Author Mike Cyra & Emergency Laughter
"Butt Smoke"
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"Butt Smoke" is one of my surgical stories that was published in the humor anthology, "My Funny Major Medical." (Bauu Press 5/2013)
This page cannot be accessed via my web site's home page. I created it for the sole purpose of responding to a blog post, and sharing it with, the good folks at Skeptical Scalpel.
I was a Surgical Technologist working at a hospital in another galaxy when I scrubbed this case. It was decades ago.




If your life revolves around eating, cooking, growing, touching or looking at cauliflower, STOP HERE! DO NOT READ FURTHER.

If you choose to continue reading, do so at your own risk. I will not be held responsible.

Another Warning!

Wait at least two hours after eating to read this story. Be prepared to not eat, drink, smoke or have sex with anything for up to six hours AFTER reading this story. Longer if you have a vivid memory and are unable to block-out unpleasant mental pictures from your mind.

Really, really Serious Warning!

This story is absolutely, positively, NOT for children to read. That is, if you ever want them to eat certain vegetables, sleep without nightmares, not be a bedwetting freshman in college, or have a life-long phobia about what comes near, or in contact with their bottom.

Consider yourself warned!

There are certain surgical procedures that nobody likes to do. There are even procedures that people are afraid to be involved with. These are the surgeries where you could be exposed to diseases and unmentionably gross and disgusting things. 

Personally speaking, I think rectal warts rank at the top of the list of things I’d rather not be involved with. Especially the extreme cases I’ve seen.


Let me give you a visual. Go to your supermarket and buy a medium sized head of cauliflower. Bend over and stick it between your butt cheeks. Please don’t do this in the supermarket. I shouldn’t have to say that, but then again… Now, keep it there for three or four months until it turns soft and gray and grows some hair.

Hey, I warned you!

I was new to surgery when I saw my first case of rectal warts. I was in the operating room, in my sterile gown and gloves waiting for the patient to be brought in when a nurse walked up to me and said, “You’re going to need this.”

She began smearing menthol ointment on my mask. The smell was over-powering. I asked her, “How come?”

Her eyes squinted and crows-feet appeared so I knew she was smiling under her mask. In a musical tone she said, “You’ll see.”

She opened up a sterile package and tossed a clear plastic tube onto my instrument table. The tube was large enough to accommodate your thumb. I glanced at the package the nurse had thrown in the garbage. The label read, Smoke Evacuator. In the same musical tone the nurse had used, I heard myself say, “Uh oh.”

The doors to the operating room opened and an already anesthetized male patient was rolled into the room on a gurney. He was placed face down on the operating table with a sheet covering his back.

When the nurse pulled the sheet off, I involuntarily blurted, “God dam, what the fuck is that?”

The guy had a huge head of gray gooey cauliflower sticking out of his ass.

It was the grossest thing I’d ever seen in my life. I couldn’t take my eyes off it.

I continued my uncontrollable blurting with, “Oh…My…God,” periodically changing the emphasis on each word.

The surgeon backed into the room holding his wet hands up in front of him. I offered him a sterile towel and began saying, “Good morning Doctor.”

He cut me off with a stern, “We’re gonna make this quick.”

I gowned and gloved the surgeon and his entourage of residents and medical students. None of them looked exceptionally happy to be there.

The patient was covered with sterile drapes and the suction tubing and electro-cautery machine was connected.

The surgeon looked at the anesthesiologist and asked, “Ok to cut?”

When he nodded his head, the surgeon immediately held up his hand and ordered, “Bovie!” I put it in his hand and he began cutting into and around the huge wart thing.

Let me stop here and explain what a ‘Bovie’ is. It’s an electrosurgical device that applies high-frequency electric current to tissue. This enables the surgeon to cut, coagulate, desiccate and fulgurate tissue.  If you don’t have a medical dictionary handy, that’s OK, it just means you can cut tissue without a lot of blood loss. Minimizing blood loss in surgery, as you can imagine, is very important.

What the surgeon holds in his hand looks like a plastic pencil and has a flat piece of metal at its tip that resembles a miniature butter knife. This pencil is attached by a wire to a box that generates the electrical current. Also attached to this machine is a grounding pad that’s stuck to the patient.

You’ve heard horror stories of patients being burned and drapes catching on fire during operations? A poorly grounded electrosurgical unit is usually to blame. That, or the Anesthesiologist is sneaking a cigarette.

The term “bovie” is an informal name referring to its inventor, Dr. William T. Bovie. A Harvard man, circa 1926.

So there you have it. It’s an amazing, indispensable piece of technology in modern-day surgery. Blah, blah, blah. That’s the upside. The downside is that anytime you put electrical current to tissue with the intent of frying said tissue. It creates smoke.

 Human tissue tends to put off quite a bit of smoke when you burn it. Rectal warts, on the other hand, put off incredible amounts of smoke.

As far as burning flesh goes, I consider rectal wart smoke to be one of the most toxic. Who knows what’s floating around in that viral plume of smoke? All I know is that I don’t want to breathe it!

Enter, The Smoke Evacuator. “Ooooo.”  Under normal surgical conditions; let’s say when you’re cutting into someone’s belly or just frying a bleeding vein, the normal suction apparatus will take care of things just fine.

But when you’re talking Toxic Butt Smoke, you need to bring in the heavy artillery. You need an industrial grade; monster sucking, micron-filtering tube and you need as many as you can get your hands on. In the Navy this would be, “All hands on deck. Man your battle stations. This is not a drill.”

On this particular cauliflower burning extraction bonfire, everyone with a free hand had a smoke evacuator suction tube and was frantically sucking up every molecular toxic trail of smoke the surgeon was creating.

Every stray wisp of smoke was accompanied by a chorus of, “Get it, get it, get it!” by the surgical team. I won’t describe the actual removal of said grossness because it is just too disgusting. Mere words could never do justice to the ghastly image seared into my visual cortex. It’s an olfactory image no amount of mentholated jelly smeared on my mask or post-op alcoholic binge can erase.

The way I deal with things like this is simple. I block it out. I psychologically screw myself up so bad and bury it so deep, a twelve hundred dollar an hour psychiatrist couldn’t find it with a blowtorch.

What I choose to remember is how funny everyone looked dancing around, sucking and dodging mushroom clouds of smoke.

I have enormous respect for surgeons. They’re a dedicated lot. I watched as his head disappeared in a rising blue-gray smoky haze.

I sucked until I could see his face and asked,  “How do people get these?”

He almost laughed at me, “You gotta be kidding, right?”

I thought about it for a second, “Um, no, I’m not. They didn’t spend a lot of time in school telling us about a huge head of cauliflower hanging off a guy’s ass.”

The Surgeon kept cutting away at the monstrosity,  “You get these by sticking the wrong things up your ass!”

That made me ponder the question. Are there any “right things” to stick up your ass?  I couldn’t think of any off hand.

A masked head popped in the door of our operating room, then instantly disappeared. I heard the pitter-patter of running feet and someone yelling, “Butt smoke. Run, run for your life!”

This was my introduction to large rectal warts and how to remove them. I didn’t eat cauliflower for years after this.

2012 by Mike Cyra.
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