The Stealth Turd


I learned a great deal in medical training, but I must have missed the ‘stealth turd’ lecture.

I don’t know exactly what I expected the practice of medicine to be like when I started medical school. I was 32 years old on the first day of Gross Anatomy. I just wanted a job that would pay well and offer stability for my family that the Army could not. I honestly had no idea what awaited me.

I do this for a living, and at times, I still have difficulty separating true mental illness from the garden variety quirky and weird. However, I do know I’m not clever or original enough to make this sort of stuff up. What follows transpired exactly as described.

My patient this day was a 74-year-old woman. She was appropriately dressed and behaved like any other genteel Southern grandmother. Plastered across the top of her chart, however, was a chief complaint most peculiar. This lady claimed to have passed a snake in her bowel movement.

I did not take her literally and began a line of questioning that might lead to a more conventional explanation. Perhaps she had experienced a ribbon stool or was suffering from hemorrhoids. She soon detected my skepticism and explained, “Son, I’m 74-years-old. I know what a snake looks like. It was about two feet long and had a head with two eyes.”

I was gobsmacked. I passed her my prescription pad and pen and she rendered the thing on the back cover. It was indeed a plausible graphic depiction of a snake coiled up in a toilet bowl replete with a head and two eyes. Now with some timidity I inquired how she might think it got in there. In response she asked, “How big is a puberty snake?”

“Ma’am?” I responded.

“You know, a puberty snake. A baby snake. How big is a baby snake?” she asked. “I ate at a Chinese restaurant a few days before, and I might have eaten a puberty snake by mistake.”

Wow, thought I.

“Well, I don’t know,” I responded. “Inside of you it’s dark and there’s no air. I think if you accidentally swallowed a baby snake it would have died. I can’t see it growing up that big in three days anyway.”

“Son, I can’t eat a two-foot snake,” she observed.

I acknowledged her point.

I learned a great deal in medical training. I spent an aggregate seven years studying human physiology, pathology, microbiology, pharmacology, biochemistry and the like. I didn’t learn squat about what to do with a woman who passes a two-foot snake in her bowel movement. I freely admit to being vexed.

This woman had not, however, ever had a colonoscopy. A colonoscopy is a screening test for colon cancer. Insurance will typically pay for one of these procedures every ten years once you turn 50-years-old. Errant reptile or not, that is always a good idea.

I sent her to a surgeon pal for the procedure but called him up in advance. I knew he typically began his colonoscopies with a digital rectal exam to assess sphincter tone. I warned him that when Mrs. X arrived, he had better get in and get out fast because there could be a snake in there. He was confused, but I assured him it would make sense eventually.

Three weeks later I got a letter. It was drafted in classic med speak and went something like this:

Dear Will,

Thank you so much for referring Mrs. X to me. You no doubt recall she is the very nice 74-year-old woman with a chief complaint of having passed a snake in her bowel movement. I am pleased to report that after an uneventful colonoscopy wherein the entirety of the colon was visualized all the way to the ileocecal junction, I encountered no flora or fauna of any sort. While I am at a loss to explain her complaint, I send her back to you with a high fiber diet.

I am most sincerely yours,
Dr. Y.

I saw this woman three more times after that. At no point did she really give me a crazy vibe. I did in each case gently inquire if she had encountered any other peculiar creatures in her bowel movements. She answered, thankfully, no. She did, however, describe what I have come to refer to as the stealth turd. She said she had a sizeable bowel movement and when she turned around to look at it the thing was gone. She suspected it might have indeed been another snake.

Don’t forget to flush!

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