Thursday, December 15, 2016

Pus in polite conversation





A couple of comments to yesterday's missive reminded me of a pair of events from my naval aviation/medicine past.

The comments were in regard to the gory image I showed of my post-surgical foot. One commentator didn't like the gore, one didn't like it but was fascinated by it, and one asked for more!

The first one reminded me of an old mess-deck adage (which may still hold true in 2016), "never eat chow with corpsmen, and never sit at a table where corpsmen are talking shop."

It's an interesting phenomenon. Corpsmen (and other non-administrative medicos) see and deal with all the "icky" stuff that most of the rest of modern society is shielded from. Everything from boo-boos to bad trauma; spit, mucous, shit, pus, vomit, blood; shattered limbs and bodies, disarticulated parts, enucleated eyeballs, bones and brains and guts, dead bodies, rotting dead bodies -- all of it. It's all part of the job, and to do the job you have to be able to deal with that stuff.

That doesn't mean that corpsmen or the rest of the non-admin medical troops are somehow special or different. Not so many years ago, pretty much everybody had to deal with that stuff. Before the advent of hospitals and emergency medical services and mortuaries and government regulation of corpse handling and disposal, stuff happened to everybody and everybody, at some point or other, had to deal with it.

Today most folks living in the first world never see more than a glimpse of the reality of human disease, trauma and death. They are traumatized when confronted with such things. This is neither good nor bad, it's just a fact. In some ways it's a form of developmental retardation. I believe that there's a cost associated with being sheltered from icky stuff, and that cost is a reduced ability to put many events into a healthy and useful scale and context. I'm not on a crusade to rub everyone's face in gore, I'm just pointing out a feature of modern society. There are plenty of other things modern, first world humans are sheltered from. Most people don't know how food is grown or how weather and climate work or where water comes from or how energy is generated. We all live in bubbles of artificiality, protected from the elements and protected from darkness, hunger, cold, silence, etc. Most people in the first world see nature and reality on the tee-vee or via some other artificial construct, and are often shocked when confronted with real reality. It can be an extreme trauma to see and recognize the enormous difference between what one knows and what one thinks one knows.

Wow. I wasn't really planning to go there. Ah well.

So anyway. USS Birdfarm had departed home port at 0800, heading out on long overseas deployment. The weather was dogshit and the mighty aircraft carrier was heaving around in all three axes. It was the kind of motion that old seadogs hardly noticed. Neophyte sailors noticed it though. Most noobs found it a unique and enjoyable sensation, but some found it quite nauseating.

At zero-dark my fellow flight deck corpsman and I took the rare opportunity to head down to the mess decks for midrats. Midrats are "midnight rations," the fourth meal of the day served on navy ships which, believe it or not, operate 24/7. Or did, anyway, bitd. As it was the first night and the weather was bad, flying was secured, which meant that we denizens of the flight deck battle dressing station could sneak below and have a sit-down meal, rather than remain above and subsist on the infamously bad box lunches which were our usual fare.

For the pedantic, yes, the first night usually means a full flight schedule as aircrews bag enough night traps to regain currency. For a number of reasons, including the weather, this evolution was put off for 24 hours as we steamed in an undisclosed direction and into calmer seas.

Midrats was always a crap shoot. Sometimes it was excellent fare, and sometimes it was awful. An example of awful might be dried out roast beef served with mushy rice and petrified gravy with a side of industrially boiled brown greenbeans. It was technically nutritious, and you could eat it as long as there was plenty of Trappey's hot sauce. And so long as you were very hungry.

Then there was the excellent version. My second favorite was pork adobo. My all time favorite was eggs to order served with hash browns and SOS gravy. Heaven on a steel mess tray!

And what style of midrats did we get on this, the first night of the cruise?

Heaven.


My partner and I sat at an empty table and I tucked in, and within a few minutes were joined by four or five noobs. You could tell they were noobs by their uniforms; unfaded, non-wrinkled dungarees with crisply stenciled, legible names above the shirt pockets. They were all slick-sleeves, most likely E-2's. They looked a bit lost, and as they sat there looking at the scrumptious meals in their stainless steel trays, they began to look a bit green as well.

Spotting the greenness, my partner launched into a fictitious but gaudily explicit tale of lancing a boil. He described the look and the feel and the smell of the thing, and when he got to the part about pus squirting across the compartment, one of the noobs leaned forward and deposited his barely tasted meal back onto his try. This was my partner's cue.

"Oh man," he exclaimed, "you don't want that?!?" Then he reached across the table and shoveled up a big spoonful of the noob's vomit. Which immediately caused the rest of the noobs to imitate their leader. 

