I’m a doctor. And, like most medical professionals, I\’m a bad patient.

Two years after my last appointment, I got a CTJ, \”Come to Jesus\” from my doctor.

I called his office for a form. I needed proof that I don’t have tertiary syphilis. For my Thai visa.

Why tertiary syphilis, as opposed to HIV, cholera, lepers or bubonic plague? I don’t know. That’s the power of bureaucracies. They don’t have to make sense. They make the rules.

My doctor wasn’t happy. “Come get seen or get lost,” he said. Or something to that effect. Politely wrapped.

I went.

Good news: I didn\’t have tertiary syphilis.

Bad news: I didn\’t have a colonoscopy either. At 57, I\’m seven years late. No recent mammogram either. As for the PAP smear…

Whatever you think, I’m not totally negligent. I brush my teeth. I floss. I pay attention to what I eat. Too much, maybe. I work out. I don\’t smoke. Anything.

But I live and work in a small community in the North Country.  I know every doctor, including the vets. I work daily with the OBGYNs and the GIs Nice people. Down to earth, outdoorsy, mostly easy-going. I love seeing them in the ER, though they seldom feel the same way. We commiserate about the weather. We bash the administrators\’ latest move. We’re friends on Facebook. I know the names of their dogs, the size of their wives, and how many cocktails they had before posting.

I like them, but a colonoscopy? That’s a level of carnal knowledge I’m not up for.

I don’t know about you, but I find it easier to show my privates to people I don’t know than to my friends. Having them examine my insides – and my outsides – is not my idea of fun. Not like it’s life and death, people! Yes, I see them in the ER. I examine them. I even intubated a few. But they didn’t have a choice! They were dying!

My doctor got it. He didn’t care.

“You need preventive care. You’re way past due for colon cancer screening. And pap smear.”

\”But I’ve never had a bad pap smear! And my social life is not worth mentioning!\”

He nodded, smiled and referred me across the lake, in the next state, for GYN. He got me Cologard.

What\’s Cologard? It\’s a test for colon cancer that doesn’t require a colonoscopy. You provide a sample (of you know what) in the comfort of your own home, then send it for DNA testing.

I can do that, I thought.

Yesterday was Christmas in July. The mailman brought me a Doximity plaque proclaiming me “The most entertaining author,” and a cardboard box of Cologard with multiple interrelated plastic parts and 80 pages of bilingual instructions.

Did you ever buy furniture from Ikea? It’s DIY. Comes in boxes. The instructions are more entertaining than straightforward. My success rate is 1:3. Three assemblies to get one right. Cologard must use the same writers.

Instructions started with Step 6: Label your samples.

That’s jumping the gun a little, I thought. But I didn’t let that deter me.

Next brochure: How to return your kit. Four pages later I got enlightened: Weekend pooping is a no-no. The package needs to be sent immediately and tested within 48  hours.

Further explorations brought me to another unputdownable 60-page brochure. Indications, contraindications, warning, precautions, test interpretation, risks and more. The style was crisp, the images graphic, the protagonist daring.

Twelve pages into it, I got to Step 1: Check the expiration date, then to Step 2: Prepare to collect a stool sample. How to assemble your Cologard kit and avoid pooping next to it. Or something to that effect.

I pulled the heavy zipper bag out of the box to remove the contents. It wouldn’t come. I pulled harder. Nope. I turned it upside down and shook it. It was stuck.

I tore it off the box. Then I saw it, right there.  Leave the plastic bag and the white tray inside the box.

I pushed it back to cover the tear and I engrossed myself in lecture. Half an hour later, I\’m an expert in Cologard. I can\’t wait to test my new expertise, once the weekend is over.

The pap-smear, you say? Seriously? I hope he forgets about it!

But that got me thinking. Am I foolish to avoid preventive care? I wouldn’t let my patients do that. Am I risking my health? My life maybe? Why?

Is it because I’m a doctor? Do I secretly believe that my medical knowledge will keep me safe? That I\’ll know it if my body goes rogue?

Or is it just the opposite? Do I know enough about medicine, including how little we really know, to lose respect for the science?

There’s so much we don’t know. Then, half of what we do know is wrong. We just don\’t know which half.  From blood-letting to smoking and coffee, the only constant in medicine is change. This here is just the latest.

Or is it the NNS, the number needed to screen, that makes me hopeless and fatalistic? 25,000 to prevent one death from melanoma. 1374 (every five years) for colon cancer, 2451 for mammograms. They cost money and time. They have risks. Many risks. False positives, exposing you to more studies. Colon perforation. Infection. Bleeding. Sedation gone bad. More.

Is that why I’m a bad patient? Maybe. But I’m not an exception. Most medical professionals are bad patients.

We should take better care of ourselves. We should sleep more. Drink less. Avoid stress. Get our colonoscopies and our mammograms. Ask for help when we need it. We\’d live better and longer.

But we don’t. Why?

I hope I remember that next time my patients are difficult and noncompliant.

In the meantime, I\’ll go look for some essential oils. Anybody knows how to grow aloe?

Rada Jones MD is an  Emergency Doc in Upstate NY, where winters are long, people are sturdy, and geese speak mostly  French. She lives with her husband, Steve, and his black deaf cat Paxil. Her ER thriller, OVERDOSE, is on  Amazon, Audible and Apple books. MERCY, Book 2, is on preorder. 

If you’re sexy, fit and nimble,  if you can part your thighs and bend your knees, if you can see your private parts without a mirror, ignore this. Move on. This is not for you.

This is for those with flailing sex-drive and failing abilities whose sex life is a challenge, but they\’d like to make their partners happy and have some fun. Maybe your parents or grandparents. This must be an awful thought, but I\’m pretty sure they did it before, or you wouldn\’t be here.

Sex in the elderly is not a need. It\’s a privilege.

Most days you just hope for a good bowel movement.  You walked out of bed, you peed without a tube in your urethra, you pooped without an enema! Wow!

Towards the end of your life, the day you even think about sex is a good day. You have a spring in your step and tickle in your nether parts, reminding you of the good old days. You feel naughty. But your partner…They may or may not be into it.

You\’re not quite sure how to ask. There used to be signals: that special smile; that slow touch; the tongue maybe? You didn\’t use to have dentures, then.

It\’s hard, whether you\’ve been together forever or just since your granddaughter hooked you up on Tinder. You spoon while you sleep. You switch plates at dinner. Sometimes you take his meds. Your intimacy is not sexual.

Today, you feel the stir. You\’re not sure how to go there. Wouldn\’t that be fun?

Maybe.

There are challenges.

Artificial hips and fused backs hinder your mobility and limit position choices. Avoid low chairs. They make hips come out. Nothing spoils the mood like an ambulance trip.

Atrophic vaginas lack flexibility, so lubrication is essential. Lubricants come flavored in endless choices. Naked strawberry. Pina Colada. Cinnamon roll. I\’m looking for one in bacon. They say bacon makes everything better. You need lube, love, and lots of patience.

The penis needs blood to engorge. Lots of it. Your heart needs to stand up to the challenge, besides just keeping you alive. Sex may be the only demanding physical activity you\’ve engaged on since fighting for that TV on Black Friday. Sex is risky for your heart, your brain, your aorta. Your body works just as hard as if you were shoveling snow, but you\’re having too much fun to notice the warnings.

I\’m an ER doc, so I\’ve seen plenty of heart attacks and strokes caused by sex. A few deaths. They were all men. Their lovers were distraught.

So were their wives, when they all met at the bedside. I saw that twice. Neither man made it.

Be careful. Speak to your doctor. Ask them if your heart is strong enough for sex.

Viagra works. It made a difference in my patients\’ sex lives. It gave them hope and joy. It also gave them HIV and Hep C. Viagra doesn\’t work well with alcohol. You may want to forgo the wine and stick with roses and candles. Viagra interferes with nitroglycerin, our go-to drug for the heart. Tell your doctor if you took it.

Regardless, sex is fun, sex is joy, sex is love. If you\’re not doing it, you’re missing out.

If you\’re lucky, you have an interested partner. Still, coordinating is a challenge. Maybe it\’s not their day.

In comes oral sex. The blow job is the refuge of the intercourse destitute. Whether you had surgery, you hate being touched down there or it’s just not your day. Oral sex can be your friend.

How bad can it be? It won\’t make you fat. Like celery and grapefruit, it\’s negative calories. It will help soothe a relationship that needs more than you can deliver. Look at it as a gift. Share sex like you’d share a special dinner: You can choose your entree, but you have to agree on a time and place.

A few technicalities:

• Soap is cheap. Skin folds are tricky. Wash them twice.
• Dentures: Remove them if they don’t fit well.
• Breathing is a challenge. If you\’re oxygen dependent, secure your oxygen first!
• Sex is exercise. Getting in shape will improve your health, your endurance, and your fun.
• Use condoms if it\’s just a random night. HIV, HSV, HCV, and gonorrhea don\’t care about age.
• It\’s not kosher. I checked.

Still, oral sex may not be your thing. You\’re not that adventurous. You have a gag reflex. Your morals don\’t agree.

Modern technology is there for you. You can cater to each other’s needs without the physical demands. Vibrators conquer challenges that hypertension, diabetes, and strokes make unmanageable. Electricity is cheap. 

Caveats:

1. Be careful with batteries. If they catch fire, they spoil the mood.
2. Avoid vacuum cleaners. Too much suction.
3. Avoid vegetables, even healthy ones. If they break inside, they go bad.
4. Same with glass. Stick with plastic.

Bottom line:  Sex in the elderly is not for the faint of heart, but its a way to stay together even as everything else falls apart: joints, friendships, retirement accounts.

Sex is just another way to love each other and meet each others’ needs. Getting them what they need, whether you need it or not is like you’d get them their cereal even if you live gluten-free.

Sex in the elderly is both a challenge and an opportunity. Like walking with a walker, it\’s clumsy, but it gets you there.

Until the stairs.

Rada Jones, her husband Steve, and his deaf black cat Paxil live in Upstate NY.  Her first ER Thriller, OVERDOSE  is on Amazon. More at RadaJonesMD.com,  instagram RadaJonesMD and twitter@JonesRada. 

I’m an ER doc. I care for patients. All patients: Those who need to be in the ER; those who don’t; those who wouldn’t be there if they knew better. For them, for you and for fun, I\’ve got some tips to keep you happy, safe and away from my ER. Enjoy.

