The Do It Yourselfer

Humor – 4 Pages –

“When we finally came to rest, I was spread-eagled over an obese, senile naked lady in a lake of diarrhea..”

I’m proud of the fact that I’m self sufficient in the ED. And it irritates the fire out of me to see prima donnas, read surgeons, come into the department and require the entire staff to follow them around to do little things they could do for themselves.

Perhaps I was taught well by the charge nurse where I did my training. She was a heavy set matronly type with a ruddy complexion. She still wore her nursing school cap that said St. Francis over her hair that was tightly pinned and covered with a net. She once came out to the nurses’ station to confront me where I was writing a note after suturing up a wound. Having seen the mess I had left from the procedure, she brought out a whole roll of plaster casting material, a bucket of water, and a sling and put it on the counter. Deep in thought, I didn’t notice her at first, but her rapid foot tapping drew my attention and I looked up to see her glaring at me.

“What’s all this stuff for?” I asked.

“Well, I saw the mess you left,” she said. “And I just assumed that both your arms were broken.”

“Yes, ma’am,” I said instinctively, reaching back into my childhood of groveling. “I’ll clean it up, ma’am,” I said as I walked briskly to the room.

“You’re damn right, you’ll clean it up,” she lectured, following me into the room. “Or you WILL have two broken arms.”

“Yes, ma’am,” I repeated several times. The scene was a déjà vu of childhood when my mother would make me select the branch with which she would thrash me. Needless to say, the lesson in self-sufficiency took.

I learned how to do everything on my own. Of course, my wife is incredulous. She thinks that every time I forget to take out the trash it’s because I have an entourage of nurses following me around at work picking up after me, handing me instruments, saying “Yes, doctor”, and mopping my brow. The reality is that I work for the most part solo. And if I don’t do it, it probably won’t get done.

But sometimes trying to do it all without assistance can get me into trouble. Like the other night. I knew as soon as I arrived that I would be on my own. The waiting room was full and the racks were jammed with charts. Everyone had their task.

Several hours into the grind, I picked up a chart with a name I recognized. Ethel Barnes was an elderly patient from a nursing home that I had seen many times before. She was morbidly obese with thinning snow white hair and skin to match. Unable to walk any more, she was confined to a wheel chair. And despite suffering from severe dementia, she seemed to have a jolly disposition. She just sat in her chair all day smiling and drooling. Every now and then she would make a noise that sounded like Chewbacca from the movie Star Wars. The clinical picture was always the same. Having had multiple abdominal surgeries over the years, her adhesions precipitated multiple episodes of bowel obstructions. But because of her sunny disposition, no one could tell she was in trouble until her abdomen blew up.

It was the same story tonight. The nursing home sheet just said “No stool for one week.” And I’m sure they just kept on feeding her, I thought to myself.

There was no other history. The exam was predictable. The vitals were normal as was everything else except for her massive, distended, silent abdomen. She seemed oblivious to her condition. I ordered the basic labs and an abdominal series of xrays to rule out another obstruction and dashed off to the next patient.

About an hour later her chart re-surfaced. The labs were all normal. The xrays, too, were unremarkable, except for the huge amount of stool present in her colon. I went back to the room to make a final check before sending her back to the nursing home. They can clean out her gut just as easily as we can, I mused. But when I opened the door I found Ethel still sitting beside her bed in a wheel chair, where the tech had left her, surrounded by a huge pool of diarrhea. It had overflowed her Depends, filled her seat, run down her legs and formed large brown lake. She just sat there grinning.

“Ethel, Ethel, what am I going to do with you?” I asked out loud to no one in the room but her. “Well, first we have to get you out of that soiled hospital gown.”

By stretching my legs as far as they would go I was able to straddle the puddle and reach her neck to untie the gown. Pitching it to the side, I then unwisely decided to attempt the “one-man move the fat lady to the stretcher maneuver.” While facing her I reached under her arm pits embracing her in a giant bear hug and lifted with all my might. Once I had her massive hips lifted from the chair I quickly lifted one leg and kicked the wheel chair out of the way. My plan was to make one large step over the puddle and muscle her onto the clean bed. And it worked until her sagging buttocks hit the unlocked bed, sending it rolling across the room. Now I was stuck with her suspended over the muck.

The coup de grace was when my chair kicking foot landed right in the edge of the puddle of stool. I wasn’t worried about my shoes. But my foot started to slide ever so slowly. I tried several times to regain my footing, even finally sacrificing any hope of saving my shoes. But nothing would stop our relentless slide to the floor. Each inch of horizontal slippage translated directly into excruciatingly slow downward momentum. It was inevitable. Wishing to save my hands from complete contamination, I finally pulled them from under her arms and rested them on her shoulders for the last stage in our voyage together. When we finally came to rest, I was spread-eagled over an obese, senile naked lady in a lake of diarrhea.

“Help,” I called out softly, not wishing to draw too much attention to my predicament.

“Help,” again somewhat louder. Finally in full voice, “I need some help in here!”

“Doctor Plaster is calling for help in room 12,” I heard someone shout in a panicked voice. Oh no, I thought. They think it’s a code. The door flew open and Jo Ann the charge nurse just stood there frozen.

“What are you doing?” she deadpanned in disbelief.

“I was sailing on the $#!+ Sea and got marooned on Blubber Island!” I yelled. “What do you think I was doing? Help me get off of her.”

Ethel just smiled, drooled, and gave out a loud ‘Arrgggh!’

As expected everyone came running up with the crash cart, stopped, saw what was going on, and then began snickering. After my rescue and clean up the rest of the night went without hitch, except for the sailing comments.

“How big is your boat?” was the favorite. I couldn’t wait to head home.

“How was your night?” my wife asked in her usual fashion.

“You don’t even want to know,” I said with a look that warned her not to pursue the issue.

“The toilet’s not working again,” she said taking the lead to move on.

“Oh, I can fix that. The plumber always charges an arm and a leg. I’ll do it,” I said.

“You are going to fix the toilet by yourself?” she said incredulously. “You …,” she repeated slowly.

Our eyes met in a long question. “You know,” I finally said. “On second thought, he has tools I don’t have.”

Originally posted 04/05/2006

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Dr. Mark Plaster

Dr. Plaster has been an emergency physician for more than 30 years, working exclusively night shifts for the past 20 years in emergency departments across the country. During that period, he joined the U.S. Navy and served two tours in Iraq. Dr. Plaster is the founder and executive editor of Emergency Physicians Monthly and the founder of Plaster Publishing. Note from Editor: He is still publishing articles today! Read more of his work at:

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