Brian? Trauma Centre. Trauma Centre? Brian.

It’s taken us 10 years, but we might finally have an answer to the Brian Persaud question, and I wasn’t even looking for it.

Story time. Years ago, somebody at work told me about as a good place to get answers to just about anything. I went there to read people’s suggestions for alternatives to CAPTCHAs, those squiggly lined letters and numbers that show up on websites that you have to solve to prove you’re not a robot. What did I call them back in the day, fucking blasted son of a bitch goddamn piece of shit graphical word verification thingies? Yes, those things. But I started receiving Quora digests, and for reasons I will never understand, they almost immediately started straying away from the technical, and going into things about interpersonal relationships. Then, they started going into medical issues. I have no idea what I did to cause this, I’m sure it’s something I may have done since the rest of my colleagues at work still receive informative posts about app and web development and the like. I do have to say that the answers on Quora are mostly very well-thought out and free of nasty trolls. Now, I almost always receive ones about doctors and hospitals and the like. I got one asking if MRIs are dangerous right before my MRI. Thanks, Quora, and…you’re creeping me out now.

Then, the other day, this thread showed up in my digest. The question? “Is it true all people involved in trauma get a rectal examination in the ER? If so, why?”

And here was the top answer.

We used to do this routinely in major trauma. ‘A finger and a tube in every orifice’ was the unofficial mantra of trauma evaluation, and a rectal exam was part of the secondary survey (the head-to-toe evaluation of a trauma patient, to look for any and all injuries). We even called rectal exams the “[major trauma center] handshake” and I know that phrase was used at at least 2 other major trauma centers (with the correct name substituted in, of course)
Why a rectal exam? First, as a sign of possible bowel injury — blood on rectal exam can be a finding if there is an intestinal injury. More so in penetrating trauma (shootings/stabbings) than blunt trauma (car accidents, falls). Second, as a way of evaluating the spinal cord — the muscles of the rectum are innervated by the lowest parts of the spinal cord.
From some who have asked, there is some debate about the utility of digital rectal examination in the trauma patient – for example, see…
At the academic trauma center where I work, rectal examinations are still done on patients who meet the criteria for calling in the trauma team. They are also often done on other trauma patients who don’t meet full trauma activation criteria. I cannot comment on whether or not this is still done on all trauma patients at all hospitals, but I know plenty of physicians who no longer routinely perform rectal exams on trauma patients.
I am amazed at the number of views/upvotes this answer has gotten. Who knew rectal exams would be such a popular topic?

It still doesn’t explain why they would sedate him to do the test, unless some of those spinal responses they’re looking for are involuntary, but at least it explains why a bonk on the head might lead to a finger up the other end.

Signed On Your Liver, I’m Yours

Small update: Simon Bramhall has been sentenced. It looks like he has to pay £10000 and do 120 hours of unpaid work. I wonder if they made him clean up graffiti.


A doctor in England has been convicted of burning his initials into a couple of patients’ internal organs during surgery.

Was Simon Bramhall a rancher in a past life and felt like branding his patients like cattle? What would possess him to do that? And, were all the people watching him freaked out but didn’t know what to say?

You know a crime is weird when they have to shoehorn it into another category of crime because there is no category where it fits.

It’s weird to think that, while they were removing my gallbladder, some surgeon could have decided to etch some graffiti onto my organs. Thankfully this is a rarity, but *shiver*

Did You Hear The One About The Naked Doctor? Did You See It? Would You Like To Do Both?

In certain contexts, telling the story of how one time your buddy was trying to show somebody a picture on your phone and wound up giving everyone a good long look at you naked instead is pretty funny. Hell, once I got over the embarrassment I’d probably tell that story if I had one like it to tell. But if I did, I’m pretty sure I’d be able to tell it without needing to give anyone visual aids…especially if the audience was made up of a bunch of my female patients and office staff.

Georgetown family physician Dr. Nigel Phipps has admitted to showing naked pictures of himself — selfies, to be specific — to more than a dozen patients.
But why?
“I thought they would think what I thought . . . I thought it was humorous, innocuous,” the 57-year-old doctor testified in his own defence at his discipline hearing Thursday at the College of Physicians and Surgeons of Ontario (CPSO), about how he wanted to share with patients what he thought was a “funny” story of a stranger accidentally seeing one of the naked selfies several years ago.
“Through counselling, I realize people don’t think what you think.”
Indeed, a number of complainants testified Thursday, as well as at the beginning of the hearing in July, that they felt embarrassed, violated, and confused when their doctor showed them the photos in the examination room. “A strong yuck factor,” as one patient put it in an agreed statement of facts filed by the college Thursday.

