Armchair Anonymous: Nurses III

0:00Welcome, welcome, welcome to our chair anonymous. I'm Dan Shepherd. I'm joined by Lily Padman. Hi. This prompt delivers. It delivers on the level that foreign objects does and does unauthorized evacuation. It's a good task. It's nurse. It's nurse three and I'm here to tell you there's going to be nurse four through 100. That is my commitment. We got it all. So these heroes are going through. This would be our one story of our whole life. And these people have to figure out which of 150 stories do they want to tell us? I bet we'll have some folks back. I hope. Yeah. Okay. Please enjoy and being a place where you can run to the bathroom. Nurses part three. We get support from quince. I have to say I am so ready for fall. I want sweaters. I've been craving a true crisp morning where I actually need a jacket. I can't wait. I'm fully there. The second at dips below 70. I'm like, this is my season. Give me the layers.

1:01Give me the boots. Give me a reason to wear something other than a t-shirt. And honestly, that's why I love quince because fall is when your wardrobe actually has to show up. And everything at quince is 50 to 80% less than similar brands. We're talking 100% Mongolian cashmere sweaters starting at $60. $60. $60 for cashmere that you'd expect from a luxury brand without the luxury price. It's amazing. It gets me every time. It really shouldn't be real, but it is because they go straight to the factories. They skip the middlemen and they just hand you the savings. The stuff isn't trendy. It's the kind of pieces you grab over and over because they work every time. The 100% Mongolian cashmere sweaters for me are it. When I look at Steve McQueen, this man owned a couple of sweaters. He wore all the time and he looks iconic. It's a uniform. And quince isn't just about the clothes. They have hotel quality bedding, cookware, bath essentials, softly designed furniture. You can really go there and outfit your entire apartment or house. So if you're in need of any kind of fall refresh at home too,

2:02same quality, same attention to detail for every corner of your life. Find your next fall favorites at quince. Download the quince app for app exclusive offers or go to quince.com. Get free shipping on your order and 365 day returns. Now available in Canada and the UK too. And when quince asks where you heard about them, let them know it was armchair expert. It's the best way to support the show. This episode is presented by YouTube Premium. YouTube was already great, but Premium supercharges it. If you like YouTube, you'll love Premium. Try YouTube Premium for two months free at youtube.com slash premium. Trial eligibility varies, terms apply, cancel anytime. Now let's get into today's episode. All times come and go. Good times take them slow. My life I had them all. Remember one thing you gotta know I'm gonna keep on shining.

3:05Hello. Hello. Hi, is this Andy? Hi, yes it is. And Andy, where are you other than in your closet? I am on Vancouver Island. Oh my goodness, is it heaven right now? It's gorgeous and we have a pontoon boat. We keep it in the water until like October, usually Thanksgiving, which is middle of October for us and we use it to the max. And it's in salt water or in a lake? In a beautiful, beautiful lake. Oh, it's crystal clear. It's green, blue. Like it's almost Caribbean colored. Like when you see the people wake surfing, the wave is gorgeous. The pictures I take of my friends wake surfing. I'm always like, look at the color of the water. You're missing the color of the water. Yeah. I wish I could say the same for our lake old Hickory in Nashville. It's quite murky, but we love it just the same. A little brown. Yeah, it's a little brown, sure. But that water you're describing is very much like Northern Michigan has torch lake, a few lakes that look like the Caribbean or the Caribbean. Yeah, we're so thankful we get to live by.

4:07And then we're only a little ways from the west coast. Like to Fino, you clue it, which of course is spectacular. Okay. And are you a nurse? I am. Okay. Wonderful. How long have you been a nurse? I've been a nurse for about 20 years. 20 years? What's the lifespan of a nurse? And I don't mean like, before you die, I mean like, do people fatigue out of the job? Is it stressful? Or do people stick around a long time? The beauty of nursing is that you can change your focus. There's so many different areas of nursing. So people kind of maybe burn out in a critical care situation, like emergency. Yeah. And then they'll go to like community, which is a little more chill. I'm an operating room nurse. Oh, okay. I love it. I can't imagine doing anything else. After listening to Dr. death, we need you. We need your eyes on the scene. That's what we're necessary. Okay, so you have a crazy nurse story. I do. Our ORs run on a slate and normal schedule.

5:07And sometimes we get emergencies. And the surgeons will come in in the middle of the day and say, I need to bump in. Okay. What does that mean? Bump in? It means that they're going to interrupt the slate as it's supposed to be. People with scheduled surgeries, and they need to do their emergency now. Lots of emergencies. We can wait till the end of the day. We finish this book to patients and then add these guys on. But this one, they're like, we need to do it now. They say it's a younger gentleman. And he's got an open wound on his scroodle. Coxic's kind of area. What's coccyc? Your tailbone. Okay, so somehow there's a tear between his tailbone and his testicles. Yes, exactly. And in the summer, we see lots of these because this is a gross human anatomy thing. But when people sit for a long time, often on long sweaty car rides in summer vacation, they can get an infection or something down there. And so we see a lot of gentlemen come in when they need their scrotum or coccyx area kind of tended to. Okay, and is it generally staff?

6:08Is that what people get there? Sometimes. Sometimes it can also be a necrotizing fasciatus. That means necrotic flesh like it's done. Okay, and that's got a really nice smell, right? It's a distinctive one. There's no mistaking it. We don't even need to pull back the blankets. We're like, ah, necfache, welcome. So the urologist warns us and says, we've seen some maggots. And we're like, okay, no biggie. But this is odd for this location. Like sometimes we see maggots, but it's on wounds that are more kind of exposed to the air, like limbs, like legs or feet or something. And people who aren't necessarily taking that well care of themselves. Between the patient coming from a merge to our operating room, we learned that it's sadly a paraplegic. And the mom was the primary caregiver and she had passed away recently. And nobody stepped in to care for this patient. And they were kind of trying to make a go of it on their own at home. It's really, really sad.

