Whats the worse thing you've ever seen?

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It sounds like you're looking for this thread that we've been running for a long time over on the Emergency Medicine forum.
 
Labial edema secondary to toxemia! Scared the hell out of me! It was one of those things that made you forget the ABCs!!
 
Originally posted by Sessamoid
It sounds like you're looking for this thread that we've been running for a long time over on the Emergency Medicine forum.
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Whoa, that thread is amazing. Actually, the freaky stuff on the wards is different than the freaky stuff in the ER.

...for example, this would not have been so interesting in the ER but developed on the wards. Maybe this is just crazy and nothing more. My first patient when I did my sub-I at Bellevue was a deaf/mute black man who I found running around our MICU naked. He only responded to written french. Once I got over that hurdle,we found out he was looking for his pregnant wife who he claimed to be a famous "Today Show" personality.
 
1) Blind man with swollen leg. Turns out the leg was filled with...maggots. They were crawling in and out of little holes in his skin. The x-ray showed that they have completely infiltrated the entire leg.

2) Woman who came to the ER smeared in feces. She was s/p some strange surgery where they made mulitple deep (>10 cm) cuts in her legs for an unknown reason. Stranger still, the cuts were not infected...

3) Man impaled with nail in eye. 'nuff said.

4) Schizophrenic who dropped his dentures, put them in the janitor's mop bucket to wash, then put them back in his mouth. Also took off his underwear and put it on my chart.

5) Man who was paralysed from a bullet had stage IV decub ulcers on his butt which extended to his bladder. He was peeing out his ass, and I could see the whole thing!!!!

This is just the beginning. When people say that they could never do ER because of the blood, I tell them that blood is the least of my gross-out worries...
 
schizophrenic woman w/ couple of leaking AA batteries in her vagina😕
 
1) 400+ pound woman with a sacral decub literally larger than a person's head. Worst dressing changes ever (and required at least 4 people)

2) Psych ER patient who punched through a sharps box and began eating needles

3) 2 year old with rare bile tract genetic disorder, dying with skin that was literally forest green
 
Bleah. I've been grossed out tons of times in med school. Sometimes I have to wonder if patients know how grossed out we really are, or if they actually believe us when we say "what, this peri-anal abscess? You kidding me, this isn't gross, I see this kind of stuff all the time!". Just because your in medicine, it doesn't mean that you aren't human and aren't grossed out by gross stuff anymore. Anyways, the grossest thing I've ever seen was actually something that I had to do. I was on call over the weekend, just relaxing, reading a book, waiting for patients to come in while covering patients for my team. That's when a residnet pages me and informs me that one of the patients that I am covering for needs a manual disimpaction! I tried to make it seem like no big deal while I was doing it and tried to make light conversation too, but I think that my patient could tell that I was really grossed out too because I was trying to get it over with so quickly. Also, he saw that I put on some 5 layers of glove before doing it. I told him that was standard procedure though. Anyways, days like that really make me wonder why we need to wear a tie and white coat while working with in-patient work. There is nothing glamorous about it, it's dirty work that shouldn't require professional attire IMO. Once I get to be an attending, I'm never going to wear a tie.
 
have you ever had your tie ... drag around on the pt while you were doing procedures?
 
Originally posted by uclacrewdude
have you ever had your tie ... drag around on the pt while you were doing procedures?
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Only if I forget to tuck it into my shirt during procedures. Usually, I put some sort of gown on too, depending on the procedure. I almost always take my white coat off too. You get tired of bleaching the thing after a while.
 
This is more along the lines of the funniest thing I've heard recently ...

Patient comes into to the doctor's office swearing that an animal has been attacking him while he sleeps. I perform a quick exam - no findings. I proceed to examine the bite marks. I don't see any. Patient starts telling me that this "mf'ing ferret" has been following him from house to house; is so intelligent that it can get in his house with all doors, windows, and holes, completely sealed. I am gullable and think that this is possible ... until of course he tells me "I was having sex one night and I look over in the corner and the mf'ing ferret is standing on its hind legs, arms crossed, watching me. Oh, and do ferrets have wings?" It took all my power not to piss myself laughing. Vicodin misuse can do strange things to people ...
 
I had a see-through patient once. The unfortunate man had undergone two failed operations - one anterior and one posterior - to close a bronchopleural fistula. With the anterior chest wall dressing removed, the posterior dressing was visible (and vice versa.) During dressing changes, his tidal volumes would drop to zero as I (quickly) repacked 3-4 lap sponges into the 6-inch deep anterior cavity, rolled him and repeated the process.
 
