Today we have Dr. John Lawrence on the blog sharing 10 of the craziest things he experiences in medical school.
If you have yet to meet Dr. Lawrence who was recently on The HIM & HER Show, he is the author of the series Playing Doctor and is in fact a doctor. In the episode he talks about surviving medical school and residency training, his best and scariest moments from practicing for 20 years and his transition to becoming a writer. He also covers issues with today’s medical system, when to take your kids to the ER and what it’s like teaching.
Lauryn is such a fan of all 3 of the Playing Doctor books that she just had to have Dr. Lawrence on the show.
Trigger warning: this post is not for the faint of heart! Your knees might buckle, you might feel faint, you might get the heebie-jeebies, you might lose your appetite. But you’ll also smile, laugh and feel relief after these short stories.
Without further ado, let’s welcome Dr. John Lawrence to the blog.
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When people ask about crazy medical stories, they often want me to jump right to removing foreign bodies from various orifices – and perhaps I will share one such event. But first, a few tales you might not have heard about in the wacky world of medicine – a mixture of the scary, kind of gross (for which I apologize) and heroic (not on my part). Here are ten that first came to mind:
Dr. John Lawrence’s 10 Craziest Moments From Med School
OB gone wild.
Despite work hours that openly mock child labor laws, OB rotations were usually fun. You deliver babies and despite the healthcare team’s continuous battery of tests, pokes and prods, things normally go well. But when OB cases went off the tracks, for whatever reason, the entire team instantly became superhero focused on what was literally, and you don’t say this often in medicine as it sounds a bit melodramatic, a life-or-death situation.
One night on the High-Risk OB team, while all the actual OB residents were having fun performing C-sections, I was left to check on patients in their rooms. We had one patient on bedrest whose placenta, growing like an aggressive cancer, spread through her uterus and invaded her body, called Placenta Percreta. The placenta is engorged with blood vessels – so there was a terrifying knowledge that she and her child could rapidly bleed to death. The OB/GYN, oncology and surgical teams all kept very close tabs on her.
She had experienced several false alarms, when she felt blood might be trickling out, but she always turned out to be fine. So when she paged me that night, worried some bleeding might have started, I was not too nervous. I checked and did not see any blood. I reassured her that it was another false alarm, and hoped she had a quiet night.
Twenty minutes later she called me again. This was not a patient you accused of crying wolf. So, I trotted back to her room and turned back the blanket to re-examine between her legs. This time, against all my hopes, I saw red fluid on her bed sheets. Now, I know what blood looks like, I’m not a total bozo, and it definitely looked like blood, but I still stared at it for several seconds, needing to be absolutely certain. I was about to set off a serious beacon of alarms to a lot of people, and if I was wrong, and it was some red reflection, or a mirage from my sleep deprived resident brain playing tricks, I was going to look really stupid and then likely be exiled from the hospital.
So I stared, hoping my eyes were deceiving me. No, it was blood. Another resident walked by at that moment, and I called for him to help me. Hospitals are pretty calm places and doctors act pretty unflappable. But in this case, we had been told to run screaming to the OR. So we did. We ran down the hall, pushing her hospital bed as fast as we could, hollering the entire way, shouting to call and alert all the teams.
Inside the OR, many medical teams converged, and almost on cue, the floodgates opened, and blood splattered onto the tiled floor, echoing loudly like a sink overflowing with the faucet left wide open. They saved mother and baby that night and, in the process, gave her over 40 units of blood. To give you an idea, that was probably 4-5 times the amount of blood in her body to begin with.
Trust your instincts.
One calm morning, I was working in the ER when a husband brought his wife in, saying she was feverish and not feeling well. They had just visited her doctor’s office for the same thing and been sent home after having a few tests run. But they decided to stop in our ER as she still felt sick, too sick to go home. And she looked miserable, like someone with influenza or pneumonia. Her temperature was over 104 F—high for an adult, likely signifying a serious infection. Then she started complaining of a severe headache. These symptoms were starting to sound like meningitis, an infection around the brain. Bacterial meningitis, if not treated right away, can be fatal. Then things got crazy.
She complained that her fingers and toes were starting to hurt. Somewhere, deep in the recesses of my slow working medical brain was a memory of complexes forming in blood from an infection which could block off small blood vessels, thus causing pain. Blood tests were drawn, I did a spinal tap, sent her for a CT scan and antibiotics were started – but things kept getting worse. Her fingers and toes started turning black. She was transferred immediately to the ICU.
Turned out to be a random Strep infection (Strep Bovis) causing meningitis. It was terrifying how quickly the infection overwhelmed her from the short time between her arriving in the ER and being taken to the ICU. She lived, after a lengthy stay requiring intubation and multiple amputations. But I don’t think she would have made it if they had gone home instead of deciding to stop in the ER.
Why we don’t take unnecessary medicines.
