We were inserting a urinary catheter into an elderly woman. It smelled so foul, like some poor fish had died and been left baking in the sun for day. As the catheter went in, streams of brown pus started leaking out running along the catheter. Turned out to be a really bad UTI. Also necrotizing fasciitis, don’t google it.

A guy was street racing with his two year old daughter in the back of his car. He rolled the car. Little girl was fine. He, on the other hand, had his arm ripped off. When limbs come off, they’re usually severed pretty cleanly in an accident or crushed and need to be amputated. No one in the ED had ever seen one ripped off. It was pretty brutal. Arm was not reattached.

Some of you may know smegma. Otherwise known as dick cheese. Was an intern at the time, working at casualty/emergency department. In came a male. idk if he was homeless or not. He was aged around 50-70, can’t remember. He couldn’t pass urine on his own, so catheter it was. But first the lil man down there had to be cleaned. Here’s where the smegma came in. (1/2)

It was THICK. This guy had it like it was a scarf covering his thing. And the scarf was thick as a rope. I still remember it because that was my first catheter insertion. Circumcised or not, clean your thing, guys. (2/2)

In medical school and was doing my rotation in the emergency department. I come in for my shift and the resident sent me into a patient’s room to change their wound dressing. Easy enough. So I go in there and I see this dressing is absolutely filthy and smelled terrible. Apparently it had been on her burn wound for over two months because she was afraid to touch it. (1/2)

I carefully use saline and start unwrapping the bandage which caused extreme pain. As I got a couple layers down I start seeing things move and I thought it was me starting to get lightheaded from the smell but I looked closer it was thousands of maggots. Finally got to the skin, cleaned off all the maggots I could see then returned 30 minutes later to see it covered in maggots again meaning they had burrowed under the skin. (2/2)

I once had a guy that was brought in after lying on the same side on his apartment floor for about a week. The neighbors called 911 because of the smell. Everything had rotted away to the bone on his hip, and when he moved his legs you could see the joint and ligaments articulate. He was also covered head to toe in scabies. His overall look I would best describe as the guy who was Sloth from the film Se7en.

Limbs displaced is the hardest for me. Saw a motorcycle rider who clipped a parked car with his foot and came in with his foot on backwards.

I had a patient with a hole in their back the size of both of my fists together due to a stage 4 pressure ulcer. I would have been able to touch their spine while we were cleaning the wound if I had been so inclined. We took a massive chunk of necrotic tissue off of this guy and the fellow I was working with said he would most likely die with the wound because it had gone so far. But nothing I can do can describe the smell. Even through an N95 mask and a surgical mask I was wearing it was so overpowering that I still have nightmares about it to this day.

I am an ENT resident, I saw a gentleman with a history of cancer on his scalp. The ED called because they thought his scalp was infected. Walking in the room it immediately smelled wretched. When I looked at his head I did a double take because I saw a patch of his scalp literally move, when I examined closer I realized that it was a swarm of maggots crawling around his open wound which was exposed skull. Maybe the maggots actually helped control the infection, idk, but I felt very sad for him.

An athletic guy came in because his leg hurt during exercise at first, then at rest too. Nothing to see but a pimple on the thigh and it felt oddly doughy. The pimple was the exit of a huge abscess. The whole thigh was filled with puss. In the OR the surgeon dove in with both hands just hauling masses of puss and dead muscle out. (1/2)

Pilonidalis cysts are similarly gross. Large abscesses above the anus from ingrown hair. The holes after cleaning those out vary from golf ball to grapefruit size and need to be tightly packed with gauze every few days so they heal from the bottom up. Takes a while, but they do heal. (2/2)

Veterinary, not human, but I’ll tell the story of something that came out of my patients body, because why not. It’s not often this story is appropriate to tell! We get a call of a dog on its way in who has eaten the contents of a garbage bin. I was in a big city and had just started working at a new clinic. Reception page to let me know my patient has arrived. I walk out to greet them. We lock eyes. We know each other. This client was a nurse at my last clinic. Client turns bright red. (1/2)

Client: “Oh no, why are you here?! I came to the other side of town so I wouldn’t know anyone!” Me: “Great to see you too!” Client: “No, I’m sorry but this is so embarrassing” Turns out this naughty dog has eaten the entire contents of the owner’s bathroom bin, which was full of old used tampons and pads. I got to spend an hour catching my colleague’s week old used tampons in a tray as her dog vomited them up. So that was a day. (2/2)

In med school I met a gentleman who the world had let down – homeless, disheveled, malodorous, and he wasn’t quite there upstairs due to chronic alcohol use. Sweet guy but very confused. He said he came into the ED because his foot hurt. Covered in random scratches and bruises which didn’t bother him. We suspected he had significantly reduced sensation from neuropathy – there are different types e.g. alcoholic neuropathy, diabetic neuropathy. (1/2)

We put on some gloves. I extend his leg while the senior registrar removes his boot, and a chunk of his foot came off with it. Just a big chunk of heel. His foot was covered in necrotic tissue and the smell made my stomach turn. The old boot had been acting like a compression stocking, holding his foot together until it didn’t. (2/2)