Now he’s doing the Macarena on the stool.
“Then why do you think he behaves like this?”
She looks at me like I’m denser than a neutron star.
“Isn’t it obvious?” she asks incredulously.
I shake my head to indicate it’s not.
“He’s just curious!” she explains.
Curious George falls off the stool and lands on his butt.
“Ow, Mommy! That hurt!”
“Oh, my poor baby! Come let Mommy give you a big hug, Georgie!”
I’ll probably get a letter from some flesh-eating personal injury litigation lawyer next week.
Cerumen
Last Sunday afternoon the populace stormed the ramparts and our ER was overrun by an army of bellyaches, chest pain, asthma, migraines, fevers and minor trauma. Every time I turned around the receptionist was in dumping a fresh batch of charts on the desk. Sorry, she’d smile at me apologetically before hurrying back to her battle station. Even though I knew it wasn’t her fault, I was beginning to dislike her anyway. Crappy days make me a tad irrational sometimes.
Four hours into the carnage the triage nurse handed me a chart and asked, “Would you mind seeing him next?”
“Sure,” I replied. “Where is he?”
“In the third cubicle.”
“What’s wrong with him?”
“Earwax.”
“Earwax?”
“Yep.”
“Geez.”
Allow me to explain. Ever since I was a little kid I’ve had this thing about earwax. Simply put, I don’t like it. I don’t even like my own earwax, let alone someone else’s. The less earwax I see, the better. My other beef with earwax is that as far as acute-care medicine is concerned, impacted earwax is without a doubt the world’s biggest non-emergency, particularly when the department is under siege.
I marched over to cubicle C with an electron cloud of negative thoughts whizzing around my head: Isn’t this supposed to be an emergency department? Did this guy even try to book an office appointment with his family doctor? By the time I got there I had worked myself into quite a lather. I yanked back the partially drawn curtain and unleashed an intimidating glare. The gnomish 80-year-old man sitting on the stretcher blinked back at me in surprise. Then he smiled widely and said: “Hello, doctor! Sorry to be such a bother. I know you’re terribly busy today.” All of a sudden my petulance atomized. It’s hard to be mad at someone who reminds you of your dear old great-grandfather.
“Hi Mr. Magoo. I’m Dr. Gray. How can I help you?”
“I have a lot of, um… .” He pointed to his left ear.
“Earwax?” I offered clairvoyantly.
“Yes, earwax! Do you have time to flush it out for me?”
“No problem, sir. I’ll look after that right away.”
I foraged the department for the appropriate hardware and returned to his cubicle. First I examined his ear with an otoscope to make sure his self-diagnosis was correct. His left ear canal was indeed chock-full of the stuff. It was Earwax Heaven in there – the legendary mother lode. Next I draped a thick towel around his neck and got him to hold a kidney basin under his left ear. I then went to the sink and filled a large, stainless-steel syringe with warm water.
“I’m going to flush your ear out now,” I advised him. “It’ll probably feel a little uncomfortable, but if there’s any sharp pain please let me know right away, okay?” He nodded assent. I squirted a jet of water into his left ear canal. The fluid that drained back out was completely devoid of earwax. As I turned to refill the syringe with water I noticed him stealthily inspecting the contents of the basin. I flushed again. Crystal-clear returns. You could have used the water in the basin for an Evian ad. I motioned for him to pass me the basin so I could empty it into the sink. Before handing it over he peered into it again and sighed.
“No wax,” he said, his voice heavy with disappointment. I felt like I had struck out with the bases loaded. Call me Casey. Some years ago – never mind how long precisely – having little or no money in my purse… .
“Don’t worry sir, we’re not finished yet,” I reassured him hastily as I dumped the water down the drain. I refilled the syringe with fresh water and tried again. This time there were a few specks of wax in the effluent. When he caught sight of them, his eyes widened.
“Look!” he said excitedly. “Look!”
“What?”
“Wax!”
“That’s nice.”
I repositioned the basin under his ear and flushed one more time. A brownish glob shot out of his ear canal. It looked big enough to be a vital organ.
“Look! Look!” he said, waving the basin around a couple of millimetres away from my nose. Some of the fluid sloshed out onto my lab coat. “A chunk! A chunk!” He was practically yodeling. I hazarded a glance. A huge, turd-like piece of earwax was half-submerged in the now-sludgy water. “I can hear!” he shouted. He deposited the basin on the counter, doffed the towel and shook my hand. “Thank you, doctor!” And with that, he was gone; one helluva satisfied customer. I sat on the stretcher with the intention of taking a 20-second Zen break before rejoining the fray and had an unexpected Damascene conversion. That took all of what, three minutes? How often are we modern-day physicians presented with the opportunity to make a patient that happy with such a quick, inexpensive, low-tech procedure?
So now I try really hard not to kvetch too much whenever someone presents to my ER requesting ear syringing. But I do have to confess - I’m still not that crazy about earwax.
For Better or Worse
I have a real love/hate relationship with my job. Some days I think being a doctor is the best job in the world. Why? Easy:
• It allows me to help people
• It’s exciting
• It’s intellectually stimulating
• It pays well
Other days I’m convinced practicing medicine is without a doubt the worst job ever. Why? Once again, easy:
• It’s stressful
• It invades my personal life
• It burdens me with an absurd amount of responsibility
• It exposes me to a never-ending stream of demands from the public
Most days I’d never consider doing anything but medicine for a living, but there have certainly been times I’ve sworn I’d sooner dive head-first into a wood chipper than work one more shift in the ER.
One day recently my feelings regarding medicine went from one extreme to the other within a span of 30 minutes. Here’s how it happened.
As is often the case on Wednesday mornings, by 10:30 the ER was completely gridlocked. When a cubicle finally became available, the nursing supervisor went out to get my next patient. To my dismay, she returned with Blair Neanderthal.
Blair is the president of our local Society for the Advancement of Alehouse Brawling. His abrasive personality is legendary. Unfortunately for me, this knuckle-dragging troglodyte also happens to be my patient. I hadn’t seen him in more than a year, which made me wonder if he hadn’t just completed yet another “timeout” in the slammer.
I reviewed the triage nurse’s note. “Dental infection.” Seemed fairly straightforward. I stepped into his cubicle and just about bounced off the force field of hostility crackling around him.
“I’ve been waiting for over an hour!” he barked.
“Sorry, Mr. Neanderthal, it’s been super-busy this morning. How can I help you?”
“I’ll tell you how you can help me! You can fix these!” He peeled back his chapped lips to give me a terrifying close-up of his furry, yellow teeth. I cringed.
“I agree – your teeth look pretty awful. Have you been to the dentist?”
“Dentist? Dentist? Don’t talk to me about the dentist!” he roared. “He wants to charge me 70 bucks for each tooth he pulls! 70 bucks! Do I look like I’m made of money?!”