7:09No nurse visiting ever, just completely solo paraplegic. Yeah, so the patient's not doing well because this infection is now gone systemic, they're septic. We need to get them in and clear out this infection. So we bring the patient into the operating room. We don't really see much. We pull back the blankets to move them from the stretcher to the operating room table. And I can see the maggots, they're crawling around. And if you had to ballpark how many maggots are we talking 10 or 100? At this point, I can probably see 40 to 60. And they're just kind of crawling. But I haven't seen the wound yet. So we move them over and we move the blankets. We get the patient to sleep. And then we lift up the legs to check the extent. There are probably three to four holes that are between, I would say, five to 10 centimeters. And they are packed with maggots.

8:15This is going to be like baseball size of maggots. They're actually tiny, but they're so packed in that it looks like a honeycomb. If you can picture that, it's just a big butt stacked on top of each other. Yeah, if I'm you guys like, but do I start with raid? No, normally. So if we have a cavity that we have to prep, like you do surgery, right? You try to decontaminate the area that you're going to operate on. Normally for a cavity, we would take a sponge with iodine a solution on it and just kind of swish it around in there. I look at the surgeon and I'm like, I can't. I'm like, all I'm going to do is stir up these maggots. Yeah, yeah, yeah. I mean, are you to scoop them out first? We're trying not to disturb the wound. Like they want to get in there in a sterile as possible way first, right? So he's like, I don't know, just pour it on. So we just start trying to angle this betadine solution into these holes the best we can.

9:16To like flush them out. Totally, or just to get the area as germ-free as we can. We do that and the maggots kind of start to make a run for it. They're interesting just to go into the wound and stay with the flesh that's dying. They all start to come out, but we've got to get on with surgery. So we throw the drapes on, put them on, which is like, you know, when you see surgery on TV, it's all the blue kind of paper and stuff. But they're starting to run up the patient's body. So we have a scrub nurse that's with the surgeon. And so the surgery gets started and the scrub nurse and the surgeon are just like scooping out handfuls of maggots and putting them in buckets. And then we're also suctioning them up as well into big suction canisters. But I'm under the drapes because I am in charge of scooping up all the ones that are making a run for it. And we've got an anesthesiologist, of course, at the head of the bed. And anesthesiologists do what they do because they don't love the muck and the mire of the operating room. For the anesthesiologist, the thought of maggots heading his way.

10:17He was just like, paticked. So I'm just under there scooping them into a container and then dumping it and then scooping them and dumping it. We're talking hundreds and hundreds. Thousands. When you had gathered them all, were you putting them in like a five gallon bucket or smaller? For the OR people who were sterile, they had like stainless steel buckets. They were scooping them in and then dumping them into something else. I was just putting them into like smaller containers that I had under the drapes. When you had the majority of them in the central container, how much volume are we looking at? Probably a couple of leaders. If anyone can picture the two-liter bottle of coke on the shelf at the grocery store, I mean fuck. Yeah, it was a lot. And at one point I came up from the drapes to dump and our wonderful scrub nurse who was actually a travel nurse that was visiting with us. It was his last day. And he just looked at me straight in the eye and he said, I do not get paid enough for this.

11:21So what did the den that surgeon goes in in their jobs to try to cut out all the necrotic flesh so there's no more of that? Yeah, so they're trying to get rid of all the decaying flesh because now that's going systemic and it's making the patients sick. Oh my gosh. And what's the recovery time for this person? They went away to the ICU. I'm not sure about the outcome. That's the problem with the OR. We stitch them up and we send them off and we don't necessarily know what happens after that. When you were younger, did you ever check? Were you curious and over time you just don't check? We're actually not allowed. They monitor nurses very closely in terms of looking at charts. So if you open up a patient's chart, it's flagged that you've opened it and you can't check on them kind of after you've seen them. And that prevents stuff like looking at people you know or looking up stuff for family members and that kind of thing. So we're really restricted. The only information we get about how a patient's done is if the surgeon knows and they can come back and tell us they did fine or they didn't do fine.

12:23Oh boy. What a heartbreaking scenario. Oh, it's terrible. So he must have just felt so bad from being septic. He finally called 911. I think someone went to finally check on him and what we heard was that he was already down in the home and someone called 911. Oh, if we give that one a 10 over this 20 years, you've had, I'm sure, numerous. And it was a hard for you to pick what story you would tell. Yeah, I mean, the OR we see all kinds of crazy stuff. Years ago, I had a rodeo guy who got kicked in the jaw by a horse. Oh, and normally we would have a certain entry point to fix a jaw, but the course had kicked him enough that it opened up. So we were able to just go in through the opening that the horse had nicely made for us. Oh my goodness. That's crazy stuff sometimes. Andy, my deepest gratitude that you're doing what you do. I think everyone feels that way. I mean, it takes a certain breed to be able to look at the honey comb with the maggots coming out.

13:24I looked online to see if I, because of course we can't take pictures and video and stuff in the operating room just for privacy. And I thought I'd look online to see if I could find anything and comparable. I stopped going down that run. No, I'm backing out. You know when you're algorithms are feeding you that. Yeah. Can I give a little shout out? I would love to hear a shout out. So I'd like to show it to my best friend, Christy. She is the ultimate arm cherry. You are hands down her celebrity crush and she talks about it all the time. Oh, I love it. Upstairs at L's was definitely our track of the summer. Oh, thank you for putting us on to that. And did you dance with reckless abandoned? Absolutely. Oh, wonderful. Well, big shout out to her and thanks. I don't know if she turned you on to it or not, but we appreciate it. Yeah, I've been listening for years, but this was when the nurse prompt came up. She's like, this is you. This is you. So you're up. You're up. Yeah. Pinneth with the maggot story. For sure. Well, it's lovely meaning you know, I hope you get extra extra days out on the pontoon before it gets cold.

