I Just Did My First Hemoccult Test — and Now I Want to Apologize to Every Patient I've Ever Sent Home With Anything

As I get older, I'm starting to recognize the absurdity of some of the things we routinely ask patients to do.

I went to my primary care doctor yesterday and got handed a hemoccult test to take home — and let me tell you, I knew what it was, I've given it to patients many times, but I had genuinely never read the directions or done one myself. Doing it changed my perspective on patient experience in a way I want to share.

For those of you who haven't had the pleasure: a hemoccult test (also called a fecal occult blood test, or FOBT) is a take-home screening test that looks for blood in your stool — a screening tool for things like colorectal cancer.

The basic idea:

• You take home a card
• You put a small sample of your stool on it
• You send it in
• The lab puts a few drops of developer solution on the card
• If there's blood in the stool, the card changes color

Simple, right? In concept, yes. In practice…

Here's what they don't tell you when you blithely hand one to a patient as a clinician.

You get sent home with:

• Three test cards (because you have to do this for three consecutive days)
• A stack of giant tissue-paper sheets that you have to drape under the toilet seat to catch your sample before it hits the water
• A handful of small wooden sticks for sample collection — one for each day
• Detailed instructions on how to paint your stool onto the card with the stick

So the actual process is, and I'm going to describe this because I am still emotionally working through it:

1. Position the tissue-paper hammock under the toilet seat
2. Catch your stool in said hammock before it gets to the bowl
3. Use the little stick to apply a sample to the test card
4. Repeat for three consecutive days
5. Mail it in

I'm not exaggerating. I know what the test was. I just didn't fully comprehend the logistics of doing it at home.

Here's why this matters to me beyond the comedy.

For years, I've been the surgeon on the other side of this dynamic — confidently sending patients home with:

• Surgical drains they have to strip, empty, and log
• Compression garments that have to stay on for weeks
• Wound care instructions that involve looking at, cleaning, and dressing wounds they didn't want to look at in the first place
• Self-checks for early signs of complications

…and I've been telling them, with a perfectly straight face, that this is all completely normal.

It's not. None of it is normal. All of it is genuinely weird and uncomfortable when you're actually the one doing it.

The hemoccult test gave me a tiny taste of being on the patient side of "this is just a routine test, you can do it at home, nothing to it" — and the disconnect between the clinical confidence with which we deliver those instructions and the actual lived experience of executing them is a real thing.

A few things from my actual practice:

When I send patients home with drains after a tummy tuck or mastectomy, I now think about it differently. I'm asking someone — usually within 24 hours of major surgery, often groggy, often with someone else helping them — to:

• Squeeze a bulb to maintain suction
• Empty fluid into a measuring cup
• Log the volume in a journal
• Sometimes strip the tubing
• Not panic at the color of what comes out

I do this every day and I forget it's genuinely odd to ask a non-medical person to do.

The SOMAVAC device that I've started using in select patients is partly motivated by exactly this — taking some of this burden off the patient. The less manual work my post-op patients have to do, the better.

When I describe how to clean a fresh surgical incision, change dressings, or apply silicone sheets — I'm matter-of-fact about it. But to a patient who has never done this before, it can feel terrifying. They're looking at their own surgical wound. They're afraid of touching it wrong. They're afraid the instructions are wrong. They're afraid they'll undo all the surgical work.

A little acknowledgment that this is genuinely weird and uncomfortable goes a long way. So does writing clearer instructions, providing photo references, and having a clear point of contact for questions.

The garments we ask patients to wear — fajas, compression bras, supportive vests — are a meaningful part of recovery for many procedures. But putting them on for the first time after surgery, when you can barely sit up, is a genuinely difficult experience. We could do better at preparing patients for that specific moment.

We ask patients to watch for:

• Signs of infection
• