LA JOLLA, CA—After rounding on his patient, the incomparable Dr. Seuss entered the following progress note into Mr. Scott Hess’s chart:
I confess I just assessed Mister Hess.
Do you want to know his progress?
Why yes, I guess.
Well, poor Mr. Hess,
please God bless,
for I assess that Mr. Scott Hess
is nothing but a hot mess!
Would ya believe (I cannot deceive)
he’s got dung in his lung,
and a fart in his heart,
a ladder in his bladder
and an arrow in his marrow?
Oh God bless, poor Mister Hess!
Why’s there dung in his lung?
Well, a week ago, don’t ya know,
to my office he showed,
having just returned from Korea,
with the most foul-smelling diarrhea!
Without question, my first impression
was it must be a bad viral infection.
But upon some reflection,
I realized I missed a strong connection.
I forgot he had said
his throat had been red,
so he found a doc in Korea
who said, “Sure, I’ll see ya!”
But for what was surely a virus
the doc said, “Here, try this.”
Ugh! Arrgh! It was clindamycin!
(I swear he’d been better off if it were ricin.)
You’re quizzical; you know where this is going.
I did a physical; his poop was flowing.
Took an ample sample,
sent a slab to the lab.
But no need to wait,
After taking just one whiff,
It was clear this was c. diff.
C. diff, C.diff
That dastardly, bastardly bug!
The mostest grossest. Ugh!
Tres difficile to treat it,
Still I feel we’ll defeat it.
So I tried my best for poor Mr. Hess.
But the Flagyl made him fragile,
While Vanc—it just stank!
And Dificid didn’t fix it.
So I called the GI doc, who was such a crock,
he wore a smock, and was personable as a rock.
This crock of a doc, in his smock,
said he knew just the cure, one that’s so pure:
“We’ll put fresh poops in his colon loops!”
It’s called FMT, don’t you see?
F is for Fecal (“poop-related” that equals)
M is Microbiota (that’s bacteria—if you care one iota)
T is for Transplant (a poop transplant?! I just can’t!)
I will spare you the whole spiel
of how fresh poo rids C. difficile,
Just know that healthy stool
can suppress C. Diff the Cruel.
Well, Mr. Hess, I must stress,
was at first disgusted,
so we discussed it.
“FMT, you see,
is 90% effective
at killing this infective
bug.” “Ugh! What the fug?!
I guess I’ll just trust it.”
So the GI doc in his smock
Prepared some feces
From Hess’s sweet nieces
Then looked at the clock;
It was time to rock.
Using some lube,
he inserted the NG tube,
then infused all the poops
into Hess’s intestinal loops.
But what’s that? Whoops! Oops!
Mr. Hess squirmed
and the X-ray confirmed:
The Gut is not where the poop is
because the Lung is where the NG tube is!
Oh, that GI doc
I told ya he’s a crock.
Mr. Hess griped:
“You inserted the tube with the lube
down the wrong pipe!”
That’s why there is dung inside of his lung
Oh, how it stung!
Poor Mr. Hess, oh God bless,
is such a mess:
He’s got pieces of feces
Flying out with his sneezes
Oh poor guy, with poop in his bronchi,
No wonder he now wheezes.
And talk about bad breath.
It smells worse than death.
It’s halitosis to the extreme
Yeah, I know this is quite obscene,
but can you start to see, my friend
that now his farts come out the wrong end?
Oh Mr. Hess, now in distress.
He’s got dung in his lung.
I swear it’s among
the worst things ever done.
So knock, knock. Hey, GI doc,
YOU made this mess for poor Mr. Hess!
No one would believe it
Or even conceive it,
But it’s true, because of you
There’s dung in his lung,
Now you must retrieve it.
So what did he do, that GI magoo,
That hack, that quack,
that crock of a doc?
You’d think he’d act contritely,
ask forgiveness from Mr. Hess nightly.
But what he did next was quite a shock
And suggests he’s still a crock.
“To empty the dung out of your lung,”
he told Mr. Hess, oh so politely,
“Please inhale a gallon of GoLytely!”
That’s so unsightly.
“But,” the GI doc gleamed,
“my plan’s so clever!”
To which Mr. Hess screamed,
“Yeah, I’ll do that never!”
So to the rescue (oh phew!)
came a doc from pulmonary.
He put a scope down his airway
Then said a “Hail Mary”
He sucked it, he plucked it, he chucked it.
“Oh fuck it!
There’s just no way, I say,
to clear all the dung away!”
“Oh I could die,” Mr. Hess replied,
“Give me one reason I shouldn’t cry!”
Ok, my guy, I’ll try.
“Here’s why you shouldn’t cry:
At least our certainty is high,
you’ve got no c diff in your alveoli!”
At last a crack of a smile
but only for a little while.
Cause this tale has more parts
like the fart that’s in his heart.
There’s also the matter
of the ladder in his bladder.
And don’t you want to know
about the arrow in his marrow?
Well, don’t be rude or cop a ‘tude
This progress note is to be continued…