14:26Yes. Well, if you ever want to come to us coast. Oh, I do. We have, I'd say a disproportionate amount of people we interview from Vancouver Island. I don't know. Shit goes down up there, but definitely on armchair anonymous. I'll just say Canadians in general, considering that you're less than one tenth of our population, you're definitely more than one tenth of our crazy calls. Love it. All right. Well, take care. It's so nice meeting you, Andy. Do do. Thank you so much. All right, bye bye. Hello. Hello. Hello. You have gorgeous teeth. Oh, thank you. Really nice smile. Yeah, they really hit you right between the eyes. Don't they? Good. That's how they should be. What fake name should we use? What would you like? I want to say Kelly, because you look like my cousin Kelly. All right. If you have no sworn enemies name, Kelly. No, totally fine. And where are you, Kelly, other than a dark room? I'm in the Midwest, and I wouldn't be surprised if at the end of this, you might be able to guess what state I'm from just based on how I talk. Okay, so are you a nurse?

15:28I am a nurse. Okay, we love you already. I've been a nurse since 2010, so 16 years. And what type of nurse are you? And I bet maybe that's changed over the 16 years? Yeah, it's been different. I have been a cardiac telemetry nurse. I now teach full-time at a technical college. So I get to teach the nurses to be nurses. Is the cardiac telemetry where you are assisting putting in pacemakers? What did that mean? We would care for patients after they had a pacemaker placed. The system that I worked in, we sent patients to different hospital that cared for them, higher level, and stuff like that. So we saw a lot of chest pain patients who were there for a stress test. But then also, of course, everything else. You being a nurse and a teacher crosses over on two favorites. Yeah, I'd say you got two of the four quadrants. I'm not even sure that there's two more, but it just feels like to be safe. Okay, 50%. 50%? Yeah. Okay, so you have a crazy nursing story? I do. So this takes place.

16:29I think about 10, 11 years ago, I know I was definitely not a new nurse when this happened. This took place kind of in a Midwest sort of suburban hospital. We admitted this patient for severe abdominal pain and hematematist. Do you know that word? No, what's hematematist? I know blood is hemah. Yeah, bloody vomit. Yeah. Yeah. Yeah, kind of my least favorite thing too. So they were vomiting up a lot of blood. Is there a high percentage of gas at what that normally is? Perforation. Yeah, usually we think something's up in the stomach or the upper intestines. We needed to rule out upper gastrointestinal bleed and figure out what was going on. Of course, managing the pain was part of this whole care plan as well. And so we immediately had to do diagnostic tests. So EGD colonoscopy, the EGD found nothing. Not a single source of bleeding, not even any tissue that was questionable.

17:32The gastrointestinal providers was like, I literally found nothing. Not in the esophagus, not the stomach, not the small intestine, where they could reach the scope. Same with the colonoscopy, nothing in there, which wouldn't really make sense for vomiting up blood. So you did nose to tail on this person and we don't see any tears or anything. Correct. You need Dr. House at this point. Yeah, we do. We did blood work, of course, nothing really showed up. No infection, maybe a little bit anemic, you know, they're losing blood. So that's what we know for now. We get support from our presenting sponsor, YouTube Premium. Now, you already know I'm a big YouTube person. It's incredible on its own, but Premium makes the whole experience feel enhanced. Like you don't realize how much better it can get until you try it. The biggest game changer for me, background play. I love long two-hour deep dives of you name it, Motorcycles Travel Cars.

18:38Cooking shows for me. Cooking, listen, with Premium, you don't have to keep the screen open. So I can lock my phone, slide it into my pocket, and listen to a podcast while I'm folding laundry or working out. It's also completely out-free, meaning when a narrator is building up to the climax of an insane story, there's zero interruption. And for travel, offline downloads saves the day. I love this one. Relying on airplane Wi-Fi can be a gamble, so I just download my favorite videos before take off. And with Smart Downloads, Premium will automatically download new videos from channels. You actually follow without having to lift a finger. I'm covered if I forget to download a video. I want to watch, or even if there's no service. And the home run for me is that YouTube Premium remembers exactly where I left off, and lets me continue watching on another device from right where I stopped. So I can start a video on my TV while brushing my teeth, and pick a right back up on my phone on my morning walk. So yeah, YouTube was already great, but Premium supercharges it. If you like YouTube, you'll love Premium. Try YouTube Premium for two months free at youtube.com slash premium.

19:41Try out eligibility varies, terms apply, cancel anytime. We get support from Scottsdale, Arizona. Monica, with summer ending or heading into fall, I've been researching a nice quick getaway location, and I keep coming back to Scottsdale, Arizona. Ooh, Scottsdale's good. What's drawing you to it? Well, first of all, I have this wonderful memory of going there as a kid. When I go see my stepdad, when he's working out there. The weather is perfect in fall. Warm, sunny, no humidity. And you can really do whatever you want with your time there. I want to do a sunrise hike through the Sonarun Desert. Be surrounded by Soiro, and then at the same afternoon, just completely melt into a spa treatment at one of their luxury resorts. Oh, that sounds amazing. I want to do that. Also, I was there visiting my brother once, and I loved old town Scottsdale. It's so walkable. They have galleries and cute little restaurants and shops. The food scene alone is worth the trip. What I keep reading is that it's luxurious, but not stuffy. There's no pressure to do it a certain way.

