Friday, May 23, 2008

perhaps not unlike the birth of reeses peanut butter cups

There was a patient today for which I was planning to do a saddle block, and in preparation, I took out a small ampule of hyperbaric bupivacaine (a kind of local anesthetic, like lidocaine) to use for the case.  The ampule is a glass cylinder, just about an inch long and as thin as a toddler's pinkie finger, with a hollow glass stem that can be snapped off before the drug is drawn up and administered.  They didn't stock hyperbaric bupivacaine in the OR where I was working today, so I actually walked all the way over to the cystoscopy suite, hunting through the drawers in three separate rooms until I found what I was looking for.  This is called MAKING AND STICKING TO YOUR ANESTHETIC PLAN.  

Well, turns out that despite my planning and despite my hunt for The Perfect Anesthetic, in the end that the case was cancelled--the procedure was listed as RECTAL EXAM UNDER ANESTHESIA and I guess he decided that was just as unappealing to him as it sounded, and never showed up.  So I put the hard-won ampule of bupivacaine in the back pocket of my scrub pants, along with my iPod and a partially eaten Power Bar, figuring I would keep it handy, just in case the opportunity might present itself for use later on.

The rest of the day went as planned, and as I was walking down the hallway at the end of the day, it occurred to me that I could sure go for the rest of that Power Bar.  It was all warm and melty from being pressed next to my butt all day (SO GRAPHIC) but I figured that would just make it easier to eat, because if you've ever tried to eat a cold Power Bar, you know that it turns to cement and you'll be working on that thing for hours.  For those of you who are just disgusted at this point, please note that the Power Bar was simply next to my butt, but at no point during the day did it ever touch my butt.  Got it?  There was no Power Bar to butt contact.  Therefore, still good!  So I extricated the bar from my pocket, peeled back a little more of the foil, and without really looking, took a bite.

The first thing I thought when I felt the crunch was that this was just an unusually potent flavor crumble, the likes of which are seen in certain flavors of Power Bar--for example, Vanilla Crisp.  However, the texture of the crunch was different from that of a Rice Krispie embedded in some sort of gluey carbohydrate matrix--much more crisp, much more bite, almost like a chip.  The next thing I noticed (and this was probably just a fraction of a second later) was that this Power Bar tasted awful, kind of watery and bitter, like chemicals.  What had just happened?  Had I just shattered a tooth?  How could I break my tooth on a Power Bar?  And what was all this foul liquid leaking out?  Some sort of mercury filling amalgam?  Some sort of frightening nerve pulp liquified by years of subpar dental care on that crappy resident health insurance plan?  What the hell was going on here?

I looked at the Power Bar in my hands.  And what I saw was this: the vial of bupivacaine had, over the course of the day, worked its way into the bar itself, with heat and time pressing and molding itself directly into the goo.  And when I bit into the Power Bar, I had actually bitten into the vial.  I bit through glass.  I WAS EATING GLASS.

Needless to say, I spent the next minute assiduously pooling my saliva and spitting into a sink, for fear (perhaps after one too many Tales of Intrigue) that I would swallow microscopic glass shards and cut myself internally and DIE.  I do, however, think that the Power Bar saved me to some degree--it was so gluey and sticky that most of the glass shards just kind of got pressed into it, where they stayed in place, like bug in amber.  (Aside: does anyone think that bugs in amber make creepy jewelery?  I mean, I get it, amber is a pretty color, and nature is beautiful, whatever.  BUT THEY ARE DEAD BUGS.  I do not want to wear dead bugs as earrings, sorry.)

I thought that hazards of the workplace in anesthesia mostly consisted of environmental exposures, like standing next to the fluoro beam for hours at a time, or of biohazards like getting blood sprayed in your eye after someone dings the renal artery or some such thing.  However, I now have to expand my scope of workplace hazards, those being the improbable hazards facilitated by my own ridiculousness.  If anyone has a story worse than this, I would like to hear it.

(And for those thinking one step beyond: yes, my tongue and lower lip were quite numb for about half an hour afterwards.)