Blood, shit, piss and pus

What we touch in the hospital and who we are

There are two groups of workers at hospitals and medical centers. There are those of us who, at times in our daily work, come into contact with blood, shit, piss and pus and there are those who don't.

The first time I put my hand in blood was when I was a medical student and didn't see the pooling puddle on the patient’s bed. The last time I came into contact with piss was on rounds in the last month. I carefully judged the color and volume sitting in the bag, and I noticed, too late, that some had leaked onto the floor.

My friend David became a neurosurgeon and I remember seeing his clogs in the hallway of his home during his residency. They were caked in blood, and coated with bits of broken skull like flakes of sea salt.

I remember the first time pus splattered on my scrubs — during an I&D in the ER as a resident at the VA. The patient immediately felt better, and I went to change my top. The smell lingered till I went home to shower.

Blood, shit, piss and pus. Doctors, nurses, technicians, mid-levels, janitors and more come into contact with these fluids during our work.

When you step in these fluids you can't work from home. When you wash these off your clothes you are always a pragmatist. You can't cling to unrealistic idealism when you touch these fluids. You have to abandon being neurotic when your job routinely risks exposing you to these things.

I appreciate the many people who keep the hospital running who never encounter these fluids. We couldn't do it without the ancillary services. At the same time, I am concerned by the growth of the hospital admins. Increasingly there are more and more employees who don't touch these liquids.

I am troubled when a recent college graduate who has never had blood on their sleeve, locks me out of EPIC so I can complete my annual research ethics module.

I am annoyed when someone who hasn't changed their shirt when it gets stained with pus tells me that I can't get an inpatient PET CT on my patient with transformed lymphoma.

I get irritated when a laboratory cancer researcher who hasn't stepped in piss tells me that antibody drug conjugates save so many lives while my patient has neuropathy so bad he uses a wheelchair.

When my nurse who has covid declined the COVID vaccine, I didn't think twice. That's her decision and I was fine with it. When the administrator told her she has to stay at home, even when she felt well, and, instead, I would have to work short-staffed, I knew he has never touched these fluids.

When I get an email from an admin telling me I have to reschedule shifts until I complete my annual respirator fit test — and I am the only one of the two of us who gets coughed on — I am not happy.

Blood, shit, piss and pus. For some of us, it defines our work. I appreciate the folks that help me who don't come into contact with these fluids, but too many don't. Too many of them follow rules blindly. Rules set by other groups of people who don't touch these fluids. They are building an empire of people who don't touch these things. They, at times, stand between me and doing what I think is best for my patient. My patience wears thin.

But remember one thing, someday you will need someone to touch your blood, your shit, your piss, your pus and that day you won't like it if I am off duty completing my annual respiratory fit test.

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