Show full transcript 0:47 I have to say, I am so ready for fall. 0:50 I want sweaters. 0:52 I've been craving a true crisp morning 0:54 where I actually need a jacket. 0:55 I can't wait. 0:56 I'm fully there. 0:57 The second it dips below 70, I'm like, this is my season. 1:01 Give me the layers, give me the boots, 1:02 give me a reason to wear something other than a t-shirt. 1:05 And honestly, that's why I love quints 1:06 because fall is when your wardrobe actually has to show up 1:10 and everything at Quints is 50 to 80% less 1:13 than similar brands. 1:14 We're talking 100% Mongolian cashmere sweaters 1:17 starting at $60. 1:19 $60, $60 for cashmere 1:21 that you'd expect from a luxury brand 1:22 without the luxury price tag. 1:24 It's amazing, gets me every time. 1:25 It really shouldn't be real, 1:26 but it is because they go straight to the factories, they skip the middlemen, and they just hand you the savings. 1:32 The stuff isn't trendy. It's the kind of pieces you grab over and over because they work every time. 1:37 The 100% Mongolian cashmere sweaters for me are it. When I look at Steve McQueen, 1:41 this man owned a couple of sweaters he wore all the time, and he looks iconic. 1:46 It's a uniform. And Quince isn't just about the clothes. They have hotel quality bedding, 1:51 cookware, bath essentials, thoughtfully designed furniture, you can really go there and outfit 1:56 your entire apartment or house. So if you're in need of any kind of fall refresh at home too, 2:02 same quality, same attention to detail for every corner of your life. 2:05 Find your next fall favorites at Quince. Download the Quince app for app exclusive offers or go 2:10 to quince.com. Get free shipping on your order and 365 day returns now available in 2:16 Canada and the UK too. And when Quince asks where you heard about them, let them know 2:20 it was armchair expert. It's the best way to support the show. 2:24 This episode is presented by YouTube Premium. YouTube was already great, 2:29 but premium supercharges it. If you like YouTube, you'll love premium. Try YouTube 2:34 premium for two months free at youtube.com slash premium. Trial eligibility varies, 2:40 terms apply, cancel anytime. Now let's get into today's episode. 3:06 Hello? Hello? Hi, is this Andy? Hi, yes it is. And Andy, where are you other than in 3:14 your closet? I am on Vancouver Island. Oh my goodness, is it heaven right now? It's 3:19 gorgeous. And we have a pontoon boat. We keep it in the water until like October, usually 3:24 Thanksgiving, which is middle of October for us. And we use it to the max. 3:28 And it's in salt water or in a lake? 3:31 In a beautiful, beautiful lake. 3:33 Oh, it's crystal clear. 3:35 It's green blue. Like it's almost Caribbean colored. 3:38 Like when you see the people wake surfing, the wave is gorgeous. 3:42 The pictures I take of my friends wake surfing. 3:44 I'm always like, look at the color of the water. 3:46 You're missing the color of the water. 3:48 Yeah. 3:49 I wish I could say the same for our lake, Old Hickory in Nashville. 3:52 It's quite murky, but we love it just the same. 3:54 A little brown. 3:55 Yeah, it's a little brown, sure. 3:58 But that water you're describing is very much like Northern Michigan, 4:01 has torch lake, a few lakes that look like the Caribbean or the Caribbean. 4:05 Yeah, we're so thankful we get to live by. 4:07 And then we're only a little ways from the West Coast, 4:10 like Tafino-Yuclulut, which of course is spectacular. 4:13 Okay, and are you a nurse? 4:15 I am. 4:16 Okay, wonderful. How long have you been a nurse? 4:18 I've been a nurse for about 20 years. 4:20 20 years? 4:21 What's the lifespan of a nurse? 4:24 And I don't mean like, before you die, 4:26 I mean like, do people fatigue out of the job? 4:29 Is it stressful or do people stick around a long time? 4:31 The beauty of nursing is that you can change your focus. 4:35 There's so many different areas of nursing. 4:38 So people kind of maybe burn out 4:40 in a critical care situation like emergency. 4:43 And then they'll go to like community, 4:45 which is a little more chill. 4:47 I'm an operating room nurse. 4:49 Oh, okay. 4:49 I love it. I can't imagine doing anything else after listening to dr. Death. We need you 5:00 Okay, so you have a crazy nurse story I do our ORs run on a slate a normal schedule and 5:08 Sometimes we get emergencies and the surgeons will come in in the middle of the day and say I need to bump in 5:13 Okay, what does that mean bump in it means that they're gonna 5:16 interrupt the slate as it's supposed to be. People with scheduled surgeries and 5:19 they need to do their emergency now. Lots of emergencies we can wait till the end 5:25 of the day. We finish this booked patients and then add these guys on but 5:29 this one they're like we need to do it now. They say it's a younger gentleman 5:33 and he's got an open wound on his scrotal coccyx kind of area. What's coccyx? 5:39 Your tailbone. Okay so somehow there's a tear between his tailbone and his 5:44 testicles. Yes, exactly. And in the summer, we see lots of these because this is a gross human 5:50 anatomy thing. But when people sit for a long time, often on long sweaty car rides in summer 5:57 vacation, they can get an infection or something down there. And so we see a lot of gentlemen 6:02 come in when they need their scrotum or coccyx area kind of tended to. 6:07 Okay. And is it generally staff? Is that what people get there? 6:09 sometimes sometimes it can also be a necrotizing fasciitis that means necrotic 6:15 flesh like it's done yeah okay and that's got a really nice smell right it's a 6:19 distinctive one yeah there's no mistaking it we don't even need to pull back the 6:24 blankets we're like a neck fash welcome so the urologist warns us and says 6:30 we've seen some maggots and we're like okay no biggie but this is odd for this 6:35 location like sometimes we see maggots but it's on wounds that are more kind 6:39 of exposed to the air, like limbs, like legs or feet or something, and people who aren't 6:44 necessarily taking that well care of themselves. 