no. 51: this is happening.

this story is old, but so good it must be told.

about 6 months ago i was working a night shift and, with a groan, i signed-up for a 20 y/o female patient in room 13. room 13 is the ob/gyn room, so this is not my favorite place to see patients, for two reasons. first, i don't like doing pelvic exams and second, pregnancy seems to reduce some women to quivering masses of ineptitude (please hold off on your cries of "misogyny!"i'm not saying women are stupid, nor am i maligning females with child in general, but, some women get so worried that something bad is going to befall their child that reason disappears like a virgin on prom night).

the patient referred to herein was not one of these women who needs pregnancy to make her stupid--she was almost certainly born a dolt. here are some synonyms for "stupid":

brainless, dazed, deficient, dense, dim, doltish, dopey, dull, dumb, dummy, foolish, futile, gullible, half-baked, half-witted, idiotic, ill-advised, imbecilic, inane, indiscreet, insensate, irrelevant, laughable, loser, ludicrous, meaningless, mindless, moronic, naive, nonsensical, obtuse, out to lunch, pointless, puerile, rash, senseless, shortsighted, simple, simpleminded, slow, sluggish, stolid, stupefied, thick, thick-headed, trivial, unintelligent, unthinking, witless

i thought long and hard about what single adjective best described her lack of intelligence and just couldn't find le mot juste, so i went with all of the synonyms listed for "stupid" on thesaurus.com, mostly as a quantitative indication of her global ignorance, which will become quite evident as the story unfolds.

the chief complaint is listed as "gyn+", which means she's pregnant and has a pregnancy related complaint. i enter the room and see a pale, nervous young woman with brown hair, a dirty white tshirt with a red stain that i took for marinara sauce and gray sweatpants with matching tomato-colored splotches. he boyfriend (partner, husband, well wisher) appeared to have been blessed with the same poor eating skills since he too was spattered in various places with the same putative tomato sauce, including some of both sleeves which lead me t believe that he had been using this portion of his clothing as a napkin. she looked young; she was young.

as i started with the history ("...tell me what brings you in tonight...") i couldn't help feeling bewildered and melancholy. i thought back to what i was doing when i was 20. however irresponsible my behavior had been, the bacchanal never landed me in the ED.

in any case, i was snapped out of my reverie when she said "...i think the baby fell out." i paused and asked her to expound on that idea. she explained that she woke up "take a dump" (these are her actual words). she went to bed feeling well and currently felt the same--no abdominal pain, no vaginal bleeding or discharge, no nausea or vomiting, and no fevers; basically she felt fine and had no complaints.

so...why did she think that baby had "fallen out?"it bears explaining by me at this point that i am recounting this story somewhat out of order from a chronological standpoint for the sake of entertainment. the basic story, as it stands now is this: a 20 y/o woman who is about 12 weeks pregnant comes to the ED at 215am but with no physical complaints or symptoms, but with a fear that her baby has somehow "fallen out"
of her.

back to the story: what was so compelling about her late-night "dump" that lead her to the ED? i was perplexed, since i hadn't yet figured out that she was dumber than a sack of doorknobs. i literally asked her "why do you think the baby fell out?"her answer: "when i stood up, after shitting, i looked in the toilet and what was in there...it looked like a baby..it was the baby...i was scared, so i called 911." i remained confused, thinking that she had left out part of the story. i asked a series of detailed questions: there was no blood in the toilet, no blood on the toilet paper she never had cramps, and the pregnancy had been normal up to this point. i asked her male companion if he had seen it, but alas, she flushed it away before anyone else saw.

it finally dawned on me what was happening: she had defecated, her turd resembled a fetus and she thought, literally, that she had shit out her baby. now you understand where my all this stupidity talk originated.

i spent some time trying to be sure that this was in fact what had happened, and even though in many ways i wish it hadn't been the case, this truly was what she felt had occurred. i briefly explained the anatomy of the female reproductive system and the GI tract, highlighting the fact that they are in fact, not connected. i might as well have been speaking latin for all she appeared to understand. i realized that no amount of explaining would raise her intellect beyond the level of troglodyte. my solution: a quick bedside ultrasound showed a single live intra-uterine pregnancy. a wave of relief washed over their faces, with a similar feeling washing over me, although in my case it was relief that i could quickly (and safely) eject her from the ED (i use "eject"in a humorous way, as in to leave a place quickly (eject mailman, eject!), not as in forcibly removed for dubious behavior).

all in all, it was a fairly benign trip into room 13--no pelvic exam required, no labs needed, no consults or imaging ordered (these are good things since they allow quick patient discharge; if patients need any of these items i don't hesitate, but for a number of reasons, i prefer not to perform tests on/for people who don't need them.

so you decide: which synonym of "stupid" best describes this woman's particular brand of idiocy?