Emergency services at my hospital.
8:30 am after 12 hours of night shift. I am slightly confused/dizzy.
An old man comes in with his son.
“Hello sir. This is my father.”
Me : Hello. What brings you to the casualty today?
Son : He has not been able to pass stools for the past 5 days.
Me : Okay. Any other issues/co-morbidities/dietary problems ?
Son : No, sir. Nada. He is perfectly fine otherwise.
Father was quiet all this while, sitting slightly slouched and not making an eye to eye contact. He might have been feeling terribly ill.
Fellow casualty doctor : This is not OPD and this clearly is an OPD case. It’s not an emergency . Please take him away and bring him back tomorrow.
Me : It’s not an issue sir. I’ll handle it before going home. Last case of the day.
So, (addressing the father) : Sir, will you like to tell me about this condition of yours ?
No response.
Me (examining the pulses and abdomen) : Let’s get a X ray of the abdomen and chest done. Maybe there is some organic cause. (He had already taken a purgative with no results).I could not find anything except what was probably feces, since the abdomen was doughy. No pain, no tenderness, no mass or anything suspicious.
Son : Okay sir.
Uncle’s still suspiciously quiet.
15 minutes later, X ray :
Some air under the diaphragm ( damn you, perforation )
and something else also (representative picture from Google images)
I am confused, dizzy and unable to comprehend the situation.
Took him to a senior officer there. Told him the situation.
He asked the patient how had this happened.
It turns out, in the ‘heat of the moment’ while doing some carnal exercises alone, Uncle had accidentally put it there and could not figure out how to take it out. He wasn’t mentally ill. Just forgotten to take it out, or rather, was unable to take it out.
You’ve got to be kidding me, man. You shoved up a complete Pepsi Pet bottle up your ass.
He then went on to get a laparotomy done, whereby his rectum was found to be perforated. He had to live with a stoma for some time.
Wild, wild world. Within 6 months of starting clinics, I got a hang of what crazy must be like.
Thanks for the edit suggestions Mr Narottam