1. Never, ever say “hold my beer and watch this!” Besides \”I do!\” they are the most dangerous words ever spoken. They\’re a harbinger of disaster worse than \”Winter is coming.\” They have their own section on YouTube – great watch after a rough day. Better than kittens. Still, hold on to your beer.
2. NEVER drink and drive. It’s obvious, but it’s obviously not obvious enough. As per CDC, in 2016, 10,497 people died in alcohol-impaired driving crashes, accounting for 28% of all traffic-related deaths in the US. They\’re still counting 2018.
3. Same with drugs. Any drugs. Legal, illegal, yours, or borrowed. Except for Tylenol. And Motrin. They\’re OK.
4. Don\’t tell your significant other that your life is no longer worth living, just to upset them. If they call 911, EMS will bring you to me. I’ll keep you until you’re legally sober if it takes a week.  By the time you\’re sober, got your evaluation and went home, your significant other has had a chance to enjoy life without you. Speak wisely.
5. Shoveling the roof is overrated. Especially in winter. It comes with broken heels, fractured backs, and ER trips. The roof is for the birds.  And cats. You\’re human. Stay on the ground.
6. Your motorcycle? The one you love? I love them too, but I sold mine. My first MCA patient came by ambulance. His leg followed in another car. I\’ll get a motorcycle when I get terminal cancer. For now, I’ll stick with my car. Not your thing? At least wear a helmet.
7. Do not, I repeat, do not, stick your hand in your snowblower to clean it. You may never be able to play the guitar or tie your shoes again. It may put a damper on your loving.  Yourself or others
8. If you’ve been coughing for a week and you smoke, go buy honey. Don’t come to the ER unless you have a fever, you\’re short of breath or you have chest pain. You\’ll cough for at least three weeks. There\’s nothing I can do to stop that unless I kill you. That will stop your cough, but it’s illegal.
9. Your twelve-years-of-God-awful-back-pain? Unless something\’s really different today, the ER is not the place for it. Especially now, that Percocet has become a 4-letter word. You’ll wait, and wait. You\’ll get a lot of rotten looks and a script for ibuprofen — 800 mg every 6 hrs — or acetaminophen — 1000 mg every 6hrs. That’s Motrin and Tylenol. Go get them over the counter.
10. If you have an appointment with your doctor, don’t cancel it to come to the ER instead because you’re too sick to see your doctor. Unless your doctor is Dr. Seuss, Dr. Pepper or a plastic surgeon, caring for sick people is what your doctor does. Keep your appointments.
11. Don’t separate fighting dogs with your bare hands. Dogs can handle dog bites better than you can. They come from wolves. We come from monkeys. We\’re out of their league. Stay out of it or use a prop.
12. Don’t throw gasoline on an open flame unless you\’re looking for a Brazilian wax.
13. NEVER EVER stand around minding your own business. It’s the most dangerous thing known to man. 90% of my assault victims were doing just that.
14. Church is dangerous. That’s where my syncopal patients come from. They go to church, they faint, they fall, they break a hip. Bars are safer.
15. Forget Dr. Google. He’ll drive you insane worrying about improbable things that you can’t pronounce, let alone understand, and he won’t even give you a work note.
16. If you’ve already seen a specialist for your problem, coming to the ER for a second opinion won\’t help. I specialize in first opinions.
17. Unless you\’re actively trying to reproduce, use condoms. They are cheaper than medications, alimony, and college. The strawberry ones smell better than diapers.
18. Get a flu shot. Beats getting the flu. It won’t give you the flu. If you got the flu last time you got a flu shot, it\’s because they happen in the same season. The flu season.
19. If you walk with a walker, avoid ladders.
20. Turn off your oxygen tank before lighting up. Even better, stop smoking.
21. Don’t eat spicy food if you have diarrhea. You\’ll get sensations like never before. Besides rectal lidocaine – which you won\’t like – there\’s little I can do for you. You’re gonna feel like a reverse fire-spitting dragon. As for diarrhea: One runny episode doesn\’t count. Diarrhea is when you run out of toilet paper. 
22. Vaccinate your children. The connection with autism is fake. The hack who made it up lost his license. Even if it was true – and it’s not – I\’d rather have an autistic child than a dead one. If you trust Jenny McCarthy more than you trust your pediatrician, you should take your kids to her when they’re sick.
23. Use protection. Use the guard of your saw. Use safety glasses when you\’re welding. That’s not wimpy – that’s smart. Unlike lobsters, you don’t regrow limbs. Unlike spiders, you only have two eyes. Use them wisely. 
24. Don’t hold your chainsaw between your legs to start it. 
25. Same with pouring hot coffee. Set the cup down. It feels better.
26. Don’t put on mascara while you\’re driving. 
27. We\’re ER folks. We do emergencies. Our tests look for emergencies. If you come to the ER for anything but an emergency, you’re in the wrong place. Seeing an ER doc for a non-emergent problem is like seeing a cardiologist for your diarrhea.
28. Don’t leave your meds around for your toddler to sample. Check grandma\’s house too.
29. Fibromyalgia is seldom lethal for patients, even though it kills me. 
30. Get a doctor. Your own. He’s better than me at managing your blood pressure, your diabetes, your ED (erectile dysfunction). Cheaper too. It will save you time – it’s gonna be a long wait if you’re here for a Viagra script. Plus, I have no free samples. 
31. Help others. Volunteer within your community. Focus less on yourself and more on others. It will make you happier and healthier.
32. Get rid of your trampoline. Unless you don\’t like your kids that much.
33. Don\’t hurt my feelings by telling me that you really, really hate doctors.
34. Overweight is bad. Bad for your back, bad for your knees, bad for your diabetes. We eat too much and we move too little. Next time you\’re thinking Fudge Sundae, try an apple and a walk instead. I know, walking is for the dogs. Get one. People with pets are healthier, happier and have more fun. 
35. If you\’re calling the ER to ask how busy we are, you don\’t need to come. 
36. Get a dentist. Teeth are a great investment. They brighten your smile. They make you look younger. They\’re prettier than tattoos. They chew your steak!
37. Stop smoking! You won’t set your house on fire. You\’ll save money. Your doctor will stop harassing you. You\’ll set a good example for your kids. Your car will smell better. So will you.
38. Don’t lock your children in the car. Ever. Not in summer, not in winter, not on Wednesdays. Find childcare or take them with you. Same with pets.
39. Don’t fry bacon naked.
40. Don’t ride your bike while you\’re walking your dog.
41. Don\’t keep shampoo bottles on the floor. They tend to get lodged in people\’s rectums.
42. Don’t keep bleach in soda bottles. If you do, don’t leave them sitting around for your kids to drink them.
43. Invest in a cock-ring with a release, and a butt plug with a wide flange. It\’s cheaper than a trip to the ED. Less embarrassing too. 
44. If you can\’t control your anger, punch a pillow. Walls, doors, and windows tend to fight back.
45. Never wear flip-flops to run, walk your dog or climb a ladder.
46. Power tools, tree stands, and ladders don’t mix with alcohol.
47. Same with anything fire-related: Fireworks, fire pit, bonfire.
48. Take your meds as prescribed. Your seizure meds, your blood pressure meds, your other meds. Except for other people’s meds. Don’t take other people’s meds. Not even if they’re the same color.
49. Make good choices. Not funny, I know. See below.