I had a T10-T12 paraplegic. The docs amputated his right leg and grafted the skin onto the sacral decub. However, this poor guy's skin graft didn't hold. One could flip open the "butt graft" and see the pelvic bone and the acetabular joint of his left femur. The pt was a real nice guy but anyone who took one look at the ulcer were basically repulsed by the sight of the flesh and bones. The smell was also very difficult to handle.
 
16 y/o G2P0A0L2 who's chief complaint was "My Stuff be Itchin'"

Gyn is bad enough, but when mixed with unprotected sex, drugs, and stupidity, it just gets worse.
 
OB/Gyn: Woman who only gets Pap's done under general anesthesia due to her weight; D+E; hemoperitoneum due to botched postpartum tubal ligation

Ortho: above-knee amputation for severe PVD/ulceration down to bone/tendons...saw the flexor hallucis longus quite nicely

Trauma: women being stabbed by scissors by jealous girlfriend over a "man" issue; woman with type 2 LeFort fx after tree limb falling on her while bike-riding

Surgery: sepsis as result of perforated stomach due to fishbone

Peds: CF in a Pakistani child; testicular torsion missed at another hospital; TB of olecranon; omphalocele

Urology: urethral tear due to rupture of 13-inch stirring rod placed as "self-dilation" for apparent stricture; GSW to scrotum


and many many more...
-s.
 
So the worst things you've seen are normal injuries? Lucky you. Wish the worst cases I ever worked on were LeFort fractures, AKA's, and manual disimpactions... 🙁
 
My 2nd day on urology as an intern: a 21yo man, pod#3 from an elective circumcision comes into the ER after having anal sex with his boyfriend the day before - busted half of the sutures during the act & the resulting infection had swollen his penis to twice the normal size.....and the smell!!!

He went into the OR for debridement & basically had to have his penis filleted open. Nothing like doing Q6h dressing changes on that to really brighten your day.....
 
i interpreted "worse" as "unusual"; whatever.
-s.
 
Woman bringing in her aborted fetus in a paper bag. There is something you want to forget.
 
MSIV during my ER electives rotation:

26yr old female wheeled in with a slit throat ? attempted suicide: you could practically see through her slit neck and gawk at her slit trachea and her slit left carotid in spasm. The Anesth resident intubated her and popped open her carotid while doing it ? the sprouting, red blood across the room was a sight to behold?. She was already in shock and arrested while she was being transferred to the OR. Eventually lived through to tell her tale to her shrink.
Later turned out to have h/o severe depression and non-compliant ! Dangerous combination ?
 
Okay, I'm not an MD, but...
Anything INFLICTED on a child sucks. While in a burn clinic, I did some scar management and splinting on a little girl that had these curious S-shaped scars on her head, coming out from underneath her hat. Turns out her whole head was scarred in a similar fashion...the cause? She had the nerve to ask her mother for something while mommy was cooking, and the girl was rewarded with boiling spaghetti on her head. So that sucked.

The fact that mom still has custody sucks even harder.

dc
 
Child-abuse cases suck big-time.

Not to detract from such gravity, but on a different note....

When I was oncall one night during Ob/Gyn, I was called to deliver a baby by NSVD for a 30-something G2P1. I'm sitting there between her legs, and my resident is standing on the lateral side of her right leg. I gowned and gloved but didn't wear a mask at the time; no one else did, and I stupidly followed suit. Delivery was fine, then during Stage III there I was with my face in-between her legs, tugging lightly on the cord. And then, without warning, like looking into the eye of a geyser: SPLAT, blood all over my face, in my mouth and nose, I'm left doing my best Carrie impression. Resident and nurse are shouting "Spit! Spit! Go rinse!" I spit, give umbilical cord to resident, head to pt's bathroom, rinse my mouth. A few minutes later I emerge from the bathroom, and my resident is still standing holding the cord which hasn't moved, and he ever so graciously says, "Wanna continue?" How could anyone resist?
 
1. Dog mauling victim, there wasnt a single piece of instact skin more than 2" across on his entire body.
2. Monorail accident, man had a few dozen cinderblocks fall across his legs and pelvis. Do you know what happens to a testicle when it has 500 pounds of concete fall onto it?? I do.
3. 6 year old girl that caught a stray bullet to the right eye
4. man in his 30's in uro clinic s/p "i didnt know that ho had a razor in her mouth"
 
Originally posted by soon2bdoc2003
Do you know what happens to a testicle when it has 500 pounds of concete fall onto it?? I do.
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MAN....

that just hurts to even read......

