butt pus
Several days ago, I wrote a post that prompted a lot of comments about butt pus, which reminded me of a story of when I was a medical student. So today, on my last day of residency, I'll re-tell the tale that happened when I just started out on this long journey to becoming a surgeon seven years ago.
My surgery rotation was the last of my third year. After being on the service for a mere four days, I had decided I could do nothing else except be a surgeon; these were the people with whom I was meant to be and this was what I was meant to be doing. I told my residents as much and they could see my enthusiasm. They let me do more than other medical students because, let's face it, if you're going into radiology, you're not going to need to know how to tie.
One of the calls that had come in during the day was a perianal abscess that had come into the emergency room. We had just finished one of our weekly conferences, where we were all supposed to dress professionally and not just in scrubs. I went down with the chief resident, also named Nicole (note the lack of an "h"), who told me she was going to walk me through the incision and drainage of the abscess. The butt pus, if you will. From what I can remember, it was a young man, not many medical problems except the painful, giant, pus-filled pockets around his anus. (Again, I'm rolling my eyes at the google hits I'm going to get with this word, but what are my choices?)
Before we went into do the procedure, she explained how she was going to numb the area and the kind of incision I was going to have to make to adequtely drain the area. I was nervous, but excited. I couldn't get into any real trouble... I was with my chief.
We warned the patient the prick of the needle that would deliver the anesthetic was coming. After a few seconds elapsed to let it take effect, she motioned over the abscess where I was going to make my incision. I grabbed the scalpel and make the ellipcial incision and removed a little piece of skin. (We take out a bit because if you just make a linear incision, the skin could heal before the abscess cavity and you can have a re-accumulation of pus which would require another drainage procedure.) But there was no pus there. She had warned me about this. That it might be a little bit deeper and I would have to probe with an instrument and break up separate cavities.
She handed me an instrument and I started to dig a little. Well, dig gingerly. She kept frowning. "Where the hell was the pus?" she communicated nonverbally.
"Let me try something," she tells me. Fine by me, I really didn't know what I was doing anyway. She digs now, albeit a little more agressively.
"Sorry, sir," she apologized, which was more an acknowledgement of the pain that we were causing him and less of an assurance that we were close to being done.
She put down the instrument and begins to squeeze the affected area. Yeah, squeese like a giant zit. After all, that's what it was.
The pesky little bastard gave. We found the motherlode of pus. It came flying across the table... and landed on the hair that was draped over my right shoulder and on my silk sweater.
My eyes got really big and I stepped back from the gurney. "Oh my God, did it get me?" I whispered.
"Let me see," she said. I walked over and she inspected my shirt. "No, I don't see anything."
"But I smell something," I insisted. "Are you sure?"
She looked a little harder. There was a small intake of breath. "Oh... yeah. It's right there," she said as she pointed at my right clavicle.
If you've never smelled butt pus, let me assure you, you only need a few tiny little drops to know it's there. And these were small drops... like condensation on a flower in the morning. Except it wasn't dew on a rose. It was butt pus. On my hair and sweater.
"Why don't you go get cleaned up? Go home and shower and come back." Even as a young medical student, I knew the magnitude of this gesture. Surgeons don't leave the hospital if they get blood on them. They clean it with a little soap and water, change their scrubs, and keep going. Most of the time, they don't even miss a step. But I was being sent home. Which was a good thing, because I think I might have eventually thrown up at my own stench.
The news of my misadventure in the ER spread like wildfire. Actually quicker than wildfire, because one of the interns ran around the surgical floor spreading the story. When he was done there, he went to the OR and told each and every operating room team what had transpired.
When I returned to the hospital, people were asking me how I got my hair to be so shiny and smooth. Was it the butt pus conditioner I was using? Ha ha, very funny.
And from then on, I was known as the butt pus girl.
Rox on Fox