The Burn Unit teams treat injuries from all sorts of crazy places: lightning strikes, boiling water spills, falling into bonfires, meth lab explosions, picking up fallen power lines, you name it. But the single worst case I saw during my Burn Unit rotation was a young woman who had been treated for a common cold with a common antibiotic. Unfortunately that gratuitous medicine (antibiotics don’t treat viruses) had triggered a severe allergic reaction called toxic epidermal necrolysis syndrome (TENS). She looked like she had been dropped into a vat of boiling oil.
Inside her body, the reaction combined with intense medical care, had caused all sorts of havoc leading to multiple organ system damage. Months later I learned she needed both lungs transplanted. All for a common cold that never needed antibiotics. When patients try convincing me (sometimes yelling at me – which is not convincing whatsoever) that it wouldn’t hurt them to take an antibiotic for a cold, just in case it helps them get better faster, that’s the case I think of as I politely explain why it’s still not a good idea.
Not everything in the ICU goes badly.
We were treating a patient in the MICU who we expected to die every day. Much like the Dread Pirate Roberts (for all you Princess Bride fans) saying he would likely kill Wesley the next day, we all expected the bizarre heart failure that was inflicting her, to kill her the next day. She looked to be several hundred years old and sported an alabaster white skin pallor that would leave ghosts envious. Every day I was pimped in front of the ICU team about what to adjust to make the balloon pump make her heart work more efficiently, and every day, after looking inept, the team agreed, it probably didn’t matter what we did, she was going to die anyway. And one day things looked dire.
We told her family to say their final farewells. But she told us she would be up dancing in the hospital the next day. I have no idea what happened, what super-smoothie she drank, but the next day, her skin was pink, she was sitting upright, looked to be only 40 years old and was transferred to the regular hospital floor the very next day. She was likely dancing the night away and we had no idea how she got better.
Sometimes, it’s just not your time, no matter how hard you try.
The Burn Unit could leave you dumbfounded just seeing what people can survive. Our patient-to-be, straight out of a road runner cartoon, had been rock climbing in a nearby canyon when he was struck by lightning, The high voltage blast, amongst other traumas, had stopped his heart, essentially killing him. His mostly dead body fell around 40 feet onto a rock floor. That fall shattered his spine, ribs, and many other bones. Fortunately, as all The Princess Bride fans will recall, “There’s a big difference between mostly dead and all dead. Mostly dead is slightly alive.” The impact of slamming into the rocks however, not only broke bones, it also shocked his heart back into life!
He took a few months to recover, but walked out with instructions from the head doctor to figure out what he was supposed to do with his life, because apparently, he must be alive for a reason. To complete the Wile E. Coyote story, years later I saw him again in an urgent care clinic, this time after he tried using a new espresso machine at home and scalded most of the skin off his hand. Apparently being a barista was not his reason to stick around.
The most freaked out I ever felt.
It’s rare that a hospital delivery does not turn out well. There are teams of nurses, doctors, neonatal and respiratory specialists, anything you wanted, with all sorts of machines and medicines to help. But one day, working on a rural rotation, far from the big hospital with all the experienced teams, the doctor I was working with told me we had a delivery to perform. No problem. I did lots of those. I confidently took over this pregnant woman’s care and everything went great: I was speaking Spanish, telling the woman when to push as I eased the baby’s head out, and next prepared to deliver the infant’s shoulder.
But the shoulder did not appear.
I heard the rural doctor tell me to deliver the shoulder — which was exactly what I was trying to do…except the shoulder just would not come out. The baby’s head was sticking out, but that was as far as he would move. I was encountering something you read about in textbooks, called “shoulder dystocia.” But until you see it, you have no idea how scary it can be.
The textbooks and lectures taught a protocol to follow: Apply pressure on the mothers stomach and pubic symphysis; try rotating the child; put the mother’s legs further towards her head; relatively conservative techniques to start. But with the baby being compressed, blood supply to his head was being cut off, so if things were not going well, next steps in the protocol included breaking the infants clavicle or cutting the mother’s pubic bone. OUCH! Ouch on all accounts. But less traumatic than the child dying. And I could not get the kid out.
At this point everyone was perspiring, the doctor and I bantering instructions, the mother was crying, and my arm was deep inside her, twisting the kid, trying to get him out. But he would not budge. The doctor joined me in pulling and pushing – and finally we delivered him. But there was no breath of relief because the kid was blue and floppy. I suddenly thought that in our efforts to get him out, we had twisted and damaged his spinal cord. I just about doubled over and vomited – but instead started rapidly drying him off, warming him up, sucking mucous from his nose and throat, and willing him to breathe… and finally he came around. He was just fine.
I however was not; I was freaked out and close to shock and wanted to quit medicine. Even though everything turned out fine, that was a serious wakeup call as to what can happen. We never forget the cases that don’t go well, and probably learn the most from them – although not exactly a point you share with patients, “It’s better for me if your care doesn’t go well.” But every medical student or intern I taught received a lecture on shoulder dystocia and maybe that has helped save another kid.
True Hero.
