Let’s start with a few definitions (links to sources by clicking on words… ps, please click).

Bezoar:  A ball of swallowed material that collects in the stomach and fails to pass through the intestines.

BMI:  Body Mass Index.  Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women

A Michigan Unit:  This is a term applied to people to be politically correct without their knowledge.  One Michigan Unit is 200 pound (some people use 1 MI = 100kg as well).

Snickers:  A delicious candy bar with 273 calories per bar.

Now the story begins.

A patients “walks” into the Emergency department for abdominal pain.  His BMI is 66.  That is high.  His estimated weight is roughly three Michigan Units.  As it turns out, he had eaten 24 full sized snickers bars.  I think you might have missed it… TWENTY-FOUR snickers bars.  As it turns out he might just be the first person in history to actually have a Snickers Bezoar. 

…that last picture came up when I went to google images and typed “snickers bezoar.” I have no idea why either.

My wife went on a girls-only trip for a day with her mom and two sisters.  This left me alone with my wonderful daughter for >24 hours for the first time. 

So, logically, what is the best course of action?

Invite two other fathers with daughters over to your house for an all night party/play-date of course.

To be honest, I originally wanted to have a games night and other such fun, but it just turned out that only two others could make it and both were dads with daughters.

Three fathers, three daughters.  It almost seemed like a smarmy sitcom.  I kept waiting for Tony Danza to pop out and start screaming for “Angela!  Mona!”  I’d keep going but I forget the rest of the cast from Who’s the Boss.

The cuteness level was off the charts…

kinda like this tiger paw high-five:

Actually the night went by without a hitch and all the girls got along swimmingly.  The boys played a variety of games (Rook, Carcassonne, Rummikub, then Mario-Kart on the Wii, simple awesomeness).  I may or may not have consumed a beverage called a “Flaming Dr. Pepper (dark beer 1/2 full in cup, one shot glass 3/4th full of amaretto, 151 rum, lit on fire and then dropped into the beer and then slammed).

Also, my brother in law is doing a modified Atkins diet, so he brought a pound of bacon with him.  I may not totally agree 100% with his dieting plan, but what I cannot disagree with is the fact that bacon is delicious.  It’s kind of like cinnamon, it just makes good food even better. 

Weight loss… blah…  at least it’s not fat pill supplements.  Don’t get me started on those.

When I turn 92 years old, I hope to have the bullet-proof titanium cojones of Merl.  Merl was a recent ER patient.  On the other hand, I hope I to never have his level of dementia.  Please don’t misunderstand me in this regard.  Dementia is a horrible, traumatizing, and frustrating disease, however, in the ER, sometimes you have to laugh because otherwise you’d spend all day crying.  I think I need to create some dialog to do this story justice.  Thus, I will add parts in italics and underline for whats going on inside peoples heads.

EMS: “Patient coming in after being found on ground covered in bird seed and woodchips.  Also, the patient seems to be glowing with a glorious radiance that I can only assume is the glow of his own awesomeness.  Also, he has dementia.

ER Staff: “Copy that.  We’ll see you on arrival.  WTF?  Birdseed?
(patient arrives)
Merl: “You don’t know if they want to take the rooster, do you!  Well, if you don’t filter out the bats, you can’t even fly, can you?  CAN YOU!  I didn’t think so.  So I had to get out (anyone notice how awesome I am?) .
ER doc: Uh, right, sir.  So, what happened today (I wonder if he’s batshit crazy)?
Merl: I got away (I got away!)!
ER doc: OK, how did you do that (batshit craziness confirmed)
Merl: You don’t own me (bitch).

Then we called the nursing home.  This is where the story got interesting (boring up to here, right?).  Apparently, he’s in a lock down unit for his dementia when it gets bad (today was bad…).  They found his window broken (of the 3rd story building, at 92 years old remember).  Attached to the bed was tied one corner of the bed sheet.  Hanging outside of said window was several sheets tied together.  Tied to the bottom of the sheets were shoelaces.  This hung outside the window down to about 10 feet from the ground.  On the ground, found, by EMS, was Merl.  Covered in birdseed from a nearby bird feeder.

That’s right, at 92 he made a pseudo-jailhouse escape from his lock down unit on the dementia ward.  A successful escape, except for the fact that at 92 you can’t hold onto the bed sheet rope ladder you hastily created as well as you did in your youth. 

Aaaah, the ER, how I love it. 

Oh, here’s another quick story.

I walked into a room to see a nice young woman and her child.  The child (3 years old), kept running up to me and giving my leg a hug.  All smiles and happiness as only a 3 year old can have.  I don’t know why this kid loved me so much, but he did.  So, after evaluating the patient, and picked him up quickly with a smile.  In my haste, I proceeded to smash his head into the overhead (hanging down) light present in every room.  His love for me didn’t last.

 Oh well.

