“How Did That Get In There?”

If you’ve been in emergency medicine long enough, chances are you’ve asked that question. A couple of days back, I got the following e-mail from a friend and fellow paramedic instructor:

Today was a red letter day in my Paramedic Class. They discovered The Butt Page.

It all started with a HIPAA violation perpetrated by one of my students. I am shocked and appalled by such behavior and promptly issued an appropriate admonishment. We do not tolerate this.

He managed to get a phone photo of the x-ray of a very large vibrating dildo lodged between the Sigmoid flexure and the transverse colon in a patient who “presented” during his clinical shift last week. Unfortunately he was NOT able to determine whether the vibrator was activated at the time, whether the patient sought removal or simple battery replacement, or something else.

I admonished him about the necessity of doing a complete Hx and Physical exam on every patient, which would have revealed the status of the object. Remediation noted.

Since we were on the module on abdominal emergencies, naturally the discussion turned to occult colonic objects, and while discussing the medical and social implications thereof, one student who was at the time conducting research online (my students bring their computers to class and I encourage them to Google and seek information on topics we are studying) seems to have stumbled upon The Butt Page, or, Rectal Foreign Bodies. He pointed out to us that at that moment he was visitor # 1, 742,394 since 1997, a fact that must have some sort of special significance.

QUERY: How many visitors were Republican?

Well, anyway, at that point I took a break, because further attempts at carrying on any sort of academic dialog were futile.

Now, the apex of the ensuing informal discussion landed, as one might surmise, upon Gerbiling.

Suffice it to say that this revealed several interesting demographics about my class: Those who were aware of Gerbiling and those who were not were 3:1.

Now I can say without fear of contradiction that the ratio is currently 4:0.

Sadly, Gerbiling has now been relegated to Urban Legend status. However, using the opportunity as a Teaching Moment, I asked the class to consider alternatives to Gerbiling, such as Mousing, Snaking, and Baby Alligatoring [it’s a Louisiana thing].

In the next hour, we examined the dynamics of Beer Mug removal, Softball removal, and Vegetable removal.

At 1630 I got a call from my boss, the Dean of Allied Health, asking me if I could account for a sudden influx of students asking for information about taking the Paramedic Course.

I had no idea.

Heh.

When I taught paramedic classes at a technical college, the nursing students used to make up absences by sitting in on paramedic classes. They’d listen to the lectures, do some of the practical skills if they were of such a mind, and role play as victims for our scenarios. On exam days, we’d have the prettiest volunteers dress in their skimpiest bikinis, use a little theatrical makeup and wound effects to give them realistic injuries, and dress them in old, tattered breakaway warmup suits like you often see NBA players wear.

One day a group of my victims was standing outside in their bikinis, smoking and chatting as they waited for their turn at the makeup table. A group of aircraft mechanic students asked what they were doing, and one of them answered, “Oh, we’re waiting for the paramedic class exams. In an hour, they’ll be taking our clothes off and examining our bodies from head to toe.”

The next morning, I got a similar phone call from our dean.