Wednesday, April 28, 2004

Things that go squick in the night

Mostly I don't get weirded out or disgusted by anything I see at work. Not any more. I no longer have nightmares about things I've seen.

There are still things that squick me out, though. It's not blood or vomit or the thought of disimpacting somebody who hasn't had a bowel movement in six weeks. It's the little things.

Two days ago I stopped by Arlene's room. Arlene is one of my favorite people. She's the sort of patient you never dread seeing come back; the sort of person you hug when you see them just because they make a balls-out dreadful day much better. She doesn't whine, she's not a junkie, and she sends me funny political cartoons in email. I've never once heard her complain about the complex and long-standing problems she has as the result of being run over by a truck.

I was standing in her room, examining a dressing more out of curiosity than anything else, when she asked what the weirdest thing I'd ever seen was.

"Weirdest looking, or weirdest squicky?" I asked.
"Either, I guess."
"Um....the weirdest was probably the guy with a brain worm."
"What does that mean?"
"He had a worm in his brain."
" actual worm? In his brain?"
"Yep. Encapsulated parasite. Very nasty. They're a result of improper treatment for some sort of parasite that you get from living where there's no water treatment."

I watched as a fine shiver passed over the woman who's had multiple surgeries and joint replacements and borne them without any evidence of squick. I guess different people have different triggers.

One of mine is eyes. The other nurses know not to assign a patient with, say, a fungal infection of the cornea to me. They will, of course, if they have to, but they know I hate it. It's not the every-half-hour eye drops that gets me; it's the appearance of a cornea with a fungal infection. Don't ask me to be more specific.

Another is injuries to the ends of fingers or toes. Chop off a hand in a combine and I'm your pal. Stick a staple under your fingernail or avulse the end of your toe somehow and I'm in a swoon in the corner. My least favorite thing that involves toes is probably bunion surgery, since that entails checking the circulation and health of toes with big pins sticking out of the end of them. I have to steel myself before I walk in the room.

And bone flaps...oy. "Bone Flap Out" is a nice medical way of saying "We did surgery on this guy's brain, and for some reason we had to leave a chunk of his skull out, so don't whack him on that side of the head or let him lie on it for very long, okay?" People with bone flaps out have either very little deformity or huge sunken areas in their skulls--there's hardly ever any in-between. The weirdest *looking* things I've seen involve bone flaps. You'd think there wasn't that much space between the outside of your head and your brain until you've seen somebody who's forehead slopes back, Neanderthal-like, because his frontal skull is in a bucket somewhere.

I have one nurse friend who passes out at the smell of blood. It's a good thing he doesn't work trauma. Another can't stand anything having to do with face lifts. A third flips out and becomes incompetent in the face of rashes. It's amazing to me, sometimes, that we can handle so much and still get stuck on the smallest, strangest things.

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