    
      4 AM Emergency

Early in the morn’ when the call came in,
‘nother drunken wacko? Or a broken shin?
He doesn’t speak English, they said in a grin,
The EMS there to greet.

We then hauled out the translator phone
So I could see why this patient did moan,
Could he have a really bad kidney stone?
That’d surely be quite neat.

Through the phone he did then say
that super-dry skin he’s had all day,
and thus he came through ambulance bay,
in order for me to treat.

Dry skin? I said with one long glance
He was quite dry not happenstance,
for this he needs an ambulance?,
I sighed in sad defeat.

I check him out, go through the motion,
No sir, no pills nor magic potion,
But here you go, I call it lotion,
apply from head to feet.

Another life I saved today,
The ER’s here so come what may,
and I’ll be ready till that day,
When it’s our turn to meet.

==========================

-I kinda wish this wasn’t a true story, but I can’t make this crap up.

I am a quirky nerd.  So are many of my friends.

Currently I’m crazy-happy.  I’m so happy a waterfall of techno-colored dolphins couldn’t even express it.  I’m brimming with joy like narcoleptic at a pillow factory.  You know when Charley first gets the Golden Ticket and he runs home in a crack-like spastic joy over winning?  Yeah, happy like that (only less prepubescent boy awkwardness, well, a little less).  This is cool.  New T-shirt out of nowhere.

Most recently I have received a few things from friends.  To be honest, one of the COOLEST things in the entire world is to receive a gift (not just a card) in the mail that you were not expecting.  It’s like a surprise Christmas present.

I recently receive an awesome T-shirt from Greg/Kelly (they prefer Grelly).  They saw the shirt and thought “hmm, this really reminds us of our idiot friend.”  Here’s the shirt.

It was for Samantha.  She wears it proudly quite often.  Also, she lives up to the T-shirts key message quite often.  Have you ever seen a dump made completely of blueberries?  I have.  It’s kinda frightening.  Corn + Blueberries = how did she get any nutrition at all, it looks the exact same…  How did I get talking about poo.  Oh wait, I’m me, nevermind.

Did I mention I love T-shirts yet?

I love T-shirts!  I also love analogies.  I love analogies like I love T-shirts, they are warm and comfortable to me, and sometimes make people laugh.  Dang, I’m clever.

I also just got what will probably be my first pick for T-shirts in my closet for years to Come.  Lisa H has been a friend ever since residency.  At first she seems kinda shy and quiet/reserved… then, if you happen to be near her during lecture you start to hear the continuous hilarious sarcastic comment machine in full swing.  We got along juuuuuuust fine.  I just got a surprise package today with this shirt…

I’m not sure how to keep this trend going.  But please, continue to send me sweet awesomeness in T-shirt form, and I will continue to spew happiness and joy non-stop.  I will continue to crap rainbows and pee unicorns.  I will continue to speak in Skittles and sweat sunshine.  That’s supposed to mean I’m happy.

I’m happy.

Thanks Lisa!  Thanks Greg!
(oh, and Lisa, I finished my book, and it’s currently getting edited… which seems to be a slow, painful process, but I did finish

For those of you who have never had the joy of hanging out in an ER on a Saturday night, come with me.  Come with me through the window of insanity and enter the portal to the world that exists only in the minds of the bizarre tranquility of the insane.

Remember the show where Bill Cosby sat with kids and tried to get them to act crazy.  I think it was called Kids Will Say the Darnedest Things, or something like that.

This is true.  Kids will say the Darnedest things.  Know who else will say the darnedest things?  Unmedicated schizophrenics on meth, crack, alcohol, and turpentine.  Man, they will say the funniest stuff!  If I could have Bill Cosby in there with me when I’m talking to these people it would make for a great show.

Me: “Hello ma’am, it says here that you’re here because the walls are melting.”
Her: “Where’d you come from!  You know that color?  The one that smells like rotten hay?  I do!  You will too, I bet.  Right when the pickle truck forgets to run over the mailman.”
Me: “I see.  Well, are you having any pain anywhere?”
Her: “…and forget about the Blarney Stone.  I kissed that bastard back in ’88 and he didn’t even change colors when Autumn came around.  I’m Satan!  I’m Satan!  I’m Satan!  Wait, no.  Where’s is that Mutherf’n’ nurse with my coffee!!”
Me:  “That’s great.  Well, we’re going to need a urine drug screen and a blood sample.”
Her:  “I put the earwigs in the pudding.  That’s where they belong.”
Bill Cosby: “And I recommend Jello Pudding Pops (makes a funny face at the camera).  We’ll be right back with a man who thinks he’s Jesus, and a young lady who drank two bottles of Listarine since she was already too drunk to make it to the Liquor store.  We’ll be right back.”

I keep a quote-book during my shifts.  It’s hilarious but I can’t really share most of them without violating confidentiality.  Sorry.  But I can share a few recent situations.