6:47 Between the patient coming from a merge to our operating room, we learned that it's sadly 6:52 a paraplegic and the mom was the primary caregiver and she had passed away recently. 6:59 And nobody stepped in to care for this patient and they were kind of trying to make 7:05 a go of it on their own at home. 7:07 It's really, really sad. 7:09 No nurse visiting ever, just completely solo, paraplegic. 7:13 Yeah, so the patient's not doing well 7:16 because this infection is now gone, systemic, 7:19 they're septic, we need to get them in 7:20 and clear out this infection. 7:22 So we bring the patient into the operating room, 7:25 we haven't really seen much, 7:26 we pull back the blankets to move them 7:28 from the stretcher to the operating room table 7:30 and I can see the meg, they're crawling around. 7:36 And if you had to ballpark how many magnets are we talking 10 or 100 at this point I can 7:41 probably see 40 to 60 and they're just kind of crawling but I haven't seen the wound yet 7:47 so we move them over and we move the blankets we get the patient to sleep and then we lift 7:55 up the legs to check the extent and there are probably three to four holes that are 8:03 between, I would say, five to 10 centimeters, and they are packed with maggots. 8:11 Oh, my God, this has got to be like baseball size of maggots. 8:18 They're actually tiny, but they're so packed in that it looks like a honeycomb. 8:22 If you can picture that, it's just maggots, butts stacked on top of each other. 8:28 Yeah, if I'm you guys like, do I start with Ray? 8:31 No. Normally, so if we have a cavity that we have to prep, like you do surgery, right? 8:36 You try to decontaminate the area that you're going to operate on. Normally for a cavity, 8:41 we would take a sponge with iodine solution on it and just kind of swish it around in there. 8:47 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 8:53 is maggots. 8:54 Yeah, yeah, yeah. 8:56 I mean, are you to scoop them out first? 8:59 We're trying not to disturb the wound, 9:01 like they wanna get in there in a sterile 9:03 as possible way first, right? 9:06 So he's like, I don't know, just pour it on. 9:09 So we just start trying to angle this betadine solution 9:13 into these holes the best we can. 9:16 To like flush them out. 9:17 Totally, or just to get the area as germ-free 9:20 as we can. 9:21 We do that and the maggots kind of start to make a run for it. 9:25 They're instinct is to go into the wound and stay with the flesh that's dying. 9:29 They all start to come out, but we've got to get on with surgery. 9:34 So we throw the drapes on, put them on, which is like, you know, 9:37 when you see surgery on TV, it's all the blue kind of paper and stuff, 9:40 but they're starting to run up the patient's body. 9:43 So we have a scrub nurse that's with the surgeon and so the surgery gets started 9:47 And the scrub nurse and the surgeon are just like scooping out handfuls of maggots and putting them in buckets. 9:54 And then we're also suctioning them up as well into big suction canisters. 9:58 But I'm under the drapes because I am in charge of scooping up all the ones that are making a run for it. 10:06 And we've got an anesthesiologist of course at the head of the bed. 10:09 And anesthesiologists do what they do because they don't love the muck and the mire of the operating room. 10:14 For the anesthesiologist the thought of maggots heading his way. He was just like panicked 10:22 So I'm just under there scooping them into a container and then dumping it and then scooping them and dumping it 10:27 We're talking hundreds and hundreds thousands 10:31 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 10:39 They had like stainless steel buckets. They were scooping them in and then dumping them into something else 10:43 I was just putting them into like smaller containers that I had under the drapes. 10:47 When you had the majority of them in the central container, how much volume are we looking at? 10:55 Probably a couple liters. 10:57 If anyone can picture the two-liter bottle of Coke on the shelf at the grocery store, I mean, 11:02 fuck. 11:04 Yeah, it was a lot. 11:06 And at one point I came up from the drapes to dump and our wonderful scrub nurse who 11:11 He was actually a travel nurse that was visiting with us. 11:13 It was his last day and he just looked at me straight in the eye and he said, I do not get 11:18 paid enough for this. 11:21 So what did the surgeon goes in in their job to try to cut out all the necrotic flesh 11:27 so there's no more of that? 11:29 Yeah, so they're trying to get rid of all the decaying flesh because now that's 11:32 going systemic and it's making the patient sick. 11:35 Oh my gosh, and what's the recovery time for this person? 11:38 They went away to the ICU. I'm not sure about the outcome. That's the problem with the OR. 11:44 We stitch them up and we send them off and we don't necessarily know what happens after that. 11:49 When you were younger, did you ever check? Were you curious and over time, you just don't check? 11:54 We're actually not allowed. They monitor nurses very closely in terms of looking at charts. 11:59 So if you open up a patient's chart, it's flagged that you've opened it 12:04 and you can't check on them kind of after you've seen them. 12:09 And that prevents stuff like looking at people you know 12:11 or looking up stuff for family members 12:13 and that kind of thing. 12:14 So we're really restricted. 12:16 The only information we get about how a patient's done 12:18 is if the surgeon knows and they can come back 12:21 and tell us they did fine or they didn't do fine. 12:23 Oh boy, what a heartbreaking scenario. 12:26 Oh, it's terrible. 12:28 So he must have just felt so bad from being septic. 12:30 He finally called 911. 12:32 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 12:39 9-1-1. Oh 12:41 If we give that one a 10 over this 20 years you've had I'm sure 12:46 Numerous then it was a hard for you to pick what story you would tell. Yeah 12:49 I mean the OR we see all kinds of crazy stuff years ago 12:53 I had a rodeo guy who got kicked in the jaw by a horse and 12:58 And normally we would have a certain entry point to fix a jaw, but the horse had kicked 13:02 him enough that it opened up, so we were able to just go in through the opening that the 13:06 horse had nicely made for us. 13:08 Oh my goodness. 