Welcome back to the Doctor Rich Channel. Today we’re talking about medical horror stories — we’re going to talk about one particular event that occurred during my career that is cringeworthy! And make sure you stick around to the end to hear all of the gory details!
Don’t have time to read this post? Watch the video here instead!
Hi, I’m Doctor Rich — board certified urogynecologist and passionate advocate of women’s healthcare issues. Thanks for joining us! You know, we’ve watched a lot of videos online out there talking about different medical horror stories…like this one! I took a flight to Orlando last weekend for a friend’s wedding, and 20 minutes before we landed, we got a call overhead for any doctor on board — there was a medical emergency.
So I raced to the back of the plane, and the patient was non-responsive. We did a basic vital checkup, and thankfully, I had the assistance of an ICU nurse from Austin. Together we resuscitated the patient, and everything went well. Ironically, two years ago, I was on a flight to Vegas — and a very similar thing happened! When I went to check on the patient, they were non-responsive. I looked over at the flight attendant and said, “I need a blood pressure cuff, I need a glucometer, I need oxygen, I need a pulse oximeter…” to check all of the basic vitals. And they looked at me and said, “Well, we don’t have any of that.” So you know (oddly enough!) I had that experience two years ago. So I got online and I got one of these little finger pulse oximeter things, and I carry it with me! And I was like, “You know, one day I may need that and I have it on the plane!” And, lo and behold, sure enough, I had to use that on the flight to Orlando last weekend!
But that’s not why we brought you here today!
We brought you here today for one of my surgical horror stories. So this happened one week into practicing medicine. One week out of fellowship, I get a call from the ER. A patient had come in, and they’d called general surgery because she had what’s called an evisceration (which means that the guts that are supposed to be on the inside are now outside of your body).
And in this particular case, the reason that I, a urogynecologist, was called is because the patient had very poor nutrition and overall health — and had very weak, bad tissue. The tissue got worse (and was bearing down), and she had prolapse. Her bowel blew out the top of her vagina and 40 centimeters of her small bowel was hanging outside of her body through her legs.
Very shocking stuff!
The general surgeon looked at it and said, “What am I going to do?!” So he calls me in, and together we put her organs back inside her body (under anesthesia) — him pulling from above and me, pushing from below.
When tissue gets pushed through a narrow opening, sometimes the blood pressure going in allows continued blood flow into the organ, but the venous return is the lower pressure — and you can’t get blood out.
So the entire bowel had swollen up to about three or four times the normal size! We had to actually go one little centimeter at a time, because it wouldn’t go back in otherwise. Once we’d done that, my general surgeon colleague did an open incision from above to check the rest of the bowel, and make sure everything was okay. Then we stitched it up, and closed it up. As gynecologists and pelvic surgeons, we spend most of our time suspending organs that fall out of the body (the bladder, the vagina, the rectum) on a day-to-day basis. That’s what we see. We don’t usually see anything like this! This is (hopefully!) a once in a career type of thing.
But given the nature of the injury (the swelling, and the potential for infection that was going on from all of this), we closed the hole that had been created at the time — and our plan was for her to come back in three months. Then we did the repair to keep the vagina back inside the body. And fortunately — that incident did not recur!
So during this “COVID Era,” a lot of patients have deferred all of their care! ALL of their healthcare! There’s things that they’ve needed to get done, and because it wasn’t an absolute emergency — like a heart attack or an appendicitis — they’ve just deferred their healthcare and haven’t gotten their routine care.
So not that this story we just told would happen to you — but you certainly don’t want to defer! You want to get seen for anything that doesn’t seem right. So if anything seems off, you should get it checked out. As my dad is fond of saying, “Bad news rarely improves with time.”
So if you enjoyed our first episode of Surgeon Horror Stories, subscribe and turn on your notifications so you can find our next video of things we found in people’s butts.