Rada Jones is an ER doc practicing in Upstate New York, where she lives with her husband, Steve, and Paxil, his deaf black cat. She\’s the author of three ER novels: OVERDOSE, MERCY, and POISON. 

1. You don’t like to be told what to do. Especially not by arrogant doctors who act as if they know better, just because they’ve been through a little training!
2. Your child hates shots. As her parent, your main job is to keep her comfortable.
3. Dr. Google told you about side effects: fever, pain, irritability. “The pro-vaccine mafia is quick to sweep all cases of vaccine-related injury and death under the rug as extremely rare anomalies, but many a parent of a vaccine-injured child will be the first to tell you that, if she could do it all over again, she wouldn\’t have let her kid get jabbed,\” the anti-vaxxers say.
4. Once, you got the flu after you got the flu vaccine. Vaccines don\’t work.
5. Vaccines weaken immunity. An often quoted anti-vaxxer, Tetyana Obukhanych Ph.D. states: “in the debate over vaccine safety, we have lost sight of a bigger problem: how vaccination campaigns wipe out our herd immunity and endanger the very young.” Her Amazon sales pitch ends: “Disclaimer: The information in this book is not intended as medical advice. Readers assume sole responsibility for choosing for themselves and their children disease prevention options that are compatible with their convictions.” No medical advice here. Just philosophy.
6. Taking your kid to the doctor takes time. Plus they\’re always late, taking care of sick kids or something.  You don’t have time for this.
7. Vaccines cost money. Not yours, the insurance\’s. You still have to pay for the gas!
8. Jenny McCarthy and other celebrities, including a famous – now infamous – doctor, whose license was withdrawn for fraud, say that vaccines can lead to autism. The entire medical community disagrees, but you trust her, not the doctors.
9. Doctors are just looking to make money out of your child.
10. Vaccine companies can\’t be sued if your child is harmed. The National Childhood Vaccine Injury Act of 1986 exempts drug companies from liability, in an effort to avoid vaccine shortage. It also establishes alternative ways to compensate those who have been harmed. As Natural News says, “Is this really a risk you want to take with your child?” (Not be able to sue if they die?)
11. As per the same website, \”vaccines can cause lifelong, incurable diseases… If your child develops permanent nerve damage, she could require lifelong care… If you choose to vaccinate, are you prepared to reorient your life in the event of autism or brain damage?\” Easier to just let them die.
12. You always wanted a boy. This one is a girl.
13. Vaccines kill children. Your anti-vaxx resources told you that \”Gardasil, the HPV vaccine, has injured and killed tens of thousands of adolescents and teenagers.\” While you\’re looking for the mass graves, how about checking what CDC has to say?
14. You know better than anyone what’s best for your child. You don\’t need to take her to a doctor. She shares your DNA. You don’t need an education or even information. It’s in your DNA.
15. Gandhi was against vaccines. He disapproved of using cows to produce the smallpox vaccine. He also disapproved of eating cows. He didn\’t care for steaks. Not even burgers. He was a Hindu and a fruitarian. Are you?
16. Vaccines contain toxic stuff. As a matter of fact, vaccines are mostly water and antigen, plus preservatives to keep them from going bad. You wouldn\’t inject rotten stuff into your kids, would you? They\’re similar to those in your packaged bread, soda, mayo, and mascara.
17. Your kid looks like your ex. And you hate your ex.
18. Vaccines will overwhelm your baby\’s immune system. Newsflash: Your baby doesn’t really have one. Yet. That’s what vaccines are doing. Building up her immune system to help her fight disease.
19. The immunocompromised – young babies, cancer kids, pregnant women – they\’re not your problem. They’d better take care of themselves.
20. Childhood diseases have been mostly eradicated. Why vaccinate for something that doesn’t even exist? Good point! That\’s why we no longer vaccinate for smallpox. Because it’s extinct. Why? Because of the vaccine. We vaccinate for other diseases. Measles, mumps, pertussis. They\’ve been resurging since people refuse to vaccinate.
21. God says NO. Like some in the Middle East, you think that vaccinating your kids is against God\’s will. In Pakistan and Afghanistan, many thought that the Polio vaccine was intended to prevent their kids from reproducing, so they listened to God and killed the healthcare workers.
22. Your anti-vaxxer friends told you: Natural exposure to disease is the best vaccine. “Truth be told, the only way to truly develop vibrant, lifelong immunity, is to live your life as you normally would, without injecting dead viruses and chemical adjuvants into your muscle tissue. Natural exposure to whatever diseases are lurking in the world is the only way for the body to develop permanent antibodies that will forever protect against disease.” Remember Darwin?  Survival of the fittest? Good luck.
23. Your child is special. Unlike all the others.
24. The earth is overpopulated anyhow.