20:42You can explore public art, check out the architecture, go off-roading in the desert, or just sit and watch a sunset. It really is the perfect fall reset. Learn more about all Scottsdale has to offer at unwind in Scottsdale.com. In terms of like pain management, that's kind of where I come in, making sure that they're getting the appropriate medications to manage their pain. They were getting opioid pain medication through their IV access. I was giving hydromore foam to lauded through their IV. That's a nice product, you know? Yes, and it was not really doing the tricks. I was seeing him vomit up blood, like filling the kidney basin that we put at the best time. Huge clots in his vomit. I was seeing this before. The vomit is like one of my least favorite things, that in sputum.

21:44So it's like take your pick. So that's probably one of the reasons why this story stands out to me so much. Can I ask how big are these clots? Are they the size of a penny? Like a golf ball. Very. A poached egg. Yeah, poached egg. No, don't say that. Don't feel like poached eggs. At some point during the hospital stay, this is kind of over the course of a number of days that I'm hearing for this patient. You know, the providers are getting a little suspicious about something's up here. And so we needed to assign the patient to be a one-on-one sitter, where we have, typically a CNA, sit with them in their room, 24-7, eyes on them, the whole time, safety reasons, right? And we needed to make sure that they weren't causing any harm to themselves. So I remember being a little bit like oblivious to like these suspicions and thinking, I just so badly wanted to believe this patient that something's really wrong.

22:47What's happening? And giving them the benefit of the doubt. Do you have a guess? Well, it sounds moon shells in the array. I have a guess, but I'm not going to say. Oh, okay. Good guess is one of the other things that we were dealing with was that we were not able to maintain like peripheral IV access. So in forearms and hands, we weren't able to keep any IVs in there. So we did attempt, and I partnered with the hospital provider at the time to put in a central line, just because we did need IV access. And where's the central line go? The central line goes in the neck. So they find a big vein in the neck, either just above the clavicle or below the clavicle. We attempted to do that at the bedside, but that did not work. We were unsuccessful. We were not able to access this vein that we needed. I'm getting junky clues as well. Like if you've collapsed a lot of veins, they too run out of veins to use. Yeah. And so we ultimately were able to place a pick line, a peripherally inserted central catheter, which dax you know goes in the upper arm has a very long tube that enters all the way to the top of the heart.

23:53Crazy long, I would say. Yes. Yeah. I think when they get taken out, everybody goes, oh my gosh. I know that guy was pulling it for a while. As he had to wind it like a hose as it was coming out. Yeah. So we got the pick line in. We were able to use that to administer the IV pain medications and still being watched one-on-one with a citter. And then some of the behaviors we started to see the little bit worried about. So I was getting reported to from the citter about, hey, this patient keeps putting their head underneath the blanket. And so I can't see their face. I can't see their head. I've asked them to please keep your head visible. I need to be able to see you all that stuff. And they would just I think pretend that they were sleeping and that it was really bright in there. And thankfully, because I was pretty good at building a relationship with patients at this time, I had to be really stern. Hey, this isn't going to work. Like you're going to have to stay out where we can see you at all times. It would work for a little while and then back under the blankets again.

24:56Can we get an age range of this person? I was wondering if you would ask. I think probably 40s. Okay. Okay. Maybe early 50s. So unfortunately, we got to the point where there was really nothing else we could do. We had no more tests. Everything was inconclusive. Pain management was as good as we can get it. We tested for everything. So ultimately, we discharged the patient from the hospital. You know, of course, this patient is on my mind for some time afterwards. And so I caught up with the hospital provider who I worked really closely with and said, hey, whatever happened to this patient and the story goes, the patient was admitted to another nearby hospital for the same problems. And it was found out that they were under the covers of the blankets, opening up the ports, the hubs on the end of their pick line,

26:00undoing the clamps and taking off the hub cap that we put on there and sucking the blood out. Of the pick line swallowing it and then throwing it out. Okay. That was my guess. He was drinking blood. It was. Yeah. It was. Nice. He's a vampire. He's an auto auto vamp. Where do you think he was getting me initial blood from before the pick line? That's a good question. I'm not really sure. I don't know if they had any injuries. I don't know any of that. It may have been collecting blood over time. And is the theory that this person was Moonshaw's an or a drug seeker? I have a feeling that at this point in time, this was this patient's solution to getting to withdrawal medication. Yeah. Oh, uh. If I would have known now what I knew back then, my approach with this patient would have been totally different.

27:04You know, thanks to learning from you guys over all this time and making sure that, hey, yeah, this is a real thing and it's really hard. I wouldn't have changed how I cared for their pain. What a patient says their pain is is what they say it is. If you're wrong, someone suffering greatly because you know everything, then you're going to feel terrible about that. That happened. So you got to live with it. It's like the justice system. Some guilty people are going to get away with it. You know, that's preferable, right? It'd be preferable to suck the blood out of your pick line than to deal with the detox. It's pretty powerful. Yeah, that speaks pretty greatly to what they're willing to do. Yeah. Oh, wow. But yeah, that's my craziest story. And how my patient drink their blood. Oh, my God. Oh, that is so horrifying. Kelly, this has been a delight. And anyone who has you is a nurse is so lucky. And a teacher. Thank you. I have to, of course, shout out my husband and my kids

28:06who we would listen to armchair anonymous together. Great. My husband's not necessarily a podcast person, but he's totally hooked. And the kids are 12 and 10. And we do a lot of teaching with them. Yeah. Yeah. Yeah. That's a great conversation starter. Yeah. Yes, exactly. A lot of pausing. Okay. What questions do you have about this? But they do not know I'm doing this. Oh, my. Oh, my. Say hi, mom. They'll hear my voice, I think. And they've been telling me to submit for a long time. Do you have a story, mom? Do you have a story? Yeah, I sure do. Of course I do. Well, I want to say to both the little ones that were so delighted they're listening. Definitely. Whether it's ethical or not, I won't decide. I let my kids listen. So you know, all all burning hell together, I guess. So yeah, anybody wants to judge us. You know, I just say, well, Dex does it. So they seem to be attending school.

