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BACKTALK

Quit Your Bellyaching

Bill Benda, MD, Associate Editor

ach of my editors from various journals knows that

it is wise to give me a deadline a few days before
they actually need my work in their ink-stained
hands, as I invariably put off writing until the literal last
minute or, more often, soon thereafter. But this time it was
going to be different! I sat down at my computer last
Monday an actual 8 hours before this piece was due to
knock off a commentary on the pitfalls of peer review of
research submissions, something with which I am
intimately familiar. But as I sat in bed staring at the screen,
a strange irritation began to flare in the center my
abdomen, a vague achy feeling not quite like heartburn
and more constant and nagging than the proverbial gas
pain we are all familiar with.
I put down my MacBook and crawled under the
covers, waiting for this nuisance to pass so I could get back
to work. But it didnt subsideit grew slowly into a
unique, throbbing sensation we males recognize from
slipping forward off a bicycle seat and landing on the
crossbar (I think the word exquisite may apply here). And
then, after about an hour or two, it began to migrate down
toward my right lower quadrant.
Well, you all know what that means. But I stayed in
denialbesides this deadline I had a night shift starting at
7 PM as well as a closing on my first house the following
day. However, time, and appendicitis, wait for no one, and
I finally dragged myself into my truck and headed for the
nearest emergency department. My own hospital was too
far to drive in such discomfort, and, besides, we always
torture each other with talk of urinary catheters and rectal
exams if we should end up in our own ER as a patient.
As I lay curled up in a fetal ball on the waiting room
floor, watching weenies with chest complaints led to the
triage area before me (hint: If you want to be seen in an ER
immediately, clutch the front of your shirt and state
it feels like an elephant sitting on my chest), I pondered
the ridiculous irony of the situation. Even more so when
the young woman doctor who finally saw me, and works
part-time in my own department, took a call during our
interview asking if she could cover my shift that night.
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Integrative Medicine Vol. 14, No. 5 October 2015

Anyway, I decided that I would at least use the

experience to research what my patients must go through.
First the exam (yes, none of us do much of an exam as the
story is far more informative). Next, experimentation with
the same pain medications I give out by the gallon
(4 mg of morphine just takes the edge off, and 1 mg of
Dilaudid does about the same. No real high, at least not for
this child of the 60s). And of course the ubiquitous lab
testsno elevated white blood cell count, but white and
red cells in the urine with no bacteriaclassic for early
appendicitis. Then, the CT scan (did you all know that
radiation actually feels warm inside?). Finally, the gurney
ride down the hall to the OR and the chat with the
anesthesiologist and surgeon (Hi, Im an ER doctor. Did I
mention I was an ER doctor? No catheter for me, please!).
Ive had 2 experiences with anesthesia before, once for
a colonoscopy and another for repair of a rotator cuff tear.
Two idiosyncrasies Ive discovered about myself and these
pharmaceuticals: the first being retrograde amnesia where
I never even remember the medications being pushed, and
the other that I become extremely flirtatious when just
going under or just coming out. Thank goodness I can
never remember how badly I embarrass myself.
Anyway, all went well, with the exceptions of
awakening a little too soon when the endotracheal tube
was being pulled, and a visit from our friend Mr Ileus,
where the bowel is paralyzed from pain and narcotics but
the gazillion bacteria living there continue to give off more
useless gas than political pundits on Sunday morning talk
shows. But as they say, this too shall pass, and I confess
that I am happy to be alive to jot down my experience
and equally happy that I have something easy to write
about instead of that complex peer-review thing.
So the next time you are in an emergency room, do
notice how long you have to wait, and how you are treated,
and ponder deeply the meaning of life and death. And
remember, should all else fail and you begin to feel
ignored: elephant

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