Sunday, January 11, 2009

Sticking Up For The Underdog

So the other day I was zinging around at work, in a freakishly cheerful mood (and after several days of that, I think I'm starting to annoy the more sour-puss types at the clinic), and for some reason it reminded me of this from my intern year.

As an intern, I worked at a hospital group htat had several different hospitals including two 24-hour care centers. One weekend day I'm manning one of those, and L, my tech, comes back and says I have an appointment in room one.

"What is it?" I ask him. He gets A Look on his face.
"A woman with her finger in a dog's mouth," he says.

Eh?

"Ummm... did she say WHY she had her finger in the dog's mouth?" I ask, wondering if we should be calling the human ER, plus or minus the local nut hatch.

"She says if she takes it out the dog will die," L reports, shaking his head - just the once, mind you, but that's a lot coming from him. Apart from being a top-flight tech, he is also well-nigh unflappable. I've seen him take the most hysterical and unreasonable clients, not to mention the most difficult patients, right in stride. I can only imagine the bizarreness that has him shaking his head.

Well, as it turns out, I CAN'T imagine the bizarreness. Even with the description, I wasn't QUITE prepared to see a woman standing calmly in the exam room with her index finger inserted to the last knuckle into the mouth of a Chihuahua.

Now, you have to picture this. Here's this little Chi standing on the exam table with an entire human finger in his mouth. Naturally he can't turn his head, thus restrained, so when I walk in he rolls his buggy and protuberant little eyes (perhaps a bit MORE buggy and protuberant than usual, in view of his current oral circumstances) in my direction. I detect a distinct note of alarm in them, but for once it seems not to be directed at me - arriving in my white coat and no doubt armed with an absolute plethora of rectal thermometers just waiting to be pressed into duty (so to speak) - but instead to be focused on the woman who has his little head gripped firmly in one hand, and the (handsomely be-ringed) index finger of the other pushed quite far into his little mouth.

"What seems to be the problem?" I inquire with a cheerful grin (which is mainly engendered by the ridiculousness of the tableau, but which luckily passes for bedside manner).

"He's having seizures. I stopped them by putting my finger in his mouth, but if I take it out, he starts having another one. I'm afraid he'll choke to death," the woman reports.

Hmmm. Well, apart from the fact I don't recall the head of Neurology ever mentioning anything about finger-down-the-mouth being a preferred treatment for epilepsy, I am having a hard time imagining what kind of seizure might be precipitated by NOT having a finger down your mouth. Hence (and here I know you'll think I'm being rash) I conclude that the dog is not having seizures and instead has some other problem, as yet undetermined.

I get a bit more history - young dog, no prior seizures, otherwise healthy, but as it turns out, not her dog. He belongs to some friends, currently waiting in the parking lot, too upset to come in, in case I say the dog needs to be put down. It just happened that she was with them when the behavior started and was the only one cool-headed enough to do something when they all returned to their respective cars after getting Slurpees in the 7-11. She's had her finger in the dog's mouth ever since, though - this having understandably impaired her ability to drive her own car - they all piled into one to make the trip to the hospital. I nod as she tells her story and do a physical exam, working around the woman's fingers. The Chi watches me as best he can, rolling his eyes to and fro to follow my movements, now more white-walled than ever with fresh alarm.

"Okay, take your finger out of his mouth, " I tell the client.
"I can't, he'll have a seizure," she protests.
"You have to; I need to complete my exam," I tell her patiently. "Besides, you're at the hospital," I add soothingly. This apparently does the trick, because she removes her (somewhat dog-slimed) finger from the Chi's mouth.

The effect is immediate. The dog throws his head back and whips it from side to side, making gnashing motions with his diminutive jaws, at the same time as tongue-thrusting so vigorously that it appears he is hoping his tongue is all grown up now and ready to be out on its own.

"Okay, you can put your finger back," I say, which the client does promptly, because I have ascertained the source of the mysterious seizure disorder. There is a stick jammed between the upper carnasial teeth, and the dog's gargoyle-esque facial contortions are his attempt to remove it with his tongue.

"Hmmm, I think I have something in the back that will cure him completely," I tell the client, who is suitably impressed that I can cure seizures with some exciting new advancement in medical technology. "Wait here."

I go in the back to grab a hemostat. L looks up from his treatments.
"Did she take her finger out of its mouth?" he asks; I nod. "What is it?" he asks.
"Stick in mouth," I reply, to his chortling glee. I snag a handy pair of hemostats and return to the room.

"Okay, take your finger out, " I say, wielding my hemostats. The dog goes immediately into his gargoyle routine, jaws helpfully opened to their fullest extent, and I nip in and pop the stick out in under two seconds.

"There," I say with satisfaction. "Cured."

The client goggles at the stick, now clenched between the jaws of my hemostats, and then at the Chi, who is magically restored to complete equanimity by stick removal, and is now standing quietly on the table having his first unimpeded look around. The woman bursts out laughing.