Ah, it was priceless.


A few years later I was deployed on a different carrier. Seeing sick call one day, a fellow from my squadron showed up with a big boil on the back of his ear lobe.

It wasn't really a boil, just swelling and backed up oil from a sebaceous gland, so properly an aseptic sebaceous cyst.

It was pretty impressive, about the size of a ping pong ball and just at the point of draining on its own. Which was nice for me, because I could basically just squeeze it and clean it up and he'd be good to go. I had the fellow sitting on the exam table in the treatment room and while I grabbed some sterile gauze I explained what I was going to do. I put the gauze over the lump and gently pressed from the other side. The cyst opened painlessly and deposited a ping pong ball's worth of sebum in the gauze, along with a tiny bit of blood.

"There," I said, "all done."

"That didn't hurt a bit," said the sailor.

"Good," said I. I showed him the gauze and sebum, then turned to toss it in the shit-can. As I turned away, I saw him start to go down, and inertia and momentum prevented me from turning back fast enough to catch him as he toppled off the table in a dead faint.

"Thwack!"

His chin was the first thing to hit the tile-covered deck. I quickly knelt down and, hoping against hope, gently turned him over.

"Whew," I thought, "no damage."

But then his chin erupted in a welter of blood. In striking the deck he'd opened up a large, complex stellate laceration.

Shit!

Long story short, he ended up on a backboard and cervical collar while we x-rayed him to make sure he hadn't broken his neck. Then he got his chin sewed up. From a professional perspective, the complex laceration was fun and challenging to suture, but it was a completely unnecessary and preventable event.

Instead of a 15 minute trip to sick call, the poor guy got x-rays and stitches and several days off work.

I still feel terrible about that.

And that's about all I have for today, except for this...


Looks better, no?


16 comments:

  1. The distal portion of the incision is definitely looking better. Must be nice to have had the drain pulled.

    FWIW I'm currently dealing with complications from wisdom teeth extraction. No expletives were uttered by the dental student but there's a bit of my mandible poking out my gums at the moment that appeared several days after the procedure.

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    1. Great to have the drain out. Hoping the skin holds up for the sutures -- already lost one. Well, it will or it won't.

      Oral surgery has always given me the creeps. We had an oral surgeon on Nimitz who was a huge bear of a guy with ginormous hands. He was responsible for about half the medical emergencies we had that deployment. Not his fault directly but he'd do a procedure and send the patient to his rack with lots of pain meds and the guy would invariably fall down a ladder.

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  2. Wow, what did they stitch you up with, barbed wire?

    I was going to go to bed when I saw that you had a new post, then I saw the title. Must. Read. Now.

    Most excellent. (FWIW, I love SOS, my Mom made it for us when we were kids, of course, she didn't call it SOS. When Dad did, he caught Hell for it. Great fun at the table, I can tell you!)

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    1. That's 3-0 vicryl. Pretty stout stuff but no barbs. SOS is hard to beat. The navy has two other versions made with hamburger, one with tomatoes (so-so) and one just substituting hamburger for the chipped beef. That one is very good.

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    2. The hamburger substitution for dried beef is basically hamburger gravy. In WWII, the hambuger gravy was the Navy Standard SOS.

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  3. If you really love hash browns etc, you owe it to yourself to get to Baton Rouge someday and go to Louie's, preferably late at night:

    http://louiescafe.org/default.html

    Truly the greatest hash browns on the planet, made Cajun long before Cajun was cool. A huge batch gets cooked regularly and they sit on the 6'x6' cooktop till all sold - at which point a new mountain is made up. Late at night the edges can get very beautifully well done crispy. With a couple of eggs and some cream gravy OMG....

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    1. clicked too quick - Louie's late at night also provides a regular supply of attractive, inebriated coeds trying to eat, drink coffee and get a little sober - thus the floor show is also fun!

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    2. Sounds like a place I've got to visit. Way up nort' at Bah-Ton Roooooge, as Justin Wilson used to say. Thanks for stopping by and commenting! :)

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  4. On a older DD way back. About 360 guys for the whole crew.
    Our mid-rats were split between really, really good and it's food.
    Still remember the fresh warm bread from the night baker, now that was part of the really, really good.

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    1. Ah, the fresh bread. You could make a fine meal on the bread alone...

      Thanks for stopping by and sharing!

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  5. So, what's the greenish/brownish stuff dead center? Clotting?

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    1. The ten-dollar medical tern is eschar, the playground word is scab. Dried/clotted/congealed plasma, blood components, detritus.

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