… was my initial, no-pun-intended explanation about why I needed to disimpact my patient; luckily his sense of humor (and the 10 of valium I gave him) helped. After the fact (and washing my hands), also inappropriate would have been:

• It stinks that you’re constipated.
• Can I log this procedure?
• It’s hard to get it all.
• What a crappy job.
• So this is Brownian motion.

See also: Whit Fisher’s Rectal Regrets Procedurette on how to gown up appropriately.

(Side note: An attending once told me the most awkward thing he’d heard during a disimpaction was his patient, saying, “What, you aren’t going to take me out to dinner and a movie first?”)