Exit Only

Was he ready to paint?

It was early evening and it seemed to me that the crowd had grown each minute for the past few hours. People were arriving at the ER with every possible ailment a person could imagine.

On these shifts that turn out to be some of the busiest, it often includes some of the strangest cases. This one did not disappoint in that regard.

I had just returned from my break when suddenly we had an ambulance arrive with a possible stroke victim. The patient was in his mid forties and from a very large family. His family members came in by the groups. There was upwards of 35 people out in our waiting area to see him, and some were pouring out into the entrance area to take turns smoking. All were anxious and concerned about their loved one, which is understandable.

As the people in registration constantly called back with requests from the stroke victim’s family for updates, the tension increased.

I glanced over to one of our laceration beds and saw a beautiful blonde haired, brown eyed 4 year old girl who was whimpering as she lay there in obvious pain. When she saw me, she tried very hard to muster up a little smile. Her eyes were sad as she laid there waiting to go to xray. I looked at her chart and saw her injury was her left arm that had been slammed in a car door. There was significant tearing of her skin on that arm and it appeared to be seriously injured. Moments later our xray staff came and wheeled her out to the radiology department. I was relieved to know that she would be one step closer to relief and that I was no longer looking at those sad eyes.

I peered out into the waiting area and saw all manner of pain and discomfort as people awaited their turn to be seen. I noticed a disheveled looking man, approximately 40 years old that was sitting and leaning heavily to one side. He appeared to be very uncomfortable and I felt such empathy for him as he suffered in the crowd of those around him.

Time passed by as some patients were seen, fixed and discharged, others were admitted to the hospital for further care and a couple of people left  AMA (against medical advice). What a night, as soon as one or two were discharged and sent out into the world, two or three more came in for help.  The crowd was not diminishing at all, instead it was growing rapidly.

I looked up to see one of our physicians on duty and he looked so tired and weary. I am certain a part of his weariness was due to the fact that patients were so plentiful and there seemed to be no end in sight. As soon as I got a few moments I ran to the break room nearby and got him a fresh cup of coffee. One look at that coffee, lifted his spirits considerably; it felt great to see his spark return as he sipped that cup of coffee. It’s the little things that make life enjoyable or at least bearable.

I had been talking to a patient’s family in an effort to calm them as they were worried about their child who had stuffed a piece of chalk up her nose and they hoped it hadn’t damaged anything in there. It was then that I noticed the 40 year old man who I had observed earlier, as he was wheeled in to a room. He looked even worse than he did when I glanced at him in the waiting room earlier.

Almost immediately, this dishelved male patient was whisked off to xray. I knew something especially bad or potentially bad was a probability in this case. When the xray was back, several of us looked at it with awe. How in this world could someone do this to themselves or allow it to be done to them? This was one of my questions as I stared at that xray.

This man had the handle of a paint roller in his rectum. It was in as far as it could go and stuck there where it had been pushed, or jammed or whatever means of insertion had been used. I now could understand his severe discomfort as he waited outside.

We called and got the operating room personnel set up to take care of him on an emergent basis. He was in jeopardy of all sorts of possible injuries. I learned later that he was bleeding pretty badly by the time he reached the operating room; the paint roller handle had ripped his flesh as it entered his rectum and he was in serious peril. 

Over the years I had seen patients who had anything and everything one might imagine lodged in their rectums, but this paint roller handle patient was the first I had seen.

He was also the only case I had seen that resulted in death from the insertion of a foreign object into their rectum. I thought of this man and his sheer pain, I could still see that  terrified look on his face and it was a sad sight.

Of all the cases I have observed, these are the ones that I had difficulty fully understanding.

Once a male patient said to me, “I was just experimenting”, another said, “When the guys get together to watch football, THINGS happen”, yet one man told me that he had inserted this same screwdriver many times without a problem, but this time it went too deep and he could not get it out. These guys were normal, personable and easy to talk to, yet I still cannot understand why they risk their health, even their lives for whatever pleasure it brings them.

We are all complicated creatures and we all see things from our own perspectives. For me the rectum is an EXIT ONLY orifice.