fecal occult blood test [2] is not uncommon, nor is it anywhere near as difficult or disgusting as one might imagine. The patient brings in three cards that are folded and sealed. Within each card is a small smear of poop, which the patient collected at home. Whoever is processing the test simply pulls on a labeled tab and a tiny strip of poop-covered paper comes out. This happens without disrupting the rest of the poop blob, and without creating much of a smell, if any. You put some solution on the poop, fold it into another card, wait ten minutes, and interpret the results. As clean and simple as a test involving human excrement could possibly be.
When a doctor orders this test, they give the patient a special plastic cowboy hat-shaped collection device that sits inside the toilet so they can poop like normal; the poop will be caught in the bottom (or top) of the hat. The patient then takes a little poopsicle stick (which is also provided), gets a little nugget, smears it on the card, folds it, seals it, and brings it in. I have become very used to performing several of these tests on a daily basis, so when any specimen is dropped off at the lab, I slip into some gloves and get started.
Many people are self-conscious about wandering around with their own shit. They will often wrap it in several boxes or bags. Small bags from fancy department stores are very popular. I think maybe they think that nobody would expect to find someone that rich and classy carrying around their morning bowel movement.
As far as disguising poop goes, this poop was no exception.
Good thing I'm always careful. Rather than open the top of a closed bag and blindly pull out its contents (who knows if the patient had any trouble collecting the specimen), I will tear a bag open so I can see what I am reaching for. So I peeled back what today happened to be a simple brown lunch sack to find a glass bowl of orange diarrhea.
It wasn't a turd in a plastic collection tube. It wasn't the everyday poop cards. It was wet diarrhea, with small chunks of semi-solid poo floating around in a rather large glass bowl, sealed with plastic wrap.
We have to monitor ourselves carefully in this line of work. It is easy to be overheard muttering criticisms of patients or the disgustingness of their particular ailments. But my ridiculous "Oh NO!!! What the F*CK!?" certainly made it to the reception and waiting area loud and clear.
Tearing open paper is supposed to make you think of happy things, like birthdays and Christmas and surprises. For me -- not anymore.
I was in shock. I had been working in this lab for only a few months, so I hadn't encountered anything of the sort. I slowly stepped away from the counter. My boss, who happened to be taking a nap in the EKG chair, heard my call of distress and inquired.
"What?"
"The specimen on the counter... yeah... it's a bowl... of diarrhea."
"A BOWL?"
"A glass bowl."
Amidst hysterical laughter and fairly accurate imitations of my loud and inappropriate response, I managed to gather that we do NOT process any specimen collected in such a manner -- thank GOD! -- and that I needed to call the patient and let him know.
I don't think this is a HIPPA violation as of yet, since really, anybody could have used a glass bowl. We all have them in our kitchen cabinets. We eat breakfast cereal out of them.
I wish I could describe the fury expressed by that man -- a man who had managed to shit diarrhea, without the aid of a collection hat, into a bowl for his test -- when he was told that he had not collected it properly, and would have to repeat the test. I wish I could have offered a consolatory compliment on the impressiveness of his amazing feat: aiming what looked to be pretty violent diarrhea into that bowl with his hands behind his back. But it just wouldn't have been appropriate.
Eventually I recovered from the shock, and things went back to normal. When my co-worker arrived to relieve me later that afternoon, she told me that she'd brought a can of soup for lunch, but that shed forgot to bring a bowl.
I was so tempted.