I\’ll offer you a compromise: Don’t vaccinate all your kids. Only vaccinate the ones you want to keep.

As for all of you who can\’t immunize your kids for medical reasons, take care and stay safe!

Rada Jones MD is an Emergency Doc in Upstate NY, where winters are long, people are sturdy, and geese speak mostly French. Her ER thriller Overdose is now on Amazon.

Humor is a shield in the ER. It helps us cope, so we laugh a lot. At each other, at ourselves, at the weirdness. Check these out. They are all real complaints of real ER patients.

1. \”I have Bavarian cysts.\”
2. \”My doctor said that I may have a blood clog in my leg.\”
3. \”I have a stiff neck. My doctor said it could be Smiling Mighty Jesus.\” Either that or spinal meningitis.
4. \”My lips are chapped.\” 
5. Attacked by an ostrich.
6. \”I can\’t get the apple out of my vagina. The orange came out fine last night.\” It had to be surgically removed.
7. \”The left side of my brain isn\’t working. It gets better when I eat beets.\”
8. Superman got hit by a car. He came in naked, wearing only a cape and socks. Why? \”The FBI implanted something in my brain and now I can\’t fly!\”
9. \”I got attacked by a squirrel.\”
10. \”I was cleaning my butt with my electric toothbrush and it got sucked in, the whole way.”
11. \”Ghosts are sexually assaulting me.\”
12. Got attacked by a yak while cleaning the yak pen. 
13. \”I was sexually assaulted by the mushrooms I ate. They melted my brain.\”
14. \”Ghosts are touching my cat.\”
15. The patient thinks she\’s a cat and will only eat cat food. She refused milk.
16. Got attacked by vampires.
17. \”I\’m Jesus Christ. I was told to come see you.\” At 3AM, Christmas day.
18. \”I woke up lookin like Forest Whitaker.” 19 years old white girl
19. \”I\’m coughing. I think I\’ve got ammonia.\”
20. \”My vulva is swollen.\” That one, in your throat, is your uvula. Your vulva is lower.
21. \”Im a robot, and my sister put me together wrong. Watch…\” Shakes her arms to demonstrate.
22. \”My pussy be drippin...\”
23. The patient got blown over by the wind at the waffle house. 
24. \”My stuffed animals keep saying, \”kill me, bitch.\”
25. \”Every time I ejaculate I smell like bleach.\”
26. \”She tastes funny down there,\” states the boyfriend of the patient coming for a vaginal discharge.
27. \”I had sex and he went into where I pee. Now it hurts to pee.\”
28. Two years old fell into grave. Grandfather\’s.
29. “The thing that hangs down in the back of my throat is upside down, and now I can’t spit.” That\’s your uvula. That\’s how it hangs.
30. \”I cut my arm off and I threw it in the trash.\” Would have been funny if it wasn\’t true.
31. Patient one: bleeding from groin trauma.  Patient two: epileptic seizure and choking. Do the math. 
32. \”My surgeon said I could have a hematomato.\” 
33. \”I have a bleeding hemorrhoid.\” He pulls his shirt to reveal an abscess on his side.
34. Glass rod shattered inside the penis
35. \”I had a vasectomy last week and my ovaries hurt.\”
36. \”I’m feeling homicidal after seeing a midget, a unicorn, a leprechaun, and a dog playing cards...\”
37. \”Just want to make sure that my dealer gave me the good meth.”
38. \”Do you pierce baby\’s ears?\”
39. A sack of flour got spilled outside a grocery store. The whole town came in to be tested for anthrax.
40. \”I \’m being controlled like an avatar and I woke up with a moist butt hole.\”
41. \”I have a worm in my tentacle.\” Pointing to a testicular vein.
42. \”Got Gorilla glue in my hair.\”
43. \”I sat on a cocaine-dusted gerbil. He crawled into my butt. He\’s trying to claw his way back out but he\’s lost and I\’m bleeding.\”
44. \”I drank cleaner fluid and my throat hurts.\”
45. \”When I was younger, I wore special shoes.\” So did Forrest Gump.
46. \”I got food stuck in my sarcophagus.\”
47. “Google said I could die from hypothermia, so I wanna make sure I am
    not too cold.” 98F.
48. \”I need Dilaudid for my finger. I burned it with a French fry.\”
49. \”I have acid reflex.\” 
50. \”I\’m allergic to tazers.\”
51. The patient called an ambulance because she dreamed she had a stroke.
52. \”I\’m tired of my thighs touching.\”
53. Patient stapled scrotum back together after his spouse lacerated it.
54. \”I\’m bleeding from a paper cut.\”
55. \”My son\’s penis is too small.\”
56. During Bird Flu season: \”I walked in a room serving fried chicken. I think I caught the bird flu.\”
57. The patient was brought from jail for drinking from his colostomy bag
58. \”I have purple stuff coming out my lady pocket.\” 83yo female and her husband ran out of KY jelly. They improvised with Smucker\’s grape.
59. \”\”I ripped my nipple with my piercing in the shower.\”
60. Got hit in the face with a catfish.
61. \”I have a low sperm count.\” A young man coming by ambulance.
62. \”I think someone peed in my beer.\”
63. \”My BF said I taste funny.\” She had trichomonas.
64. \”I have a problem with my prostitute.\”
65. Elderly woman getting ready for a rectal: “My husband’s usually the one doing this!” “Grandma!” Patient: “I mean getting sick and coming to the ER.” 
66. I’ve got clogs coming out my Eucharist!
67. Vacuum cleaner stuck on penis.
68. \”I accidentally swallowed half a bottle of Clorox bleach.\” Accidentally? Half a bottle?
69. \”My penis shrinks when I sneeze.\”
70. \”My child swallowed bath water.\”
71. \”I don\’t last as long in bed as I used to.\”
72. \”I have a condom lost in my vagina.\”
73. \”My poop doesn\’t float.\”
