Thursday, August 25, 2005

Say what?

During my second year of ear, nose, and throat residency at LA County Hospital, one of our chiefs (call him el Jefe) did a study on ear foreign bodies. Very simple study: he reported on the first one hundred ear foreign body patients to walk in our clinical door. It took el Jefe only three months to rack up 100 cases. If you're easily grossed out or still have nightmares of the Night Gallery earwig episode, skip the next paragraph. The number one foreign body? Not earwigs, but Blatella germanica, the German cockroach. But don't freak out. LA County Hospital's patient population can't be generalized to the world at large. Here's my favorite ear foreign body story. No bugs.
No Elmos, either. 10 PM on a Saturday night. I trotted out my broken Spanish on a 28-year-old guy who had just told me he'd put a piedrito in his ear. Piedrito? A little rock? "Why are you putting rocks in your ears?" I said in my not-half-bad Spanish. "Little children put rocks in their ears. You're an adult. What's the matter with you?" What is this damned thing? I thought as I looked at his ear under the binocular microscope. White. Hard. Wedged in pretty tight. "I can't believe it," I said, still in Spanglish. "A grown man putting a rock in his ear. What were you thinking?" My patient started talking a mile a minute to my nurse's aide, and he started laughing. "No, Dr. Hoffman. Not a rock. A rock of cocaine." Aha. Well, that explained it. (In case you're thinking Huh? These folks stuff the rock in their ear when they think they might get busted.) This solved my problem, though. I irrigated his ear with alcohol, dissolving the rock. My patient was not a happy camper. He'd expected to get the rock back.
That's not my favorite mangled Spanish story, though. This one is. I told this one to Michelle not long ago, but I don't think I've shared it with the rest of you. Let's backtrack a few years to my last month in medical school, when I did an Emergency Medicine rotation at Santa Clara Valley Medical Center. Like LA County Hospital, SCVMC served a poor, largely Spanish-speaking population. As we go back in time, we also go downhill in the quality of my Spanish.
My attending physician asked me to do a pelvic exam on a sixteen-year-old girl with vaginal discharge. "It's her first pelvic," my boss said, "but don't worry. From the sound of it, she's been very active." So what if she's sexually active, I thought. This is her very first pelvic exam . . . it's bound to be stressful. I vowed to put her at ease by speaking slowly and calmly, doing my best to reassure her and let her know this was all very routine, nothing to be afraid of. I'd tell her in great detail what I was about to do before I did it. After explaining to her the general idea of what we needed to do, I held up my gloved and lubed hand, my index and middle fingers standing at attention like proud little soldiers, and said, "Voy a poner dos piernas en su vajina." To save you from having to Babelfish that one: "I'm going to put two legs in your vagina." Ever hear the expression bug eyes? We somehow managed to sort out the misunderstanding, and to her credit, she let me go ahead with the exam. And, yes, I used my fingers. D.


Blogger mm said...


Oh thank you for sharing that! I'm going to laugh myself to sleep tonight!

(I think I post on blogs to use up all those exclamation points I'm not allowed to use in my writing.)


8/25/2005 06:30:00 PM  
Blogger Jona said...

When I had my first pelvic exam, the doctor was kind enough to tell me it was his first 'real' one too. I've been sure if he was telling the truth or trying to put me at ease (it didn't ;o))

8/26/2005 05:14:00 AM  
Anonymous F. O'Brien Andrew said...

HA! HA! HA! HA! HA! HA! I'm showing that one to my wife. She's finishing up her residency in peds right now. Her experiences are a little different since we are in New Orleans. Her language barrier is more one of listening to Heavy-Street-Slang and getting a confused look on her face. Say what? Then picking up one or two more words out of each repetition until she understands what they are trying to say, repeating it back and getting a blank stare because they don't hear regular English very often. Well, that and having a nurse help the illiterate fill out basic forms. The educational system around here.... don't get me started.

8/26/2005 07:02:00 AM  
Blogger Douglas Hoffman said...

Sometimes I wish I were in New Orleans. I'd be 40 pounds heavier, but I'd be in hog heaven.

We used to pass around a list of language goofs -- patients (or doctors) getting it wrong. My favorite: 'fireballs of the Eucharist' for 'fibroids of the uterus'.

In med school, I once dictated, "The patient has a history of a large abdominal aortic aneurysm," which became, "a large abdominal area cancerism."

Debi: was it good for him,too?

8/26/2005 07:31:00 AM  
Blogger Gabriele C. said...


I have one, too. One day I went to a Pizzeria restaurant with a friend who had studied her Italian in Italy, not via opera. So we decided to order in Italian and all, and it went pretty well. Until I found out they'd forgotten to give me a knife. No knifes in operas, they use bigger stuff. So I said "ho bisogna d'un pugnale (dagger)." Well, the guy has some fun with that and came back with the biggest, meanest butchering knife he could find in the kitchen.

8/26/2005 09:28:00 AM  
Blogger Shadow said...

My 2 favorite ear FB stories:

First was med school, ER rotation. It was a cockroach, but before I could fetch the resident, the thing WALKED INTO the otoscope spec. I just shook it onto a mayo stand and mushed it.

Second, a few years ago (a good decade into solo family practice): kid with ear pain. Both she and her mother denying putting anything in them. I looked, then sat back and said, "There is *nothing* naturally occurring in the human body that is that shade of pink." (fluorescent) After a beat, my favorite words (from the mother, no less): "Oh, yeah." She had been putting play-doh in her ears.

Oh, yeah; then there was the kid with a tick. Had to send her to ENT to get that one out. Ok, so it was 3 stories.

And I have some good dictation typos too.

8/28/2005 02:22:00 PM  
Blogger Douglas Hoffman said...

Those are good ones, shadow. I've taken out my fair share of silly putty. Once, I had to take a kid to the OR because the putty was so damned impacted. Yeesh.

In residency, I had to disimpact dried mud mask from a crazy guy's ear. That was no fun!

8/28/2005 05:03:00 PM  
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