The Nation's Health

The Elephant In The Room

"33 year old male, bleeding per rectum"

I'm not going to lie. The prospect of visiting a man with a bleeding rectum isn't how I wanted to start the shift. In all honesty when I signed up to this job I didn't know bleeding rectums existed! My issue with them is this. First, there is nothing I can do. Secondly, despite what the patients who are suffering the bleeding rectum think, I will not be examining, visually or otherwise. Finally, when people have a bleeding rectum they invariably find out on the toilet. This then leads to that awkward moment where they want you to visual inspect the content of their toilet bowl. On special occasions, they save used toilet paper in a bowl to look at and more often than not, are insistent that you look! I can promise you, a description of events will usually suffice and no, you need not bend over, spread your cheeks and tell me to look.

Today, I was on the car. Generally any job involving genitals, rectums, embarrassing bodies or anything else that may cause embarrassment, I prefer to be on an ambulance. Maybe it's because I like to share the awkwardness, or maybe because in some situations there should always be a witness! Anyway, sometimes, awkwardness is unavoidable and it's our job to try and not make things worse!

I rang the buzzer of the flat and was met at the door by the patient who immediately darted back up the stair case. I reached the landing of the flats and headed into the open door. The patient seemed very nervous and anxious. He was breathing very fast and sweating profusely. I spent the first 5 minutes or so just calming him down! His blood pressure was through the roof but I put it largely down to his nerves and fear of being seriously ill.

He explained what was wrong, and offered for me to look at the blood in the toilet. He told me it was bright red and there were no clots so I didn't feel the need to cast my antique-roadshow-esque eyes over his toilet bowl contents! The reason for the bleeding was somewhat of an enigma, so I just carried on with my questioning hoping that some kind of cause would become apparent. This is what can be awkward. There is me and the patient, alone, and no ambulance to be seen and I have to fill the time with asking questions about his rectum and toilet activities. You can see why it was a little cringe!

I asked about any medication he was on. He started trying to recall them, with little success so I asked if he had a prescription. The patient was sat on the end of the bed, I'd grabbed one of his chairs and sat opposite him. Next to us was another chair with his coat sitting on it. He reached forward, grabbed the coat and pulled it towards him. As he did so, in slow motion, something fell from the chair.....

As it fell, it rotated. I think I saw it slightly before he did. My eyes fixed on the moving target, as he realised what was happened. He lunged his hand out to try and catch it but missed. As it hit the floor it bounced slightly and began rolling towards me. It was like watching it on a super slow-motion camera. I knew it was going to hit my foot but I couldn't move to stop it. Contact was inevitable. Then it hit, wobbled and stopped. Motionless it laid there. Looking at me. A panicked swipe by the patient scooped it off the floor and back under his coat. Now there was a Mexican stand-off of sorts. Who was going to mention it first? Or would we both pretend that nothing had happened and that I'd seen nothing?! Maybe he was hoping I hadn't seen anything?!

I didn't know where to look. I didn't know what to do. There was an elephant in the room. My face stayed emotionless. Behind the cool exterior there was utter panic! My mind was screaming at me......

"THAT WAS A DILDO. A MASSIVE DILDO. A RIDICULOUSLY MASSIVE DILDO. HIS DILDO JUST HIT MY FOOT!! MY FOOT!! HIS DILDO!! HIS MASSIVE DILDO!"

"IT LOOKS LIKE IT WAS MOULDED ON AN ELEPHANT! DILDO DILDO DILDO DILDO DILDO!"

"DON'T......SAY......A......WORD. You'll just make it more awkward. BUT IT WAS A DILDO! A FRICKIN' DILDO. And it's HUGE. And it hit my foot. HIS DILDO HIT MY FOOT."

Whilst my inner monologue continued, the patient was shuffling through his jacket pocket 'trying to find the prescription'. I imagine he knew exactly where it was but his mind was probably busy screaming....

"THAT WAS MY DILDO. MY MASSIVE DILDO. MY RIDICULOUSLY MASSIVE DILDO. MY DILDO JUST HIT HER FOOT!! HER FOOT!! MY DILDO!! MY MASSIVE DILDO!"

"DON'T......SAY......A......WORD. You'll just make it more awkward. BUT IT WAS MY DILDO! MY FRICKIN' DILDO. And it's HUGE. And it hit her foot. MY DILDO HIT HER FOOT."

I think both of us wanted the ground to open up and swallow us whole. Where was the bloody ambulance. This situation was now 'time critical' because I WAS GOING TO DIE! Despite my trusted inner sanctum telling me to keep my mouth shut I had to be the one to discuss the 'elephant'.

"Have you....errrr....could that have....errrr....do you think that....errrr.....it's the cause of the bleeding?"

*Awaits answer* CRINGE!!

"Yes, I think so, sorry"

Before I could respond there was a knock at the door! The ambulance! I shot off down the corridor to let them in. I gave them as sensitive a handover as I could. I managed to avoid blurting out 'THE DILDO HIT MY FOOT'. I said goodbye to the patient (we shared 'a look') and I hurried back to my car. I got in, turned the engine on and laughed out loud!

HIS DILDO HIT MY FOOT! HIS DILDO!

DILDO!