13:10 That's crazy stuff sometimes. 13:12 Andy, my deepest gratitude that you're doing what you do, I think everyone feels that 13:17 way. 13:17 I mean, it takes a certain breed to be able to look at the honeycomb with the maggots 13:23 coming out. 13:24 I looked online to see if I, because of course we can't take pictures and video 13:27 and stuff in the operating room just for privacy. And I thought I'd look online to see if I could 13:32 find anything. Comparable. I stopped going down that route. I was like, nope, nope, I'm backing out. 13:38 You don't want your algorithms to start feeding you that. Yeah. Can I give a little shout out? 13:43 I would love to hear a shout out. So I'd like to shout out to my best friend, Christie. She is 13:47 the ultimate arm cherry. You are hands down her sliver to crush. And she talks about it all 13:53 the time. Oh, I love it. Upstairs at L's was definitely our track of the summer. 13:59 Oh, good. And so thank you for putting us on to that. 14:02 And did you dance with Reckless Abandon? Absolutely. 14:05 Oh, wonderful. Well, big shout out to her and thanks. I don't know if she turned you 14:09 on to it or not, but we appreciate it. Yeah, I've been listening for years, 14:12 but this was when the nurse prompt came up. She's like, this is you. This is you. 14:16 You're up. You're up. Go. Yeah. 14:18 Hit him with the maggot story 14:20 Well, it's a lovely meeting you know, I hope you get extra extra days out on the pontoon before it gets cold 14:26 Yes, well if you ever want to come to west coast. Oh, I do we have I'd say a 14:30 Disproportioned amount of people we interview from Vancouver Island. I don't know shit goes down up there, but definitely on 14:36 I'm sure anonymous. I'll just say Canadians in general considering that you're less than one-tenth of our population 14:41 You're definitely more than one-tenth of our crazy calls 14:44 Love it. 14:45 All right. 14:46 Well, take care. 14:47 It's so nice meeting you, Andy. 14:48 You too. 14:49 Thank you so much. 14:49 All right. 14:50 Bye-bye. 14:51 Hello. 14:53 Wow. 14:54 You have gorgeous teeth. 14:56 Oh, thank you. 14:58 Really nice smile. 14:59 Yeah. 14:59 They really hit you right between the eyes, don't they? 15:01 Good. 15:02 That's how they should be. 15:03 What fake name should we use? 15:05 What would you like? 15:06 I want to say Kelly because you look like my cousin Kelly. 15:09 All right. 15:10 If you have no sworn enemies named Kelly. 15:12 No, totally fine. 15:13 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 15:19 You might be able to guess what state I'm from just based on how I talk 15:26 Okay, so are you a nurse? I am a nurse. Okay, we love you already. I've been a nurse since 2010 15:32 So 16 years and what type of nurse are you and I bet maybe that's changed over the 16 years 15:38 Yeah, it's been different. I have been a cardiac telemetry nurse 15:42 I now teach full-time at a technical college, 15:47 so I get to teach the nurses to be nurses. 15:49 Is the cardiac telemetry, 15:50 were you assisting putting in pacemakers? 15:52 What did that mean? 15:53 We would care for patients after they had a pacemaker placed. 15:57 The system that I worked in, 15:59 we sent patients to a different hospital 16:02 that cared for them higher level and stuff like that. 16:05 So we saw a lot of chest pain patients 16:07 who were there for a stress test, 16:09 but then also, of course, everything else. 16:11 You being a nurse and a teacher crosses over on two favorites. 16:16 Yeah, I'd say you got two of the four quadrants. 16:19 I'm not even sure that there's two more, but it just feels like to be safe. 16:21 We'll probably add two quadrants. 16:23 Okay, 50%. 16:23 Yeah. 16:23 Okay, so you have a crazy nursing story. 16:26 I do. 16:27 So this takes place, I think about 10, 11 years ago. 16:32 I know I was definitely not a new nurse when this happened. 16:35 This took place kind of in a Midwest sort of suburban hospital. 16:39 we admitted this patient for severe abdominal pain 16:44 and hematematous, do you know that word? 16:47 No, what's hematematous? 16:48 I know blood is hema. 16:50 Yeah, bloody vomit. 16:51 Oh, yeah, kind of my least favorite thing too. 16:56 So they were vomiting up a lot of blood. 16:59 Is there a high percentage guess 17:01 of what that normally is? 17:03 Perforation. 17:03 Yeah, usually we think something's up in the stomach 17:05 or the upper intestines. 17:07 We needed to rule out upper gastrointestinal bleed and figure out what was going on. 17:14 Of course, managing the pain was part of this whole care plan as well. 17:18 And so we immediately had to do diagnostic tests. 17:23 So EGD, colonoscopy, the EGD found nothing, not a single source of bleeding, 17:29 not even any tissue that was questionable. 17:32 The gastrointestinal providers was like, I literally found nothing, 17:37 Not in the esophagus, not the stomach, 17:39 not the small intestine where they could reach the scope. 17:42 Same with the colonoscopy, nothing in there, 17:44 which wouldn't really make sense for vomiting up blood. 17:47 So you did nose to tail on this person 17:49 and we don't see any tears or anything. 17:51 Correct. 17:52 You need Dr. House at this point. 17:54 Yeah. Yeah, we do. 17:55 We did blood work, of course. 17:58 Nothing really showed up. 17:59 No infection, maybe a little bit anemic. 18:02 You know, they're losing blood. 18:04 So that's what we know for now. 18:13 We get support from our presenting sponsor, YouTube Premium. 18:17 Now, you already know I'm a big YouTube person. 18:20 It's incredible on its own, 18:21 but Premium makes the whole experience feel enhanced. 18:24 Like you don't realize how much better 18:26 it can get until you try it. 18:28 The biggest game changer for me, background play. 18:31 I love long two-hour deep dives. 