'Twas a dark and stormy night in our busy high risk Labor and Delivery unit. We received a call that we were getting a girl in who was only 28 weeks pregnant, with severe abdominal pain. Oddly, the transferring hospital described being "unable" to examine her cervix. "Something" was blocking the entrance to her vagina. This piqued our interest somewhat... this admission might be fun and interesting.
So when she rolled in, I was the first to jump up and claim her as my patient. (I was bored.) This poor girl was about seventeen, and in obvious pain, clutching her stomach and rolling around on the bed. I summoned the resident OB, and several of the nurses jumped in to help me, as we were concerned she might be close to delivering a precariously preterm infant.
The OB arrived and, after asking some initial questions, pulled on a glove and tried to examine the poor girl. An odd look came over his face. "What IS this?" The entrance to her vagina was, as described by the other hospital, completely blocked. He felt around a little more. "When was your last BM?" he asked the patient. She replied that she had had a movement the day before. I was getting more and more thrilled with this admission. This was certainly different -- and in OB, different is FUN.
Turns out that, after some digging around in there, our OB doc couldn't get to her cervix to determine if she was in preterm labor either. There was a blockage of HUGE proportions filling her entire vagina, and the consistency was that of a brick. So... a rectal exploration was undertaken, and soon the reason became clear. Her entire rectum was filled to capacity by an enormous poo ball.
Words cannot convey how big this poo ball was estimated to be. It was so big that it filled the entire rectum and bulged so far against the neighboring vaginal wall that it was as if there was a cannon ball in there, making a vaginal examination impossible.
Therefore, we were at a loss as to how to proceed. Was the girl in pain simply from an enormous stool impaction? Or was she actually in premature labor, about to deliver but with this huge basketball of poo blocking the infant's way out? There was no way to tell, without clearing the rectum of stool.
The OB doc made a few delicate rectal forays, each time breaking off a small chunk of poo. It was soon apparent that this would take all night. Plus, digging poo out of someone's butt is not high on the list of desirable, life saving activities that doctors like to run around doing. So it fell to me to give this poor, unfortunate girl an enema.
The new game plan was to clear out her colon so we could try to determine how far her cervix was dilated. Very tricky and controversial, because enemas can actually CAUSE premature labor. But there was felt to be no other way to determine what the hell was going on.
(Background--enemas really aren't given in L&D anymore, and I was one of the few old timers who had actually GIVEN one before.)
While we were waiting for an enema bag, reminiscent of the "old days," I gathered the younger nurses round the desk and described tales of days gone by, when EVERYONE got enemas, and the amusing things that often happened after them. Ahhh, the good ol' days...
So the enema bag eventually arrived, and I showed everyone how to mix the soap and warm water. I triumphantly carried my prize into my vict... er, patient's room. The girl was pretty out of it with pain, and I don't remember her objecting a lot. I also don't remember it being very hard to get the tube in, surprisingly. I figured with a resident pooball of that caliber, it would be a lot harder.
The tube goes in pretty far, and I let the solution flow. The girl starts screaming "STOP, STOP" after just a few ounces had gone in. I, being a legendary enema giver of yore, was not swayed from my course. I held the tube in and kept the flow going. When almost a liter had gone in, I removed the tube and admonished the young girl to "hold it" as long as possible. She immediately made a move to leap out of the bed towards the bathroom. Hah! An amateurish trick! I blocked her effectively and made her lay on the bed for about twenty minutes. When the time was up, I let her go, reminding her not to flush so I could see how much came out. This was where I misjudged the whole situation.
I gave her about twenty minutes or so to do her business, and came in to find her pale and crying, sitting on the bed. She was pointing at the bathroom, speechless. At this point, I grew alarmed that maybe she had delivered in the toilet or something, so I burst in to gaze at a sight few have ever seen in their lives!
There was, literally, a HUGE brown "baby" in the toilet. I was absolutely awe-struck by the sight of it, sitting sedately in the bowl. It had to be a five-pounder, I reckoned! Not an ounce less, of that I was certain -- and I know poo. It was roughly the size and thickness of a man's lower leg... and even THAT doesn't do it justice.
