33 year old male came in to the ER b/c he felt like he couldn't urinate. He said for the past 2 days he was barely able to pee, and he felt like his bladder was extremely full. I put the ultrasound probe over his lower abdomen, but didn't see a distended bladder.Next step in a male with this complaint is to do a rectal exam to check for prostatitis. I explained it to him, and he dropped his pants and I proceeded. Normal prostate. He swore, though, that his bladder was full. I was more worried about other things at this point. His abdomen was pretty tender. Was he having an appy with referred pain? Maybe something more serious going on that's causing irritation in his lower abdomen, like diverticulitis? He refused to let me proceed without fixing his "peeing problem." The only thing left to do was to place a foley. We did just that, and very little urine came out. Sit was confirmed that his bladder was basically empty.
But man.....was he pissed! He was screaming that I raped his asshole for no reason and shoved a tube up his penis. I explained over and over that it was all medically necessary, but to every employee that walked by he shouted that I shoved my finger in his ass and a tube in his pisser.
His urine came back with bacteria and mucous...suspicious for prostatitis. But his white count was elevated more than I was expecting (about 18k). So I decided to get a cat scan of his abdomen. His scan showed a perforated diverticulitis...and he needed IV antibiotics and surgery. My shift was over and I signed him off to one of my colleagues. My colleague said that this guy continued to complain to everyone about his rectal exam. He was now determined that since his diagnosis was perforated diverticulitis, he never needed the rectal exam in the first place and that he wanted to sue me for violating him.
I understand rectals are a pain in the ass....I don't enjoy doing the test myself. It's the worst part of my job. But this guy needs to freaking chill. I believe there was a Family Guy episode about this same thing.
-ER Doc
10 comments:
Maybe Psych Doc should sit down with him and ask him why he protesteth so loudly.
Did you give him the ol' three finger rectal that's reserved for special patients?
This dude's visit to the malpractice lawyer is going to be brief. Sorry, ER Doc was right.
Perhaps he has some unresolved issues about his sexuality he was taking out on you?
I think he had to have some unresolved issues. I only used 1 finger and have small hands for a guy. My daughter makes fun of me and says I have girl hands
-er doc
Doc:
With comments like that about your hands, you'd think he'd have been happy that you did his DRE instead of the other doctors, one of whom could have had monster hands!
My dad always told me he looked at the doc and his hands before consenting for a DRE. Small hands = DRE, large = wait for next guy with small hands.
Using one finger rectal exam is not good practice. I always use two. That second opinion could come in handy in a lawsuit.
Dude has some SERIOUS issues... seriously.
I had this happen to me as well.
The patient called administrators at the hospital and claimed post-traumatic stress because of it. Said that he can't stand in lines anymore because he is afraid to expose his butt to other people.
Sometimes you just can't win.
I HOPE he had serious issues. Otherwise he's just a WATB. We women have internal exams every year at the gyno.
I'd have had a hard time not just telling him to "get a grip."
Angry. Angry at being ill/sick and powerless. Can you get angry at ill-sickness? No. So anger transferred onto something living, you.
You did explain you had to examine the prostate so...
This is why all of our rectal exams now have chaperones.
It sucks for MD's who have done this practice for years.
I have seen many innocent residents and interns accused of bullshit.
Post a Comment