18:34 You name it, motorcycles, travel, cars. 18:38 Cooking shows for me. 18:39 Cooking, listen, with premium, 18:41 you don't have to keep the screen open 18:43 so I can lock my phone, slide it into my pocket 18:46 and listen to a podcast while I'm folding laundry 18:48 or working out. 18:49 It's also completely ad-free, 18:50 meaning when a narrator is building up 18:52 to the climax of an insane story, 18:54 there's zero interruption. 18:56 And for travel, offline download saves the day. 18:59 I love this one. 19:01 Relying on airplane Wi-Fi can be a gamble, 19:03 so I just download my favorite videos before takeoff. 19:05 And with smart downloads, 19:06 premium will automatically download new videos 19:08 from channels, you actually follow without having to lift a finger. 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So Monica just informed me that she's a girls girl 22:39 And I nodded like I knew exactly what that but the girls who get it they get it 22:44 Okay, but for those of us who are clearly not girls walk me through it 22:48 Well, you know how much I love my skims fleece joggers because the plush fleece is so soft 22:53 it's cozy, it's really comfortable without feeling too heavy. Well, I went to friend them 22:58 and she would not stop talking about how comfy they were. She almost didn't give them back 23:02 to me, which was upsetting, but I'm a girl's girl, so I let her have it. 23:05 Great, great, great. 23:06 So the sleep sets are awesome because they are very soft and comfortable, but they're 23:11 cute. If I'm in my sleep set, I feel fine about going down the street to pick up 23:15 my food. I'm still looking cute, but I'm comfy and I'm cozy. 23:20 Roger. 23:20 A really fun thing to do is if you're going on vacation with your girlfriends to get matching 23:26 Skims pajamas. I've done this with Kali and it is so fun. First of all, the pics are so cute 23:31 But also it's just fun and friendship. So a girl's girl is looking out for your friends with better lounge wear 23:37 I get it. Am I one of your girls? 23:40 You and the other girlies can shop my favorite loungewear and pajamas at skims.com 23:45 After you place your order be sure to let them know we sent you select 23:48 podcast in the survey and be sure to select our show in the drop-down menu that follows. 24:01 In terms of like pain management, that's kind of where I come in, making sure that they're getting 24:07 the appropriate medications to manage their pain. They were getting opioid pain medication 24:12 through their IV access. I was giving hydromorphone delotted through their IV. 24:17 That's a nice product, yeah. Yes. Dependable. And it was not really doing the tricks. 24:23 I was seeing him vomit up blood, like filling the kidney basin that we put at the bedside. 24:30 Huge clots in his vomit. 24:32 I was seeing this, and vomit is like one of my least favorite things. 24:39 That and sputum, so it's like take your pick. 24:42 So that's probably one of the reasons why this story stands out to me so much. 24:46 Can I ask how big are these clots? 24:48 Are they the size of a penny? 24:49 Like a golf ball. 24:51 Ew! 24:53 Baby. 24:55 A poached egg. 24:57 Yeah, poached egg. 24:59 No, don't say that. Don't ruin poached eggs. 25:02 At some point during the hospital stay, 25:04 this is kind of over the course of a number of days 25:06 that I'm caring for this patient. 25:08 You know, the providers are getting a little suspicious 25:11 about something's up here, 25:13 and so we needed to assign the patient 25:15 to be a one-on-one sitter, 25:18 where we have typically a CNA, 25:20 they sit with them in their room 24 seven, 25:24 eyes on them the whole time, safety reasons, right? 25:28 And we needed to make sure that 25:30 they weren't causing any harm to themselves. 25:32 So I remember being a little bit like oblivious 25:35 to like these suspicions and thinking, 25:38 I just so badly wanted to believe this patient 25:41 that something's really wrong. 25:43 What's happening? 25:45 And giving them the benefit of the doubt. 25:46 Do you have a guess? 25:47 Well, it sounds moonshows in here, right? 25:50 I have a guess, but I'm not going to say it. 25:51 Oh, okay. 25:52 Good guesses. 25:53 Okay. 25:54 One of the other things that we were dealing with was that we were not able to maintain 25:59 like peripheral IV access. 26:01 So in forearms and hands, we weren't able to keep any IVs in there. 26:06 So we did attempt tonight partnered with the hospital provider at the time to put 26:10 in a central line just because we did need IV access. 26:13 And where does the central line go? 26:15 The central line goes in the neck, so they find a big vein in the neck either just above 26:19 the clavicle or below the clavicle. 26:22 We attempted to do that at the bedside, but that did not work. 26:26 We were unsuccessful. 26:27 We were not able to access this vein that we needed. 26:31 I'm getting junky clues as well, like if you've collapsed a lot of veins, they too 26:35 run out of veins to use. 26:37 Yeah. 26:37 And so we ultimately were able to place a pick line, a peripherally inserted 26:42 central catheter, which, Dax, you know, goes in the upper arm, has a very long tube that enters all 26:48 the way to the top of the heart. Crazy long, I would say. Yes. Yeah. I think when they get taken 26:53 out, everybody goes, oh my gosh. I know the guy was pulling it for a while. I think he had to 26:58 wind it like a hose as it was coming out. Yeah. So we got the pick line in. We were able to 27:04 use that to administer the IV pain medications and still being watched one-on-one with a 27:10 and then some of the behaviors, 27:12 we started to see it a little bit worried about. 27:14 So I was getting reported to from the sitter about, 27:18 hey, this patient keeps putting their head 27:20 underneath the blanket. 27:21 And so I can't see their face. 27:23 I can't see their head. 27:25 I've asked them to please keep your head visible. 27:27 I need to be able to see you, all that stuff. 27:30 And they would just, I think, 27:31 pretend that they were sleeping 27:32 and that it was really bright in there. 27:34 And thankfully, because I was pretty good 27:37 at building a relationship with patients at this time, 27:39 I had to be really stern. Hey, this isn't going to work. 27:43 Like, you're going to have to stay out where we can see you at all times. 