74. \”I have lickulitis. I need that pill flagall.\” Must be oral transmission!
75. \”My diabolic blood pressure is too high.\” Diastolic of 150? Diabolic all right. 
76. \”I have diabetes type 3. The one you fix by eating a candy bar. Type two is the one with a pump. Type one is the one that gets shots.\”
77. \”I just don’t feel like myself.\”
78. \”A raccoon fell into the baby stroller at midnight while we were fishing.\” Are you here for the raccoon?
79. \”I got beat up by a ghost.\”
80. Female patient: \”I googled it. I’m worried that this could be prostate cancer!\”
81. “My pussy hurts.” Triage nurse: “We don’t treat animals here.”  
82. \”Hey doc, I have Driver Triculitis.\” Occupational medicine referral? 
83. \”I have end-stage fibromyalgia.\” 
84. \”I brushed my teeth with my hair remover.\”
85. \”I got attacked by an owl.\” 
86. \”Aliens froze my urethra. Now I can\’t pee.\”
87. \”I walked through meth and it absorbed through a wound on my foot.\”
88. \”I think I have Fluumonia.\” She had both.
89. \”I can\’t read.\” 
90. \”I have no ambition.\” That sounded funny until the cardiac enzymes came back positive. 
91. \”I’m vomicking out of both ends.\” That\’s efficient!
92. \”I have sick as hell anemia.\” Sickle cell too.
93. \”The doctor took my castrator out.\” He\’d just had a prostatectomy.
94. Glass Christmas ornament in the butt. In July.
95. \”I have fireballs in my Eucharist!\” Religious psychosis? Nope. Bleeding from her uterine fibroids.
96. \”I was impregnated by my ex-husband, who is a warlock through the internet.\” Not clear if the impregnation or the training happened online.
97. \”I got hit in the head by a cow.\” Ended up with a detached retina.
98. \”My house smells like carbon monoxide.\” CO has no smell.
99. \”I’m here because I’ve been walking all day and my feet hurt.\” I\’m here in spite of that.
100. \”I knocked my joint out and now can\’t find it.\”
101. \”My labia got tangled in my underwear.\” It required a procedure to set it free.
102. \”I got hit in the head with a frozen burrito.\” It flew off the assembly line and smacked her
103. \”Her cummer is stuck.\” She had a seizure during sex. 
104. \”My acid reflux came out my ears after I ate.\” Anatomy be damned! 
105. \”I need an ambulance. I dropped a jar of peanut butter on my toe and I think it’s bruised.\”
106. \”I fell as I was running from an ostrich.\” Ill-tempered birds!
107. Live bat found in family home and attic. Didn\’t hit anyone or bite them. The family of 6, including those who were not home, insisted on getting rabies IgG.
108. \”I kissed a girl, not my girlfriend. Now my cum tastes different.\”
109. \”I\’m bleeding from my mouth after oral sex.\”
110. Fractured penis. Male subject 120 lbs, partner pushing 400. She was on top. It broke as she was bouncing.
111. Injected testicles with industrial grade silicone with a manual bicycle tire pump. Can you say big balls? 
112. \”I swallowed my wife\’s hearing aids.\” They\’re so expensive that he had to poop in a bucket for a week, in an effort to recover them.
113. “I think I have ovarian cancer.” A man who googled his symptoms.
114. \”I have an enlarged Prostrate. 
115. \”I have a pinched nerve, right above my testicles.\” 
116. \”I have anxiety brought on a silent retreat. It was too quiet.\” She was there for two days.
117. \”Pussy discharge.\” Foul smelling discharge with pus coming from her \”vaginia.\”
118. \”I got raped by my dildo.\”
119. Lotion bottle stuck up his ass to get out of jail. Now his colon is silky soft and his poop smells like cocoa butter.
120. \”I was playing with magnets. Now they stuck together. I can’t get them off my junk.”
121. \”I have sperm dripping from my vagina.\”
122. \”I\’ve had trouble breathing since birth.\” Age 68.
123. Got nuts stuck in a lawn chair,
124. Iguana bite. It took off half her finger.
125. \”I pulled a worm off my butt.\”
126. Got scalped, after a horse bit off her hair bun. (70 y/o)
127. Gored by a buffalo while loading his buffalo herd onto a truck and they stampeded. He drove himself in with significant injuries.
128. Possible inhalation of potato chips.
129. Got into a fight with a raccoon. 
130. Fell on 8lb sledge hammer and it got stuck in the butt. He drove to ER. 
131. \”I got run over by a pig.\” Works at a slaughterhouse and got trampled by a 350 lb pig.
132. “I’m pretty sure I’m a dead man walking.”
133. Girlfriend shoved a knife up patient\’s rectum, blade first, as he was tied to the bed.  He earned a colostomy.
134. \”I think I broke my penis. It’s crooked.\” He was right.
135. Confused patient: \”I have smoke in my attic!\”
136. \”A squirrel urinated in my eye.\” How?!?
137. A baby turkey pecked me in the corner of my eye.\”
138. \”I\’m starting to see Satan.\”
139. \”I\’m turning blue.\” It was dye from her jeans.
140. Got bit by zebra.
141. \”I have a dead kitten hanging from my lip.\” She kissed it, it bit her, she choked it.
142. \”I\’m worried I got HIV.  I got monkey poo in my face.\”
143. \”I ate sushi two years ago. Now there’s a parasite crawling out of my skin.\”
144. \”I got apesex and pain.\” Bad way to spell abscess.
145. The patient requested transport to ED for Valtrex when his girlfriend told him she had herpes. The second unit brought her. She\’d been assaulted.
146. \”I went to take a shower. My wife had put a zucchini on the bathroom chair. I sat down to dry my feet\”…The last zucchini standing.
147. \”I ate the wrong vagina.\”
148. \”Been sick for twenty years, worse tonight.\”  

