A gross story

BMJ 2002; 325 doi: (Published 27 July 2002) Cite this as: BMJ 2002;325:227
  1. George Dunea, attending physician
  1. Cook County Hospital, Chicago, USA

    “Get up, I tell you, girl, get up! Wine keeps not ever in the cup.” (Ogden Nash)

    “I must tell you a gross story,” said the girl with the pigtails, over cocktails, speaking in modern teenager dialect.

    She had gone to a bar with friends, and late in the evening had put a coin in a jukebox to hear her favourite song. As the record was slow in coming, most members of the party went home, leaving only the girl and two friends, all with more liquor than usual on board.

    The girls were noisy, insisting that they wanted to hear the song, to the annoyance of the bartender, who “had to hear that stupid song 10 times a day” and also wanted to go home. When the song came he turned up the volume and shouted at the girl: “Now dance, dance, girl, right here, up on the bar, come on.” The girl leapt on the bar and began to dance with the man, who was much taller.

    As they danced the girl felt his perspiration run all over her. “It was gross,” she explained. They danced for a while, then stopped. The lights went on, and she found that she was drenched in blood. It was all over her dress, her hair, in her mouth, in a puddle on the floor. It was also all over the bartender, who, when jumping on the table, must have sustained a slight scalp injury that bled profusely.

    There were no complications, merely a few days' anxious waiting for test results, in this age so different from when we did not worry about being covered in blood after invasive procedures and even used the same syringe on different patients. But now dialysis and intensive care nurses wear astronaut-style protective gear and residents put on gloves when they examine patients or test urine. Ward rounds have become Kafkaesque: as you enter the isolation room of a patient with HIV being “ruled out” for tuberculosis or pneumocystis pneumonia, you are masked and gowned, the patient likewise masked, and you try to communicate through muffled sounds or listen with a stethoscope while the mask gets in your way and your glasses fog over and noisy fans blow out contaminated air and drown out murmurs, crepitations, friction rubs, and any semblance of Oslerian bedside medicine or even normal conversation.

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