Medicine Is Disgusting

"Watching a baby being born is a little like watching a wet St. Bernard coming in through the cat door."
-Jeff Foxworthy

I'm now halfway done with my OB rotation.  Our schedule in EM is a week off from the OB residents' schedule, so my entire team changed over from the week before.  The other intern who worked with me this week was the same OB intern who was working in the ED with me last month as an off-service intern, and it was nice to see her again.  It also made for the rather odd situation where she was showing me how to use the electronic medical record and charts on my first day in the ED, and I was showing her how to do the same thing on her first day in OB.

Some of the OB residents and I had an interesting discussion at one point about which field is more disgusting: EM or OB.  I argued that there is nothing more disgusting than delivering a baby: you always have some combination of blood, mucus, amniotic fluid, urine, and feces (both the mother's and the baby's) covering you from head to toe after each delivery.  Plus, the infant is born covered with vernix, and its skin is gray, both of which conspire to make it look like some kind of creature from Gremlins.  And the mother is often screaming  the whole time, which makes for a less than pleasant backdrop to this ghastly scene of childbirth.  What do we do in the ED that could possibly beat a delivery in terms of sheer disgustingness?

One of the OB residents countered with abscesses.  Abscesses?  Come on!  Incision and drainage of pus from abscesses is THE best procedure to do in the ED.  You can literally cure a patient in about ten minutes.  They come in with a lot of pain and swelling; you numb them up, cut the abscess open, and poof, all better.  Plus, an abscess only contains one body fluid (or maybe two if you count some bleeding), neither of which includes feces.  She pointed out that abscesses can smell pretty bad too, which I had to concede.  I have opened up some abscesses that smelled bad enough to make my eyes water.  But worse than feces?  You've got to be kidding.

It occurred to me later that what it comes down to is that all fields of clinical medicine are disgusting.  Really, what body fluid is there that is beautiful, pleasant smelling, and nice to have all over you?  I guess if I had to pick the least offensive body fluid, I'd go with urine.  Assuming the patient doesn't have a urinary tract infection, at least urine is relatively sterile.