Cuts like a butter knife

A 45 yo strange looking female arrived to the ED with chief complaint of "bright red blood per rectum." I went into the room and asked her "What brought you in today?"

She kind of avoided eye contact but matter of factly stated, "I have been constipated for the past three days, so I took a butter knife from my kitchen drawer and I used the knife to alleviate my constipation. After the first bowel movement, I noticed blood in the toilet. I am not very concerned, but my family made me come in to ensure nothing serious was happening."

Sometimes, it's difficult to maintain a professional demeanor. I had to put the chart over my face to avoid smiling and laughing at this poor patient. I had many questions I wanted to ask, such as "Is this a normal dinner discussion in your family? Wouldn't you keep that a secret?" Nevertheless, I decided to avoid any additional questions because I didn't really want any answers.

I did a though anal exam with an anal scope to look for deep cuts in her anus. Thankfully, it appeared nothing was seriously injured in her butter escape hole. I discharged her with a script for a stool softener and gave her strict ED warnings to avoid butter knifes.

I can believe its not butter!

-Doc Sensitive