Monday, March 12, 2007

Sex, Tattoos, and Death

When a patient arrives after a 40 minute transport in full asystolic arrest the chances of me making a difference are about zero. It was no different tonight when a 44 year old woman arrived from an outlying area.

She had, in all probability, suffered an acute myocardial infarction and had died instantly from ventricular fibrillation. The paramedics did everything right but the CPR and shocks administered did not abort the rhythm or restore cardiac activity.

During our code in the ED we ran the algorithms per ACLS. I even stuck needles in her chest in case she had a tension pnuemothorax (a collapsed lung forcing the heart to one side of the chest and a reversible cause of sudden death) as I could not see her heart clearly with the ultrasound machine (I saw air). I tried the needles, there was no rush of air, the Xray was normal, her heart was still motionless, and we were done.

During CPR I happened to get a good look at a tattoo over her left breast. It pictured two camels having sex and said underneath it, "Humpin' to Please". My brain did a very quick flip while putting this whole picture together and then it was back to business.

It was in that moment, and before I pronounced her dead, that I was again struck by the strange confluence between sex and death that is sometimes conjured in the heat of a resuscitation (see prior post on the same topic here: One's Mind Wanders).

Conclusions? I have none.

8 comments:

  1. One of the most distracting tattoos I've ever seen on a patient was a gentleman who had "pussy eater" on his face (left cheek had pussy, right cheek had eater). Try taking an H&P on that guy...

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  2. My, my. I bet he got a lot of high-class dates with that one! In an earlier post entitled "The Meaning of the Swastika" I found myself having to fix up a guy who had been beaten up for his swastika tattoos which he was boldly displaying in a biker bar. Now how am I supposed to feel about that?

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  3. Well, since the ice is broken...I took care of a prison inmate who had "I Eat Pussy" tattooed on the inside of his lower lip. How he did that I don't know, and why I looked there I can't remember.

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  4. Again, he must travel in different circles and with different ladies...

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  5. I'm trying to figure it out. Breast = humps? And um, "aiming to please" signifies um..."activity between the humps"? Was there a breast augmentation symbolizing something placed over something, ergo a "humping"? I still don't get it. (And why I'm trying to figure it out, I'll never know...)

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  6. The camels have humps, hence the 'humpin' pun. Who was being pleased? I don't know. Was it sexual? Yes. What was she thinking? I don't know.

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  7. I took care of a patient who had a nasty tattoo on the underside of his penis. For hippa reasons I will just leave the imagining up to you. We discovered it after intubating him for his overdose and inserting a foley before shipping him up to ICU. Because of his poor lifestyle we had the occasion the see that tattoo several more times over the next few months, usually in similar circumstances.

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  8. She had, in all probability, suffered an acute myocardial infarction and had died instantly from ventricular Buy Cialis Australia fibrillation. The paramedics did everything right but the CPR and shocks administered did not abort the rhythm or restore cardiac activity.

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