Barrier to Care

The old foreign-object-in-the-rectum story, the stand-by of any ED raconteur, finds its latest iteration in this recent post from ER Stories:

Sir, I find it somewhat bizarre that given the circumstances of your ER visit, you are reluctant to let us examine you. Well, let me correct myself. I can understand your embarrassment, however given the fact that you regularly engage in receptive anal intercourse, I wonder why you are shy about showing us (health care professionals) your anus. After all, I imagine the penetrator that caused your anal trauma must have visualised the target. Also, the fact that your other “friend” advised you to come to the ER after noticing the pain you were in and the blood soiling on your pants, leads me to believe you are no stranger to revealing your sphincter.

Now, I must tell you that despite your embarrassment, a 5 mega-pixel snapshot on your fancy camera phone is NOT adequate for us to properly evaluate the trauma you sustained. I am sure the nurse was not thrilled to see it. Yes, it does look painful in the picture and despite the fact that I would rather be outside standing naked in the snowstorm, I am actually ethically and professionally bound to examine your ass. I recommend you delete that picture as soon as possible, less it fall into the hands of your parents, wife, cooworkers, [sic] or anyone else whom you might not want to know your position on the proverbial alternative lifestyle baseball team.

I am not exactly clear why health care professionals, and the public at large for that matter are so fascinated with things being stuck up the bum. Titillation served with a heaping helping of sanctimony and a light glaze of homophobia? Who knows?

I am very sad to report, however, that the grand-daddy of all FB Rectum tales, the rodent-in-the-rump story, which I personally first heard sitting in a pub in Kingston in 1988 from a guy whose cousin’s uncle’s neighbour swore it was absolutely true —- is an urban myth.

My own rectal foreign body story involves a 34 year-old buddy whose partner decided sex play involved inserting a snake flashlight rather high into the colon. He presented to the emerg with excruciating abdominal pain. Of course his colon was perforated, and he required emergency surgery and a reversible colostomy.

His wife was mortified. They were good middle-class folk, or so it seemed, living out the dream in some suburb, taking the kids to hockey, summer weekends at the lake — and now, this. What would her mother say? How would she explain to her daughter why Daddy is suddenly walking around with a colostomy bag?

Oh yeah, his wife. The inserter of the infamous snake flashlight.

Now please raise your hands if you assumed buddy was some pathetic closeted gay guy on the DL? Come on, don’t shy. Probably all of you.

Maybe we are more wedded to our preconceptions and stereotypes than we think, to the detriment of the care we give. Given that the tags for this post included “Bizarre”, “Fetishes”, and “Shocking” and the general tone of what? — contempt? —  that ER Stories has for his patient, I’d be embarrassed to seek health care too. But then, ER Stories just reflects the general culture, doesn’t he? Too bad he didn’t consider fundamentally why his patient was embarrassed to be seen.

It’s a barrier to care, ultimately. Shouldn’t we, as health care professionals be maybe a little more reflective about these things? Maybe people shouldn’t be embarrassed to seek treatment when needed?


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  1. #1 by Gert on Monday 11 January 2010 - 2206

    I thought “buddy” was literally his male friend, then I thought ‘sick game for two (I inferred straight) guys to be playing. Then, when you mentioned a wife I immediately thought the guy must be bi or a closeted gay man. So, my FIRST thought wasn’t that they were gay.

    But, since the guy doesn’t have to walk around showing off the colostomy, only his wife needs to know (and the surgeon)….so no worries about the kids, parents, et. al., finding out.

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