i know why i'm not a microbiologist. in one word, worms.i was doing a gastroscopy. the patient had a previous gastroenterostomy (small bowel attached to the stomach) somewhere else for unknown reason. the result was, over and above the pyloris (the normal stomach outlet) which was normal, he had another stoma which had an afferent loop and an efferent loop of small bowel. i took a look at all three pipes leaving the stomach, intubating them one at a time.
in the efferent loop is where i saw them!! ascaris!! (see above picture to fully appreciate this little critter). they seemed pissed off that the patient was npo because they were writhing around and moving like mad. even worms get hungry. obviously every one gathered around to take a look. i think it has to do with the fascination of all that is gross.
i just wanted to run. i think i now understand that some people have a rather robust vaso vagal reaction to blood etc, because the same happens with me when confronted with worms.
one of the sisters suggested i take a biopsy. why i wondered. it's not as if i have any doubt as to what it is i'm looking at. anyway, can you imagine how the thing will go crazy if i start taking bites out of it. biopsy is just out of the question here.
i woke him up, gave him deworming treatment and sent him on his merry way.