The woman I was dating at the exact same time as that shoulder case was the chief resident on the surgery team. She was a serious, no-nonsense, amazing, workaholic doctor, who did everything the right way—i.e. typical surgeon in sharp contrast to yours truly. One evening she was on her way out of the hospital to pick up some take-out food as a friend of ours was in the hospital after his lung collapsed (a different story altogether, he’s a pain in my ass as he rode a one-hundred-mile mountain bike loop in the desert with that lung collapsed). Anyway, on her way out, she gets a call that one of her surgical patients is coding on the sixth floor hallway.
She drives back, sprints up six flights of stairs (she was an ultra-marathon runner, so that was faster than the elevator) and pushes aside the medicine team crowding around her unconscious patient about to shock his heart (there are surgical and medical teams in the hospital– it’s a serious rivalry, trust me). She then demands a pair of scissors. The internal medicine attending, whose team is technically in charge of the code, starts yelling at her, “What the hell are you doing??!!” as she takes the scissors and cuts the patient’s abdomen open—right in the middle of the hallway!
The attending keeps shouting at her as she sticks her hand into the patient’s abdominal cavity (she had put gloves on) and clamps his aorta against his spine with her hand. While the attending yells at her and everyone else stands wide-eyed and gawking, she keeps calmly asking the nurse, “Do you have a pulse yet?” And then, the pulse comes back. She is wheeled down to the OR, in her flowing skirt, on top of the patient, on top of a gurney. In the OR, she opens him up, sews his bleeding splenic artery back together and saves his life. This was pre-internet type stories going viral, but it went viral. All the other surgical residency programs around the country heard about it.
I was at dinner with her older brother a few weeks later, along with a group of his surgery buddies—all of whom were all-star surgical residents. They were bemoaning how much they wish that it had happened to them, that insane lifesaving moment in front of the hospital staff, showing the medical team who was the better doctor, talking about how they would have handled the case. Then her brother looked around the table and said, “You know what though? I never would have had the balls to do it.” And they all agreed, none of them would have either. True hero.
Just silly moments.
As chief resident we had to be on phone call duty in the hospital to answer medical questions for people calling their sleeping doctors at odd hours. The rationale being that we residents were awake anyway—which was true. One night I received this call: “My husband has had two heart attacks and just had bypass surgery. He’s having chest pain right now and says it feels just like the last two heart attacks. Do you think I should take him to the hospital?”
“Well, how much do you love your husband?”
“Excuse me?”
“I’m joking. You need to hang up and dial 911 immediately.”
Adventures in Manscaping.
Turns out “manscaping” is an actual word. Yours truly was actively manscaping, trying a new electric razor to clean up the nether region, when suddenly the shower water turned bright red. As I mentioned in one of the above cases, I know what blood looks like, and this was definitely blood. A lot of it. I jumped out of the shower thinking to grab a towel, but they were all white, and the bathroom tiles my wife chose are wood and white, and she was coming home with the kids from school any minute.
I needed to stop the bleeding because there was no way I was letting all three kids wonder what was going on with me bleeding from my midsection and then telling their respective schoolmates that their dad had castrated himself, but then mom killed him for ruining the fancy tile work before he had a chance to bleed to death.
The bleeding was so heavy, that I could not stop it despite roll after roll after roll of gauze pressed to my groin. The only thing that helped was using painful spring-loaded clamps to squeeze the entire bleeding area – but whenever I tried to look, thinking it had clotted off, I couldn’t see a thing as the bleeding immediately started again. Finally, eight hours later, with everyone asleep, and worrying I really might be slowly bleeding to death, not wanting kids to be traumatized if that happened, and stubbornly refusing to go to the ER to tell a receptionist what was going on, I got out an old suture kit and needle and blindly started putting sutures into the area of bleeding. Eventually the bleeding slowed enough so I could see what was going on and finally sewed up a lacerated vein. Sorry, that was gross.
The risks and rewards of cooking naked.
The rewards are pretty obvious, less cleanup if things splatter, of course – but maybe you’re thinking something else? The risks however can vary – the aforementioned splattering (I personally don’t recommend frying foods naked) for example or slipping. Slipping?? Yes, we had a very nice woman arrive in our clinic after she slipped while cooking. She had been preparing potato salad in the nude, as one might do, and landed right on a potato — which was now lodged in her vagina. No judgment, just informing you of the inherent risks involved with nakedly preparing root vegetables.
Entire chapters of medical books are dedicated to the techniques for removing the variety of objects that somehow wind up stuck inside people. By far, the majority of culprits are kids shoving candies, buttons, popcorn kernels and other objects up their nose or in their ears. But yes, adults have their own fun with objects and while x-ray images can be impressive, the stories behind the images are just as entertaining.
OK, those were a few tales that appear in more detail in my book series, Playing Doctor. If I’m invited back after those stories, I’ll give you 10 more less serious stories, including the time I got to play Sheriff and when a spider bit my penis.
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Be sure to listen to Dr. Lawrence’s podcast episode for more, and like he said: stay tuned for fun stories and a Q&A with him.
Have you read Playing Doctor yet?
x, The Skinny Confidential team
+ Fun facts about John Stamos.
++ Bryan Johnson on slowing down the aging process.
PLAYING DOCTOR BOOKS:
