BM

Our daily assessments for sick patients in jail involve asking and charting when the patient has last toileted and any pertinent description.

I cringe at this question. 

It’s not that I’m bothered by poop, I’ve changed countless diapers, mostly adult, many with infected diarrhea.  It’s not a job I enjoy but asking about it gives me this itchy shivery feeling. 

Picture making eye contact with a stranger and asking when their last bowel movement was like you'd like to have a full-on conversation about it and I think you’ll get it. 

I try considering different ways to ask that don’t make my face scrunch up like I can smell it. 

“When did you last toilet, sir?”  I do find this one funny, especially given the setting. But I gave it a shot, and they didn’t get it. I had to ask twice, so it didn’t turn out to be any better. 

“Have you pooped today?” Fucking, uh, gross.

I ask one guy when he went number two and he answered me but I felt like I was talking to an 8-year-old and it was just as cringy as BM.

I do think it makes sense to standardize what language is used clinically for different things in textbooks for the purpose of clarity. But once you find your specialty...doesn't it make sense to adjust accordingly? Wouldn't that allow both the clinician and the patient to feel like people while discussing some of the most personal details of our physical humanity?

If they tell me about something else going on, like light-headedness, abdominal pain, chills, or any of many other things, then I have to ask follow-up questions.

I picture this line of questioning like a skit:

Nurse, in a professional voice, as she listens to abdominal quadrants: When was your last bowel movement?

Patient: Yesterday.

Nurse: What color was it?

Patient: Brown.

Nurse, in a voice that is starting to sound interested/flirty: Dark brown, light brown, reddish brown? Tell me more.

Patient, uncomfortable: I don’t know, brown, maybe yellowish brown.

Nurse stands and the patient stares at the ground not wanting to continue the conversation.

Nurse: You don't have to be uncomfortable, it's just nature. Any tarry or coffee ground texture, tell me more about the texture?

Patient, quiet, fully avoiding eye-contact: Solid logs.

Nurse: What did it smell like?

Patient, annoyed and uncomfortable, staring at the ground: Like shit.

Nurse, excited: Uh, huh, and what did it taste like?

We don't actually ask about the smell or the taste, but it feels exactly that amount of creepy. I either feel like a robot or a perv to the degree that it's almost intolerable.

A while in I’d had enough.  I was doing my assessments and just didn’t have it in me anymore. I care about the assessment, but the fucking language I can’t handle. 

I asked myself if I was being impulsive or if I had sincerely hit that wall.  I went inward and checked in with myself.  I was confident.  I had definitely hit a wall and was willing to accept any repercussions.

I go to my next cell which houses a man who has killed two people and say, “Hey, when’s the last time you took a shit, man?”

He goes, “About half an hour ago.”

I say, “Anything weird about it?”

He says, “No, no problems.”

And that is how I asked from then on.

I felt liberated, free really. A giant weight lifted off my shoulders. No longer am I a clinician asking about the movement of bowels. I am just doing my job and checking in with this human being.

I notice the deputy looking at me as if to say with his eyes, “Is this…is this really the level of medical care we’ve stooped to?”

I give him a shit-eating grin that confirms, “Yes! Yes, it is.” 

And he returns it. 

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Review

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This piece is witty, unapologetic, and brilliantly human. It captures the absurdity of clinical professionalism clashing with raw human reality in a setting that demands practicality over polished formality. The humor feels natural and serves a deeper purpose: exposing how ridiculous some aspects of "professional language" can feel in environments where honesty and simplicity are more effective.

The dry humor and sarcasm make this piece entertaining and easy to connect with, especially for anyone who’s worked in healthcare or dealt with awkward professional norms. Despite the humor, there’s a subtle reminder of the heavy realities of the job—this man has killed two people, yet this interaction feels purely human. It’s a reminder that even where clinically detached language can inadvertently dehumanize both patient and practitioner, including in jail, dignity and mutual respect can still exist.

This story is hilarious, bold, and relatable—a brilliant reflection on how breaking from forced professionalism can lead to genuine human connection. The humor serves not just to entertain but to highlight the deeper truth that, in some moments, authenticity is the best medicine.