27:48 It would work for a little while, and then back under the blankets again. 27:52 Can we get an age range of this person? 27:55 I was wondering if you would ask. I think probably 40s, maybe early 50s. 28:02 So unfortunately, we got to the point where there was really nothing else we could do. 28:08 We had no more tests. 28:10 Everything was inconclusive. 28:12 Pain management was as good as we can get it. 28:16 We tested for everything. 28:18 So ultimately we discharged the patient from the hospital. 28:21 You know, of course this patient is on my mind 28:24 for some time afterwards. 28:26 And so I caught up with the hospital provider 28:28 who I worked really closely with 28:30 and said, hey, whatever happened to this patient 28:34 And the story goes, the patient was admitted to another nearby hospital for the same problems. 28:43 And it was found out that they were under the covers of the blankets, opening up the 28:52 ports, the hubs on the end of their pick line, undoing the clamps and taking off the hub 29:00 cap that we put on there and sucking the blood out of the pick line, 29:10 swallowing it, and then throwing it out. 29:13 Yes. 29:14 Okay. 29:14 That was my guess. 29:15 He was drinking blood. 29:17 It was. 29:18 Yeah. 29:19 Ew. 29:19 Nice. 29:20 He's a vampire. 29:22 He's an auto, auto vamp. 29:24 Where do you think he was getting the initial blood from before the pick line? 29:28 That's a good question. 29:29 I'm not really sure, I don't know if they had any injuries, I don't know any of that. 29:35 It may have been collecting blood over time. 29:38 And is the theory that this person was moonshowsen or a drug seeker? 29:43 I have a feeling that at this point in time, this was this patient's solution to getting 29:49 opioid medication. 29:51 No. 29:52 If I would have known now what I knew back then, my approach with this patient 29:57 it would have been totally different, you know, 30:01 thanks to learning from you guys over all this time 30:04 and making sure that, hey, yeah, this is a real thing 30:08 and it's really hard. 30:10 I wouldn't have changed how I cared for their pain. 30:13 What a patient says their pain is, 30:14 is what they say it is. 30:16 If you're wrong with someone suffering greatly 30:19 because you know everything, 30:20 then you're gonna feel terrible about that. 30:23 So you gotta live with it. 30:24 It's like the justice system. 30:25 Some guilty people are going to get away with it, you know, that's preferable. 30:29 Right? 30:29 It'd be preferable to suck the blood out of your pick line than to deal with the 30:33 detox is pretty powerful. 30:36 Yeah. 30:36 That speaks pretty greatly to what they're willing to do. 30:40 Oh, wow. 30:42 But yeah, that's my craziest story on how my patient drank their blood. 30:48 Oh my God. 30:52 Oh, Kelly, this has been a delight. 30:54 And anyone who has you as a nurse is so lucky and a teacher. Thank you 30:59 I have to of course shout out my husband and my kids who we will listen to armchair anonymous together 31:05 great 31:06 my husband's not necessarily 31:09 Podcast person, but he's totally hooked and the kids are 12 and 10 31:15 And we do a lot of 31:18 teaching 31:18 with them. 31:21 It's a great conversation starter, yeah. 31:23 Yes, exactly. 31:25 A lot of pausing. 31:26 Okay, what questions do you have about this? 31:29 But they do not know I'm doing this. 31:31 Oh, fun. 31:32 Oh, fun. 31:33 Say hi, Mom. 31:35 They'll hear my voice, I think, and they've been telling me to submit for a long time. 31:40 Do you have a story, Mom? 31:41 Do you have a story? 31:42 Yeah, I sure do. 31:43 Of course I do. 31:44 Well, I want to say to both the little ones that were so delighted they're listening. 31:47 Definitely. 31:48 Whether it's ethical or not, I won't decide. 31:50 We don't get to... 31:51 I let my kids listen, so, you know, 31:53 we'll all burn in hell together, I guess, so... 31:55 Yeah, if anybody wants to judge us, you know, 31:57 I just say, well, Dex does it, so... 32:01 They seem to be attending school. 32:02 I'm happy that they're learning it from me, 32:04 rather than on the school bus or at school. 32:07 I heard all these kind of stories on a playground 32:09 with just no context or anyone explaining 32:12 what was really going on, you know. 32:14 Exactly, exactly. 32:15 They will not be the kids that grew up to put anything in their butt. 32:19 That doesn't have a base on it. 32:20 Yeah, exactly, cautionary tale. 32:22 Or if they did put a tether on it, you know, if we've learned anything, 32:25 make sure you can get it out. 32:25 It needs a tether. 32:26 And all-wise. 32:28 Can't go out of town. 32:30 There's a lot to learn from this. 32:31 And be realistic in what fits in there. 32:33 We've learned. 32:34 But some things are too small. 32:36 They get lost. 32:37 It's a real fine line. 32:38 Dildos exists for a reason, I guess, is the moral of the whole story. 32:42 Like, there is a perfect size. 32:43 I'm sure some have gotten stuck. 32:45 Oh, sure. I'm sure. Yeah. 32:48 Well, I'm glad we could send this into the ditch right at the end. 32:51 Lovely meeting you and I'm delighted the whole family will be listening. 32:54 We're sending love. 32:55 Thank you so much. This was so fun. 32:57 All right, take care. Bye. 33:02 Hi there. 33:03 Hi. 33:04 Do you have a fake name that you're drawn to? 33:06 Anything you want to use. 33:07 Well, you look like a cherub. 33:09 I don't know where we go with that. 33:11 Angel. Boom. Really good job. 33:13 You can do that. 33:14 Angel, where are you? 33:15 Currently in Florida, but this story takes place in the Southwest. 33:20 Okay, great. I love the vagueness. This promise is to be juicy. 33:23 We love this prom. 33:25 I'm already picking Arizona. 33:26 Okay, she can't say. 33:26 Yeah, we're not gonna say, but just I'm already feeling Arizona. 33:29 It's a wild place, Arizona. 33:31 There's a lot going on, man. 33:32 Yeah, there's a lot of things happening. 33:34 So are you a nurse, I presume? 33:36 Yes, I am a nurse. 33:37 Okay, and how long have you been a nurse? 33:39 Nine months. 