29:06I've had it that they're learning it from me, rather than on the school bus or at school. I heard all these kind of stories on a playground. With just no context or anyone explaining what was really going on. Exactly. Exactly. They will not be the kids that grew up to put anything in their butt. That's exactly what they said. Or they can put a tether on it. If we've learned anything, make sure you can get it out. It needs a tether at all wise. Yeah, can't go out of town. There's a lot to learn from this. And be realistic and what fits in there. We've learned. But some things are too small. They get lost. It's a real fine line. Dildos exists for a reason. I guess it's the moral of the whole story. Like there is a perfect size. I'm sure some of that is stuck. Oh, sure. I'm sure. Yeah. Well, we could send this into the ditch right at the end. Lovely meeting you. And I'm delighted. The whole family will be listening. We sending love. Thank you so much. This was so fun. All right. Take care. Bye. Bye. Hi there. Hi.

30:07Hi. Do you have a fake name that you're drawn to? Anything you want to use? Well, you look like a chair. I don't know where we go with that. Angel. Angel. Boom. Really a job. OK. You can do that. Angel, where are you? Currently in Florida. But this story takes place in the Southwest. OK, great. I love the vagueness. This promises to be juicy. We love this prop. Morning picking Arizona. OK, but she can't say. Yeah, we're not going to say, but just I'm already feeling Arizona. It's a wild place, Arizona. There's a lot going on. Yeah, there's a lot of things happening. So are you in nurse, I presume? Yes, I am. I'm a nurse. OK, and how long have you been a nurse? Nine months. Oh, my goodness. OK, wow. Congrats. How are you liking it? I love it. It is the best ever. Some challenges for sure. But it's been a great experience. I'm very excited. I imagine it's just an exciting job. Everything's different. It's never stops. Yeah. And the co-workers agree. Everyone you work with is lovely and wonderful. You guys are the best we got. OK, so you have a crazy nurse story.

31:08And we want to hear it. OK. So I'll set the scene. I graduated in December with my nursing degree. I went to school in Arizona. You were right. OK, funny. We'll see another state in the Southwest for work. And I took a job at a large teaching hospital where everyone's brand new. There's new doctors, new nurses, new everything pretty much. And the beginning of the year is hard, because a lot of people are transitioning into new jobs. So there's a lot of change. But I'm going through orientation. It's about four months. And so I get off orientation around April. And I've been off orientation two weeks. It's going great. I love everything. My patients are wonderful. The other thing to note is when you are a new grad, they give you the easiest patients usually on the unit. Yeah, dip your toe in and then build your confidence. So great. And easy. And you're like, yeah, it's great. And then it gets worse. Yeah. So I'm getting a report on these patients. It's my first shift of three. The last patient that I get report on, they're telling me like 50s male. He is one day post-op. He had his penis removed. Oh. OK. That's a bombshell.

32:09Let me go meet him. Let me go say hi. And so I pop in and he's sleeping. So I'm like, oh, come back. I get the rest of my poor. And the other person's telling me she's like, well, he left a caulking on. Oh. Oh, my god. I know it gangrene for three weeks. No. Oh, wait. Why? Oh, he just loved it. Or could get it off, maybe. Yeah, he could not get it off. Wow. Good for him. Oh, good for her or him. Oh, my gosh. OK. How small are these caulk rings? Well, I think they come in different sizes. So I think you're supposed to get one appropriate to your. Anybody want to just squish it? Squeeze it. Well, because all your penis is doing to get hard, right? Is it's restricting the blood that can come back out. It's filling up all these vessels. So just keeping it hard. Harder. I think you get increased size with it. I'm going to be very candid. I've not ever worn one. So I'm speaking not theory. Yeah, yeah, yeah, yeah. I'm just guessing what's going on.

33:10OK. Uh-oh. So he got a child shot. Well, let me say this. This is what I heard earlier from a dude who I knew who was a male stripper. And he said the thing the male strippers would do is they would tie a bit of string at the base of their shaft or a caulk ring, because they're at work for whatever, six hours dancing. And they want their penis to be engorged. Oh, wow. OK. Oh, my god. Well, don't do it. Now we know. So I'm getting a report, my jaws on the floor. And I'm like, well, what happened? How is he found? Did he just walk in with this? And he was found by his friend that he lives with, some sort of social situation. He was found down. And his friend had thought he'd overdosed. And so he's calling 911. They bring him in. They're treating it like an overdose from his house to the hospital. Comes to the hospital. They take all his clothes off. And they're like, don't think he overdosed on anything. Don't know. But we have other problems here. And they're giving him some fluids. He's kind of coming to. And I guess they got consent downstairs. They're like, look, we don't want to take your penis.

34:12But it's not looking good. We can treat him as like vascular procedure. Oh. Brancing it. And he's like, OK, let's do that. Really quick. Was he sepsis? Is that why he was unconscious? Partially that, but also his urine's backing up. Because he's not able to get any urine out. Oh, for how long again? When I talked to him later, he was saying, he's like, I had like a full stream of pee for like the first week and a half. And then after that, he was like, probably. Oh. Oh, mama mia. Papa Pia. Oh. Oh, wow. MUSIC So they take him for that procedure. He wakes up the next morning on our unit. And I'm getting this all in report. So she's telling me like, I had him. And it just looked bad. It was black. It just didn't look like it was going to survive. And so the search comes in and he's like, look,

