THE BATSHIT-CRAZIEST THINGS I'VE SEEN WHILE PRACTICING MEDICINE
Thanks @ChrisK for this fun list request!
- •A co-resident who was strangled with her own stethoscope by a psych patientThat's why I don't wear a stethoscope around my neck when I see psychiatric or combative patients.
- •A woman delivering her baby in her pantsHer labor was so fast she didn't even make it from the hallway to the bed before the baby's head was already in her pants!
- •A pregnant manHe was born female and had been taking testosterone for years. His wife could not conceive, so he underwent IVF! This is more amazingly crazy than batshit crazy.
- •A roomful of relatives screaming with a laboring patient "in solidarity"This was so weird. And loud. I felt bad for my patient who was trying to quietly labor in peace next door. One guy had an especially blood curdling roar. 😳 Oh, and they all wore matching printed T-shirts.
- •A pregnant schizophrenic woman with red lipstick on her eyebrowsIt was an interesting look, I suppose. She also burped in my face several times when I tried to convince her to let us induce her.
- •Fetus in fetuA very rare condition where the fetus has a tumor in the abdomen made of separate fetal parts (vertebral column, organs, etc). May be a variant of monozygotic twinning or a highly differentiated teratoma. It's the weirdest thing to see on ultrasound. You see the fetus and then what looks like tiny fetuses within the fetus!
- •An 19 week abdominal ectopic pregnancyEctopics are abnormal pregnancies outside the uterus that are scary because they can lead to hemorrhage. They're usually in the Fallopian tube, sometimes the ovary, rarely in the abdominal cavity. Most of the time, ectopics are discovered early and treated with medication or a simple surgery. This patient had a 19 week fetus in her abdomen next to the bowel and major blood vessels. Yikes! Luckily, we were able to surgically remove the ectopic pregnancy without any hemorrhage.
- •EXIT procedure@sally and I both have this on our list! 🙋Ex Utero Intrapartum Treatment is performed when the fetus has a neck mass compressing the airway. The fetus is partially delivered by C-section, but remains attached to the placenta while the pediatric ENT surgeons secure the fetal airway. This way, the fetus still receives oxygen and nutrients from mom while the surgeons are working. After ENT is done, OB completes the C-section.
- •A cesarean-hysterectomy for placenta percretaA placenta percreta is when the placenta grows abnormally through the uterine muscle. This patient's placenta grew onto the bladder sitting in front of the uterus. After delivering the baby, we had to remove the uterus and repair the bladder, as well. She had a ridiculous blood loss and received multiple units of packed red blood cells, platelets, and other blood products.
- •A baby whose belly was massive from ascites (fluid in the abdominal cavity) due to an intestinal condition that developed in uteroThis was one of those times I literally thought to myself, "Oh, holy shit!" The fetal anatomy scan was normal, so I didn't expect complications. The baby's head and shoulder delivered easily, but the abdomen just wouldn't come out. My attending hip-bumped me out of the way, cut a big episiotomy into the anal sphincter, delivered the posterior arm, fracturing it in the process, got on her knees, and finally got the baby out. 😨 The fetus had developed intrauterine intussusception.
- •A Fallopian tube torsion twisted on itself 7 timesYou hear more about ovarian torsion in patients with an ovarian cyst or mass. This patient was 34 weeks pregnant and had severe right sided pain. I was convinced it was appendicitis, but all the imaging disproved that. She was taken to the OR and found to have the Fallopian tube twisted around SEVEN times!
- •A calcified tamponA woman came in complaining of foul vaginal odor for several months. I found a tampon that was so old it that parts of it were hard. Who knows how long it was in there for! The stench was horrible. We had to shut down that clinic hallway.