Years ago now, while I was still in high school I started working at a Veterinary clinic to pay back my family for the cost of some (minor) car repairs. As many of you know, the experience was actually the inspiration for my desire to “do” medicine. I hadn’t been on the job -but-a-week or so, before being asked if I wanted to see a miniature surgery. Excited as most skinny-lil-boy’s would be at the prospect, I planted my self squarely over the vets right shoulder and stared intensely as he evacuated an inflamed “anal gland”
From what I understand, dogs and cats have the same gland that skunks use to ruin your day – it’s just grown dormant over time…and occasionally gets infected. This one was properly palpable, and sadly, ready to burst. With a slight squeeze and a prick of a scalpel – it popped, sending its nausea-inducing fluid over his right shoulder…and onto my freshly ironed (yes…at the time I ironed my scrubs) blue scrubs. Like the memory of childbirth, I’ve long forgotten the stench…and how much of it got on my face.
But last week it all came back.
Few of you probably know how timid medical students really are. Grey’s anatomy would have you believing that we’re all down-to-slice between midnight trysts in the on-call room, but most of us are actually somewhat squeamish about breaking the skin of another human being.
Allow me to explain, My patient had a rather cyst in the center of his back (just to the right of his lumbar spine) 3 cm wide and shaped like a mussel. Standard procedure with such nuisances is a quick slice known as an I &D (incision and drainage) we poke a hole – lil’ fluid drains out – and we stuff the hole with sterile strands of absorbent paper. The patient goes home smiling, able to sleep on their back for the first time since who-knows-when.
The downside? It hurts like all get-out. You know that sensitive feeling of an inflamed hair follicle? Imagine sticking a needle into it three times over…even if only to fill it with an anaesthetic.
Well we did so, and the guy handled it like a champ. However his cyst – boy that thing was as uncooperative as a two-year-old at toys-r-us. Despite my multiple attempts to carve out a large enough exit wound for the goop to flow, nothing was coming out. My resident finally lost his patience and stepped in to complete the procedure; pressing forcefully on the sides of the cyst to ease some more fluid out. With his full weight leaned on the lump, it burst….all over the right side of his face.
Usually Sh@!)$(* rolls down hill….but sometimes, it shoots up.