35:14we have to take this. We're going to remove your penis today. Oh, my God. What a sentence to hear. Also, let's be clear. This man is an active man. He enjoys his penis. Clearly. He's got tock rings on. And so I'm getting him the day after he just had his penis roved. Oh, boy. And I walk in and I'm prepared for like emotional, let's have a conversation. This is really challenging. I'm so sorry. This is going on. Let's talk about this. And he's like, oh, I'm doing good this morning. I'm not having a lot of pain. Doing really well. In report, I got that we had to change the dressing every two hours because they rerouted his urethra through his scrotum. Oh, OK. Because he didn't want to have a like super pubic catheter. He didn't want a bad external of him. That was like the agreement he came to with the urologist. If we can try it, but it may not be a thing. And so his urine is draining out of his scrotum. Wow. Hold on a second. I'm just trying to like really model what

36:15it would feel like to grab my ball sack and aim it. You'd have to aim it. It was sure, sure, sure. Or you stand at an angle. Or you might want to sit, you know, because they're going to droop down, downward anyways. OK. Wow, that's an adjustment. You're in 83, your balls. So does he have a catheter through his urethra that is in his ball sack? No, it is just his urethra coming out. Oh, OK. All right. Modern medicine. They can do anything. I wasn't crying. I want to have mine run out the palm of my hands. So I can just like be out the window and stuff and be driving. Yeah, I know. Well, then we can be here. But it's leaking there. And so I'm pulling back this dressing. It is sopping wet. I pull it back. I take out the packed gauze that's in it. And it is like a baseball-sized gaping hole. Woo! Whereas penis was or in the testicles. Whereas penis was. Oh, by. They dug it. Oh, my god. It's a block. And taking the gauze out. And I'm like, I don't think this is how we're supposed

37:15to be dressing this. I need to call a nurseier nurse. I need help. Were you conscious of your face? When I saw it, my next thought would be like, oh, control your face. God knows what it looks like right now. I think I was like trying to. So I was like, I know it's going to look rough. Like, try and keep a straight face. Are you wearing a mask? Yeah. Oh, thank God. Thank God. Yeah. I have another nurse with me. We're looking at it together. And she's like, you should call wound care. She's like, I don't know what the surgeon said. I don't know what they want. And so I'm like messaging back and forth with wound care. And I'm like, hey, I just want to make sure we're doing the right thing. I don't want to make this worse. It's a really wet wound. He has urine around it. And that doesn't seem great. Yeah. Although, isn't it antiseptic? It sounds like a grenade went off in his underwear. I mean, that's what it feels like we're left with. In the whole time, he's just casually talking to me. He feels like great mood. What a champ. Yeah, I'm like, this is impressive. Okay. So wound care finally shows up. They come in and we are going in there and they're like, oh, this looks great. This is exactly what you're supposed to be doing.

38:17This looks great. This is gorgeous. I'm caring for him over the next couple days. And it's kind of the same stuff. He doesn't look great like his hemoglobin's a little low. So he's a little pale. And I'm like, hey, don't get up. Don't get on the bed. So he's like stuck in bed with this wound. Tough spot to be. And he's kind of lonely. And so I tried to go in there when I have time and just like chit chat with him. I was asking patients, I'm like, oh, we're gonna grow up. Are you from here? And he's like, well, I'm not from here. I lived in Arizona. And I'm like, they're at. He tells me where he was at and where he's working. And he worked on the same street I grew up on. What? No way. That is so sad. I got to take as a keepsake burbling into the top of my mind, which is this also sounds very methy. People with these kind of injuries, we learn generally meth is involved. There's to go weeks. Well, in the friend thought he overdosed. Yeah. What if the punchline was that you found out this was your real dad? Oh. Oh. Oh.

39:18Oh, God. Tell us about a meat ugly with your biological dad prompt. Okay. He lived in your street. He worked on your street. Yeah. Yeah. And so I'm just talking to him about that. And we're like building a rapport. And finally, I ask, I'm like, so what were you doing about this? What was the situation at home where like this is staying on? And he's like, well, I was like going to work and then I come home and I try everything I can to get it off. And he's like, do you want to see a picture? And I'm like, oh, no. I do, but I don't know if I'm allowed. He was like, okay. Oh, God. I know. But are you? Yeah. This man just creepy me out a little bit. Okay. He sounds friendly though. Exactly. He just got his penis cut off and he's too happy. He's probably like, finally, this is over. God, I'll finally have some free time. I'm gonna go definitely on the money with a little bit creepy. But he shows me and it is just like a black little shrimp.

40:19Oh, silver ring around it. A shrimp. Oh, fuck. Fuck, fuck, fuck. So he's a metal ring. Why didn't no people put that's a bad idea? Oh, that makes sense. Why he couldn't just like cut it off or something. This is like my second or third shift. I have some time to like look through notes and I'm looking through his notes and he had come in with a similar injury. The previous month and in the notes, it's like was left on for three days couldn't get it off. So came to the hospital and there's like very clearly like education was given to not do this again. He couldn't resist. Oh, but then why do you wait this long? This time. It's a good question. Maybe he felt like they really shamed him on that last trip. He's like, I can't go back admit I did this a week later. A couple weeks go by. I'm like working, but I don't have him as patient. I know he's on the unit, but I don't really take care of him. And we're sitting in Huddled and that's when we were just getting information about what's going on on the unit and like what patients to watch out for. And we hear the code alarm go off.

41:19Everyone goes in and day shift and night shift are both there's in a code. There's already a lot of people, but this is like double the amount of people. So there's like 30 people in a tiny hospital room. I'll try to do something. We all have roles assigned. And so I'm like standing in line to do compressions because he is unconscious. He had had some other like GI bleeding just from being in the hospital and just some other like complications with that he'd been back and forth to the ICU a couple times. Mocha came back sent him back to the ICU and I thought that was going to be by time with him a couple days later. I come back to work and I'm getting report and I'm like, I know this patient very familiar. She's like, oh, he's going to go home today and I'm like, oh, phenomenal. That's wonderful. And so I'm like, well, to see if I ride home. I go in the room and I talk to him and I'm like, hey, I hear you're going home today. That's great. I'm so excited for you. Do you have a ride? It can take a couple hours for us to get our stuff together. So just be patient. And he's like, oh, yeah, I have a ride. It's my roommate, my friend. And I'm like, preparing my teaching discharge education.

