I was on my knees on the floor, one tiny, slight student nurse was hauling the man over on his side as I stuck a rigid sigmoidoscope 30cm into his KY jelly (cheap NHS version of actually, not the branded KY) lubricated rectum.
I inserted a Faucher tube (largest one on the shelf, 36F) and stood back. Hurtling towards me down the tube came litres of gas and liquid stool, the noise was quite dramatic and was heard by the rest of his 6 bedded bay.
The man’s abdomen decompressed and he could breathe again, but there was shit everywhere. It was pooling round his wasted, skinny little buttocks. I cleaned him up with the patient cleaning mousse, wiping his thighs and buttocks and scrotum clean and the nurse and I got a fresh sheet for his bed.
We tucked him back in, abdomen almost normal again, flatus tube stuck securely to his thigh to keep his colon deflated. It was the fourth time I had seen this man, the fourth time I had decompressed his volvulus, he is paralysed and condemned to blow up time after time.
As I kneel there, wiping and cleaning his pressure sore covered sacrum, I look at my bare arm splattered with faeces and I hope that it will never happen to me, that I should never be where he is. That I couldn’t bear what he does with such dignity and composure.
Afterwards I explain again what the plan is, ask him if he feels better. He thanks me for doing it, tells me he feels much better now. His dignity in the face of what he has to endure is humbling. My eyes fill with tears, partly due to tiredness and partly due to doing something so simple and easy that has made someone instantly better. It cost me nothing, it took no real skill, used just 15 minutes of my time, there was no ego, no risk. Just me, on my knees, covered in shit, making someone feel better.