Social norms are not the norm in the ER. Things that are regarded as gross in the real world are an everyday occurrence. Our ER especially lived in a special universe where all social graces were stripped away, and the rawness of humanity is what remained.

I begin my night shift. I hadn’t taken a solid nap before my shift, and I am now headed into round 3 of 4. Nights like this always start in a haze before the caffeine has a chance to kick in. I drop my stuff off at the doc box and see that there are a couple of patients that need to be picked up.

My first patient is in the middle of the big room bed 7. It’s a woman with a chief complaint of vaginal bleeding. I talk to her, examine her belly and then rush out so I can get the supplies for a pelvic exam.

I have 15 minutes left before rounds start and I am determined to have this patient completely worked up before then. I rush to the bathroom that is right across the aisle so that I can get a bedpan. I open the door and walk in. The first thing I notice is the urinals and bedpans on the left. Then in my foggy state, I look to the right and see none other than a person sitting on the toilet dropping a deuce. I was so tired at this point that my mind was still trying to compute what was going on. It’s almost like when you try to open a program on a Mac, and that rainbow wheel comes up as it is trying to launch the program. For a moment, everything is suspended.

The guy on the pot doesn’t say anything. I don’t say anything to him. We just stare at each other. Deep into each other’s eyes. The window to the soul. We have a moment. Then without warning, he looks away from me, shrugs his shoulders and resumes pinching off another loaf. The trance has been broken. The rainbow wheel is done processing. I quickly grab the bedpan and run back to my patient.

I’m pretty sure that the natural response should have been to scream or to tell me to get out. And for me, I should have covered my eyes and quickly ran out. But then again I am in this alternate universe called the ER.

Zahir Basrai is an emergency physician who blogs at the Physician Grind.

Image credit: Shutterstock.com