Friday, January 21, 2011


I had three of the most interesting cases today. Odd because I may go a month without an interesting case crossing my path, and here today, three drop by.

First is the largest Pilonidal cyst that I have ever seen in my life. I am by no means an expert in the area of pilonidal cysts, but I have seen my fair share. They smell SO VERY BAD. One of the worst smells ever in my opinion. They are an abscess or big huge zit that grows out of the ass crack.

This poor Marine had three that had grown together into a long cavity. When I pressed down in the middle of his ass cheek, puss comes squirting out of the openings. The smell was so horrible that I left and covered my lip with an alcohol pad to help block out the smell. That only lasted a minute or two. All told after I opened up the area, 20-30cc of the rankest smelling puss known to man comes pouring out. Some of it even squirts out and sprays against the wall of the exam room. I had learned my lesson long ago and had goggles and a mask on. It smelled so bad I was trying to vomit two different times, but kept it all down. Nauseating.

My second interesting patient of the day shows up with a painless ulcer on his penis. He had a single one, then it went away, now he has five smaller ones. I run a test called an RPR that checks for syphilis. Bummer, he has syphilis. Real, no shit, ugly nasty syphilis. I can’t confirm it for two to four weeks until the formal results come back, but holy dirty dick batman!

Third case of the day. A pregnant woman. Its just not something that I normally see a lot of, especially out here. I got to give good news to a woman who was quite happy about it. Probably not the best time. The odd thing is that because of general rule number 1 that states that you will not have sex out here, the normal course of events is that if you are found to be pregnant, that usually means at least one person is in trouble and probably two people. This was an error on the screeners part and she has been pregnant for a while, and just got here 4 days ago. This is different from the last one of these that was about 2 months prego and has been here for 5. THAT one got into a lot of trouble because of the above rule #1. So, it was good to give good news, and not worry that she was going to get into trouble.

Thus ends my interesting cases for the day.