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Episode 7: My First Full Moon—The Transformers


Science kind of shakes its head at the whole “lunar effect” phenomenon, but ask an OB/GYN or emergency medicine doc and they will tell you that some of their craziest experiences occurred during full moons. So skeptics, consider yourselves on notice.

Doctors Lauren Robertson, Christopher Carrubba and Patsy Bowman Aiken offer a collection of tales to make you alternately howl and moan. Trick or treat?

Listen to Episode Seven

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This transcript is for Episode 7 of the medical podcast My First Cadaver. Enjoy!

Darkness falls across the halls—the USMLE now calls. Your skin turns pale, you quake with fear, the outcome’s uncertain, in question, unclear. And whosoever’s unprepared is bound to be quite awfully scared. Let Med School Tutors be your guide when you can’t run and you can’t hide. They’ll work with you one-on-one, get it ready, get it done. Choose MST this Halloween and watch all your colleagues turn green. Med school can be such a killer; together we’ll make it a thriller.

Do you ever have one of those days where you’re scratching your head going, “What on Earth is going on?!?” People are talking about the moon and lunar effects and you’re thinking, “Pffft. I don’t believe in that stuff.” But crazy things keep happening and even crazier people keep emerging from the ether… Which makes you wonder if maybe, just maybe there’s something to this whole “full moon” phenomenon after all. Something that you — a med student — can accept as possibly not being the stupidest, hippy-granola-crunchiest, celestial-goddess thing you’ve ever heard in your life; something that just might be a little rooted in scientific fact… Or not—sometimes science doesn’t know either. Well, that’s what we’re talking about today. Smart people in unpredictably outrageous situations and an enormous, illuminated rock to pin it all on. In this episode, we promise you the moon, some star physicians and definitive proof that there is such a thing as a “full moon code.” Starting us off is Dr. Lauren Robertson, an obstetrician and graduate of the Oregon Health Sciences University School of Medicine.

I was in charge of the labor and delivery deck one night, and it was definitely a full moon night. We had lots of people rolling in with their water breaking, with labor, with all sorts of things; and this tends to happen every time that full moon rolls around. And I get a call, and our charge nurse answers the phone and it’s an ambulance transport. So I think to myself, “This is great because I’ve got a family medicine resident that’s working with me.” And the family medicine residents will do training with us and we really try to get them as much experience as possible. So the ambulance transport calls up: “We’ve got a lady en route. She’s a G-11, P-5,” and we’re thinking, “Wow. This lady’s had a LOT of babies. This could go fast and crazy.” And they said, “She’s en route. She’s having severe abdominal pain, and she’s 32 weeks pregnant.” And I said, “Okay.” The double doors open up and here comes the ambulance transport and there’s this woman. She’s kind of disheveled looking, and she’s laying on the gurney and she’s throwing her head back and writhing back and forth and holding her abdomen and saying, “Oh my gosh! I’m in labor! The baby’s coming!” And it’s like something out of a bad TV show, so I say, “Okay. Perfect. Send my resident with her.” So he goes with her into this triage room the size of a broom closet, and they’re getting her off the gurney and swinging her onto the bed and he kind of very dramatically pulls her top up to up the ultrasound on. And I’m sitting kind of outside the door, and I’m waiting and waiting. And I think, “Don’t go in there. Don’t pop in. He needs to know how to triage this person and figure it out.” And after about three minutes, there’s nothing going on and he comes out and his eyes are gigantic. And he said, “There’s no heartbeat.” And whenever happens your heart just drops because you think, “Oh my God. What are we going to be dealing with? How is this person going to take this?” And that can be a really difficult medical circumstance that can actually put the mother’s life in danger depending on the circumstance that caused the demise. So we’re thinking, “Oh great…” So I go in, and this woman is hysterical. And I’m thinking, “Is she abrupting?” I look at the bed between her legs to make sure there’s no blood coming out. We’re kind of triaging her fast and furious; the paramedics are trying to get out of the way but trying to have us sign paperwork, and it’s kind of a total clusterfuck. And I grab the ultrasound and I look, and I pull up her shirt, and she’s pretty heavy, and I go down and put the ultrasound down, and there’s her uterus: totally empty. No baby. No baby. No pregnancy. It turns out this woman is completely psychotic. She has a psych history and was having a psychotic break and thought she was pregnant. And had the paramedics fooled, had all of us fooled, and it was kind of one of those cappers for the night of lots of stuff coming in on a full moon. And I know to this day that family medicine resident will never forget the time that he thought there wasn’t a heartbeat and there just wasn’t a baby. So, welcome to full moon medicine on the OBGYN labor and delivery deck.

