eventually our exasperated consultant began giving his patients free colonoscopic snapshots of the gooey, carroty conglomerate in their bowels so they’d at least have some hard evidence should they attempt to obtain a refund. ¡Madre de Dios! Like the saying goes, a fool and his money are soon parted.

  Speaking of fools and their money, another naturopath some of my patients liked to frequent claimed to be able to assess their bio-spiritual chi by closing her eyes and doing this weird hand-fluttering thing around their bodies. After a couple of minutes of humming and swaying she’d come out of her little trance and proclaim that they were dangerously low in xenon or antimatter or whatever. And you thought psychic mass spectrometry didn’t exist! Silly you! A vanishingly small bottle of the life-saving element or mineral their soul so desperately craved would always be available for a mere $75. Cheap like borscht! Oddly enough, the bottles all looked the same to me. I saw a lot of them because after leaving their mystic consultations my patients would invariably rush straight to my office requesting laboratory confirmation of their new diagnosis. “Do I really have a titanium deficiency, doc? Is that bad?” I was often tempted to have the mysterious fluid in the bottles analyzed to see what it really was. Probably carrot juice. A real bar-goon, folks. Ka-ching!

  Oh Lordy, here comes the hate mail!

  When Your Compassion Runs Out

  I was in a toxic mood. Why? Because I’d worked 12 of the last 14 days. Because it was my third graveyard in a row and I was beat. Because the shift had been snakebit from the get-go and I was tired of dealing with crackheads, criminals and bacchants. Sometimes prolonged immersion in the seamy underbelly of a city can be a little soul-destroying. Do it for too long and you start to grow steel behind your eyes. Cripes, who cares what the reasons were? The bottom line is I was fresh out of compassion.

  I picked up the next patient’s chart. The triage note indicated she was a 35-year-old shoplifting suspect who had been involved in an altercation with some security guards. Great, I thought, just what I need. A maenad. I knocked on the door and entered the treatment room.

  The tall, thin woman curled up on the stretcher had spiky black hair and pinched features. She was sporting an angry purple bruise on her right cheek.

  “Are you the doctor?”

  “Yes.”

  “About time.” She uncoiled her body and pointed at her cheek. “I want this documented. These too.” She rolled up her sleeves to reveal several abrasions on her wrists and forearms.

  “What happened?” I asked.

  “Some guys jumped me.”

  “When did this occur?”

  “About six hours ago.”

  “Where?”

  “Is this really necessary?” she hissed. “I already played 20 Questions with the cops as well as that nosy bitch at the front desk. I don’t feel like doing the same thing with you, too.”

  Hoo-boy, was that ever the wrong answer. Now we were going to do this the hard way.

  “As a matter of fact, it is necessary,” I replied coldly. “I need to review all the details myself to ensure nothing gets missed. If that doesn’t suit you, you’re welcome to get your medical care somewhere else.”

  She shot me a poisonous look, then grumbled, “It happened at the Cost-Savers store downtown.”

  “Why did these people attack you?”

  “How should I know?”

  It was obvious she didn’t want to admit she had been caught shoplifting. I should have just cut her some slack and dropped the subject, but for some reason I was bound and determined to extract a confession. I continued baiting her.

  “So a mob of complete strangers tackled you in the middle of a busy department store for no particular reason?”

  “They were security guards.”

  “What made them pick you?”

  “I guess they must have thought I was shoplifting or something.”

  “Were you?”

  Checkmate. Mongoose victorious.

  She hung her head and stared at the floor for a few seconds. When she looked up again, her eyes were glazed with tears.

  “Yeah, I was,” she whispered. “I tried to steal a cheap watch. But why’d they have to hurt me so bad? It’s not like I was going to fight them for it. I only took it because I was broke and hungry and I didn’t know what else to do… .”

  It was one of the lowest moments of my medical career.

  Guilt

  “The only thing that burns in hell is the part of you that won't let go of your life.”

  - Louis’ interpretation of a Meister Eckhart concept in Jacob’s Ladder

  When I woke up in the ER on-call nap room at 6:00 this morning, Mr. Trapper was sitting at my bedside. I always flinch when that happens.

  “You’re not really here,” I said. “You're dead.”

  “Well, you don’t have to be so rude about it,” he grumbled.

  “I'm sorry,” I apologized. “It's just that sometimes I get tired of reminding you.”

