When elderly patients blurt out obscenities, most of the time it takes everything I can do not to laugh out loud. No offense intended. I just get flashbacks of my mom sitting and putting her fingers in her ears while watching scenes in certain movies or seeing her gasp in shock if an F-bomb catches her off guard. I don’t expect to hear obscenities from someone who just rolled by me with a walker. For example, a while ago I posted a story about one lady from a nursing home who caught me off guard with an MF-bomb.
But this post came about from another patient encounter that made me reflect about how the things that doctors say to patients can affect a patient’s perception.
Enter the elderly patient who hobbled past the nursing station and into a treatment room with the help of her walker. As soon as we saw the chief complaint of “rectal pain” pop up on the tracker, everyone hoped it was a hemorrhoid and not a stool impaction. The other doc pretended he didn’t see the patient go by and headed into another room to see a different patient. I put my name under the “assign doctor” tab and went into the room to see her.
“Hi! I’m Dr. WhiteCoat. How can I help you today?”
“I’m having pain in my rectal region, doctor.”
Then her husband jumps in “She had surgery to fix a fissure a few days …”
Esther got upset. “You let ME tell him, Herb. It’s MY rectum.”
Herb shut up.
“I had surgery to fix an anal fissure a few days ago and I’m still having pain in the area – especially when I go to the bathroom.”
I got some more history and then had her get undressed so I could look at the area. While she described what had taken place over the past few days, she was obviously upset about her outcome.
Esther wasn’t a petite woman and she wasn’t quite as mobile as most patients. The nurse had to help her get into a gown and then helped pull down Esther’s pants. I could immediately see why Esther was having pain. There was extensive bruising to the inner aspects of both buttocks.
“Have you told your surgeon about this?” I asked.
Despite having a spine contorted from years of progressive osteoarthritis, Esther managed to twist herself sideways to give me a stern look and resolutely state “I am never talking to that goddamn sonofabitch again in my LIFE!” She then flopped back onto her stomach on the bed.
Herb started to chime in. “We went to Dr. Rectum’s office yesterday and …”
Esther’s voice, muffled from the pillow, still cut him off. “Herb, it’s MY body. Shut up.”
Herb shut up.
“I saw the bruising yesterday, so we went to Dr. Rectum’s office yesterday to ask him about it.” She explained. “That sonofabitch told me that my butt was so big he had to have two fat guys from the hospital boiler room come and pull my butt cheeks apart so he could finish doing the surgery.”
I raised my eyebrows at him and softly shook my head.
“OK, Esther, we’ll get you some medicine for the pain and I’ll give one of our other surgeons a call.”
The other surgeon who covers for Dr. Rectum was out of town, so I ended up talking to Dr. Rectum himself.
“Bruising is normal after surgery like this.” He said. “Hers was a little more than usual, but she’ll be fine. Part of it is because of her size. We had a little difficulty retracting her buttocks. Tell her to take it easy on the opiate pain medications and continue the Sitz baths and cool compresses like we discussed. She can see me in a few days if she’s still having pain.”
“She’s pretty upset with you,” I told him. “She said you told her that her butt was so big that you needed two men from the hospital boiler room to come and hold her butt cheeks apart.”
“I told her that the traction from the tape we use is what probably caused the bruising. I jokingly told her that it wasn’t like two men came in from the boiler room had to hold her buttocks apart. And I never said anything about the size of her rear end.”
“That’s not how she remembers it. She’s refusing to ever see you again.”
“I’ll call her to apologize. My gosh. That didn’t go very well, did it?”
I told Esther what Dr. Rectum had said.
More profanities. No change of heart. She remembered what she heard, she didn’t think it was funny, and she was NOT ever seeing Dr. Rectum again.
Dr. Rectum is a good doc, but his misguided attempt at humor torpedoed the care he provided … and he was lucky that the patient didn’t complain to the administrators about her perception of a statement that men from the boiler room came into a surgical suite while she was under anesthesia.
So Esther was discharged with some stool softeners and a few pain pills.
As she was getting dressed, Herb nudged me and whispered “I thought it was pretty damn funny when she told me.”
I smirked a little and whispered back “Any good comedian knows his audience.”
Making cracks about the posteriors of hearing impaired little old ladies – definitely not doctor’s office material.
This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.