A PAIN IN THE TOENAILS
by Melissa Yuan-Innes
Published by Olo Books
Smashwords Edition
Copyright 2011 by Melissa Yuan-Innes
Ah, the innocence of medical school. This is a story from my third year of clinical clerkship, which means I started rotating through the hospital wards, starting with internal medicine. I was matched to the gastrointestinal team, so I can recite the bacterial causes of bloody diarrhea to this day.
You can also find this essay in my book, The Most Unfeeling Doctor in the World and Other True Tales from the Emergency Room.
My first night on call ever as a clinical clerk, I headed down to the emergency room to see an 80-year-old lady with bloody diarrhea. She had just been discharged from the University of Western Ontario's University Hospital. As soon as they dropped her off, she promptly called another ambulance, which brought her to St. Finnan's Hospital and me, the clerk on internal medicine.
On the stretcher, Mrs. Ursel moaned and glared at her son, who was saying, "I'm leaving you, Mother, since the doctors are here. But I brought you a book. Chicken Soup for the Mother's Soul. See?"
She sniffed and turned her head away.
"I'll just put the book on your table. You can read it when you're feeling better." He dropped it there with an audible thump.
"You don't have to leave," I said. "You can stay until we decide what we're doing with your mother."
"No, that's okay." He bid her a hasty good-bye and left.
Hm. I interviewed Mrs. Ursel, a thin, elderly white woman. She was delighted to tell me about all her bloody diarrhea and how much abdominal cramping she was having and how worthless University Hospital was. She groaned and lifted her hips slightly. "Ah, there goes another one. I need a new diaper!"
I paged the senior resident on call and related the story. He said, "Her diarrhea isn't that severe. Her vitals are normal, and her blood work is okay. She could probably be worked up as an outpatient. But her son has abandoned her and she just got bounced out of UH. We'll have to take her."
In the morning, Mrs. Ursel received a colonoscopy and turned out to have ulcerative colitis. I asked her if she had any questions, but she cut me off to complain about everything from her untrimmed toenails to the pain in her second toe.
With medical treatment, her stools improved. My supervising resident thought she was A-1 after she bought pizza for everyone on Christmas Eve, but I noticed the day-to-day grumbling. She routinely dismissed her son and wanted everyone to cater to her. People with inflammatory bowel disease were notorious for personality disorders. The politically correct and more scientific interpretation was that a painful, chronic disease makes you cranky, rather than an unpleasant personality causing the disease, but I couldn't help wondering in Mrs. Ursel's case.
"Punt her to geriatrics," the consultant said. They had a multidisciplinary team, complete with physiotherapy and social work.
"Thank you. I'll never forget you," she told me when she left. It felt good. I secretly fantasized that she'd tell everyone about me, even change her will to recognize the medical student who had looked after her.
I stopped by geriatrics to visit her after hours, but she was sleeping the first time. I didn't make it back again until the end of my rotation. She'd been in hospital for the entire six weeks of my inpatient rotation and showed no signs of leaving. "She treats this place like a hotel!" exclaimed a geriatrics nurse. "She thinks we're her maids!"
So I knew Mrs. Ursel hadn't changed. I continued on to her room and said hello. "How are you?"
She greeted me with the usual litany of complaints.
I said, "I just wanted to tell you that I've finished my rotation, so I'm leaving the hospital."
She finally paused and cracked an eye at me. "Who will do my exercises?"
Her exercises? It took me a minute to figure out what she meant. St. Finnan's had an Asian female physiotherapist. So four weeks after this woman swore she'd never forget me, she was mixing me up with the only other Asian girl she'd probably ever met.
I had to laugh at my own gullibility. Change her will for me? I'd be lucky if she changed her socks for me.
On the upside, I left internal medicine with a clear conscience. No need to feel guilty about deserting this woman. She'd always look after herself. For all I know, she haunts St. Finnan's Hospital to this day, ignoring her son and railroading the staff into trimming her toenails.
THE END
Copyright 2011, Melissa Yuan-Innes
Originally appeared in The Medical Post, June 7, 2011
Published by Olo Books
http://olobooks.wordpress.com/
In association with Windtree Press
Melissa Yuan-Innes is an emergency doctor who generally cuts her own nails. She lives outside of Montreal, Canada.
Connect with Me Online:
Twitter: http://twitter.com/dr_sassy
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My website: http://www.melissayuaninnes.net/
This story is an excerpt from my book, The Most Unfeeling Doctor in the World and Other True Tales From the Emergency Room
The Doogie Howser Dilemma
As a new physician, you’re worried enough about killing a patient, getting sued, and then getting thrown into debtor’s prison for unpaid student loans without one more stress: patients think you look too young to be a doctor.