  His shoulders slumped, which made me feel guilty. I tried to rationalize: Don't be ridiculous. The dead have no feelings.

  “Why do you keep coming back?” I asked.

  He pulled a handkerchief out of his translucent pock
et and wiped his forehead.

  “You know why.”

  “Why?”

  “I want to live.”

  “I'm sorry Mr. Trapper, but much as I'd like to, I can't change what happened.”

  He blew his nose and put the handkerchief away.

  “It wasn't any fun dying alone on the bathroom floor, doc. They didn't find me for a week. I trusted you. This whole thing is so unfair,” he said quietly.

  I looked directly into his hollow eyes.

  “I truly am sorry,” I said.

  I stepped over his shimmering suitcase, entered the hallway and gently pulled the door closed behind me.

  “It's so unfair,” he whispered as it clicked shut.

  Time to Go

  Recently a pleasant 95-year-old widow named Rose presented to our ER after a brief episode of chest pressure. The discomfort subsided en route to the hospital and never recurred. One of my colleagues examined her and ordered a battery of tests, all of which turned out to be normal. Later that evening he reviewed the results with the patient and her son and recommended she stay in our department overnight for cardiac monitoring. Rose was not interested in any form of aggressive resuscitation, but she didn't mind a brief period of observation. After helping her get settled in for the night, Rose's son departed saying he'd be back at nine in the morning to take his mother home.

  At 4:00 a.m. Rose awoke from a deep sleep and rang the call bell. When her nurse arrived Rose said, “Laura, it's time for me to go.”

  Laura glanced at her watch in the half-light and replied, “Oh, it's not time yet, ma'am; it's only four o'clock. Your son said he'd come get you around nine.”

  Rose gazed up at her nurse through sibylline eyes. She clasped Laura's hands in hers and patted them gently.

  “You don't understand, dear. It's time for me to go.” She then smiled, folded her arms across her chest and closed her eyes. On the cardiac monitor above the head of the bed Rose's heart rate plummeted from 80 to 50 to 20 to flatline in less than a minute. And just like that she was gone, with a cryptic little Mona Lisa smile still fixed on her lips.

  Piece of Cake

  Joanna is a seasoned Winnipeg emergency room RN. We’re talking old-school here. Hard-boiled. Always prepared. The original Swiss Army nurse. Recently she worked a long string of 12-hour nights. On Saturday morning when she got home she was exhausted. She knew she needed to get some sleep because she was scheduled to host her twin daughters’ 8th birthday party that afternoon and her husband was out of town. Unfortunately, between household chores and all the pre-party preparations she never made it to bed. At 2:00 p.m. the guests arrived. The kids had a great time running around and playing games. At 4:30 they sang Happy Birthday, cut the cake and opened gifts. By then Joanna was wishing she had a pair of toothpicks to help prop her eyelids open. She had only enough energy left to smile blearily at anyone who approached and croak, “Would you like some cake?”

  At 5:15 the last guest left. Our sleep-deprived heroine tidied the house, made supper, helped her kids pack overnight bags and dropped them off at their grandmother’s. She then got herself ready and drove to the hospital for the last of her 7:30 p.m. to 7:30 a.m. night shifts.

  By midnight she was a complete zombie. To make matters worse, the elderly gentleman she was trying to triage was a rambler.

  “How can we help you tonight, sir?”

  “Well ma’am, in the summer of ‘52 I injured my back while I was working in the oil patch out in Alberta, but in those days there wasn’t no such thing as Compensation so I just kept plugging away until one morning the damned thing just seized up on me and I couldn’t even get out of bed so I had to get my best friend Wilbur Mercer to drive me to the nearest hospital and the doc there took one look at me all bent over like a pretzel and he said… .”

  Joanna’s eyelids began to droop.

  “… my back was just plain old worn out and there wasn’t really a whole heck of a lot he could do for me except for maybe some kind of steroid injection thing but he sent me off to see a sawbones anyway and believe it or not that doc operated on me the very next day and lucky for me he did because…”

  Joanna’s eyes drifted shut. As she quietly snoozed while sitting upright in her chair at the triage desk, the Midnight Rambler carried on with his ever-so-precise and focused history.