42:21I go to my preceptor who happens to do that. I'm like, hey, what would you educate on? Because like the problem that he came in with is gone. Right. What do you want to teach about? And she's like, maybe let's talk about not putting things in your holes. Because that's the next step. That's where this is going. Now he has an extra hole. And she's like, make sure you explicitly say, do not put anything in your your rethrough. Okay. Great. And then became the roommates problem. Oh, the roommate. Yeah, I hope he's getting reduced rent. I hope the roommate is actually like a boyfriend or something. Because if it's just a roommate and you have to live with it, that they need to call into bad roommate. Yeah, I mean, I'm trying to imagine if like Aaron went through this whole scenario, what my reaction would be. Yeah, but you guys are best friends, not just roommates. But even as best friends, I think it'd be like, brother, what's happening? Yeah, of course. You'd inquire. I think I'm still picking them up. Well, of course it'd pick them up. But I would just be like, what happened here? Let's talk. Yeah, we have a cave now. Oh.

43:21In a testicle penis. Wow, that's why on your first angel, what a heroine first shift. That was quite the first shift. That was incredible. Yes. Thanks for sharing with us. Yeah, I'm so happy you're doing this. Yeah, I'm so happy to be here. Can I give two shout outs? Yes. One to my mom. She is lovely and excellent in my favorite person. One to my best friend, Kaya in Oregon. She's excellent. And I hope she listens. Kaya, we hope you listen to an in Kaya. If you can hear us by passing her radio. Well, thank you so much for telling us all that. Yeah, have a great day. Thank you guys. I appreciate it. All right, take care. Hello. Hello. Hello. What should we call? Well, I know what I want to call you Monica on three. One, two, three Chris. Yes. Guys can call me whatever you want. Do you get that all the time? I have gotten that one as a doppelganger as well as Donald Gleason,

44:23the eldest Weasley brother. Oh, wow. The oldest Weasley brother. Monica, you would know better than me. Is that a man? I mean, I think it's more on the Christmas. Martin. Yeah. Also, Chris Martin is such a sex symbol. Oh, yeah. He is. That's a you want to be told. I would love to be told it looks like Chris Martin. Where are you, Chris? I'm in Oregon at the moment, but the story is in the inland Pacific Northwest. And are you a nurse? I am. I'm also a nurse practitioner. I kind of do both. What's the difference between those two? Nurse, you work at bedside. Nurse practitioner. I have prescriptive authority and I can see my own patients. More school sounds like more school. I have a master's degree. Okay, great. And how long have you been doing this? I've been a nurse for almost nine years now and a nurse practitioner for almost two. And are you still loving it? Yeah, it has its ups and downs. I think there's days like this story that test you. And then there's really fulfilling days where you know you made a difference in someone's life. I got to say that's every day that you guys go to work.

45:25You make a difference. Yeah, absolutely. You know how we feel about nurses. We're like, how could someone be still giving? Yeah. It's a tolerance of body fluids. It's incredible. You know, through a lot of therapy, I think the amount of nurses that have their own trauma some people kind of maybe turn towards drug addiction or substance abuse and then others turn into caretakers. Yeah, that's really terrible. Because I think there's a higher rousal setting for most people in nursing. Definitely and probably decreased the make-to-the-response. Okay, so you have a crazy story. We want to hear it. Honestly, when I emailed Emma, I was like, there's no way. There's no way they want to put this on the air. Oh, that makes us so excited. Well, just to tell you, Chris, we did just hear about someone that had two areas of necrotic flesh in their perineum and it looked the nurse said like honeycomb and total, there were thousands of maggots. It filled up two leaders. That one's on the program. Fornier is gangrene is what they call that. That's the rotting of the perineum. Oh, it's a doozy.

46:26You're like, I've been there. God, you guys have all done all these cr- Oh, my God. That's wild. Okay, so this story takes place in the in-land Pacific Northwest and I had been at working at this hospital for a couple of years after you worked there a while, you get to rotate as a trominer. So if there's a certain level of tenure and so that means like when the ambulance calls and something crazy happens in the field, you get on the ER and you respond with an ICU doctor, ICU nurse, ER doctor, ER nurse and the trauma surgeon. And so sometimes when you're waiting, you get downgraded to partial traumas and then you just go back to the unit. But sometimes they can be crazy. But you get used to it after a while. Nothing really surprises you. This one did surprise me. So we were all waiting in the trauma room. It was the five of us. And we had massive transfusion blood setup. So like this thing called a Belmont, which just pushes blood into people and then vasopressor is medication-strung up.

47:27We're all just waiting to see what comes through the double doors. And so this fast comes up with an update. It says stab wound disembodement. So then A.M.R. calls in. It gives us this story. 87 year old woman called 911 because her son who lived with her was in his mid 50s and had apparently stopped taking his psych meds. And she walked into the living room, found him sitting on the couch calmly, smoking a cigarette and he had cut his abdomen from side to side, pulled out his intestines, oh, put them on the couch next to him. No, oh my God. Oh, fuck, I haven't even seen that in an horror movie. Yeah, and he was conscious smoking a cigarette. Real quick question. When you hear that there is a psych element to it, do you now have to bring on other additional people? Like psychiatrists who are gonna help stabilize. I mean, I guess you can't stabilize someone mentally, but quickly. So after they get admitted and stabilized, then you'll have inpatient psych come see them

48:27and deem whether they're a threat to themselves or others, but that doesn't happen immediately. At this point, we're just trying to do life-saving measures and get them to the OR as quickly as possible. But yeah, oftentimes it will lead to restraints in the hospital and mixed thoughts about that, but you have to protect someone from being a harmed themselves. So Pyramedics got him in the ambulance. He lost consciousness on the way to the hospital. And then when they wheeled him into the trauma bay, one of the Pyramedics handed me his intestines and his ziploc bag. Wait, they were now separate from his body. Oh, yeah, he had like ripped them out. Oh my God. I can't believe he hasn't blood to do it. I know. It was close. We gave him, I think about six units of blood before he got to the OR. This Pyramedics were like, I don't know what the hell you're supposed to do with these. My chitlins. Chitlins. Oh my God. He got it to the OR. He got a colostomy. So like new plumbing, you know, pooping out of your stomach. And I went home. That was my Friday and I was like, that was the craziest shift ever.