33:40 Oh, brand new. 33:42 Okay, wow. Congrats. 33:44 How are you liking it? 33:45 I love it. It is the best ever. Some challenges for sure, but it's been a great experience. I'm very excited. 33:52 I imagine it's just an exciting job. Everything's different. It's never stops. 33:57 Yeah, and the coworkers are great. Everyone you work with is lovely and wonderful. 34:00 You guys are the best we got. Okay, so you have a crazy nurse story, and we want to hear it. 34:05 Okay, so I'll set the scene. I graduated in December with my nursing degree. I went to school in Arizona. You were right. 34:11 Okay, funny another state in the Southwest for work and I took a job at a large teaching 34:17 hospital where everyone's brand new. There's new doctors, new nurses knew everything pretty much 34:23 and the beginning of the year is hard because a lot of people are transitioning into new jobs. 34:27 So there's a lot of change, but I'm going through orientation. It's about four months. 34:31 And so I get off orientation around April and I've been off orientation two weeks. It's 34:35 going great. I love everything. My patients are wonderful. The other thing to note is 34:39 when you are a new grad, they give you the easiest patients usually on the unit. 34:43 Yeah, dip your toe in and then build your confidence. 34:46 So great and easy. 34:46 And you're like, yeah, it's great. 34:47 And then it gets worse. 34:50 So I'm getting a report on these patients is my first shift of three. 34:53 The last patient that I get report on, they're telling me like fifties male. 34:57 He is one day post-op. 35:00 He had his penis removed. 35:02 Oh, okay, that's a bombshell. 35:05 Let me go meet him. 35:06 Let me go say hi. 35:07 And so I pop in and he's sleeping, so I'm like, 35:09 oh, I'll come back. 35:10 I get the rest of my pour, 35:11 and the other nurse is telling me, 35:13 she's like, well, he left a cock ring on. 35:16 Oh, no. 35:18 Oh, my God. 35:19 And it went gangrene. 35:21 For three weeks? 35:22 No. 35:23 Oh. 35:23 Wait, why? 35:24 Oh, he just loved it. 35:26 Or he couldn't get it off, maybe. 35:28 Yeah, he could not get it off. 35:30 Wow, good for him. 35:31 Oh, good for her, her or him. 35:34 Remember? 35:35 Wow. 35:36 Oh my gosh, okay. 35:38 How small are these cock rings? 35:40 Well, I think they come in different sizes. 35:42 So I think you're supposed to get one appropriate 35:44 to your shaft size. 35:45 But you want to just squish it. 35:47 You squeeze it. 35:48 Well, because all of your penis is doing to get hard, right? 35:50 Is it's restricting the blood that can come back out. 35:53 It's filling up all these vessels. 35:54 So it's just keeping it hard kind of. 35:56 Harder, I think you get an increased size with it. 35:59 I'm going to be very candid. 36:00 I've not ever worn one. 36:01 So I'm speaking out of theory. 36:03 I'm glad to hear this. 36:03 Yeah, yeah, yeah. 36:04 Yeah, I'm just guessing what's going on. 36:06 Okay, uh-oh. 36:07 So he got a child package. 36:09 Well, let me say this. 36:09 This is what I heard earlier from a dude 36:11 who I knew who was a male stripper. 36:13 And he said the thing the male strippers would do 36:15 is they would tie a bit of string 36:17 at the base of their shaft or a cock ring 36:19 because they're at work for whatever, 36:21 six hours dancing, and they want their penis to be 36:23 engorged. 36:25 Ooh, wow. 36:26 Okay, oh my God. 36:28 Well, don't do it. 36:29 Now we know. 36:30 So I'm getting report my jaws on the floor, 36:32 And I'm like, well, what happened? 36:34 Like how was he found? 36:35 Did he just walk in with this? 36:37 And he was found by his friend that he like lives with, 36:41 some sort of social situation. 36:42 He was found down and his friend 36:44 had thought he had overdosed. 36:45 And so he's like calling 911, they bring him in. 36:49 They're treating it like an overdose 36:50 from his house to the hospital. 36:52 Comes to the hospital, they take all his clothes off 36:55 and they're like, don't think he overdosed 36:57 on anything, don't know. 36:58 But we have other problems here 37:00 and they're like giving him some fluids. 37:02 He's kind of coming to you and I guess they got consent downstairs. They're like, look, we don't want to take your penis 37:07 But it's not looking good. We can turn this like vascular procedure 37:13 And he's like, okay, let's do that really quick was he sepsis is that why he was unconscious? 37:19 Partially that but also like his urine's backing up because he's not able to get any urine out 37:26 When I talked to him later 37:28 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 37:38 Papapia 37:48 This podcast is brought to you by Squarespace 37:51 We've talked before about Rob building our website on Squarespace 37:54 And I bring it up again because it's a perfect example of what they do 37:58 Well Rob had all the pieces the content the vision the ideas 38:01 But he needed something to actually take all that and make it public-facing and Squarespace was that bridge 38:07 Maybe you're in the same spot. 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That's worth talking about. 39:31 You know, I love therapy more than anything gets me through. 39:35 Often I'll want to cancel because I'm like, I don't really have anything to talk about. 39:38 And then I'll go and I have some major revelation. 39:42 You know, I was just talking to a friend who has just started it. 39:44 and I said, one of the most powerful elements of it is just hearing yourself say out loud the 39:50 thing that's been ruminating in your head and how different it sounds once it's out into the world. 39:54 You gain perspective immediately just by hearing yourself say it. 39:57 Yeah, you do. 39:58 If you've been waiting to start therapy, better help works with more than 125 health plan networks 40:04 and eligible members have an average copay of just $23 per session with insurance. 40:09 Don't have insurance or live outside the US, you can still get 10% off your first month. 40:13 Do yourself a favor and just try it. 40:16 Future you will be grateful. 40:18 Visit betterhelp.com slash tax to explore your payment options. 