Water is Cheap.. Take a Bath and Put on Clean Undies

I wonder sometimes if people really don't have any idea that they are dirty. In an emergency I have learned that people can show up in the ER in a variety of clothing and covered in blood and dirt. Perfectly acceptable and no one looks askance at them. A lot of ER's are now being used as a clinic and we see a high number of non-emergency cases that present to the ER in ridiculous states of dress and hygiene. The older I get the less I hesitate to tell someone that their hygiene sucks.

Oral Hygiene: Brush your teeth....sometimes. When you have green mossy plaque attached to your front teeth thick enough to plant flowers and you smile it is about all I can do not to smack you over the head with a tooth brush. THERE IS NO EXCUSE. Water is cheap and if you can't afford toothpaste try baking powder and salt. Cavities can make you sick. When you come to my ER I will address the issue with you regardless of the reason that you came.

Body Dirt: If you come to the ER (unless it is a true emergency) and you are dirty I will mention to you that you should bathe...sometimes. Especially if you are here for boils, impetigo, lice, crabs, ring worm and poison ivy. Clean skin is important. Water is cheap. I have had to bathe children at times before I could treat them for minor ailments. I have had people tell me that they don't need to bathe but every two or three days. Yes. You. Do. You smell. You have rings of dirt around your neck and that is so not attractive. You are not going to catch cold or get pneumonia if you bathe even when you don't feel good.

Attire: If you come for a non- emergency... like something you have had for weeks...look at your clothes. If you and your kids are filthy you are going to get sick. Water is cheap. We have a lot of water in Louisiana. If your water got turned off, take your clothes to the bayou and beat them on a rock. I promise you that they can't be worse off than they are now. There is no shame in being poor but there is a heap of shame for being willingly dirty. Mama always told me to wear clean underwear if I was going out. You know, just in case you got into an accident and someone other than family had to divest you of your drawers. I had a patient come stating she was pregnant and bleeding. I asked to see her pad(huge yuck factor but it is a legitimate question) and guess what, she wasn't wearing one. But don't be too upset her panties were just fine.... because she wasn't wearing them either. Just her nasty jeans and a wad of toilet paper. Apparently undies make her feel all bound up(her words). I actually couldn't speak for a moment. If you come in for say, a non-emergent recheck on your gunshot wound from a week ago, AND you are a 20 year old man, it is not cute to be in dirty moose slippers and your girlfriends pink frilly robe and boxers. You. Look. Stupid. Don't get upset if I laugh at you.

Body Odors: Some people cannot help certain body odors and I understand that having battled stinky feet for over a year(nylon allergy... alas a story for another day) I had a patient once who presented to the ER for bad breath... whoooo boy was it bad. She knew it and she couldn't help it. She brushed about 10 times a day, gargled and was going nuts. Turned out to be a stomach problem. I have had wives take me aside and ask me to include in the discharge orders that their husbands have to bathe more than once every few days. It takes some creative thinking to tie bathing into instructions for a welder's flash burn of the eye. You know what, you married him and he is yours to raise..... tell him to bathe or you won't play the mattress mambo with him. Ladies all I am going to say is that if during your routine vaginal exam your nurse and doctor have tears running down their faces it's not because your Miss Puss is the most beautiful one they have ever seen. One word... douche

Feet: Last but not least is feet. When you come to the ER please, please, please PLEASE..change the socks that you have had on non-stop for the past year and wash your feet. If your feet are clean and they stink than you probably have some kind of medical problem. When we have to peel those dirty, 'stanky' socks off your feet and you have toe nails that are curling at the top and mounds of toe jam, do not be offended when we scrub and soak your feet AND spray them with Lysol.