"Oh, I can't WAIT to tell them," she says. Evidently her friends had gotten some kind of jerky which is impaled on a stick like a kebab skewer, and the Chi, yielding to his gluttonous instincts, decided to eat it. All of it, including the stick.

With admonitions to watch for other stick-related disorders, we release our miracle-cure Chi to his grateful (and uproariously relieved) owners. That was by no means the only stick I've pulled out of a dog's mouth, but I have to say it was one of the most dramatic, thanks largely to the patient's facial gyrations. It's also not the only time I've cured "seizures" by taking something out of a dog's mouth, but that's another story....

15 comments:

Pat said...

OMG! That's one for the Annals of Dog Doings. I thoroughly enjoyed reading about the dog-sled race and I was thinking "How could she top that?" Well, you did. Thank you.

Dragon43 said...

Why did the finger down the throat keep the dog calm? Physically over powered the critter?

Good way to get bitten?

Interesting day that one....

Keep them coming...

Sure glad I have your blog to read....

MaskedMan said...

My reaction to Chi's is pretty extreme - I either love them, or loathe them. More often the latter, I admit. This little one, I think, would wind up in the former category.

Claire MW said...

I can't stop laughing....oh my word...sort of like the peanut butter on the roof of a dog's mouth trick...

Holly said...

headdesk


while I was reading this I was trying so hard to figure it out.....I never ever ever thought of a stick-in-the-mouth!

AKDD said...

Well, I'm glad I'm not boring you all yet! :D And I'm glad I'm not the only one who found this entertaining. Not to diminsh the dog's distress in any way, but it's not every day you see a someone with their entire index finger engulfed in a Chihuahua.

Dragon, I think that the finger in the mouth just held the Chi's tongue down so he couldn't do his frantic tongue-thrusting activity (mistaken by the owners for a seizure, perhaps understandably.) I think it also was so weird from the dog's point of view that he wasn't sure WHAT to do. And yes, a GREAT way to get bitten, except that it really was a nice little Chi-wee-wee; a bit overfaced on intake, but very sweet once we fixed him up. (And you're right, MM, you probably would have liked him.)

Oh, and BTW, Dragon, I'm glad you have my blog to read,too, if only to keep you from going out and experimenting to see how many tools you CAN operate with your hand in a cast....! (MEN!) Take care of the digit. Hope it doesn't hurt too much.

Joe Allen said...

My favorite restaurant serves pork chile so tender that little stemlets of it get lodged between teeth, especially in the back of my mouth.

I now have a better understanding of why people look at me so strangely just after I've eaten there!

Della said...

Ohmygoodness!! Your stories are one of the best stomach workouts around. They also work out my face muscles and tear ducts. I giggle for Days! I try to retell them... but fail miserably. I think I may have approached hysteria on this one. Best medicine available, I tell ya!

AKDD said...

JA - snerk! (entertianing mental image)

Della - thanks! I'm glad to know I'm not only entertaining, but also improving the health of my readers! :D (Long may we all prosper, with much laughter.)

LC said...

Thanks for chuckles ! I couldn't read fast enough to try and figure out what it could be!

Flo said...

I was thinking it was a needle in the roof of the mouth, having worked at a vet clinic in high school and being the tech dealing with getting the crazy sobbing lady clamping her doxie's muzzle shut into an exam room... but a finger down the hatch sounds even weirder.

I love the "miracle" fixes- tick paralysis, this story, our needle in the mouth Dachshund, and others. The vet looks like God and builds instant karma with the owners.

I think I followed a link to your blog from Three Woofs (web stalking for the win), and I've been reading for a while. I'm very glad to have found you, and please keep posting, the more you write, the more I giggle.

Jenn said...

That dog was probably wondering what the heck the woman was trying to do to him!

My old lab has a weakness for horse hoof trimmings and every time the farrier comes out he inevitably eats them and then has a barf fest later than night.

Not too long ago the dog came inside and started bashing his face into the floor and tearing at his mouth with his feet. I thought he was having a seizure. He was bashing his head hard enough to leave blood and saliva all over my floor. I was able to get him to stop bashing himself long enough to pry his jaws open and take a peek (thinking maybe he ran into a skunk or porcupine) and a found a piece of hoof wedged between his teeth in the roof of his mouth.

Once I pried it loose the head bashing ceased. But it is scary to see them behave like that so I understand why the woman was afraid to remove her finger!

AKDD said...

Floyd and friendlyf, glad you're enjoying the blog! If I can make a few people smile - and maybe keep them from feeding their cats dental floss and their dogs jerky-on-a-stick (or needles, YIKES!), I feel my efforts have been successful.

Jenn, good thing you found the hoof fragment. Sticks stink bad enough if they're wedged in there for any length of time. Horse hooves - Yow. That would be a whooooole new experience in stench.

Anonymous said...

OMG!!! This is utterly hilarious!!!! Desparate measures, huh??

AKDD said...

Hey, at least she was brave enough to stick her finger in the mouth of a strange Chihuahua in an attempt to save its life. I know plenty of owners who (justifiably) are afraid to do that to their OWN dogs, let alone one belonging to someone else. Gotta admire her for that, I figure!