40:21 That's better H-E-L-P dot com slash tax. 40:26 We get support by Peloton. 40:29 You know that feeling when you're spiraling over a problem 40:31 and you just can't figure it out? 40:33 When that happens to me, I need a change of pace. 40:35 And I've found that running is the best way. 40:37 It takes my brain out of the driver's seat 40:39 and I come back with a fresh perspective. 40:41 Running can be freeing and cathartic, and Peloton helps you feel all of that. 40:46 And now that feeling fits wherever you need it with the new Peloton Tread Flax. 40:52 It's movable and foldable, designed to fit your life. 40:55 So next time you feel stuck, you can go for a run literally anywhere. 41:00 Whether that's in your office, living room, or even the attic, plus they have classes 41:04 with expert instructors and programs to meet you at any level and keep you moving. 41:08 Let yourself run. 41:10 Explore the new Peloton Treadflex at onepeloton.com. 41:22 So they take him for that procedure. 41:24 He wakes up the next morning on our unit 41:26 and I'm getting this all in report. 41:28 So she's telling me like I had him and it just looked bad. 41:31 It was black. 41:32 It just didn't look like it was going to survive. 41:35 And so the surgeon comes in and he's like, 41:36 look, we have to take this. 41:39 We're going to remove your penis today. 41:41 Oh my God, what a sentence to hear. 41:44 Also, let's be clear. 41:45 This man is an active man. 41:46 and he enjoys his penis, he's got cock rings on. 41:50 And so I'm getting him the day 41:51 after he just had his penis removed. 41:53 Oh, boy. 41:54 And I walk in and I'm prepared for like emotional, 41:58 let's have a conversation. 41:59 This is really challenging. 42:01 I'm so sorry this is going on. 42:02 Let's talk about this. 42:04 And he's like, oh, I'm doing good this morning. 42:07 You know, I'm not having a lot of pain, 42:08 doing really well. 42:10 In report, I got that we had to change the dressing 42:12 every two hours because they rerouted his urethra 42:14 through his scrotum. 42:16 Oh, okay. 42:17 Because he didn't want to have a like super pubic catheter. 42:21 He didn't want like a bag external of him. 42:23 Well, that was like the agreement he came to with the neurologist of like, 42:26 we can try it, but it may not be a thing. 42:29 And so his urine is draining out of his scrotum. 42:32 Wow. 42:33 Hold on a second. 42:35 I'm just trying to like really model what it would feel like to grab my ball sack and aim it. 42:41 You'd have to aim it. 42:42 To go, well, sure, sure, sure. 42:44 Or you stand at an angle. 42:45 You might want to sit, you know, cause they're going to droop down more than anyways. 42:50 Okay. Wow. That's an adjustment, urinating through your balls. 42:54 So does he have a catheter through his urethra that is in his ballsack? 42:58 No, it is just his urethra coming out. 43:02 All right. Modern medicine. 43:04 They can do anything. 43:06 It's incredible. 43:07 I want to have mine run out the palm of my hand so I can just like pee out the 43:10 window and stuff and I'm driving. 43:11 Yeah, I mean, that would be so convenient. 43:13 But it's leaking there and so I'm pulling back this dressing. It is sopping wet. I pull it back 43:19 I take out the packed gauze that's in it and it is like a baseball-sized gaping hole 43:27 Whereas penis was are in the testicles whereas penis was 43:31 They dug it 43:35 I'm taking the gauze out and I'm like I don't think this is how we're supposed to be dressing this 43:39 I need to call a nurse to your nurse. I need help. 43:43 Were you conscious of your face? When I saw it, my next thought would be like, 43:47 oh, control your face. God knows what it looks like right now. 43:50 I think I was like trying to, because I was like, I know it's going to look rough. 43:53 Let me like try and keep a straight face. 43:56 Are you wearing a mask? 43:57 Yeah. 43:57 Okay, I got it. 43:58 Thank God, yeah. 44:00 I have another nurse with me. We're looking at it together. 44:02 And she's like, you should call wound care. 44:03 She's like, I don't know what the surgeon said. I don't know what they want. 44:06 And so I'm like messaging back and forth with wound care. 44:09 And I'm like, hey, I just want to make sure we're doing the right thing. 44:13 I don't want to make this worse. 44:14 It's a really wet wound. 44:15 He has urine around it and that doesn't seem great. 44:18 Yeah. Although isn't it antiseptic? 44:21 It sounds like a grenade went off in his underwear. 44:23 I mean, that's what it feels like we're left with. 44:25 In the whole time, he's just casually talking to me. 44:28 If he's feeling a great mood, what a champ. 44:31 Yeah, I'm like, this is impressive. 44:32 Okay. So WoundCare finally shows up. 44:34 They come in and we are going in there and they're like, oh, this looks great. 44:37 This is exactly what you're supposed to be doing. 44:40 This looks great. 44:41 This is gorgeous. 44:43 I'm caring for him over the next couple of days. 44:46 And it's kind of the same stuff. 44:47 He doesn't look great, like his hemoglobin's a little low. 44:51 So he's a little pale and I'm like, 44:53 hey, don't get up, don't get out of bed. 44:54 So he's like stuck in bed with this wound. 44:57 Tough spot to be. 44:58 And he's kind of lonely. 44:59 And so I tried to go in there when I have time 45:00 and just like chit chat with him. 45:02 I'm always asking patients, I'm like, 45:03 oh, where'd you grow up? 45:04 Are you from here? 45:05 And he's like, well, I'm not from here. 45:07 I lived in Arizona and I'm like, they're at, he tells me where he was at and 45:12 where he's working and he worked on the same street I grew up on. 45:15 What? 45:16 No way. 45:17 That is so simple. 45:18 I gotta say, because it keeps burbling into the top of my mind, which is this 45:22 also sounds very meth-y, people with these kind of injuries. 45:25 We learn generally meth is involved. 45:28 Does it go weeks with this condition? 45:30 Well, and a friend thought he overdosed. 