I made some of my students smell the organic waste material excreted from the anal end of a patient yesterday during the night rounds.
Don’t get me wrong. I am no sado-masochist trying to make my student’s life more miserable.
I wanted them to smell the unique unpleasant smell of stool mixed with blood, otherwise known as melena (actually when I googled ‘melena’ on Google Image, I got pictures of naked ladies!!!). It’s got a unique pungent smell and looks typically black and tarry; a lot like the inside of chinese dumplings with black beans paste (tau-sar-pau).
A patient in my ward had an upper gastrointestinal bleed (UGIB) and so passed out a lot of melenic stool. The ward nurses were changing his diapers just as I was passing that way with students in tow. I saw it as an opportunity to get them to take a deep breath, close enough to the patient to experience the smell.
My intentions were noble of course…I wanted them to recognise the smell, so that in the future if they come across a similar scent again while attending to a patient, they would be alerted to the possibility of an UGIB, without even having to tear open a patient’s diapers to see.
My students probably thought I have finally lost it (and the last marble in my brain) when I first asked them to do the unpleasant and unexpected task, but then they saw I was serious. And so, one by one, they gamely went near the patient and took a deep breath.
But I am certain they will NEVER forget the smell, ever. Like I told them, not everything in medicine is pleasant.
Wed, 281107 @ 1315; post-call and suffering the beginning of a major migraine! Sigh…