Sore Nostril

0200hrs

It is raining heavily outside. Hurricane Igor is approaching, and the roads are slick and wet. The ER is empty - and rightly so, considering the weather conditions.

Then a bedraggled, drenched man in his 30s walks into the department. He checks in at the desk and is triaged. I keep an ear open from my hidden place behind the triage area.

"What brings you out in this awful weather?" the triage nurse asks.

"My bed has bedbugs."

"Yeah, there's an infestation across Canada. But what can we do for you today?"

"Get rid of the bedbugs."

There is a short silence as the triage nurse ponders this serious predicament.

"Sir," I hear him say, "we unfortunately do not exterminate pests here. Go home. Open the Yellow Pages. Look under Pest Exterminators. This is not the place to be coming for bedbugs. Or rats, or insects or wasps for that matter. Now, go home."

And with that, the triage nurse ushers him out the door and gently shuts it.

0400hrs

A 19yo woman checks in at the front desk. I pick the chart up. "Nose Problem", is the chief complaint noted on it.

I read the triage note. The triage nurse is having a hard time keeping a straight face, as a look of utter disbelief is written all over mine.

I call the patient in and wait as she sits down. She is soaked from the sheets of rain pouring down outside.

"What's going on?" I ask, in as neutral a tone as possible.

"My nose hurts. I was picking it all day and now the nostril hurts."

I can't think of anything to say.

"Can I have some cream for it?"

Silently, I stand and reach for the otoscope. I shine the light up the nostril she points at. The mucosa is raw and red.

"You don't need a cream," I say, replacing the otoscope. "You need to stop picking your nose."

"There's no cream that will fix this?"

"No, there's no cream for this. You just have to stop picking your nose."

I can't believe I'm having this conversation - in the back of my mind, I wonder how it's possible that I spent 5yrs in medical school, 3yrs in residency and am now sitting in an ER at 0400hrs advising a woman not to pick her nose.

She's not happy, but she leaves. The triage nurse waits until she is out the door, then bursts into laughter. I roll my eyes at him and go back to my game of Jumbline on my iPhone. Darwin loses another battle.