Tuesday, December 20, 2005


The abscess in Patient W had come to a head, surrounded by a large circle of inflamed, erythematous tissue. I actually don't mind draining abscesses. The results are immediate, and getting all that pus out of someone is puzzlingly satisfying. However, it was one thirty in the morning and I had no desire to be standing in the ER looking at a groin abscess.

I had already been awake for 20 hours and I was about to start another full work day in less than 4 hours. All I wanted to do was to drain this abscess, get out of the ER and into my bed, and try to get some sleep before the next day started. I often kick out the family members from the room when I perform a procedure, but I let Patient W's 6-year-old cousin stay in the room soley because I didn't feel like wasting my time trying to convince him to step out for a minute, or trying to find someone to take responsibility and babysit this kid while I was doing a procedure. I was content to let the little guy sit in the corner and play his little pocket video game.

The majority of abscesses that people develop on their skin is caused by a bacteria in the Staphalococcus family. They're mainly skin dwelling bacteria, that somehow breach the skin barrier, overcome the local immune defense system, and take residence. The resulting pus pocket is simply a collection of dead bacteria and dead white cells left over from the war your body declares against the offending biomatter. The best cure is to surgically incise and drain the abscess before it turns into something worse.

Thankfully, an abscess caused by most species of Staph doesn't smell all that bad. However, the groin abscess in Patient W definitely had another contaminant.

As the thick, yellowish-green and gray fluid flowed out of his incision, the room filled with this acrid stench. It was so powerfully pungent that my nose stung and I felt my eyes water up from the shock. Patient W, enjoying his sedative, snored away completely unaware. I tried to breath through my mouth and concentrated on completing the procedure. Then from the corner comes a little squeaky voice:

"Damn, Doctor! What crawled up Jimmy's ass and died?"

(Jimmy is obviously not Patient W's real name. And yes, this is exactly what the little kid said. I was so shocked by his choice of words that I couldn't even laugh at first.)