Illness stinks. Literally. Most things unhealthy do, I spose. Like obesity, for instance. Morbid obesity, not just a spare tire or two. Stuff settles under and in between and waaaay deep beyond that tends to surface when someone lies down, or just begins to undress. The only way I can describe it is by throwing out the word yeast. Like when homemade bread is rising. Or pizza crust is being tossed in the air, and not in that cool, sexy way. Ever recall making glue from scratch? I don't remember what was all in that, but that is the smell. Just like that. That is not even as bad, really. Cause that isn't hiding under someones pannis. Sometimes you can see it too, and it looks more yeasty than it smells. It curdles up on the end of my transducer. It gets on my gloved hand (so thankful for gloves). It settles in your nostrils for hours.
Equally stinky is stomach acid. Most patients that vomit in my presence project acid my way. I assume it's because they have thrown up everything at home before even coming to the ER and then they are given pain meds that make them nauseated and then given something for the nausea and it all comes up in front of me just as I'm about to lie them flat for the exam. It's sour. It's bitter. It's day-glo yellow. I've experienced my own acidity before and it burns through your nose. And it settles there. Just like yeast.
Worst of all is the sick smell of jaundice, usually from liver disease. These patients are golden, seriously. Again, not in that cool, sexy way. They are very ill. They look pregnant because their liver has stopped functioning properly and they are full of ascites (aka fluid). This fluid has a smell very similar to stomach acid, but worse for some reason. Maybe because it's seeping through the skin? I don't know. If you wiped up the acidic vomit with a musty, dirt dish towel you'd probably come very close to matching the scent of liver failure. And as you inhale it swings from nasal hair to cilia to the very core of your oropharynx olfactory factory and it settles there. Just like yeast and stomach acid, but with the urgent need for a shower.
Believe it or not, feces does not make my list of stanky stinky odors. I don't deal with it often in my department. Occasionally, I am overcome by a patient in ICU that just had a movement and it's quite overwhelming. But it is because of Vicks VapoRub that I've been able to withstand several years with these smells. And for that, I am grateful. I just wish that settled in your nostrils just like yeast, and stomach acid. And jaundice.
2 days ago