Free How to Do a Liver Transplant by Kellee Slater

than a considerably shorter finger will reach. Traditionally the procedure is done with the patient awake and aware. Every effort is made to try and keep the apparatus hidden because if the patient sees it, they may not want to participate in what is coming next. After a lot of explanation and reassurance, the patient is placed on their side and the pointy end of the tube is slowly introduced. At this moment the patient takes a sharp breath in and a natural reflex causes them to clench their sphincter tight. I call this ‘the reticent anus’ and it is pretty understandable really. The clenching of course makes the whole thing a lot more difficult and if you don’t keep enough forward pressure on the tube, it will come flying out, requiring you to start all over again. With some gentle encouragement you can usually help the patient relax and press on.
    Once the tube is in, you must bend down and put your eye up to the porthole-style window at the end of the tube. This allows you to negotiate the very straight tube up a very curvy rectum. The bowel is normally collapsed on itself making it difficult to see anything at all. To show theway, the sigmoidoscope tube has a little rubber bulb attached that literally blows air up the person’s bottom. The soft walls of the rectum billow open, allowing you to push forward, carefully dodging around any lumps of poo that get in the way.
    Sigmoidoscopy can be very treacherous for the operator, as your eye and nose come perilously close to the anus. All this introduced air mixes with the poo causing a dangerous build-up of flatulence under pressure. This will eventually result in an unfortunate expulsion of material from the anus. A vital part of the job is to develop the ability to predict when this blast of particulate-filled gas might erupt. The effluent can rush toward you like the water in the aqueduct coming toward John McClane in Die Hard 3 and unless your reflexes are well developed, you will cop an eyeful. All of this must be done whilst trying to remain professional and telling the patient that everything is fine, that it really doesn’t smell at all and it is all part of a day’s work.
    Every doctor has their own collection of fantastic poo stories. They usually get told when we get together over dinner at a fancy restaurant. It’s juvenile and we can get loud. We often don’t realise how crass we are being until our spouses elbow us in the ribs and we notice that all the other diners are staring at us with their mouths open. Humour is simply our way of dealing with this part of the job.

    There is not an object invented that has not been inserted into an anus. If something will go close to fitting and occasionally even if it won’t, people will attempt to put it in there. This feat is usually achieved at unspeakable hours of the night and the insertee will usually attempt any and all measures to extricate the item prior to attending the hospital so as to avoid the red-faced embarrassment that will surely follow. On the other hand, there is a group of patients who get their kicks not from the act of insertion, but from the hospital staff’s reaction to what they have done. They are the ones who manage to get some seriously large objects up there. The reasons given for putting things up their bums vary widely and can be pretty funny. The most common one is blatant denial: ‘I woke up and found someone had put it up there,’ is the usual story. ‘I tripped over the cat on the way out of the shower and I happened to fall on a pool cue,’ is another.
    Vibrators are pretty standard fare when it comes to insertions and to tell you the truth, it takes something a lot more creative than that to pique my interest. It’s pretty amusing, though, if it is still operating and the victim is emitting a constant low humming noise. Vibrators are usually pretty easy to retrieve. Just lube up a gloved hand and in I go. Then there was the