A patient wanted me to drain a sebaceous cyst that was causing pain on his back. I told him that it would be better if it was removed intact by a surgeon, but he didn’t want to wait to have it done. OK, no problem.

I got out a needle to anesthetize the area, the patient took one look at the needle, and he nearly DFOed on the floor. Got all sweaty and nearly puked. We had him lie back on the table, but he couldn’t lay flat on his back because the cyst was hurting. So he laid on his side – facing the nurse.

I told him that I was going to start numbing up the area. Then I looked at the nurse whom he was facing toward, gave her a smile and a wink, and mouth the words “Now he can puke on YOU!” I made the universal puking hand gesture while sticking my tongue out just to emphasize my point.

The nurse curled up her lip at me and moved down toward the foot of the bed a little further.

I leaned over and cleansed the surface of the cyst, started to inject some of the lidocaine and then that old lady karma smacked me in the head.

As I was injecting, the extra fluid apparently increased the pressure inside of the cyst. The point of the cyst popped open and spit lidocaine and cyst fluid all over my face.

Got sebum in both eyes, up my nose, in my hair.

You can’t imagine what sebaceous cyst fluid smells like until you get some of it stuck to your nasal hairs. Like someone cracked an egg in an old tennis shoe and let it sit in the heat for a couple of days.

I sat over the sink flushing my eyes with water. I even squirted saline up my nose to get rid of the smell. Didn’t work. Sucked on mint Life Savers and all I could smell all day was peppermint Nikes. I didn’t even try to eat lunch.

When I walked out of the dirty utility room, the nurse was just standing there with a smirk on her face.

Laugh it up, sister.

Just remember that Karma Avenue is a two-way street.


  1. Ah, Man! Bummer. I had forgotten about that rank smell until you reminded me. Now I’ll be smelling it all day. Face shield/Universal precautions, Dude.

  2. Dude. That’s nasty, and it beats my sebaceous cyst story. As a student, I was removing a cyst when I fleetingly thought, “wow, my glasses are small, I probably should have put on those geeky big plastic ones, naaaah.” Within seconds, it all came squirting out all over my face, including dangling from my hair and covering one lens of my glasses. Even though I didn’t get it in my eyes or nose, I could still smell it all day —sure feel for you! Did you try bengay under your nose? Or the stinky stuff you put in your mask during anatomy lab?

  3. That’s why I always wear a face shield now for abscesses. People make fun of me but I don’t get lido and pus in my eyes. Sorry, dude. It was funny, though…

    • Had a colleague from South America on shift when a botfly case came in during residency. Had the patient go outside with a nurse who smoked and had the nurse blow cigarette smoke at the hole in the lesion – the larvae came out on their own – no muss, no fuss. Never seen anything like it!

  4. I checked that out Throckmorton. Wondered what the heck a Bot fly was but figured it can’t be good.

    So I watched a youtube… just before eating dinner.

    EWWWWWWWWWWWWWWWWWWWWWWW! This guy had at least a few to be pulled out of his back and one was right behind the other. For some reason.. they had duct tape over the Bot fly area until ready to remove. (All from mosquito eggs.)

    What in the world does it feel like to have those big or little things crawling in there? talk about one’s skin crawling. eWWWWWWWWWWWWWWWWW!!

    But these were *so big*.. you could fry them up for dinner… or lob them through the air with a racket.. or baseball bat.

    I also wonder what it feels like to have them pulled out? Does it hurt or is it a relief? EWWW!

    If something like that was in me… I’d have psychological trauma!

    I would also be afraid if I was the one pulling them out.

    Also ..so glad to be living up north!!

  5. WC.. I would’ve been freaked out if that happened to me. Again.. it takes a strong person to handle these things… medical experiences. I’d want to be selective.. but you all have to do it all… to facilitate healing in whatever form.

    Thank you. 🙂

  6. OK…LOL. You’ll do for my Nurse K replacement fix. 🙂 I know she mentioned you a lot in her blog…but I never popped over to your site.

    Just started nursing school…hopefully I’ll get to work with some cool doctors like you! 🙂

  7. Makes me feel better about the time warm urine was splashed in my eye. Cyst gunk way worse in my opinion. Maybe we both should be wearing masks? Toni

  8. Mottsapplesauce on

    Totally disgusting WC, but I love the fact you’re a good sport enough to poke fun at yourself with this post. Wear the PPG next time?

  9. We have botflies in Michigan but they only affect squirrels and rabbits. No human botflies in the US that I know of.

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