Lessons learned:

1. Avoid animals and birds from austriches to zebras. Even pussies.
2. Sex is risky. Even with oneself.
3. With a name like Smucker\’s, it\’s got to be good.

Thank you to all my Facebook friends and my ER friends for their contributions.

Rada Jones MD is an Emergency doctor in Upstate NY, where she lives with her husband Steve and his black deaf cat Paxil. She authored three ER thrillers, OVERDOSE, MERCY, and POISON.

1. Murphy’s Law as it applies to the ER: If something can go bad, it will do so in a hurry. If it can’t possibly go bad, it will still find a way.
2. Clock’s First Rule: All the patients will crash at the same time. Usually when the computer system goes down.
3. Clock’s Second Rule: The sickest patients will come just before the shift change.
4. Haste’s Theorem: The healthier the patient is, the more they insist on being seen first. Sick patients are not in a hurry. Lefty’s Corollary: The patient who doesn’t ask “When is the doctor coming?” is probably dead.
5. McDonald’s Law: The patient who needs sedation will stop at McDonald’s on his way to the hospital.
6. Sweet’s Exception: Unless they are diabetics. Then they didn’t eat for three days, but they did get their insulin.
7. Sandwich’s Principle: All vomiting patients request a sandwich.
8. Mass’s Law: Whenever a non-ambulatory patient needs to be moved, he will weigh at least 300 pounds.
9. Law’s First Rule: Every drunk patient has a lawyer on speed dial.
10. Law’s Second Rule: Alcoholics will start withdrawing before becoming legally sober.
11. Law’s Third Rule: Every lawyer in the ED will be your patient.
12. Law’s Rule on Charting: The ONE case you documented poorly will turn bad and get you sued.
13. Urin’s First Law: The consultant you paged an hour ago will only call back when you go to the bathroom.
14. Urin’s Second Law: All babies will pee as soon as you remove their diaper. On you.
15. Urin’s Third Law: Whenever you need urine, the patient has just peed.
16. Cutter’s Law of Time: The surgeon who performed the surgery is never the one on-call.
17. Cutter’s Law of Space: The surgery was never done at your hospital.
18. Timer’s Law: Whenever you manage to go see a patient, they just went to radiology.
19. Gyn’s Principle: The pelvic stretcher is always inhabited by a large non-ambulatory male.
20. The Law of Detrimental Location: The trauma victim was just sitting there minding his own business.
21. Bleeder’s Law of Priority: The most important lab will be the first one to clot and the last to result.
22. Bleeder’s Law of Excruciating Challenge: The likelihood that the labs will clot again is directly proportional to the difficulty of getting them.
23. Bleeder’s Inevitability Principle: You can’t stop the bleeding even if the INR clotted on its way to the lab.
24. Home’s Placement Law: Patients will need placement only after case management has left.
25. Hitchcock’s Theorem: The likelihood of a patient having a long QT is directly proportional to the degree of psychosis.
26. Middlesex’s Law on Gender: If you are female, you are a nurse. If you’re male, you are a doctor.
27. Prick’s Principle: The fear of needles is directly proportional to the number of tattoos.
28. Segway’s First Risk Theorem: The likelihood of medical errors increases exponentially in VIPs.
29. Segway’s Second Risk Theorem: The nicer the patient, the worse the disease. Segway’s Corollary: All nice patients will have cancer, a stroke or at least a broken hip.
30. Segway’s Pregnancy Conundrum: Sitting on the toilet or swimming in the pool may get you pregnant.
31. Pain’s First Principle: Patients with high pain tolerance are allergic to Motrin and Tylenol.
32. Pain’s Second Principle: 95.8 percent of Fibromyalgia flares occur on Mondays.
33. Pain’s Rule of Furniture: Chronic back pain patients love to move refrigerators.
34. DeBeer’s Law of Correlation: The likelihood of a patient being suicidal correlates directly with the blood alcohol level.