After a few minutes of staring at the beast, I gave a tentative flush. (I am not sure why, even to this day, that I did that. Instinct, I guess.) The powerful hospital-toilet flush DIDN'T EVEN MAKE IT ROCK in the water -- that's how big it was. Jesus Christ, save us! I crossed myself and came out to look incredulously at the girl (who weighed about 120 pounds herself). Mentally I took a moment to imagine just HOW the thing had come out of her petite self, and God almighty, how BAD it must have hurt! She didn't make a peep that I heard. I pushed her down on the bed and looked at her butt-hole. It was bleeding just a bit, but no gaping tear as I imagined, thank God. She was shaken, but beginning to recover. All her abdominal pain from before was gone.
I wheeled around and ran from the room. There were still a bunch of nurses and the OB doc at the desk. Like a demented person who believes she has just seen the second coming of Christ, I stuttered and stammered out a description of what I had witnessed. "Go in there," I hissed at the scoffers "Just go in the bathroom and LOOK at it." One of them (Karen, also an old timer) jumped at the chance. She barged in the room, making up an excuse about "needing to get something" out of the patients bathroom. "OH, MY GOD" she literally SCREAMED from the bathroom. The patient was mortified, but hey, this is scientific discovery going on is the way we looked at it.
Karen emerged from the bathroom and ran out to the desk, much the way I had. Soon, a steady stream of doctors and nurses came into that girl's bathroom, all "to get something." Gasps, cries of disbelief, laughter, wails of horror, and a lot of taking of the Lord's name in vain issued from that bathroom over the next hour.
Quickly we moved the girl to another room, so we could have time with our discovery without completely demoralizing and humiliating her anymore that we already had. (Incidentally, with the monster out of her rectum, it was determined that she was NOT in preterm labor. Her cervix was not dilated, and all the pain was presumably from the enormous impaction. She had evidently been just passing chunks of this for the past few weeks, best we could reckon, and that was why she said she had been having BMs.) Anyway, we got rid of her while we moved onto Phase Two: What To Do With The Poo.
Everyone who saw it did the same thing I did: gave it a trial flush. It sat there like Buddha, stony-faced and unmoving. We thought of names for it, and everyone took turns guessing how much it weighed. Some brave souls put gloves on and poked at it, screaming with laughter and delight at its sheer massiveness. When our hilarity began to die down a bit, we decided to pull a prank on Maintenance. We called and nonchalantly told them that a "toilet was stopped up" in 312. Stifling hysterical laughter, we waited for them to show up to unstop it.
Poor guy never knew what hit him, this Maintenance schmuck. He went in, whistling, armed only with a plunger, to the scene of the bathroom "birth." We heard the (by now familiar) "JESUS EFFING CHRIST" bellow from the bathroom, and we all collapsed to the floor, helpless with laughter, eyes streaming, practically peeing our pants. He RAN out of the room and (cursing us all the way) allowed how he wasn't gonna be responsible for THAT! Fun times for all, is all that I can say...
Oh well, on to Phase Three: Disposal.
After we had showed it to every single person we could think of, and had all the fun there was to be had with "our" poo, we had to think how to get rid of it. One of the nurses had the bright idea of chopping it up with a device we use to break ladies' water -- sort of like a long crochet hook. She bravely went in and started stabbing at it. This did not work well -- the hook part kept getting stuck in the poo and was difficult to get out. Plus, we could only break off bits, and that wasn't gonna get the job done.
Perhaps drawn by news of the tremendous turd, or perhaps by our shouts of laughter, the nursing supervisor soon arrived to put a damper on our poo fun. She admonished us sternly to "grow up" and gazed down, unmoved, at the sight of the Rock of Gibraltar in the bowl. I have to hand it to her, this was professional composure at its finest. We were dispatched to get a biohazard bag. She put her arms in the bag, and plunged them into the bowl and wrestled the beast into the bag, which she then turned inside out and tied it into a knot, efficiently. By the looks of the thing in the bag, I revised my weight guesstimate up to six pounds, or possibly more. But, alas, we were never to know the true weight, as the bitch TOOK IT AWAY, lecturing us all the while on crap like professionalism and how disappointed she was in us.
I like to imagine that she possibly took it home with her, and bronzed it or something and now displays it to her neighbors as a lawn ornament. Alas, I don't actually know what happened to it; still, this remains a tale that is told and retold in our unit during dark and stormy nights.
-- Poonurse [1]