49:28I figured you'd been discharged or downgraded by the time that I got back to the hospital. He was not. And then that day, it was like three days later. And I was floating as like helper nurse that day. And so you just kind of walk around the ICU and get people breaks and help turn patients or help wear as needed. I was across the unit and I heard someone yell, help please. And so I ran over there. And this guy had been in restraints. He broke his restraints. And he had grabbed both of his testicles and de-gloved them. Wait, wait, wait, wait. Wait, wait, wait, wait. He took off the skin. He pulled the insides out. Oh. Wait, I don't even really understand what that means. Hold on, he pulled the insides. So he pulled the testes themselves out of the scrotum. Oh my God. He have to cut his own scrotum or be going through the big incision that it had been made for his bowel work. No, he just grabbed them with his hand and jerked. Oh my God. This. Oh.

50:29Oh, daddy. This. Wow. This guy's good for two unbelievable stories in one person. He's just trying to take out everything. He needs it all. Everything must go. Yeah. Spring cleaning. He was totally calm, right? Which is aluminum psychosis there. But I turned around. I grabbed some sandbags. We tried to pack pressure. The wound is mess we can, but the particular wound's bleed rapidly. And unfortunately, this gentleman did not survive this. They let out. Wow. Yeah. Wow. I've heard if you get castrated, you bleed out like very quickly, like in minutes or something. Didn't they do it on that in Django or something? Oh, probably. Yeah, that seems like a tear in the tunnel. Topic. But as an RCC, crazy things, I've had good stories and bad. But this is one of the experiences that really changed my perspective of how I see suicide. And I think that I used to see it as like a very selfish thing when I was a kid. I remember saying it was like the most selfish thing somebody could do. But that was before I spent years in healthcare.

51:30Because what I saw on that day was not selfish. It was totally in mind at war with himself. That's really sad. Chris, I had the exact same thought when you said that. I just thought, yes, some people really are not going to be in peace. In any way, and then it'll be such a misery to exist that, yeah, it's actually more humane in some situations. Like you understand the reasoning behind it. I've heard a couple people who have respond to public suicides and or overdoses as I'm so glad they're out of their pain. And I think that's kind of a nice way to frame it. Yeah, I think that's the empathetic way to look at it as best we can. I can't know what was going inside this guy's head. Sometimes people are hallucinating. I don't know if that's what it was. Because on that second instance, he had already been restarting on a psych meds at that point. And patients like had seen him. But it didn't look like panic. It was calm. And I felt like a rational decision to end his life. But that said, they illness had completely overwhelmed his brain and taken responsibility for his fear as judgment, his self preservation.

52:31Yeah, we have some acceptance over an organ failing through a disease and killing the person that we seem to accept that. But your brain can also value in the same way an organ can. Yeah, I think about there's funny parts of the Ziploc bag. And it's a crazy party story for when I'm hanging out with other nurses. Or healthcare professionals. But I also think about how much I misunderstood before I joined this job. And so I think it's good for people to question what they once believed and look at things from another perspective. We agree. Yeah. Oh, wow. Wow. That's a fucking, yeah, that's up there. A story. That's up there. Does remind me of the helicopter ride with the, yeah, yeah, yeah. I am sorry to make you guys ride. I can see both the. No. No. No, we love you. It's weirdly we love it. I know. Yeah. Thank you to both of you for the space that you guys have created. You guys bring so many important things to the surface that people carry alone. Sometimes people don't want to hear them. And getting to say things like this and other crazy stories.

53:34It means a lot. And you create a great safe space. And also you talk about things like traumas, you know, for instance, gentlemen, the trauma that his mother went through sitting in the other room. She couldn't understand. And then how right you maybe have different feelings about our parents and how complicated these stories can be. And as we change and evolve, how we can see more nuance and not blame people that go towards forgiveness and understanding. And you guys are absolutely incredible at that. And I thank you for doing what you do. Oh, man, Chris, thank you. That's such a nice compliment. That's such a nice compliment. Yeah, thank you. Really appreciate it. Thank you for doing what you do. Yes. And congrats on looking like Chris Mark. Yeah. Yeah. I know that's people are patting you on the back for that, but it's something to feel good about. Well, Steve, as we age, time may not be kind to us all. It was really a pleasure. Yeah, right back at you. I'm so grateful that you're doing what you do. Thanks for having me, guys. And there was really an honor. Thanks so much.

54:35Have a good day. Take care. What a sweet soul. What in the world? He was so special, wasn't he? Yes. Chris Mark. Okay, really when he popped on, I was like, oh my god. Chris Mark is calling it. Chris Mark is a nurse. I really thought he was going to have it. Wow, that was. Woo. Nurse is delivered. Nurse is delivered. They deliver literally and figuratively. That's right. They deliver babies. Great. They deliver your meds. We're grateful for them. They deliver your intestines in as a block bag at times. Turns out. Turns out. All right, love you. Do you want to sing a tune or something? I'm going to be with you, Sonic. Okay, great.