  “… within a month or so I was back at work on them rigs like nothing had ever happened and that’s how I ended up with this here little scar right above my tailbone. Once in a while when there’s a change in the weather it aches something fierce for a few hours and I have to take a couple of them Tylenols to settle it down. Tonight I got to thinking about it and I started wondering if there might be a good medical explanation for why that happens. But that’s not actually the real reason why I’m here tonight. No, ma’am, the main reason I decided I should come see a doctor tonight is because about 40 years ago I was on top of my neighbour Phil Resch's barn helping him patch a hole that had been leaking for pretty near a month and best I can figure I must have slipped on some pigeon poop because wouldn't you know it all of a sudden I took a spill right off that goldarn roof and… Ma’am?” Our patient had just realized his nurse was asleep. He gently nudged her arm. “Ma’am, are you okay?”

  Joanna lurched awake, bug-eyed and completely disoriented.

  “WOULD YOU LIKE SOME CAKE?”

  Skunked

  One morning this spring Jan looked up from her newspaper to see a skunk ambling across our backyard. We’re accustomed to seeing all sorts of wildlife in our neighbourhood, but we had never witnessed a skunk before. She grabbed my camera and snapped a picture of it. That evening my daughters and I viewed the image and marvelled. It’s not every day you see a skunk, even if it’s just on the LCD screen of a digital Canon.

  The next morning the skunk reappeared at exactly the same time. We all stared as she casually meandered around for several minutes before disappearing into our neighbour’s backyard through a crack in the fence.

  “I think we should do something about this,” Jan announced.

  “Nah,” I responded. “She’s probably just passing through.”

  The skunk was back at seven o’clock the following morning. And the next. And the next… . She was so regular you could set your watch by her. My daughters took to calling her Skunky. Not long after that the words pet skunk began creeping into their conversations.

  “We definitely need to do something about this,” Jan would mutter darkly.

  “Maybe she lives at the neighbour’s place,” I’d reply, fingers crossed.

  One morning Skunky didn’t show up at her appointed time. She missed her cameo the following day, too. Two months passed with no further skunk sightings.

  “Told you,” I’d say smugly from time to time. “She was just passing through.”

  Jan would just roll her eyes.

  Two weeks ago Jan and I were looking through the living room window at a peculiar strip of shredded grass in our front yard when, lo and behold, Skunky sashayed into view.

  “I wonder where she’s been?” I pondered aloud.

  Jan banged on the window. Skunky jumped in alarm and zipped down a hitherto-unnoticed hole in the earth where our garden meets the concrete of our front steps. Uh-oh. Jan turned to me with one eyebrow raised. That’s always a bad sign.

  “Just passing through, eh?”

  “I’ll call pest control in the morning.”

  The pest control company said they’d be out to set a trap in a few days.

  The following evening I was updating a family photo album in our living room when Skunky emerged from her den. For several minutes I watched her scratch great big holes in our lawn in search of whatever it is skunks call supper. Eventually I got bored and returned to my picture sorting. The next time I glanced up there were eight baby skunks cavorting on the grass in front of our garden. I nearly choked. The miniature black-and-white furballs were having a rollicking good time chasing one another’s tails, pouncing
like kittens and rolling around on their backs. Alanna noticed me gaping and wandered over to see what was going on. “Ohmygodthey’resocute!” Ellen and Kristen came running. Soon our whole family was crowded at the window watching the skunks play. They really were adorable. Whenever one of them strayed too far from the den’s entrance their mother would shoo them back to safety. Once she even picked up one of the more adventurous babies by the scruff of his neck and carried him to the hole.

  “Don’t get too attached to them, girls,” I warned. “The guy from the pest control company is coming in a couple of days with a trap to catch the mother. I’ll have to call him back tomorrow to let him know there are babies now, too.”

  “They’re not going to hurt them, are they, Dad?” the girls asked worriedly. “They’re so cute!”

  “I don’t know what they do with skunks after they catch them. I’ll find out when I call.”

  “Hi, my name’s Donovan Gray. I called recently about getting rid of a skunk living under our front steps.”

  “Oh yeah, I remember. Name’s Zeke. I’ll be out with a trap first thing in the morning.”

  “There’s been a new development – she had a bunch of babies. Can you catch them too?”

  “Sure, no problem. Cost ya extra, though.”

  “That’s okay. Listen, what do you do with them after they're caught?”

  “Drown ‘em.”

  “Oh.”

  “Somethin’ wrong?”

  “My kids have sort of bonded with the skunks, especially the babies. Can I pay extra to have them all released in a forest somewhere?”

  “Nope.”

  “Why not?”

  “Against comp’ny policy.”