I would say I think every med student, resident, attending knows that when the full moon comes out, the craziness definitely starts to happen.

That’s Doctor Christopher Carrubba.

I was definitely one of those people that didn’t believe in superstitions coming in. You have the people who are like, “Don’t ever say it’s a quiet night! Don’t ever comment about it being the full moon!” And I always kinda thought it was a little bit of bullshit. I was covering the night medicine service intern year, and there was one patient in particular that I was worried about. She was a patient on the hepatology service, was there waiting for a liver transplant, and I had kind of known her from the week before when I was actually on the service. And I knew going in that she was a little dramatic, so I definitely had in the back of my mind, like, “This lady is gonna be a problem tonight and it is not going to go well.” And sure enough, I get a page from one of the nurses and they’re like, “Can you PLEASE come down here right now. We’re freaking out. We don’t know what to do.” So I come running down from the 10th floor on one side of the hospital down to the 8th floor on the other, running in there, and coming up to the room, I see two security guards, three nurses. One nurse is clutching her face with blood pouring out of her nose and I’m thinking, “What is going on? This woman is frail, waiting for a liver transplant… She is not that strong. There’s no reason all those people need to be there.” And as I get up to the room, you look in through the window, and she’s turned the bed over, she’s smashed things up against the wall, she’s screaming, security’s afraid to go in there, her daughter’s in the room with her and the daughter is also clutching her face with blood coming out. She sees me through the window and since she got to know me when I was taking care of her the week before, “Chris! Chris! Chris, help!” So I come in and I’m like, “Hey. What’s going on? What’s wrong?” And she’s like, “Tonight, I asked for blackened salmon for dinner. They told me salmon was on the menu, and I asked for blackened salmon.” And I said, “Okay…” And she holds up this piece of fish and goes, “Does this shit look blackened to you? What do you think I’m supposed to do?”

You know there’ve been really crazy medical situations where we’ve dealt with kind of strange diagnoses. Nothing like doing a surgery and finding something unexpectedly or doing an exam and finding something unexpectedly. I recall doing a vaginal exam on a patient in the emergency department, and she was complaining of pelvic pain, and I put the speculum in and pulled out a tube of lipstick. And her reply was, “Oh I wondered where that went.” So you know you kind of just deal with some unbelievable stuff in this business.

“Oh I wondered where that went?!? Are you serious?”

Yeah. Not phased that there was a tube of lipstick in her vagina. More that she had misplaced and it and now, miraculously we had found it. In the emergency department, we had a whole folder of things that were put into orifices that weren’t supposed to go there. And, I mean, we’ve got everything from a dijon mustard jar in someone’s anus that they called us to try to remove with a fetal vacuum. They asked us for the vacuum that we us for vaginal deliveries to try to remove this from this guy’s anus, which was fascinating—well, actually it was up to his rectum by the time we got there. We’ve had people who’ve had Transformer dolls that they’ve placed in orifices. I triaged a guy as a medical student who had a ruler, a pencil and an eraser in his rectum. That was an interesting situation. But as OBGYNs, we pass those off to the colorectal surgeons who gladly accept those ones. So that’s always interesting. But women, it’s kind of funny… You get some interesting—people put things in weird places. A woman from Mexico came, and she had some vaginal discharge, and she had a complaint and I went to do an exam and I put her legs in stirrups and there was a green, sort of, leaf coming out of her vagina. And I thought to myself, “Well, that’s not supposed to be there.” And I went to part her labia with my hand and I saw more of, like, a vine. So I tried to put a speculum in, it was hard to do, she was uncomfortable, she was a little elderly. And then I just did an exam with some gel and my hand and pulled out a—probably medium-sized potato that she had in her vagina. Well, in the spirit of learning cultural competency in medicine, I come to find out that women in areas of Mexico use those as pessaries. And a pessary is a device meant to hold up the vagina and the uterus. A lot of women who have had lots of babies have prolapse, where their uterus essentially goes with gravity, down to the opening of the vagina or out of the vagina. And they use any space-occupying device to try to keep things up, and this woman had a potato in her vagina that was sprouting. For as much as you learn in this business, you are constantly humbled by not relying on assumptions. You have to take everything at face value.

