“Snip, snip,” they cackled.

“Yeah, I love you guys, too. Say hi to Macbeth for me!”

I stepped through the sliding doors and into the OR.

Irene the head OR nurse was a cheerful, matronly type.

“Dr. Gray, I see you’re here to get ‘fixed’ this morning! Har-har! Come, lie down!” She patted one of the operating room tables. I reclined on the cold table and tried to relax, but it’s hard to unwind when you’re minutes away from having the family jewels carved up. After Irene finished setting up the surgical accoutrements, Dr. Hill arrived. The quintessential man of few words, he pulled on his gloves and padded over to me.

“Ready?”

“I guess.”

Irene lifted up the front of my gown to expose “the field.” The room was chilly, and as a result “the field” had shrunken considerably. Fortunately for my self-esteem, there were no gales of hysterical laughter. After scrubbing the area with antiseptic solution, Dr. Hill picked up a syringe.

“Freezing,” he said. The injection wasn’t nearly as painful as I had expected, but I broke into a sweat nonetheless.

“It’s all right, Dr. Gray,” said Irene. “Here’s a cool cloth for your forehead.” The cloth was surprisingly soothing. I closed my eyes and felt my body begin to loosen. A few seconds later Dr. Hill began cutting.

I daydreamed.

Hey, this isn’t so bad…  .

“Gauze,” said Dr. Hill.

My afternoon office is pretty reasonable today, so with any luck I should be home by 4:30… .

“Forceps,” said Dr. Hill.

That’ll work out well, because we have a 5:00 appointment for a family portrait at the photo studio.

“Sponge,” said Dr. Hill.

As long as I don’t have to lift the kids, I’ll be fine… .

“Cautery,” said Dr. Hill.

What’d he say? Cautery? Down there?

Zzzzt! Zzzzt! ZZZZZZZZZZT!

The world’s biggest lightning bolt crashed into an exquisitely sensitive part of my anatomy. I arched so rigidly, only my heels and the back of my head remained in contact with the table.

“Yaaaaaaaaugh!”

Dr. Hill looked sideways at me.

“Did you feel that?”

“YES!”

“Oh. Sorry. Irene, could you get me some more freezing please?”

Even though the rest of the procedure was completely painless, I was so paranoid about the possibility of another close encounter with Thor that I wasn’t able to relax. When everything was finished I thanked Dr. Hill and Irene and gimped back to the locker room.

Due to a few last-minute add-ins, my office didn’t finish until 5:00. I raced home to get ready for the portrait. While I changed into fresh clothes Jan asked me if I was sore.

“It throbs like hell,” I replied. “I’ll take some Tylenol when we get back.” We rounded up the kids and drove to the studio.

“Okay Janet, move Ellen a little bit closer to you. Donovan, could you please lift up Kristen and Alanna and put them on your lap?”

“But - ”

“Trust me, it’ll make a great shot.”

“But - ”

“I’m telling you, it’ll be perfect. That’s right…now Alanna… good. Um, Donovan?”

“Yes?”

“Are you okay? You look like you just got kicked in the you-know-whats… .”

Last Call

Recently I was paged to the emergency department at 3:00 a.m. to stitch up another Jethro. This guy was totally hammered. The story was that he was drinking peaceably with his honey when all of a sudden she up and smashed him in the head with a beer bottle. Damn! Second time she’s done that this month! Funny how these guys fall prey to so many unprovoked attacks. I’ve had several drinks with my wife over the years, and I honestly can’t remember her ever bashing my head in with a beer bottle.

Anyway, I set up all of my suturing material, cleaned off his shard-filled forehead and was just about to begin stitching when he yammered, “Hey! W-w-w-wait a minute!”

“Why?”

“I gotta take a leak.”

He rolled off the stretcher, staggered to the adjoining bathroom and slammed the door shut. Moments later I was treated to the sound of a torrential stream of used beer. Within a minute he was finished.

Watching him navigate his way back to the stretcher brought to mind images of a sailor trying to walk across a ship’s deck in the middle of a typhoon. He plopped back down on the gurney and promptly fell asleep. It wasn’t long before he was snoring like a hippo.

I quickly sewed him up (no need for local anaesthetic this time, folks), peeled off my gloves and got up to make arrangements for him to be observed in the department for a few hours.

I was halfway out the door when I heard a slurry, nearly unintelligible, “Heyyy doc, hang on a shehcond…come ovah here… .”

I turned back, intrigued. Was this guy actually going to thank me? That’s a rarity at 3:00 a.m. Most times I consider myself lucky if I don’t get barfed on.

“Heyyy doc… .”

“Yes?”

“Can you lend me 20 bucks?”

Drug Charades!

Anyone who’s worked in an ER knows about drug seekers. They’re those incredibly annoying chuckleheads who are forever trying to con us into giving them prescriptions for certain drugs. OxyContin is their Holy Grail, but Percocet, Dilaudid, fentanyl patches, or just about any narcotic will do. Sedatives and stimulants are also welcomed with open arms.

Drug seekers all seem to have cribbed notes from the same manual. They come to the ER after regular clinic hours because they know it’s harder for us to crosscheck their hinky stories when other doctors can’t be reached. It’s not uncommon to hear tales of woe involving pills that have been misplaced, stolen or eaten by the family pet. To improve their odds of getting something high on their wish list they usually claim to be either allergic or immune to all non-narcotic analgesics.

Most of these characters hobble to their allotted cubicle so melodramatically, you’d think they were on the brink of death. They’re quick to display any old wounds or surgical scars they might have. Those with no physical evidence of disease to bolster their credibility usually complain of disorders that are difficult to quantify objectively such as headache or back pain. Most seasoned ER docs come to automatically suspect malingering whenever unknown patients present with symptoms of this ilk. This attitude is unfortunate, because it undoubtedly causes us to treat some bona fide sufferers with less compassion than they deserve.

Some of the more inventive drug seekers can really put on a good show. A few years ago one fellow suckered me into giving him intravenous morphine for presumed kidney stones several times until I clued in to the fact that he only writhed about in agony when he had an audience. When I tiptoed back to his room and observed him surreptitiously he was humming a Def Leppard tune while leafing through an old People magazine. As it turned out, he had been covertly adding blood to his urine samples to trick me into thinking he had hematuria. Why on earth would someone with that much drive and creativity waste his time slumming in my ER? He should be down in Hollywood making millions alongside DiCaprio and Depp.

The list of popular swindles and scams is as long as your arm, but an exhaustive review of them all is not what I had in mind for today. No, today I just want to talk about a small subgroup of highly entertaining drug seekers: the Charaders.

In regular charades one player pantomimes a role or phrase while the others try to guess what it is. A correct guess results in jubilation and a strong feeling of camaraderie. In Drug Charades, the patient ropes the unwitting doctor into a game of trying to guess the name of the medication they’re after. Although they don’t mind dropping Godzilla-sized clues to facilitate the process, they usually try not to say the actual name of the drug themselves. Why? They’re hoping the fleeting euphoria the physician experiences when he or she finally guesses correctly will help generate a big, fat prescription.