UGH.....
 
This was a strange airway/code - the patient was found on the ground, it turns out he was attempting suicide by crushing his neck in the frame of the automatic bed. To make matters worse, the bed shorted out somehow. I hadn't ever heard custodians stat overhead paged!
 
A few things here and there...but probably the grossest were the self-inflicted GSWs to the oral cavity which managed to miss any important bits necessary for survival but instead relieved the patient of his eyes/mouth/ears - essentially face, leaving nice big holes.
 
Originally posted by Desperado
Pediatric codes...nuf said.
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yea, the other stuff in here you forget about a few days later (or the next hour if you are busy). But a pediatric code, I fear, can haunt you for 20 years or more.

Judd
 
I saw a lot of bad stuff when I was a firefighter but the worst thing in the ED was a guy that was run over by a big industrial forklift. You know how when you were in grade school kids would sneak up behind someone and yank their pants down so they sere all bunched up around th ankles. It was like that but all the soft tissues below the hips were around the ankles.
One of my classmates in residency, on her second shift as an intern, had a pregnant vag bleeder come out of the bathroom screaming with the abortus (~18wk) swinging between her legs.
 
RECTOVAGINAL FISSULA.......STOOL SHOULDN'T COME OUT DURING A SCREENING GYN EXAM......

LINEMAN WHO TOOK 975,000 VOLTS ENTRY BOTH ARM, EXIT BOTH LEGS. HAD THE MISFORTUNE OF LIVING FOR 18 HRS....ALL OF IT SPENT IN THE O.R. AT THE TRAUMA CTR
 
1. debriding a feces-packed, stage IV sacral decub complete with resident cockroaches.

2. point-blank gunshot wound to back of the head with the bullet lodged perfectly to tamponade the internal carotid. no neuro sequelae with a fully patent circle of willis.

3. state prisoner who was benching 350 pounds when the bar slipped and landed on his face. eventually, his main concern was subsequent open-mouth breathing in the prison with "friends" looking to teabag him.

4. the genius, drunk kid with the 2 foot rat-tail who thought it would be a neat trick to kiss a small rattlesnake lips to fangs. finally, after his 2 weeks of intubation due to his michelin-man face, his very first words upon extubation were, "f***in' snake bit me!"
 
3yr old with empty orbital cavity...playing around barb wire, fell face first; probably what burns in my memory most, is the look on mom's face as she arrived & saw child.
 
Fulminating cancer of the sinuses. Basically rotted out (open smelly draining wound) the upper portion of the nose ( between where the eye brows should be) and the frontal lobe. One could see the blood vessels in the brain when one changed the dressing.
 
Iwakuni_doc, LMFAO that was some funny ****!
 
1. Prisoner from the county jail with a neck abscess. When cut open, yielded copious chunky green fluid that smelled so strongly like raw sewage that it left an entire clinic wing running for the doors.

2. Elderly, demeted lady from nursing home with multiple decubs down to bone in some places. you could run your hand under the skin halfway up her back in some places.

3. But the most tragic of all: guy who tried to commit suicide by shooting himself in the mouth. Unfortunately, he used a small caliber pistol and aimed too low. Succeeded only in severing his spinal cord at C2. Totally paralyzed basically from tongue down and vent dependent. Can you imagine what must go through this guys mind?
 
Originally posted by neurologist
3. But the most tragic of all: guy who tried to commit suicide by shooting himself in the mouth. Unfortunately, he used a small caliber pistol and aimed too low. Succeeded only in severing his spinal cord at C2. Totally paralyzed basically from tongue down and vent dependent. Can you imagine what must go through this guys mind?
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This is the "Chicago special" - gang banger calls 911, says a guy has been shot. They wait until sirens are heard, then stick the gun in the vic's mouth, shooting just where you said - C2. Then they run. EMS gets there in time to save the pt, but the pt is paralyzed from the neck down, 18-20 years old, and otherwise healthy, vent-dependent and never getting better.

It's like when you "pith" the frog in lab.
 
1) Head trauma are usually gross (A GSW with eyeballs hanging out).

2) Sacral decubitus on a large, or rather, immense, patient is gross.

