Emergency! by MD Mark Brown Page A

given and we waited for him to settle into twilight. In about five minutes he seemed appropriately out. The nurse and I quietly moved into place. My plan was simple enough: Remove the pillows; extend the leg and simultaneously apply pressure to the lateral side of the patella. Presto—patellar reduction!
    I quietly spoke some reassuring words to David as I began to lift his leg and cradle it in my arms. Suddenly his placid demeanor was replaced by moaning. Low and plaintive at first, his moans soon changed character. The tempo accelerated and the volume began to crescendo.
    Criminy, I thought, I haven’t even removed the pillows yet. I braced myself and continued.
    â€œMmmmmm. OH! Ohhhhhh! OOOOOHHHHHHH! OH! OH! OH!”
    I felt a little flushed and looked up at his mother. “I know this all sounds quite awful, but David really can’t feel much and he won’t remember anything after we’re finished,” I assured her. She nodded quietly. Determined to get on with it, I slowly and purposefully resumed the procedure. This time my efforts were met with more animation and louder vocalizations. One could not help but notice that they were beginning to take on the distinct tone and cadence ofthe soundtrack from a pornographic movie. I glanced across the bed at the nurse. She had the pained expression of someone straining to maintain professional composure.
    â€œOOOOOhhhhhh … OH! OOOOWWWWWW! OH! OH! OH!” By now he was sitting straight up on the gurney, eyes wide open, howling wildly. “Oooooooh. Oooooow! Oh, God! Oh, God! OH! OH! OH!” As squeamish as I am about causing pain for my patients, I was becoming even more uncomfortable with the scene being created, and I was acutely aware of turning a deeper shade of red. As his bleating continued, I felt perspiration forming on my upper lip and brow. I was grateful to feel the patella suddenly settle into its proper position.
    â€œWh-Wh-WOW!” he shouted, then dropped back onto the pillow. For a moment he lay there quietly, eyes half closed, with a peaceful countenance. Then, slowly, he opened his eyes and met my gaze as a lazy grin spread across his face. “Got a cigarette?” he asked in a loud baritone voice.
    My blush was now complete. I was sweating and my hair was tousled. I allowed an embarrassed chuckle to escape and turned to his mother. She stood with arms crossed, gazing at the ceiling, her foot tapping in nervous agitation.
    Sensing her discomfort, I decided to exit. I slid open the exam room door and looked out at the nurses’ station. My gaze was met by a gallery of slightly open-mouthed faces quietly staring at our room. Slowly the stares gave way to contorted smirks and grins. I glanced around the department. From nearly every exam room door there peered a curious head. I drew a deep breath and strode with pseudo-confidence to the nurses’ station. “I guess they think we run a full-service department here!” the charge nurse said.
    SUSAN K. SUCHA, M.D.
    Omaha, Nebraska
    

HARD TO SWALLOW
    A n attractive couple in dinner attire came in to the Emergency Department, both holding extremely bloody towels. The male was clutching his towel over his groin, and the woman had hers wrapped like a turban around her head. Both were very uncomfortable.
    They were reluctant to talk about what had happened. Physical exam of the man revealed several deep lacerations of the penis. The woman’s physical exam showed multiple puncture wounds to her scalp that were oozing blood. After some coaxing, they told their story.
    They had been enjoying a candlelit dinner together and after several glasses of fine wine, they were feeling romantic. For a special dessert treat, she slipped under the table, unbuttoned his trousers, unloosed his penis, and took it into her mouth. Suddenly, in the midst of the act, she had a full-blown grand mal seizure: her jaw clamped down tightly and her head shook back