Sunday, December 13, 2009

gangrene is the worst smelling shit ever

yesterday i was on call again...7 am to 7 am sat-sun. no prob. it was pretty slow, actually. first page was an alpha (which means get your butt down here NOW)...unfortunately the patient had already expired en route but the ER went through the ACLS code algorithm anyway. it was surreal...strange to watch, but at the same time i needed to watch it. first code i've witnessed as an med student. then we had some really long stretches of nothing. i knitted a lot, and i think i'm nearly done with my scarf. (i've been knitting this thing for about 3 years now i think.)

i went to bed around 10:00 pm or so, and wasn't paged until 4:30 am! i can't believe it! i actually woke up every few hours out of instinct i guess to check my trauma pager to make sure i hadn't slept through anything, but i'm really good at waking up to outrageously loud annoying beeps. i keep the pager right next to my head while i'm sleeping so i wake up pretty quickly. evidently there were 2 surgeries that were about to go: an open appendectomy and debridement of fournier's gangrene.

the open appy was already rolled back, so my call partner scrubbed in that one since i had already scrubbed in a case. so i waited for the fournier's. basically that's when a dude's scrotum and associated area becomes infected with GANGRENE and turns's a total emergency and the only solution is to cut all the nasty out. omg, when the patient was finally rolled back, the stench was AWFUL. i can't even describe it...the worst smell ever, like poop and sewage sludge and rot and dead stuff all rolled into one. one of the residents told me to remember that smell because "that is the smell of death" because, well, the tissue is literally dead and rotting away. it was blackish brown and dripped juices. i even put cinnamon oil on my mask to help deaden the smell and it DID NOT work! everytime we had to move the patient, a waft of horrible stench would come out on top of the base layer of stench. the fifth year resident who went to task debriding the wound, well, he has a nose of steel. i couldn't have done that. i had to step back and just hold my gag reflex in check. (one of the ER nurses earlier told me "now you get to decide whether you want to dry heave or blow chunks!" in response to my musing of whether or not i should grab some food before the case.) the sight of it was gross, definitely, but the smell. omg the smell. ugh. the trauma attending goes MED STUDENT GO IN THERE AND HELP OUT! then he laughed. so i did just that, took some scissors and cut out a chunk of foul, dropped it in the bucket, and then said "ok, i'm a pansy, i can't handle it. look, i got juice on my hands (gloved, of course), so that means i experienced it, right?" the attending laughed some more and was like "ok you're good, but the smell, it's nothing!" then he took his mask off and sucked in a HUGE BREATH...everyone in the room just groaned. he must have a defective nose or something. so after that, i just stood by the scrub tech's table and watched from afar. after about an hour of torture, a different resident asked me to scrub out and print out some admission orders, which i gladly did, and then it was time for me to leave (thank goodness).

the worst part about it all? the smell seeped through my gloves and got on my HANDS. no juice on my hands, but the SMELL. omg. i had to wash my hands so many times to just get rid of the smell, and i'm still having horrible thoughts about the stench. i hope the patient is ok, but in reality, he's not going to be ok. he was really sick going into the surgery, and from what i could tell, he'll end up with a colostomy (where he poops in a bag outside his abdomen) and some sort of stent or tube or something in his bladder area because even though i couldn't see the penis (due to the ginormous scrotum that was all swollen with infection), i can assume they probably had to cut it off or do some serious damage to it.

so note to self: keep all your parts clean! stay as healthy as possible!

after i got home i had some breakfast with H, read some magazines for free, visited with K, napped, gymmed, and ate lunch/dinner. i suppose i should read some now. one more week of plastics then 2 blessed weeks of winter break! yay!


Anonymous said...

Re: stench

Your mistake was leaving the Smell. If you can stand about 10 minutes of intensely foul odor, your nose will become desensitized (or overloaded) and the Smell will no longer be unbearable. If you gulp fresh air, however, the Smell will be just as intense when you return to it. That's why your attending was laughing.

As for the smell on your hands - double glove.

frylime said...

oh, i was in there at least a good hour or so and my nose never desensitized...i was hoping that would happen but it never nose is a weeny...

Anonymous said...

>>i was in there at least a good hour or so and my nose never desensitized>>

Ah, I misunderstood. You said you stepped back and stood by the scub tech's table.

I guess I should be thankful my nose can tune out gangrene and decomposition.

One of my friends once told me to select a practice specialty based on the substance that disgusts you least (blood, feces, vomit, pus, etc.). She's a pediatrician, and no, I never asked her.

chasingzebras said...

Guess I was lucky - I scrubbed into 2 fournier's and the smell wasn't that bad. I think I remember one of the residents saying it wasn't as stinky as usual. Poor stinky hands :(

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Danielle Walters said...

Old rule in nursing was to chew gum helps with the smell!!it goes long with the rest of this response from the previous person