The donor

You do it hundreds of times in medical school, so much so that it becomes reflexive. Knock, open door, walk into a patient's room, introduce yourself with a smile and a handshake and then promptly tell the patient to get nekkid and toss a gown at them before invading every inch of their privacy. Then you close by saying something reassuring, and telling them they can get dressed.

I had the fortune of being on the receiving end of such a wonderful encounter today for my pre-employment physical and battery of exams. I think the highlight of the day had to have been the paperwork for the urine test...but I'll come back to that.

The low-light of the day was having to shave for my respirator fit testing. I usually keep a bit of scruff, preferring to shave every other to every 3rd day to keep my sensitive skin happy. It's usually not a problem when I don't have to look professional (it's not like anyone's around to watch me build my Ikea furniture with a beer in my hand, muttering under my breath at 1AM...I hope). The secretary shook her head and told me I'd probably have to shave for my fit test. The LPN that drew my blood wished me luck with the hospital supply closet razor and offered me my tetanus booster in the next breath. So following my physical I was lead to the dreaded bathroom with a little hospital can of "shaving cream" (worst shaving cream ever) and a flimsy-handled, single-bladed hospital razor. Now I'm somewhat particular in my shaving habits because it keeps my face from feeling like it's on fire for the rest of the day...but those OCD tendencies went out the window today. I begrudgingly scraped the scruff off with the blunt instrument, lost about half a unit of RBCs through a thousand tiny cuts on my face. Then came the fit testing where an N95 was strapped onto my face for 15 minutes and I was made to do all sorts of stupid maneuvers to try to break the seal between my face and the mask...so needless to say, my face feels like burning right now.

Then the urine drug test...my personal highlight. I hadn't had much to drink the morning prior, nevermind my normal cup of high-test coffee that allows me to tolerate tedious bullshit without wanting to strangle everyone in sight. Couple caffeine withdrawl with some Ikea-induced sleep deprivation, the medieval shaving experience and being made to wait for something that should have taken all of 35 minutes, and I was getting sort of punchy toward the end of the 2-hour extravaganza.

They stuck me in the waiting room while the folks before me finished up their tests...f-ing awesome, I love waiting rooms. With everything that had transpired that morning, I wasn't really "feeling the urge", so to speak. The nurses had attempted to orally hydrate me at every opportunity by handing me two little dixie cups of water every time one of them passed, however my GFR was clamped down pretty tightly. "Bostonian?" the nurse called...and I trotted over to get the stupidity over with. I had to then sit there and watch her fill out 4 different forms which had quadruple carbon copies (yellow, white, pink and orange!) which took exceedingly long. Finally, I was escorted to the rest room, read my list of rights (don't wash your hands!!!) and there I was, alone, staring down at the empty plastic cups. I had a stupid running dialogue:"60cc's of urine to freedom...sweet sweet freedom...try not to quote Braveheart out loud...don't laugh...valsalvaaaaaaaaa and there it is...don't pee on your hands. Wait, I can't wash my hands???"

Now for anyone that's been through this ordeal, the hospital makes you sign like 4 different forms for the urine drug screen, and everything must be done according to a stringent procedure to eliminate common sources of fraud. Usually there's a legally binding document that at refers to producer of the urine sample in a consistent terminology. Not so at my institution: one form that had 3 different terms for me, including "donor". Generally I reserve the word donor for pleasant things that confer a benefit upon the recipient...eg money, blood products, semen and the like. But there was my cup freshly voided pee...and I had to sign on the line that said "Donor Signature". Who knew!

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