Friday, June 16, 2006

Pratting About

Or "Wart Treatment using Liquid Nitrogen" as our clinical system would have it.

As an humble houseman it was my job, once a week, to book in around twenty patients on a Wednesday afternoon for "Cryosurgery" with a Consultant Oncologist. Some had skin cancers. Many did not. They had warts or Naevi (little red spots to those of you of a non-medical persuasion). They had all had to take half a day off work for the privilege. All had to be checked in by a gormless specimen just out of med school (yours truly), then get into a gown (no, really, they did) and go to an operating theatre for their "surgery".

The theatre had to have a nurse and an orderly to hand, and the Great Man Himself to do the "operation". Or in other words to squirt the offending body part with liquid nitrogen for anything up to thirty seconds. If you had a few spots treatment could last for whole minutes. Some patients needed fortnightly visits for a while to erradicate bigger blemishes.

For at least fifteen years we have had N2 here on tap. We have a special zappy flask for it to go in, with a great big trigger thingy. When you squeeze it Nitrogen zaps out with a fantastic hissy noise straight on to whatever you point the nozzle at. It's brilliant.

So now when our punters come in with a little annoying blemish we can zap them on the spot (geddit?) with no need for all that mucking about referring for "operations". An especially satisfying job for all concerned on a hot day. Plus you get to prance about the corridors with the flask zapping it in the general direction of the staff, PCT managers, the cat etc whilst shouting "Freeze!" in your best SAS impersonation. Even the older wiser partners have been known to walk about with it twitching the trigger to make a satisfying "puffer train" effect with clouds of vapour and a satisfying accoustic accompaniment from the nozzle.

As a generation of final year medical students will also attest, it's the most spectacular way to remove chewing gum from the surgery carpets.*

* Something they all get asked on their induction here. Please don't tell them though. It would spoil the fun!


Shinga said...

But do you create exciting Heston Blumethal like foamy things with it? I'm sorry, warts and indulging in fantasies about puffer trains seems so pedestrian - particularly when you throw in the Good Housekeeping hints. Just imagine all the small children whom you could introduce to science (and snapped-off digits) if you let them play with this stuff.

I try to liven up my workshops with science demos - I can occasionally get dry ice - but I've never managed to purchase liquid nitrogen. Of course, what I really need is a miniature version of that fantastic Grossology exhibition about the nose...

Regards - Shinga

wendz said...

Back in SA my GP loved his Thursday afternoon sessions with that stuff..he'd eagerly book a session and then waft about with the it you've got me wondering what else he did with it..hmm...

I suppose you have to get your kicks somehow..can't imagine anything more depressing than looking at snot-nosed whiny kids and their huffy puffy Mom's all day...and all that 'poo' stuff..ew...mind you, I trained as a Medical technologist and can tell some lovely 'poo' stories..and how disrespectful we were in the lab...oops..

Universal Soldier said...

So you can really give someone the cold shoulder if they annoy you?

Doctor Jest said...

shinga-- Sorry to disappoint, but the catering facilities at the surgery are severely challenged serving up pot noodle (which we would frown upon anyway). Also there's the slightly scary phenomenon of "white out" to contend with. I.E. when the flask you are transporting it in falls over in the car (as it inevitably would, given the near universal application of Murphy's Law to such situations) the inside of the car condenses rapidly, and "hilarity ensues" as one struggles to cope with total loss of visibility, the urgent need to open a window to escape the air one just "enriched" with pure N2, plus the instantaneous frostbite induced by trying to avert the catastrophe. Our local dermatologist friend was very vocal on the subject some while ago. He bears the Honourific "Lefty" with some pride, and fewer fingers ;-). So in brief(?) no scrambled egg ice cream from this boy. Sorry.

wendz-- I lack the necessary grace to "waft about" with anything. Let alone a "killer flask" of distilled viper venom. (Well ok N2, but a boy can dream...)

US-- better believe it. And some other bits for good measure. [Samuel L Jackson] Freeze sukka! [/Samuel L Jackson]

*impersonations yet! Sometimes I amaze even myself ;-)*

Shinga said...

Gulp on Lefty.

However, I've just come across this excellent video of what happens if you dump a bowl of liquid nitrogen into a swimming pool.

Regards - Shinga

Doctor Jest said...

shinga-- now that's serious mullarkey. See what I mean about the white out though. I estimate our smallest flask would hold about a quarter of the volume they had in their bowl. But let loose in the confines of the car.....