Traumatic foley

Nothing forces you to come face to face with your own inadequacies quite like medical school and residency. I certainly have my share and there are many posts in store in which I plan to reveal my failures, shortcomings and flat out disasters. By contrast, there are two particular areas in which I have always excelled. Namely, maintaining objectivity and withstanding the various sights and smells of blood, pus, feces, urine etc. Except when it comes to the male genital tract.

While on call last week, I received the following page: "Mr. Gephardt has pulled out his foley; there's blood everywhere. You should probably come see." The nurse's words were calm and measured - as if she'd seen this a thousand times before. She seemed almost apologetic at having to wake me for something so trivial. I walked over to Mr. Gephardt's room. There was, indeed, blood everywere. The nurse didn't need to say another word as the blood splashes on the floor told whole story. The story began with Mr. Gephardt pulling out his foley while still in bed, walking over to the bathroom to urinate blood, walking from the bathroom to the nursing station (with no clothes on, mind you, and still dripping blood) and back to his bed after being chased there by the nurse from whom I had received the page. And the most relaxed person in the room was Mr. Gephardt himself.

"Mr. Gephardt, you pulled out your foley." I tried to sound as matter-of-fact as possible.
"No, it just sort of fell out."
"Did it hurt?"
"Yeah, it hurt!"
"Does it hurt now?"
"No."
He wasn't actively bleeding anymore. So, I went back to the call room, arriving just as my vision was about to turn completely black and just in time to pass out on the bed rather than on the hard tiled floor.

When there is blood coming from the female genital tract, I've never had an issue. During my former life as an OBGYN, I used to handle buckets of it! When it's coming from the male genital tract, I need to put my head between my knees and take some smelling salts. I could never have been a urologist.

For those of you unfamiliar with the concept of a foley catheter, this illustration should help you understand what I'm talking about.