So it was determined by our team that there was in fact need for a lumbar puncture to be done for this particular patient. If we hadn’t firmly ruled out meningitis in this unfortunate man with fevers and confusion, we would have to empirically treat him with IV antibiotics for 7 full days. This would take up his time as well as a much-needed bed in the ward during our busy monsoon season.
Curled on his side in the fetal position, he resisted, at the first, prick of the needle in his low back by my intern. He was not in a state to understand why we were doing this, and had no interest in cooperating. A friend helped hold down his arm, but his constant flexing threatened to bend the needle between his vertebrae.
I decided it was time to step in a get a little creative. I decided to go with a common World Wrestling Federation maneuver, the sleeper hold. I tucked one elbow behind the man’s head, and the other under his knees. By pulling his head toward his own knees I effectively opened his spine in a manner ideal for a lumbar puncture. The fact that it also had the effect of eliciting some discomfort, was I’m guessing why it was regularly used by
Muscle Macho Man Randy Savage.
The procedure took longer than I had hoped as the patient and I were tangled in this awkward position. Our patient did not like the probing needle or my sleeper hold, and was protesting loudly. In his discomfort he realized that he could free his right hand and arm which he was laying on. If you can picture the scenario, me standing at the side of his bed pushing his head down and his knees up, there was only one likely target for him to go for with his free hand……. directly between my legs.
At this point in our procedure, the needle was in place, and my intern was carefully collecting cerebro-spinal fluid in two separate containers, six drops in each. Not great timing for me to drop the guy and get out of there. The fluid flowed painfully slowly. My co-worker was completely unaware of my plight on the other side of the bed, and certainly didn’t understand why I had just turned so red or why I was perspiring so much. I mean, isn’t that the way the WWF wrestlers always look when they are working?
It was a relief that the man’s csf study came back negative, and he should be improved enough to go home in the next two days. My wrestling maneuver saved him unnecessary treatment and a bed in the medical ward and yet it may have taken my level of doctor dignity down a notch. You’ll forgive me if there are no accompanying photos.