bug in the canal

22Aug07

uh oh. she’s doing the water in the ear dance. quick differential!!! she’s got water in her ear! maybe, but why the hell would anyone come to the ER for that??? she’s crazy?? yea maybe, but look at her, no crazy person would do that for that long! i don’t know!! well young neophyte, that’s the roach gnawing at your tympanic membrane dance. remember it. oh yes. that’s right. oh god. poor her. “ai! ai! [pointing at her right ear and grimacing the grimace of unimaginable irritation]” okay, what are we gonna do about it?? um.. not sure. have her jump on her right foot with her head tilted to the right? NO! this ain’t water! this is arthropod! and the first thing you need to know is that no amount of head shaking is gonna dislodge a six claw-legged microscopic brained chitinous scavenger of crap hell bent on laying eggs in your ear canal! can we flush it out with water?? good thought, but think about the patient! that thing’ll eat straight through to her cochlea if we do that, plus the pain will be heart-stopping. “AI AI!!!!” okay, then viscous lido? yea, i guess some people do that. but that shiz is viscous, can’t get it out after. i don’t know?? why don’t we get some regular 1% lido that’ll do it. we’ll drown that piece of living excrement and numb the patient’s ear at the same time… let’s first take a look though.. damn!!! it’s a monster! it’s got fangs! what da hell?? it’s got horns!! what? weird. usually you see roach butt on exam but from what you’re telling me you see face. or can you not tell the difference? anyway, we’ll do the same thing. grab the lido. good. now ma’am, tilt your head to the left. “aiiiiiiiiii!!” that’s it, fill that ear up. let’s give this bug a bath of numbing asphyxia. afterwards we’ll have to dig it out with some allis. Oh shiz!! it’s making a run for it!!! get it!!! it’s hangin on her earlobe!! it’s taunting us! smack it! “ai ai!!” got it! no, it’s still alive!!! it’s on her leg! now it’s on the floor. “ai ai!!!!!!!” “oy oy!!!” “adios mio! que es!!” “what da hell is that doc!?!” *squish*. there. one small step for me, one flattened evil roach. [silent examination by patient]. further squishing by patient. rage. tears of relief.

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