Yes, it’s a compliment that they don’t think you need Botox or even Oil of Olay just yet. A French woman put it more poetically, saying I had “l’air d’une jeune fille.” But sometimes you can hardly start the history because they won’t let it go.
I enter the emergency department examining room. “Hi, I’m Doctor--"
The patient’s eyes widen. "You're the doctor?"
I smile and wave the clipboard. "Yes. I see here you've been having chest pain--"
He shakes his head, looking me up and down. "You look awfully young to be a doctor."
I clear my throat. "Well, I'm not. Don't worry about me. As for your pain--"
"You look like you're still in school."
“I’ve graduated.”
"Well, you don't look it. How long have you been doing this?" It took me a while to realize the last question, on its own, can also mean "You look too young and incompetent. Are you sure you know what you're doing?"
The story carries on in The Most Unfeeling Doctor in the World and Other True Tales from the Emergency Room at http://www.smashwords.com/books/view/70044
Cheap Doctors, Unite! (Or Just Fight!)
"We should form a cheap doctors club," said one of my classmates.
"Uh, okay," I said. "Actually, I could use some advice. My parents bought me a case of yogurt drinks, but I opened one and it's moldy, even though it's not supposed to expire for two weeks. I'd bring it back to the box store, but I don't have a car."
She shrugged. "Just bring it back to the grocery store."
"But they didn't buy it there."
"Bring it back anyway. I do it all the time."
Readers will be astonished to hear that I did not do this, despite my legendary Scroogishness. Why? Because my cheapness gene got sidechecked by my ethics gene.
Still, I did plenty of cheap things in first year med school. First of all, I lived in a house with five other students. I noticed other med students were renting solo apartments or limiting their roommates, but this way, the rent was low, and I got to live in a big, sunny house.
Furthermore, in order to help the environment, be kind to animals, and yep, save money, I rarely bought meat. Fake meat did the trick.
My two housemates from Alberta could not understand my vegetarian tendencies. They loved their beef.
“Ewww, veggie hot dogs! Why would you eat these?”
“They’re okay. They taste almost like beef.”
“Can I try some, Mel?”
“Sure.”
Bill took a bite and choked. “Oh, my God! That stuff is vile! It doesn’t taste like beef AT ALL! It’s HORRIBLE!”
“Well, once you put on the ketchup and stuff…”
“No way!”
“You mean, if I put all the dressings on and gave you a taste test—”
“I would be able to tell EVERY TIME! Man, that was disgusting! Hey, Ted…”
Ted took a healthy chew. "Oh, MAN! Was that ever raunchy! That was so bad! Hey, Simon..."
Simon thought it was gross, too, but it didn't offend him as much as it did the Albertans, who practically had an orgasm describing the horror of fake beef. It was like our own Fear Factor episode....
The rest of the tale continues in The Unfeeling Doctor, Unplugged: More True Tales From Med School and Beyond at http://www.smashwords.com/books/view/94743
Enter the Code Blues Contest: The Devil's in the Details!
http://olobooks.wordpress.com/contest-code-bluesdevils-in-the-details/
Do you have funny/sad/horrific/otherwise memorable medical detail that you noticed, either as a patient or a health care practitioner, that you’d like to share?
Dr. Greg Smith wrote to me after reading my medical thriller, Code Blues: "I really enjoyed Code Blues. A bit surreal reading and picturing the areas of [our hospital] that had influenced things….I wished that the oven mitts as obstetric stirrups had made it in, but one can’t have everything, I suppose. Maybe that was only my exam room...Mismatched oven mitts. With no light, so you had to use one of those sproingy desk lamps things to case into the mysterious cavern. When I started practice and had an actual light on my speculum, it was a true revelation when I could actually SEE the cervix."
I don’t remember any oven mitts in my exam room.
But I remember plenty of grotty details I’ve seen before and since! Would you like to share yours? Post your detail in the comments section by midnight on October 31st, 2011 to win!
If you want to be anonymous, Tweet me your entry at dr_sassy or e-mail me at olobooks@gmail.com and I’ll strip your ID before I post it.
If you post on my personal website or Facebook, that’s fine, as long as you know that I will amalgamate all details on this page of the Olo Books website.
No purchase necessary.
Anyone aged 18 & over may enter to win.
Second & Third Prize: your detail will be included in one of my upcoming essays/stories. In other words, everlasting literary fame and fortune.
First Prize: not only will your detail will be included in one of my essays/stories, but you have the right to name a character after yourself or someone else (slander excluded). So, even more fame and fortune. And…a free e-copy of Code Blues! If you already had the good taste to buy Code Blues, you may substitute a free e-book of your choice from Olo Books.
Good luck! Thanks for reading!