A man presents to triage at your emergency department at 1 a.m. He’s a tall, lanky middle-aged man wearing rattlesnake boots, jeans, and a belt buckle big enough to eat dinner on.

“Yes, sir,” says the pleasantly perky triage nurse. “How can we help you?”

“I need some things removed from my butt.” He shifts from foot to foot.

“Sure. Don’t be embarrassed – we see this all the time.”

“You mean people get nailed in the butt all the time? I guess this stuff never makes the paper.”

He removes his 12-gallon hat and wipes his moist brow in relief.

“Please have a seat.”

“I can’t.”

“Can’t what?” she says nearly exasperated already.

“Sit down. I told you I got shot in the butt. You’re not a very good listener.”

She scratches her head, scrunches her nose, and makes a quick radio call to the charge nurse.

“Okay … let’s get some vitals on you and get you back to a room. Do the police know about this?”

“I reckoned you’d call.”

“Do you know who did this?”

“Yeah, for 30 years. She’s parking the truck.”

“Okay … and that would be … ?”

“My wife.”

“Was that really a good idea to have the person who shot you drive you here?”

“How else would I get here? I knew better than to drive myself.”

“Call 911?”

“Them ambulances are for sissies. Fancy taxis.”

“Let’s put you right here in room 1. While you take off your pants, there’s just a few questions I have to ask everyone – routine stuff. Now, are you afraid of anyone in your home?”

“Not really. She gets ornery if I stay out late with the boys, but it always blows over by lunch.”

“But she shot you, right?”

“Accidentally,” he says deliberately, as if speaking to a child.

“Okay … have you fallen in the last 3 months?”

“Just now.”

“When?”

“When I was bein’ shot.”

“You were shot and you fell?”

“Really it was more like I dove. I came home late from work and forgot to turn off the stupid alarm. Hate that damn thing. …

“She come ’round the corner with the shotgun cocked. Just as I went to dive down the basement steps – I could tell what she was fixin’ to do – she tripped and the buckshot went a-flyin’. Ripped a hole big as your fist in the icebox. I just got the scatter.”

“Are you hurt?”

“Hell, yeah. I just told you I got shot. You really gotta work on the listenin’ skills.”

“Yes, sir. I mean no, sir. I know you got … I know you were shot. Did you hurt yourself when you dove down the steps?”

“Couple a scrapes,” he says dismissively.

“Do you have a … Oh, never mind that one.”

“What?”

“We’re supposed to ask if you have a firearm in the home,” she says, voice trailing off.

“That’s a stupid question. Round here, you’d be better to ask who doesn’t. I got the double-barrel Winchester – that’s the one she nailed me with. Then I got a .22 long for squirrels and other varmints, couple of .38s for the human varmints, my good deer rifle, and a semiauto pistol the Mrs. gave me last Father’s Day.”

“I’ll mark that as a yes. Last question. Do you wear a seat belt?”

“Hell, no. I was sprawled out in the bed of the F-150.”

“Okay … the doctor will be in soon to ask you some questions.”

If you just let the patient talk, usually they answer all the stupid questions.

Dr. Baehren lives in Ottawa Hills, Ohio. He practices emergency medicine and is an assistant professor at the University of Toledo (Ohio) Medical Center. Your feedback is welcome at David.Baehren@utoledo.edu.