45:31 Yeah. 45:31 What if the punchline was that you found out this was your real dad? 45:34 Oh 45:42 About a meat ugly with your biological dad prompt 45:47 Okay, okay. He lived in your work on your street 45:51 Yeah, and so I'm just talking to him about that and we're like building rapport and finally I ask I'm like 45:56 So what were you doing about this? What was the situation at home? 46:00 where like this is staying on. 46:02 And he's like, well, I was like going to work 46:04 and then I come home and I try everything I can to get it off. 46:07 And he's like, do you want to see a picture? 46:09 And I'm like, oh. 46:10 Oh no. 46:11 I do, but I don't know if I'm allowed. 46:15 I was like, okay. 46:17 Oh my God. 46:19 I would have said yes too. 46:20 I know, but are you, yeah. 46:22 This man is creeping me out a little bit. 46:24 Okay, he sounds friendly though. 46:26 Exactly, he just got his penis cut off 46:29 when he's too happy. 46:30 He's probably like, finally, this is over. 46:32 God, I'll finally have some free time. 46:35 Monica is definitely on the money 46:36 with a little bit creepy, but he shows me, 46:38 and it is just like a black little shrimp. 46:43 Silver ring around it. 46:45 A shrimp? 46:46 Oh fuck, fuck, fuck, fuck. 46:49 So he's a metal ring? 46:51 Boy, I didn't know people were putting, 46:52 that's a bad idea. 46:54 That makes sense why he couldn't 46:55 just like cut it off or something. 46:57 This is like my second or third shift. 46:59 I have some time to like look through notes 47:00 and I'm looking through his notes 47:01 and he had come in with a similar injury 47:04 the previous month and in the notes 47:06 it's like was left on for three days, 47:08 couldn't get it off, so came to the hospital. 47:10 And there's like very clear that like education 47:11 was given to not do this again. 47:13 He couldn't resist. 47:14 Ew, but then why do you wait this long, this time? 47:19 It's a good question. 47:20 Maybe he felt like they really shamed him 47:22 on that last trip. 47:23 He's like, I can't go back 47:25 I can admit I did this a week later. 47:27 A couple of weeks go by. 47:29 I'm like working, but I don't have him as a patient. 47:31 I know he's on the unit, 47:32 but I don't really take care of him. 47:34 And we're sitting in huddle 47:35 and that's when we were just getting information 47:37 about what's going on on the unit 47:38 and like what patients to watch out for. 47:40 And we hear the code alarm go off, 47:42 everyone goes in and day shift and night shift 47:44 are both there. 47:45 In a code, there's already a lot of people, 47:47 but this is like double the amount of people. 47:49 So there's like 30 people in a tiny hospital room. 47:52 I'll try and do something. 47:53 we all have roles assigned and so I'm like standing in line to do compressions because he 47:58 is unconscious. He had had some other like GI bleeding just from being in the hospital and 48:03 just some other like complications with that. He had been back in force to the ICU a couple times. 48:08 He woke up, came back, sent him back to the ICU and I thought that was going to be my time with 48:13 him. A couple days later I come back to work and I'm getting a report and I'm like I know 48:18 this patient, very familiar. She's like, Oh, he's going to go home today. And I'm like, 48:22 Oh, phenomenal. Yes, wonderful. And so I'm like, well, does he ever ride home? I go in the room 48:28 and I talk to him. And I'm like, Hey, I hear you're going home today. That's great. I'm so 48:31 excited for you. Do you have a ride? It can take a couple of hours for us to get our stuff 48:35 together. So just be patient. And he's like, Oh, yeah, I have a ride. It's my roommate, 48:40 my friend. And I'm like preparing my teaching discharge education. I go to my preceptor 48:45 who happens to be there and I'm like, 48:46 hey, what would you educate on? 48:48 Cause like the problem that he came in with is gone. 48:51 Right. 48:52 What do you want to teach about? 48:52 And she's like, maybe let's talk about 48:55 not putting things in your holes. 48:57 Cause that's the next step. 48:58 That's where this is going. 48:59 Now he has an extra hole. 49:01 And she's like, make sure you explicitly say, 49:04 do not put anything in your urethra. 49:06 Okay, great. 49:07 Then became the roommate's problem. 49:08 Oh, the roommate. 49:10 Yeah, I hope he's getting reduced rent. 49:13 I hope the roommate is actually like a boyfriend or something because if it's just a roommate and you have to live with 49:19 That they need to call in a bad roommate. Yeah 49:22 I mean I'm trying to imagine if like Aaron went through this whole scenario what my reaction would be 49:26 Yeah, but you guys are best friends not just roommates, but even as best friends. I think it'd be like brother 49:32 What's happening? Yeah, of course you'd you'd inquire. What is going on? 49:37 Well, of course they'd pick them up, but I would just be like what happened here. Let's talk. Yeah 49:42 Yeah, we have a cave now. 49:43 Oh. 49:44 And a testicle penis. 49:47 Oh, wow, that's wild. 49:48 On your first day. 49:51 Angel, what a harrowing first shift. 49:52 That was quite the first shift. 49:54 That was incredible. 49:55 Yes, thanks for sharing with us. 49:56 And yeah, I'm so happy you're doing this. 49:59 Yeah, I'm so happy to be here. 50:00 Can I give two shout outs? 50:01 Yes. 50:02 One to my mom. 50:04 She is lovely and excellent and my favorite person. 50:07 One to my best friend, Kaya, in Oregon. 50:10 She's excellent, and I hope she listens. 50:13 Kaya, we hope you listen. 50:15 Tune in, Kaya, if you can hear us by passing a radio. 50:19 Well, thank you so much for telling us all that. 50:21 Yeah, have a great day. 50:23 Thank you, guys, I appreciate it. 50:24 All right, take care. 50:27 Hello. 50:29 Hello. 50:30 What shall we call? 50:31 Well, I know what I want to call you, Monica, on three. 50:34 One, two, three, Chris. 50:37 Yes! 50:38 You guys can call me whatever you want. 50:39 Do you get that all the time? 50:42 I have gotten that one as a doppelganger, 50:44 as well as Donald Gleeson, the eldest Weasley brother. 50:49 Oh, wow. 50:50 The oldest Weasley brother. 50:53 Monica, you would know better than me. 50:54 Is that a math?
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