I took over for one of my partners for a lady who was drunk and “suicidal.”  Now please don’t get me wrong.  People who really are suicidal and depressed need help right away.  Depression is a real disease that needs treatment in one way or another.  So does drinking.  But it turns out that her actual complaint was more centered around his weight.

He weighed a triple-order of onion rings short of 370 pounds.  No, he was not eight feet tall.  She was maybe five feet tall.  Tops. 

Anywho, he had started some new medications recently.  He was concerned that the medications were making him fat.  At the same time, in the small ER room were bags of McDonalds.  The medicines were making him fat.  Now I will be honest, I had never met the man before, but years of training kicked in and I came to the conclusion that he probably did not add 150 pounds of weight in the last week.

Long story short, we waited for the alcohol to wear off and he felt all better.  Unfotunately I was unable to cure him of his acute on chronic fatness.  I assured him that I did not think the medications were directly responsible for his weight.  He was not convinced.

I know I have blogged on this in the past, but I think the answer is just to legalize crack for fat people like they legalized medical marajuana for people who enjoy smoking pot.  You just don’t see fat crack addicts.  You don’t, I don’t think they exist. 

Elmo.

The mere name strikes fear into the hears of any parent, while at the same time providing them with the soothing thoughts of maybe a half hour respite from an insane child.

To the best of my knowledge, my daughter had never been exposed to Elmo.  In our house we really do not watch much television.  I am not saying this to make you think we are awesome parents.  I know we are awesome parents.  I am not saying this to make you feel bad.  I already know you are terrible.

However, my wife bought Elmo bandaids several months before our daughter was born.  For one reason or another she (my daughter) was pulling open random drawers in our bathroom and just being her naturally curious self.  After opening the bottom shelf and consuming 2 bottles of rat poison, she happened across the bandaids.  It had a picture of Elmo.  She grabbed the box, looked up at my wife and clearly said “Elmo!” with a broad grin.

Insert stunned silence here.

That’s right.  Elmo is infused into the brains of children.  You can not stop it.  Just buy the toys and hope the next 6 years go by quickly.

Oh, in other news I read Twilight.  I figured I had to in order to be able to better make fun of it.  I really thought that the last 30 pages were quite good.  The first 460 kinda dragged though.

I used to write poetry.  Then I realized that there are about 5 people in the world that write excellent poetry  (two of them being Shel Silverstein and Dr. Suess).  You are not one of the five, sorry (neither am I).  All the rest of us can do is to try to mash words together and have others say how deep we are.

I am guilty of trolling through many other peoples blogs from time to time.  Most of the tripe is distraught tweeners complaining about their horrible lives through crappy poetry.  If you’re reading this, and have written poetry, then I’m not talking about yours, yours is great.

Me?  I usually write about poop.  Yet, here I am, having gone several columns without a single poop reference.  I feel I have failed you, my loyal readers (both of you).

Thus, as atonement, I present my

Sonnet* to poop.

The brownish waste with nutty taste
it glistens dark as poo comes out.
With head held high I make more paste
Some straining with my anus shout.

Log one descends, it hooks and bends,
and silent wet the bowls embrace.
Log two and three, my cheek defends,
from upward splash and sure disgrace.

A silent breath and soon the rest
that comes from job done well and pure.
As poopers go I am the best,
This is no brag, I’ll not abjure.

If green or brown or darkened hue,
Tis always grand to have a poo.

Ooh, looks like I’ve written a sonnet once before (I think this one is actually better)

Want  yet another example of my crappy poetry?

*(yes I realize the iambic pentameter is lacking (by which I mean non-existant) in this sonnet, go cry me a river)

Yeah, sometimes the night shift is boring.  Random drunk people sleeping it off.  Minor cuts and coughs.  Other times, well, let me list what was wrong with my one patient…

1. Respiratory failure (so he got intubated so we can breath for him)
2. Left pneumothorax (collapsed lung)
3. Left Hemothorax (lung cavity filled with blood), he got a left sided chest tube
4. Right pneumothorax (collapsed lung)
5. Right hemothorax (right chest tube)
6. Aortic transection (the big artery, right off the heart, try not to damage that one)
7. Free air in the abdomen (ouch)
8. Left Tibial plateau fracture (BAD leg fracture)
9. Comminuted left tibia/fibula fracture
10. Right tibial plateau fracture
11. Comminuted right tibia/fibula fracture
12. Multiple rib fracture, flail chest
13. Abrasion/lacerations… all over
14. Low blood pressure
15. Low oxygen saturation
16. Intrathoracic bleeding
17. Bad hygiene

Stabilized and off to the operating room with you.

For an ER doc, this is fun (and scary as well).  This is real medicine where the patient would VERY likely have died in the near future without interventions.  Though after the case, I was spent.  Yay for awesome support staff (and awesome PA working at the same time).

So was I done?  Was that all the chaos of the day?  No, that’s when the 350lb psych patient decided to start getting naked and running through the halls.  And people ask if it’s hard to stay awake during the night shifts… yeah right!