I was a third year medical student, it was a full moon night, I was on overnight, and I was on labor and delivery.

That’s Doctor Patsy Bowman Aiken.

And I was partnered with another med student—great guy—who’s very reserved, shy, very conscientious. And so the residents initially they treat us poorly, but then they realized that we were a really good team and that we worked hard and that we really wanted to be on the front lines as much as possible, as so they got comfortable knowing that we would be bird-dogging the laboring patients and we would keep them in the loop and all that. So, it’s a full moon, and one night we’re going from room to room and there’s this one woman who was in labor but she wasn’t quite in active labor yet. However, this was her fifth pregnancy. The nurses were starting to buzz around a little bit and get things set up and a resident had been in previously to check her cervix and she was dilated to maybe 9 centimeters when he checked it, and that seemed about what we thought too. And so Chris and I were not gloved, we were not gowned, and we were on the side of the room, and the patient was probably a good 15 feet away. And she was in the bed and she was having contractions, and thankfully the foot of the bed —which is normally dropped during active labor when the legs are up in stirrups—had not been dropped yet because we’re standing there and the patient is moaning and what have you. And she starts saying, “I’m not feeling right. I think the baby wants to come out.” And the nurses were like, “You’re fine,” you know, kind of pooh-poohing it. And Chris and I are standing there and we look at her and she either coughed or sneezed or something like that. She basically went, “BLEEEHEH!” and the baby shot out of her vagina and landed on the foot of the bed. And we were so stunned! And all I could say was, “Baby down! Baby down!” I yell that out loud. Chris was buttoned up, and when I yelled, “Baby down! Baby down!” he went, “Holy shit!” And we go running over to the baby and everyone’s like, “WHAT?!?!?!?” And Chris and I pick this poor baby up—who literally shot out of this woman’s vagina with a cough and thankfully the baby was fine and we got the cord clamped and the resident comes running in. Everything was okay but it was the funniest thing in retrospect. At the time it was horrifying. Thank God the foot of that bed had not been dropped or that baby would have hit the deck! So yeah. So that was a memorable full moon story, full moon delivery—if you can use the term “delivery”, I guess.

When you work 90 hours a week, time plays tricks on you. Days and weeks blur together in one exhausting stretch, punctuated by brief moments of exhilaration, terror and hopefully, sleep. As a technologically immersed mortal, you’re focused on the task at hand — not celestial positions.
But what do cosmetics, condiments, produce and office supplies lost in the nether regions of some very confused patients (and found by some even more baffled doctors) have to do with any of this? And what’s with that flying baby? Or the violence?
The moon, for whatever it’s worth, seems to bring forth our wilder aspects, if not with cosmic forces, then with forceps or maybe just a cough. But it’s there, it’s in us and it wants to come out. So the next time you’re having one of those days, check the moon phase calendar, and whatever you do, leave your Optimus Prime doll at home.
Thank you to doctors Lauren Robertson, Christopher Carrubba and Patsy Bowman Aiken, the My First Cadaver Team,
Papa Claire Music & Compulsion Music, our Nerf-blasting friends at Salted Stone. And special thanks to Robert Meekins, who is NOT a doctor.
Stay tuned for Episode 8 — coming soon to a listening device near you. If you haven’t done so already, follow us on Twitter, Facebook and iTunes. And if you have a story to share, email us at info AT myfirstcadaver DOT com. Lastly, remember everyone: Don’t try to win a cockroach eating contest or YOU could become someone’s first cadaver.

Oh my god. And the coughing noise you made when you said it too was incredible, just, “CAAAAH!”

I know! The whole thing was surreal. I mean, what just happened in there?!?

b a o @

Topics: Awkward Patient Encounters, OMGNFW

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