Though Phipps apologized, he maintained that nothing he did was sexual abuse and that the four different pictures he needed to show in order to spin his yarn about an accident involving a single photo were little more than an attempt at humour gone wrong by a man who was having some problems. The women who recall seeing additional photos of dongs and the one who claims the good doctor complimented her breast reduction surgery, however, say otherwise.

The hearing continues. Hopefully the laughs do not.

So You’re Here For An Injection, Eh? Well, I’ve Got A Nice Big Injection For You Right Here

I’m not saying that a joint specialist should never ask you about your sex life. I mean who knows, maybe something you’re doing in the old boudoir could be causing you unnecessary harm. It happens. But if a joint specialist is going to ask you about your sex life, it would probably be best if he didn’t go all cocks and pussies and gay magazines on you, otherwise known as the Martin Lee method.

Dr. Lee faces the prospect of having his license revoked after being found guilty of sexually abusing a patient and professional misconduct for not only a bunch of sex stuff, but also because he tried to get a patient to pay cash for prescriptions and to record or photograph other patients he had been told were illegally selling medication. He was in to probes of all kinds, you might say.

The doctor asked the patient if she and her husband had oral sex, and anal sex, and about sexual positions they engaged in.
Except this was not sex therapy.
Dr. Martin Lee, who practised in Mississauga and Pickering, is a rheumatologist, a specialist who deals with disorders involving the joints, such as arthritis.
The patient has fibromyalgia, a condition that includes chronic pain. She was seeing Lee once or twice a week for trigger point injections. She was not only subjected to questions about her sex life, but she also had to listen to Lee volunteer details about his own.
He would talk about “things of a sexual nature that I guess he wasn’t satisfied . . . Frequency, and I guess methods or types of positions that he would engage in with his wife or wanted to,” the woman, identified only as Patient A, testified at Lee’s discipline hearing at the College of Physicians and Surgeons of Ontario.
She also testified that during Gay Pride Week, Lee showed her a gay pornographic magazine and asked “What is S&M? What do they get from it? How could two men do that?”
Earlier this year, a discipline panel found Lee guilty of the sexual abuse of a patient due to his remarks to Patient A, as well as for making sexual remarks and rubbing his groin up against another woman, Patient C.

Update:As of November 2nd, Dr. Lee no longer has a licence and will have to find another platform from which to be creepy and gross.

Despite amendments by the provincial government last spring to the law around sexual abuse of patients by health-care professionals, Lee’s conduct would still not have fallen in the category of sexual abuse acts requiring mandatory revocation of his licence.
However, in its decision to revoke, the five-member discipline panel acknowledged that courts have recently been critical of the CPSO’s independent discipline committee for failing to adequately respond to society’s views of sexual abuse of patients, by handing down more lenient penalties.
“The Divisional Court recently held . . . that the committee’s prior penalty ranges in cases of physician sexual abuse are out of step with present day society’s values and expectations,” says the discipline committee decision. “The committee recognizes that changing societal values speak to a need for more serious penalties in cases such as this one.”

The committee sided with the college’s request for revocation, and also ordered that Lee post a letter of credit for $32,000 to cover potential therapy costs for the patients, as well as pay $20,500 for the cost of the college proceedings.
“The committee hopes that its order in this case will send a clear message to other victims of sexual abuse by physicians that reporting such behaviour is encouraged and will be taken seriously,” says the decision.

What The ER Looks Like From The Doctor’s Point Of View

I saw this article about what it’s like in the ER late at night, and it made me think. I know these things. I know the doctors aren’t just bumming around all day making you wait for fun, but boy is it ever frustrating. I still remember how frustrated I was when I had to go to the ER…and how maddening it was to get one test, then wait, then another, than wait, then get moved to another spot, then wait. I can’t imagine how it would feel to be on the other side. At least I can say I have never been to the ER for falling off a balcony, or some of the other stupid things people were there for in the article. I know I’ll think about what shoes I wear to the ER from now on.

Ass Ass Baby

So apparently, there are a lot of seniors with STD’s now, and it’s not something that’s getting talked about. So, Dr. Shannon Dowler wrote a rap song about it…which is pretty damn good.

I have to say that I’m feeling pretty old, because “Ice Ice Baby” was picked as a song that is supposed to reach seniors. Hmmm.

Any way you look at it, it’s getting people talking, so that’s what she was going for.

Yo, Dr. D in the house, let’s kick it.
safe sex baby
safe sex baby

Alright stop, collaborate and listen
to rap Dr. D’s rap intention
callin’ out all you fellas and ladies
STD’s are tearin’ through folks in their eighties.