3) Any colorectal pathology and procedure is gross

4) Bacterial Vaginosis is gross (and all other STDs, with pus).

Other things that make me cringe was when patients pull out their foleys while they are inflated. How do they do it.
 
Originally posted by Apollyon
This is the "Chicago special" - gang banger calls 911, says a guy has been shot. They wait until sirens are heard, then stick the gun in the vic's mouth, shooting just where you said - C2. Then they run. EMS gets there in time to save the pt, but the pt is paralyzed from the neck down, 18-20 years old, and otherwise healthy, vent-dependent and never getting better.

It's like when you "pith" the frog in lab.
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That's extraordinarily cold.

I had this 19 yo kid last year who was playing soccer and got knocked down. That's it. C4 quad from playing soccer. He came in tiring out because none of his costal muscles were working. I had to tube him. He was fully conscious. I see the dead and the jacked up every day but I have a soft spot for those that really were just minding their own business. I had to explain to this kid that I was putting him on a vent. I think I choked up a little while I was saying it. I knew what it really ment. He was just scared. One thing I remember, he was wearing shin pads. Safey first. I don't know how he did. I couldn't bear to follow up.
 
Da Vinci2 said:
Other things that make me cringe was when patients pull out their foleys while they are inflated. How do they do it.
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Ha, we had someone do that on our service too. Another med student this year had a patient who pulled out her LVAD!
 
On a slightly different note... On my medicine rotation the fellow student was following this guy who was in for CHF. She wants to be a good student (it was our 1st rotation) and does a full ROS. This guy is like 45 and has a huge belly. Guy complains of some pain in his Penis. She takes a look and finds pus and some constriction. Urology is consulted and they say it is ballanitis.

Next morning my attending (a nephrologist) shows up and finds a rubber band tightly bound around the shaft of the penis. Turns out this guy sees hookers every week and one of them played "a trick" on him. Pus on or near the penis makes me ill. Just a little bit of a funny story.
 
Only a little gross, but definitely the worst experience of my clinical rotations:

Obese woman with DM s/p TAHBSO comes back in with a terrible wound infection (sharp dissection without anasthetic at the bedside). On Thursday afternoon, we check in, and she's dehisced (sp) completely, and small bowel is above the level of her skin.

Attending won't come in and close her. Have to beg a general surgeon to clean her up.

Totally disillusioning, heart breaking case, watching the resident beg another physician to take care of someone her attending refuses to take responsibility for.
 
Here is a story told to me by a resident. 23 yo WM being worked up by a urologist for recurrent UTI. Exhaustive workup reveals no etiology. Turns out the history really is the most important part. The man, after much questioning by the frustrated cock doc, related that his 'life partner' was a nurse. They had cut some foley tubing and had been inserting one end into the man's urethra and one end into the nurse's. He said they liked how it felt to piss back and forth.

😕

Not something I've seen, but I definitely consider the source reliable. Horrifying.
 
Some things from my rotations:

Surgery:
- also saw a rectovaginal fistula - gross
- drainage of perirectal abscess - the only thing I have seen that I nearly lost my lunch over

Ob/Gyn:
- pt who didn't know she was pregnant ("My periods are always irregular, I sometimes don't get one for months") and delivered her baby in her bathroom. ("I felt like I had to go to the bathroom, I pushed and it just came out")

Peds:
- we would go to all the C-sections to evaluate the babies, and I saw a C-section on a 500-pound woman. Required two Ob/Gyns and two anesthesiologists, and a PA who was "pannus holder"

FP:
- saw a pt with metastatic prostate cancer with a supraclavicular node the size of a baseball.
 
Worse thing I have ever seen,

Medicine: newly intubated patient, comes around, no anesthesia, restrained, sets up and looks at the intern, she promptly runs out of the room to scared to do anything. Went on for 30 minutes before she gave sedation orders. You ever looked anyone in the eyes that was being tortured?


🙁
 
pinkmoose said:
Worse thing I have ever seen,

Medicine: newly intubated patient, comes around, no anesthesia, restrained, sets up and looks at the intern, she promptly runs out of the room to scared to do anything. Went on for 30 minutes before she gave sedation orders. You ever looked anyone in the eyes that was being tortured?


🙁
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That's malpractice.
 
Old man who lived alone. Had a massive CVA. Was on the floor of his house for God knows how long. Rhabdomyolysis. The fire ants found him before EMS did. He had thousands of bites, and his eye was deflated.
 
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