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In the late 1980s, I am trained to dictate "the patient was placed in the dorsal lithotomy position" for certain examinations.

What the heck is THAT? you say, and I say, isn't medical language peculiar and archaic?

This is where the person is on their back with their hips and knees flexed and thighs apart. "This position is often used for vaginal exams and childbirth."

In clinic, "stirrups" slide out of slots in the exam table. I pull out giant oven gloves. The patient gets a moment of "what the hell" panic, until I slide the oven gloves over the stirrups. The reason for the stirrups is that in order to do a vaginal exam with a speculum, the person has to slide right down to the edge of the exam table. Legs need to be out of the way. That's what the stirrups are for, to place their feet. The stirrups are adjustable for height.

In the operating room the stirrups are much more adjustable and very padded, to avoid any pressure ulcers.

The dorsal part of your body is your back and the ventral part is face, chest, abdomen, and so forth. It would make more sense if we walked on all fours. Distal is furthest from the body and proximal is closer. So, pip joint is proximal interphalangeal joint and dip is distal interphalangeal joint, in the fingers. Occasionally I have to describe a fracture to an orthopedist on the phone and have a set of books to describe it correctly: "A non-comminuted fracture of the proximal radial head." I have the books because I don't describe fractures often enough to have it all in the frontal memory banks. I need to describe the fracture precisely so that the orthopedist can give me the current update on what to do, or say "Send her over."

My first clinic job was in Colorado. I took over for another physician. My nurse said he had pictures on the ceiling that he'd taken with him, for when patients were in the dorsal lithotomy position. I brought in three reproductions of Japanese scrolls of vines and flowers and tacked them to the ceiling.

My third week there, I was getting ready to do a pap smear and my patient says, "What happened to the Chippendales?"


"The pictures used to be Chippendales."

"Oh. Um, the previous doctor took those." I did not put them back up. The previous doctor was male. Ok, it seems a bit, well, really weird to me.

I don't have pictures on the ceiling in my current clinic. The lights are in the way. Yesterday a patient asked about the spider. There is a spider in the florescent light fixture.

"Well, it's not a live spider." I said.

She gave me a look of disapproval. I suppose I should remove the body, but it doesn't bother me. I usually catch and release spiders outside, but I didn't have time to rescue the light fixture spider. Dead spiders don't bother me much as long as I don't eat them or step on them.

Iron Noder: Tokyo Drift 14

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