Can ya really help bein’ sex kittens
why can’t you wear your little love mittens?
Gotta be safe, ’cause sex has gotten risky,
no shame in bein’ a freak and gettin’ a little frisky

Dang, your body’s a temple,
Keepin’ safe’s not always so simple.
sex indiscretions lead to depression,
no matter how you like it, condoms give the best protection.

Love it or leave it, hormones start to flag
Things dry up and your tail can lose that wag.
If that’s a problem, lube may solve it,
see your family doc if it doesn’t resolve it.


Vaginal atrophy is something’.
A sex catastrophe, it can be the real thing.
Quick to the point, to the point I’m makin’
lubrication’s key, and ya know I’m not fakin’.

Trauma, from guys’ erections,
tears thin skin without detection.
Listen up, and learn from this lection,
if you don’t want a nasty groin infection.

Aging, it’s just a normal stage,
we all have to get on the same safe sex page.
Fellas on standby, wantin’ more than saying hi.
Should ya stop, or should you just drive by.

Wait until they’re checked at an STD shop
check things out from the bottom to the top.
Your sex life can be later and stronger,
thanks to Viagra, boy parts work longer.

Livin’ a sex revolution,
bein’ sex savvy is the smartest sex solution.
Let’s break it down, cougars all around,
all these STDs all the time bein’ found.

Bodies, we’re just a cafeteria
a cesspool of germs, of virus and bacteria
Once called the clap, Gonorrhea’s got a rap
Sleepin’ around? Probably a trap.

Subtle and sneaky is chlamydia
Ya may not even know when the bug has gotten into ya.
Syphilis makes a painless little sore,
then you spread it ’round every time you score.

All are on the scene, back in action,
Tearin’ things up, put your parts in traction.
STDs are a problem,
one way to solve it, see your family doctor.


Take heed, I’m an STD poet,
Rap Dr. D. I want you to know it.
In my town, I see these infections,
give bad news when they’re detected.

Sex can be a germ spill,
people aren’t safe for real.
Virus and bacteria, sexually transmitted,
How to be safe? Make sure the condom’s fitted.

I’m rap Dr. D and I wanna help ya be,
free of Herpes, AIDS and HPV.
All these STDs really are stealthy,
Without ’em, your sex life will be healthy.

No lame excuses, you know to take precautions.
Rap Dr. out, hope your golden years are awesome.
If you’ve got a problem, and condoms won’t solve it,
see your family doc, maybe they can resolve it.


Yo, let’s get outa here. Word to your doctor.

Aaaaaaaaahhhhh! That’s Not A Raman Spectroscopy Device!

Have you ever seen that thing on social media where at the start or end of the day, someone will take a few minutes and list a few things that they’re grateful for or that make them happy? I don’t generally do that, but I’m going to go ahead and lay one on you all right now.

I, Steven Wettlaufer, am grateful that my life has taken a path such that I get to sit here and do this rather than a direction that would have seen me ply my craft as an investigator for the College of Physicians and Surgeons of Ontario. While I certainly would have been far more richly compensated having gone that route, I feel without a moment’s hesitation that any vast financial reward I would receive would pale in comparison to the joy and happiness it brings me to know that on any given day doing what I do, it will not be my duty to shoot a fat, underwear-clad dermatologist full of erection drugs and then see if he’s physically capable of humping my leg.

I bet you think I’m making that up, don’t you? If yes, I invite you to read the story of Dr. Rodion Andrew Kunynetz, recently found guilty of various counts of misconduct related to sexual contact with patients. Part of the case hinged on whether Kunynetz rubbed his penis on women during exams or if, as he claimed, that wasn’t possible because the penis in question was sheltered by his giant gut.

As you know, when somebody claims something, it’s the job of the opposing side to try to prove otherwise, and sometimes there’s only one way to do that.

For the defence, Dr. Sidney Radomski, head of urology at Toronto Western hospital, injected Kunynetz with a “triple mixture” of drugs to induce an erection and then had the doctor, wearing his underwear, conduct a simulated examination on him while sitting on the examination table.
The simulated examination took place when the penis was flaccid and after the arrival of the erection. “Dr. Radomski concluded that it would not have been possible for Dr. Kunynetz to have rubbed his genitalia, flaccid or erect, against the patients,” according to the decision.
On cross-examination, he admitted other factors, such as how Kunynetz’s body was positioned, could have affected his conclusions.
Then came Dr. Gerald Brock, expert for the college, professor of surgery at Western University and specialist in erectile dysfunction. His examination of Kunynetz, where he also injected drugs to cause an erection, was observed by a college investigator and a lawyer representing the defence, whose job was to take pictures.
Brock also acted as the mock patient in the simulated examinations, which he conducted at three different examination table heights.
“When Dr. Brock sat on the examination table, he was able to feel Dr. Kunynetz’s penis when Dr. Kunynetz was standing and moving forward towards him,” the committee wrote. “He was also able to visualize the penis. Dr. Brock testified that he was able to feel the penis at all three table heights.”