35. Fahrenheit’s Law: Parents of unvaccinated kids don’t own thermometers.
36. Poor’s First Law: Smoking is inversely correlated with the ability to afford your antibiotics.
37. Poor’s Second Law: The number of tattoos is inversely correlated with being able to afford dental care. Poor’s Corollary: Beware the tooth to tattoo ratio.
38. Hope’s Law: Being on Chantix negates smoking.
39. Love’s First Law: The patient asking for your phone number is in the ER for an STD.
40. Love’s Second Law: The patient who hugged you before he left has scabies.
41. Love’s Third Law: The patient who shook your hand is positive for C Diff.
42. Pooper’s Rule: Patients with three weeks of diarrhea become constipated as soon as they step in the ER.
43. Cheeto’s Rule: Abdominal pain gets better with Cheetos.
44. Sucker’s Law: When you separate fighting dogs, you’ll be the one who gets the shots.
45. Mattu’s Law: If the patient is so diaphoretic that you can’t stick his EKG leads, just activate the Cath Lab. They’re having a STEMI.
46. L’Hospitel’s Law: Patients who need admission have pets at home they need to care for. L’Hospitel’s Reciprocal: Patients who don’t need admission have families that can no longer care for them.
47. Tester’s First Law: Whenever you need a CTA, the patient’s GFR is bad. Tester’s Reciprocal: Whenever the GFR is bad, you need a CTA.
48. Tester’s Second Law: D-dimers are positive only if the patient can’t get a CTA. Tester’s Corollary: Then, they are positive every time, and the VQ scan is out of substrate.
49. Luck’s Theorems: The likelihood of the computer crashing is directly proportional to the number of patients in the department. Multiply by five if it’s Monday night. Add 10 if it’s a full moon. If you’re red-haired and have at least one stepparent, divide by 0.25.
50. Schift’s First Law: JACHO only comes during your shift.
51. Schift’s Second Law: The other doctor has fewer patients.
52. Lavoisier’s Principle on Medication Errors: They always got too much. If they got too little, it would be easy to fix.
53. Lavoisier’s Theorem: Tylenol allergy is a risk factor for fibromyalgia, IBS, and anxiety.
54. Lavoisier’s Rule of Anticoagulation: Every patient who has a sloped porch must be on Coumadin.
55. Lavoisier’s Dictum: When the patient comes to the ER, the med list stays home.
56. Child’s Principle: Toddlers can’t swallow pills. Unless they are grandma’s. Then they’ll swallow the whole bottle.
57. Child’s Law of Location: Bleach must be stored under the sink in a Coke bottle.
58. Snow’s Method: The best way to unclog a snowblower is sticking your hand in it.
59. Needy’s First Rule: Your patient will need you as soon as you leave the room.
60. Needy’s Second Rule: Your consultant always needs the one test you didn’t order.
61. Margarita’s Law: The ER goes to shambles as soon as the pizza arrives. Margarita’s Corollary: Never order pizza in the ED. Margarita’s Conclusion: To eat hot pizza you need to retire.
62. Bell’s Rules: Patients who are hard of hearing don’t have their hearing aids. If they do, the battery is dead. If it’s not, the family will take them home, together with their watch, their jewelry, and their glasses
63. Bell’s Axiom: If the patient doesn’t speak English, the translation phone is not working. In the unlikely event that the phone is working, the patient will speak the only language that the phone does not.
64. Sage’s First Advice: Skip the CT if the patient with abdominal pain is eating McDonald\’s.
65. Sage’s Second Advice: Whenever a patient tells you: “You took care of my mom,” don’t ask how she is. She’s dead.
66. Sage’s Third Advice: The family member looking like the patient’s mother is his wife. Don’t ask.
67. Sage’s Unavoidable Error: You should have called the other consultant first.
68. Sage’s Chest Pain Rule: Every patient with chest pain, elevated troponin, and cardiac risk factors has GERD. Just ask your cardiologist.

Rada Jones MD is an Emergency Physician. Her ER thriller, OVERDOSE, is now on Amazon.