Before I began my internship, I could never have imagined some of the scenarios I would witness in the middle of the night in the emergency room. Nor would I forget them.
The year was 1983. One night, halfway through my internship in family practice, I was on duty at Mercy Medical Center in Denver, Colorado. Just past midnight, the hospital had finally quieted down with a lull in patient admissions coming through the emergency room. It was a rare opportunity for me to take a time-out and put my legs up.
Shortly after propping myself up on the narrow bed in the little call-room for the doctors on night duty, the phone rang. It was the hospital operator.
“Doctor Elliott, there is a patient on the line, a Miss Betty Johnson, who wants to speak to the doctor on duty. She said she has vines in her vagina. I’ll put her through to you.”
I hadn’t totally registered what the operator said… something about vines.
“Hello. Is this Miss Johnson? What can I do for you tonight?”
“Doctor, I need to be seen right away. I have an emergency. I have vines coming out of my vagina.”
“Miss Johnson, are you under the care of a psychiatrist or taking any psychiatric medications?” I hadn’t yet learned the art of asking delicate questions regarding mental health.
“No ma’am. I’m not crazy. I’m pretty normal and healthy. I haven’t seen a doctor in 30 years. I live 20 miles east of Denver in prairie country on a ranch. This is the first time something serious has come up. I was using the toilet before bed and felt something coming out of my vagina. It had leaves. Can I come into the emergency room and have you check me? I’m really scared.”
“Ok. I’ll have the nurses in the ER waiting for you. They’ll get you ready for me to see you. They’ll help you get undressed, put on a gown, and put your legs up into stirrups so I can do a pelvic exam.”
About an hour after the phone call, a nurse in the ER called me to come and check Miss Johnson. I took a deep breath, exhaled slowly, and walked into the exam room. I introduced myself to Miss Johnson who looked timid and frightened, and then I gloved up, adding a dab of lubricant to the fingers on my right hand.
Under the cloth drape I saw something white protruding about an inch out from the vaginal opening. It looked like a rope, about ¼ inch in diameter. I gently parted the labia, inserted the two lubricated fingers, and followed the cord-like growth until I reached something hard, shaped like an oval, about the width of a diaphragm. I hooked one of my fingers around the object and slowly pulled it out. It was a sprouted potato.
I tried to control my surprise and act as though a potato in the vagina was nothing unusual. “Miss Johnson, I have removed a potato from you vagina. The vines in your vagina came from the sprouted potato.”
“Oh. Lord. I plum forgot I put that in there.”
“Miss Johnson, when did you put the potato into your vagina?”
“About four months ago, but then I forgot about it.”
Still trying to act nonchalant, I asked, “Can you tell me why you put a potato in your vagina?”
“Us farm folks, we take care of our own problems. We don’t have money to go see the doctor. I had 5 babies, born at home with the help of my husband and a neighbor. When my womb fell a couple years ago, I started using a potato to hold the womb up and keep it in its place. Works real well. I change the potato every few months. This time I forgot all about it.”
“That’s amazing, Miss Johnson. I have to admit I’ve never heard of that being done. It certainly sounds like a good way to avoid surgery. I’m very impressed with your creative way of fixing the problem. If you ever want to switch to something that won’t sprout on you, I could fit you for something called a pessary. A pessary does the same thing as the potato, but it’s made out of a type of rubber.”
“No thanks, Dr. Elliott. I’m going to stick with the potato. But next time I won’t forget to change it. I’m going to write it on the calendar that I have hanging on the wall in my kitchen. I’m really sorry to have caused you any bother. I’m just going to drive on home now. Good night and thank you, Dr. Elliott.”
Two afternoons a week, the family practice residents worked in a neighborhood clinic. A woman had an appointment with me for a pre-op physical exam for gall bladder surgery. As part of taking her past medical history, I asked if she had had any prior surgeries.
Patient: “I’ve only had one other surgery. I can’t remember what it was called.”
Me: “Why did you have the surgery?”
Patient: “The surgeon wanted to fix my very close veins.”
I told her about varicose veins. We both had a good laugh together. I told her that her “very close veins” description was brilliant and that I’d like to borrow that phrase.
On one occasion, a tall, friendly man greeted me as I walked into one of the exam rooms in the clinic.
“Hello Doc. I sure hope you can help me because I’m having trouble remembering things. I can’t remember people’s names and I can’t even remember what I had for breakfast this morning. My wife says I’m coming down with Old Timer’s Disease. Is there a cure for that?
I told the man about Alzheimer’s Disease but I reassured him that I preferred his name for it.
Every third night I had to stay in the hospital to treat patients who came into the emergency room, some of whom I had to admit to the hospital. About three o’clock in the morning, a man brought his wife to the emergency room because she had a sudden onset of right-sided weakness. The attending physician decided to keep her overnight for observation.
Once she had settled into her hospital bed, I came to her room and introduced myself. I told her that I needed to take her medical history and do a brief exam. I sat down in a chair opposite her bed, with her chart in my lap, and began asking her relevant questions.
The patient obviously liked to talk and went into great detail, much of which was extraneous information about her grown children and grandchildren. My exhausted mind did not have the will to rein her in and ask her to stick to answering the questions. I ended up listening to a big chunk of her life story. I could barely stay awake with my head occasionally falling forward for a second or two then bobbing back up.