So yeah, maybe don’t be so quick to doubt old Steve here.

Let me also state that while I’m grateful that I don’t have to do it, I’m also glad that there exist people in this world who are willing to. They’re often all that stands between creeps who abuse positions of trust and their ability to keep doing so.

It’s Nothing, Honey. Writing Down The Time During Sex Turns Me On Is All

If the news is to be believed (not always a sure thing), therapists, patients and sexual relationships don’t tend to mix well. Even when everyone short of the ethics board is down with it, there’s a lot of room for things to go wrong. Often things go sideways in spite of the best efforts of all concerned just like any “normal” relationship, but you’re going to have a tough time convincing me that Charles Morris Adams was looking to have a normal relationship and not set some sort of record for how poorly he could make things go.

An elderly Iowa therapist who had a yearlong sexual relationship with a female patient billed the victim for his services, investigators allege.
Charles Morris Adams, 76, was busted Friday on a felony sexual exploitation charge. Adams, a family counselor based in Iowa City, reportedly confessed when confronted by police.
According to a criminal complaint, the victim told cops that her “sexual contact” with Adams “had been occurring for about a year and had happened at least 25-30 times” while she was his patient. The woman “was being billed by her therapist while she was also engaging in sexual contact” with him.

Adams, who also appears not to have been licensed since 2014, told police that he knew he should not have done what he did and understood that there would be consequences.

If convicted, those consequences could be a maximum of 5 years in prison, though it’s somewhat unlikely that most judges would toss a person that age in the clink for that long if at all.

He’s Going To Be A Real Hit In Prison With A Name Like That

Recently convicted of gross sexual imposition and tampering with records after a trial in which it was alleged that he groped various female patients during orthopedic exams is Dr. Jake Heiney. And yes, those were among the things he groped.

During Heiney’s trial, a 42-year-old woman testified that the doctor pushed and squeezed her breasts during an exam for shoulder pain. No one else was in the exam room at the time, she said.
A 33-year-old patient said she also was alone with Heiney when he asked her to bend over and touch her toes, and he abruptly pulled her pants and underwear to her knees and felt her behind, side, and upper thigh. His hand also brushed her private area, she said.
Prosecutors also presented evidence that after Sylvania police and the Ohio State Medical Board began their investigations, Heiney altered one of the women’s records.

He faces up to three years in prison in that case, and his troubles don’t end there. He’s still facing four counts of criminal sexual conduct based on complaints made at another of his offices.

Let Me Give You A Shot For That

And now, the story of a woman with an injured right arm and her hospital run-in with New York emergency room doctor David Newman, who various authorities are alleging had no such trouble with his.

The woman claims she removed her shirt and bra, but kept her pants on. The woman was still dressed in the gown when Newman walked into her room following the X-ray.
“I’m going to give you a shot of morphine,” the doctor told her, according to sources familiar with the woman’s claims.
The patient says she told the doctor that a nurse had already administered the drug, but she then felt a burning sensation in her arm that convinced her that Newman gave her more morphine anyway.
The visit turned creepy when the patient, while the doctor was examining her back, told him she felt pain on the right side of her chest. Newman started fondling her breasts, she alleged, according to sources.
The doctor then moved her bed away from the wall and positioned himself with his back toward the patient. The woman heard the sounds of someone masturbating — and then felt semen on her face, she claimed.
All the while, she was unable to move because she was heavily medicated, sources said.

Newman, after allegedly finishing his dirty deed, used a blanket to wipe off the substance from her face.

The story then picks up with some confused nurses wondering why they suddenly had an apparently overly medicated, blacking in and out disturbed woman on their hands.

The nurse, joined by another physician, Dr. Andrew Jagoda, roused the woman and asked what happened. The patient was drifting in and out of consciousness and unable to respond, she claimed, according to sources.
Once the woman woke up, she walked into the bathroom and spotted what appeared to be semen on her face and bare chest. She told police she wiped it off with a gown, which she then placed in a plastic bag along with the bedding — presumably to preserve as evidence, sources said.
When Jagoda returned to the room a short while later, the patient described what happened and said she wanted to go home. Jagoda asked the woman if she wanted him to call the police. She said she wanted to speak with his supervisor, sources said.
Jagoda then dropped a bombshell — his supervisor was Newman, the doctor she accused of sexual abuse.

Realizing that a chat with Newman would get her nowhere beyond perhaps an unwanted second date, she left the hospital. Thankfully the incident was reported anyway and an investigation is now underway. Newman has been barred from seeing any patients while the wheels of justice do that slow turning thing that wheels of justice do.