North West Passage

One of the enjoyable things about studying in a different country is learning the local twists and turns of culture, specifically medical culture and language.

To me, the Irish have a musical lilt to their speech which I adore. I find my own voice and accent sound harsh to me now, to the point where sometimes I catch myself wincing when I speak. The North American prosody seems halting, staccato, and brusk where the Irish manner of speaking is sing-song, soft, and rolling (with some exceptions, naturally).

To add to the charm, they have an immense vocabulary of slang (the particularly entertaining ones are usually some sort of insult--like wagon, spanner, minger, puck, tosser, dosser, knob, wanker, scobe). Hmpf. Might have to make up my own version of Santa's eight reindeer next year.

Anyway, one expression that slays me every time is the euphemism "the back passage" for rectum.  This is actually used even in our clinical labs, profs saying things like, "d'you know now, if someone has a low BP and has a history of ulcers, he may be bleeding out the back passage". To which I have to hide my snicker and "did anyone else find that hilarious" expression. Call me childish. Call me Beavis. But it is beyond my control.

So a few days ago we get a call for a woman who has elevated blood sugar and decreased consciousness. The two paramedics I am with go into the bedroom (which I have found is always up a narrow flight of stairs and/or the smallest room in the house). I physically couldn't have fit in there even if I had wanted so I stand outside and talk to her sister. The sister is a right proper older Irish lady who is shaped like a refrigerator box on sturdy legs with her hair in a bun, and a thick cable knit cardigan slung over her shoulders.

I was asking about medical history and specifically diabetes history to which she informs me the patient has none. She very sincerely started telling me about the patients meds, and about a 'bad turn' she had last year when they gave her some medication up the back passage which sorted her out immediately.

In my state of sleep deprivation and dangerously high levels of caffeine I was borderline giddy as it was, but she had just struck my professional Achilles. I bit down on my lip and looked at my gloved hands.

"Mmmmhmmm", I say, thinking, arrange face in serious, concerned manner.

"Yes, I am not sure what it was but they gave it up the back passage and it really seemed to work!"

"Okaaayyyy. Well I am not sure what that might have been but they'll have that info at the hospital I am sure." Please don't let her say that phrase again or I'll lose it. 


"Yes, now that I think about it, she'd never been given anything up the back passage before..."

I felt my face uncontrollably twist into a semi-grin and I tried to mask it by faking a twitch and then a cough. I mumbled something about needing to fetch some gloves out of the ambulance and bolted, pretty sure that I was the most horrible, unprofessional, medical student/nurse that had ever responded to an EMS call.


I just can't help myself. Especially after working in the Arctic. All I can see in my minds eye is Cabot or Amundsen with a fortified ship and compass trying to negotiate their way up the back passage. A journey no man had undertaken before, one they may never return from...heh.

Beavis. I know.