Suddenly the woman stopped talking in mid-sentence and just looked at me as though she saw me for the first time. She smiled at me and then opened up her covers, patted the bed next to her and said, “Honey, would you like to lie down next to me and just take a little nap? No one will know.”
Of course I didn’t confess how much I would have loved to take her up on her offer.
One night on duty, I managed to fall asleep for a few minutes in the doctor’s on-call room before the operator phoned me to say that a young man told her that he was having an emergency and wanted to talk to the doctor on duty.
The operator routed his call through to the telephone in the call room.
Me: “How can I help you?”
Young man: “My girlfriend and I have a question for you about PMS.”
Me: “About PMS? Is this an emergency? Did you know that it’s two in the morning?”
Young man: “Yes, it’s an emergency because me and my girlfriend, we’ve been having a big fight all night about this PMS question. The fight’s been so bad that we’ve been talking about breaking up. I knew that only a doctor would have the correct answer.”
Me: “What’s the question?
Young man: “My girlfriend says that she’s bitchy to me because she has PMS all month. Is it really possible to have PMS every single day? I thought that girls got that syndrome before their period.”
Me: “I’ve never heard of premenstrual syndrome lasting more than a few days each month. I suggest that you and your girlfriend get couples counseling. I’ll give some names of therapists that you could call in the morning and set up an appointment. Good luck. Try to get some sleep.”
One of my classmates—I’ll call him Jim—had an impressive IQ that we all admired, but he lacked emotional development and interpersonal skills. He appeared nervous when he talked to people, especially patients. I imagined that he would choose pathology as his career. He could excel in that field without having to interact with too many people—living people that is, as opposed to corpses.
One day a nurse confided in me about an experience she witnessed during a patient exam that Jim performed on a woman. The hospitals in Colorado required that a nurse be in the room whenever male doctors-in-training needed to examine a female, especially when clothing had to be removed in order to perform the exam. The nurse relayed the story to me with great detail, obviously relishing every moment of telling on this poor guy. Here’s what she told me:
A large-breasted young woman in her twenties came into the clinic complaining of a persistent cough and fever and wanted to be checked to see if she had pneumonia. While carefully avoiding eye contact with the young woman, Jim handed her a paper gown. He told her to get undressed and put the gown on and then left the room.
After a few minutes, Jim knocked on the door and then walked in with his stethoscope hanging from his neck. The young woman sat on the edge of the exam table and, right in front of Jim, took off the paper that covered her chest, including her breasts. Jim became visibly anxious and looked away.
He began the exam at the back of her chest. With the stethoscope in place, he told her to take deep breaths in and out. He said, “Hmm. Good. Ok.” Then he put his stethoscope above each breast and told her to keep taking deep breaths.
“In and out. That’s good. Hmm. It sounds pretty good. I don’t hear any abnormal breath sounds.”
Before Jim could finish his sentence, the patient grabbed his arm with one hand and pointed to his neck with the other hand.
She said, “I don’t know too much about medicine, but I do know that those things around your neck are supposed to go in your ears.”
The nurse didn’t tell me what happened next, but I can imagine if I were in his shoes, I wouldn’t know whether to laugh or cry or drop out of medical school. The nurse showed no mercy in telling on Jim.
As part of comprehensive training in family medicine, I spent time at an STD (sexually-transmitted disease) clinic. A young immigrant from Mexico came in complaining of pain in the tip of his penis and a yellow-colored discharge. He spoke no English. The nurse asked me to evaluate him, knowing that I spoke Spanish.
I walked into the curtained off area and introduced myself, saying in Spanish, “My name is Dr. Elliott. I would like to help you. Can you lift up your gown? I need to examine your penis.”
The young man looked frightened and held both of his hands over his penis and said, “I want to see a doctor.”
Me: “I am the doctor.”
Young man: “I want to see a real doctor.”
Me: “I am a real doctor.”
Young man: “But you’re a lady. I want to see a male doctor.”
Me: “There are no male doctors here today.”
Young man: “I don’t want you to check me.”
Me: “You don’t need to worry. I’ve checked many penises before.”
Young Man: “Oh my god.”
He finally consented to the exam. He closed his eyes and prayed out loud to Mother Mary while I put a thin swab into his urethra to get a sample of the pus to culture in order to see what pathogens grew out.
I felt sad that I had traumatized the young man because of my gender, but he survived.
In my residency training in family practice, I did a rotation at Denver General Hospital’s emergency room, nicknamed “The Knife and Gun Club.”
The nurse on duty told me that I needed to evaluate a man who had walked into the ER complaining of chest pain.
Me: “Sir, do you have a history of cardiac disease?”
Patient: “What kind of disease did you say?”
Me: “Heart disease.”
Patient: “No ma’am.”
Me: “Does anyone in your family have heart disease?”
Patient: “My father had something wrong with his heart. His doctor told me that he had to go to rehab for as few weeks because he had a massive inferior fart.
Me: “I see. Um. Can you excuse me for a minute?”
I put my hand over my mouth and tried to disguise my laugh with a fit of coughing. I definitely did not want the patient to feel like I was laughing at him.
I hesitated sharing these stories with you from long ago when I was training to be a mainstream doctor. In recounting the stories from my current perspective, they seem a bit disrespectful.
If you are one of my patients reading these stories, just know that I will never laugh at you—but I sure do love laughing with you.
And I enjoy laughing at myself.
It feels so good to laugh, don’t you think?