The Frickin' Finger of Fate

Hail,
Sunday evening, late Spring, the horses stand in the paddock and the chickens roost. We have nine white kittens in the bedroom corridor and a pining mother outside.

And if anyone has ever desired to knit a life-size model of the human gastro-intestinal system, here it is.

Now, I suspect that may be a small proportion of you, so what has happened in the last few days that may be of more general interest?

Well, I worked over the weekend, and we had three very different days. I warn those of an easily offended nature to turn away now. The following contains Adult Themes and Bottoms.

Friday, through the previously mentioned "Emergency Department Law of Association", was bum day at Florey. Three of the first four patients in our end of the ED had what more genteel readers would call fundamental problems, and since the intern managed to grab the one non-rectal patient and "look after" their mildly strained knee for ninety minutes, I looked after all three, one of whom was quite unwell, one very nervous and the other of whom struggled to contain her laughter as I asked her a series of questions about what I felt were deeply unlikely sexual practices.

Four years ago, when I was an even more nervous intern, working in the Emergency Department at Lazarus, I saw a woman who had been involved in a very minor car accident. She had been reversing out of her parking space in a shopping centre and another woman, doing almost exactly the same, had collided with her. She presented to the ED more out of a sense of duty than anything else, and after the obligatory four hour wait, was more than a little tetchy.

I went in and checked her out, and as required, went and presented my findings to the senior doctor - who, I suspect, may have used this opportunity to amuse himself.

"And did you do a full neuro?" he asked.

"Full neuro?" I asked. A full neurological examination, depending on how thorough you want to be, can take anything from fifteen minutes to half a day, and involves checking as many of the functions of the brain, nerves and spinal coloumn as you can think of. "Not a full neuro, no".

"What about the PR?" (Again, a translation - this means a digital rectal examination. It's exactly what it sounds like).

"She reckons neither car was going above five kilometres an hour - " I began.

"So you'd be prepared to stand up in court and say you have definitely excluded cauda equinae? Or transverse myelitis? Or even Guillain Barre Syndrome?"

"well, I didn't think it was that likely - "

"Would you repeat that statement for the benefit of the members of the jury, Dr Bronze?"

And so I went in to explain my new course of action to Mrs Stentor, who was waiting for me with obvious impatience. She was a no-nonsense farmer's wife, and had already got herself out of her gown and back into her clothes.

"Umm, I'm afraid I'm not quite finished yet, Mrs Stentor."

"WHAT?" For the first time, I noticed how remarkably loud her voice was.

"It's just that - "

"LOOK, SONNY JIM. THERE"S NOTHING WRONG WITH ME THAT GETTING OUT OF HERE WON'T FIX. I'M SURE YOU MEAN WELL, BUT I'VE BEEN WAITING HERE IN THIS FREEZING COLD FREAKHOUSE FOR FOUR BLOODY HOURS!!"

"It's just one quick test"

"BOY, I WANT TO GO HOME AND ENJOY WHAT LITTLE TIME I HAVE LEFT WITH MY FAMILY. WHY DON'T YOU JUST RUN ALONG AND LET AN OLD WOMAN LOOK AFTER HERSELF"

"I'm still a bit concerned about your neck."

"WHY? I'M NOT" she hollered. "SEEMS PERFECTLY FINE TO ME!!" And she wobbled her head around like a bobble-head doll, making me bite my knuckles in terror. Something in my appearence must have aroused some sympathy. "SO WHAT DO YOU WANT TO DO?"

And I launched into my rather lengthy spiel. About how damage to the spinal column can be very subtle. About how signs of damage, if detected, can alert us to the possibility of spinal damage early, rather than late... early enough to do something to prevent further damage. About how often the first sign of damage to the spinal column was loss of function of the small muscles around the anus, those of the external anal sphincter. And how any weakening of the muscles could be detected by digital rectal examination, which could... and gradually I realised that her eyes had glazed over.

"DIGITO RECTO WHAT?" she said.

"Examination" I said, and gave her the Readers Digest condensed version. "It's the easiest way to tell if there has been damage to your neck. The best way to tell if there is any damage to your neck is to insert a gloved and lubricated finger into your ... bottom and - "

"MY ARSE?" she screamed. "YOU WANT TO STICK YOUR FINGER UP MY ARSE? - OH MY GOD!!"

"It's just that - " Outside, I could hear murmuring, as if of a small, but increasingly irate crowd, gathering.

"WHAT DO YOU WANT TO DO THAT FOR? MY GOD! WHAT KIND OF PERSON ARE YOU?"

I backed away. The crowd shuffled closer. "Ms Stentor, the only way we can exclude any kind of neck injury is to insert a finger -"

She did not wait to hear more, but gathered up her possessions and stalked towards the door. As she left the room she turned for one more confirmation of what she had heard but found impossible to believe. Her voice fell to a whisper. "You honestly expect me to believe that you can check out my neck by shoving your finger up my bum?"

I nodded. Several other patients seemed to take this as an admission of guilt on my behalf. "Yes, it's called a digital rectal examination. We insert -"

"HA!" she screamed, as if having all her suspicions confirmed. She stalked out of the department, brushing aside the passers by. I stood there, as flummoxed as I have ever been in my life. There was a brief pause, and then the doors opened again, and she leant her head in and fired her parting shot: "HOW LONG'S YOUR FRICKIN' FINGER?"

Well, sorry about that. And to make matters worse, the next post is all about willies.

Thanks for listening,
John