Pull my finger!

On call last night, Dick was called to the Emergency to see a young man who had been in a traffic accident and sustained injuries to his back and pelvis.

Dick arrived just when they were rolling the patient to his side to examine the spine. Being the urologist, Dick was given the honour of performing the rectal examination to see if the urethra had been torn and if there had been any nerve injury to the anal sphincter.

So with his right index finger in the patient’s rectum, Dick proceeded to test if the patient can still control his sphincter.

‘Squeeze my finger,’ he ordered the patient.

‘Huh?’

The dazed patient did not seem to comprehend his command.

‘Eh, look here - squeeze my finger,’ repeated Dick, louder this time because like all doctors he knew the solution when you do not get the respond you want is to repeat the question in a louder voice.

‘Huh? What?’

The patient, neck immobilised by a cervical collar, strained his eyes to look at Dick, hoping that eye contact will provide some clue as to what Dick wanted from him.

By now Dick was getting a little impatient. Tapping the fellow on his shoulder with his free (left) hand and waving his index finger, he repeated himself, this time even more loudly.

‘Squeeze on my finger.’

'Er... OK...'

Still puzzled, but eager to oblige, the patient reached out with his right hand and squeezed Dick’s left index finger with his hand.

The emergency staff fought to stop themselves from laughing out loud.

Dick looked up, unfazed, and declared:

‘GCS 15*.’

The emergency staff burst out in laughter.

* - Glasgow Coma Scale, a measure of consciousness. 15 is the highest score.