Strange Smells in Medicine
Max Eduardo from Milwaukee, WI wrote in a fan mail the following:
“We appreciate all the recent updates but what the hell dude, where are the humor posts you are known for?!?! Did you get depressed on us or something while doing your doctor thing? Where’s the music? Just miss the humor posts, they were full of win.
-Max
P.S. We miss the music, where is it?”
Well, I must admit, I’ve written too much about serious stuff lately so back to the drawing board we go!
I’ve been privvy to many strange smells in my lifetime and I can attest that I can let some whopper farts loose at times, however nothing stacks up to the pure stinkpower of Medicine. Only in medicine can you smell the worst of the worst. Read on to find out the nastiest smells you can find along with nicknames and advice to fall back on to avoid being on of these people.
C. Diff Surprise: A 8/10 on the stink-o-meter. C.diff is a bacteria that colonizes the GI tract sometimes after antibiotic treatment. You see it alot in nursing home patients who get admitted to the hospital. C. Diff smells like 4 parts liquid diarrhea, 2 parts sulfur and 1 part of vanilla to create a slighty sweet but nausea inducing putrid cloud of death. It permeates the nostrils immediately and penetrates through most surgical masks. Never ever place vicks under your nose to mask the smell as the vicks just carries the smell further back and amplifies the nausea. (Personal experience). Usually preceded by a liquidy sounding fart and followed by a cascade of watery poop hitting the floor or a bedpan.
What to do:
1) Run away immediately and page a nurse for clean up on isle two.
2) Prescribe Flagyl
3) Wash your hands immediately 2-3 times to avoid getting c.diff yourself.
4) Thank the good Lord that you don’t have C.diff
5) Page your intern or medical student STAT to go check out said patient for “learning purposes”
Essence of Psuedomonas: 9/10 on the stink-o-meter, usually found in an abscess during surgery or in a morbidly obese Diabetic patient. Psuedomonas hits you with a very sweet smell initially followed by a stinch that likens to an aborted panda fetus or bear crap after ingestion of raw sewage or Taco Bell food. I’ve seen psuedomonas smell close down an entire block of OR rooms at one of the hospitals I worked at due to causing employees to spontaneously blow chunks.
What to do:
1) Run away if possible.
2) If you are stuck in surgery, it is not acceptable to vomit as surgeons are supposed to have acquired anosmia (no sense of smell), so grab onto the sterile field and think of a happy place. If this does not work, inhale the bovie smoke. It may smell like burned flesh but it beats smelling psuedomonas.
3) If possible, page the intern to come “incise and drain” this abscess STAT for “Learning purposes”. Hell, bring the medical students too. Make them take a deep whiff to destroy their poor virgin nostrils. Then see #1.
4) Order antibiotics for patient
5) Write an order for Febreeze then turn off your pager.
Eu de Po-Po Schmutz: For those who have not caught on, I am talking about “feminine odor.” Ranges from 5-10 on the stink-o-meter. Factors that contribute to the severity of the smell are as follows: If your patient presents and states something like “Mah junk iz messsed up Doc!” or has flies rotating around her, you can expect a 10. Date of last shower is also an important contributory factor. Expect a 10 if it is greater than 1 week in time. For those of you who need documentation for the number scale, here it is. This is ripped straight from the “New England Journal of Rejected Resident Studies”
Severity of Smell
5# Theme Park Urinal Cake
#6 Dead Cod
#7 Raw sewage
#8 Necrotic Colon
#9 Aborted Panda Fetus
#10 Liquid Death or Big Momma’s Butt Crack
What to do:
1) Avoid using a clothespin if possible, try to suck it up. Using a Clothespin is bad form.
2) If doing a pelvic and/or speculum examination, get in, take your samples and get out as quick as possible. The longer you take, the more smell particles that are released into the air. At a certain level, your next patient may get nauseous from lingering smell or even worse, HAZMAT team will have to be called to decontaminate the room.
3) Ask your medical student if he wants the experience of doing a pap/pelvic examination. Be sure to stand in the corner of the room and step in if he/she is taking too long to avoid complications as mentioned above in #2.
4) Prescribe a bar of soap if indicated.
5) Wear a gas mask, tell your patient that you have the swine flu and it is for her own protection.
Bathroom Stench: 4-10 on stink-o-meter. Factors depend on many things including location of bathroom, it’s normal occupants, size and proximity to cafeteria food. The worst bathroom smells are from either the hospital cafeteria bathroom or the OR Men’s Locker Room toliets. Out of the two, the OR men’s locker room is the worse. Most surgeon’s are anal retentive and feces is not an exception. They will hold it in for hours as they slice and dice around their surgical fields, letting their poop intensity and ferment in it’s stinkiness. In the 7 minutes they have in between cases, they will invade the 2-3 lonesome stalls in the corner of the Men’s locker room and let loose from the caboose in a cacophony of intestinal fortitude. If farts had a Forte, this would be it. Add that to the fact that the surgeon is usually stressed out from his case and has massive parasympathetic discharge coming on which results in instant diarrhea. The end result of course is that the unsuspecting resident or medical student comes in to change into their scrubs, or even worse, use the adjacent urinal. It can range from nausea inducing to instant ejection of stomach contents. I was privvy to this on one of my urology rotations at the end of my 4th year. One of my attendings was dropping some kids off at the pool and I swear his ass exploded. What followed was the stench of a dead cow. Be warned.
On the other hand, the cafeteria bathrooms generally aren’t quite as bad but they can be horrendous. The cafeteria where I work has really good food but they don’t skimp on the grease. Nothing says diarrhea like Crisco in your bowels. Although generally not as bad as the OR bathrooms, there can be some whoppers, especially on Taco day. Generally if you are in medicine, this should only be a 5 or 6 on your stink-o-meter. If you get nauseated in the cafeteria bathroom, then maybe you should give up and be a radiology tech or even better a radiologist. 
What to do:
1) Try to avoid these bathrooms or use a private bathroom if necessary.
2) Lysol spray if available in the room, otherwise hand sanitizer smell should suffice. Mask that smell yo!
3) Drop down on the floor, remember heat rises and poop smell is the same.
4) Sit down in the stall next door and make a worse smell yourself.
5) Page your medical student STAT and tell him that a case is pending and that he needs to use the restroom ASAP before the case.
More to come,
Richie
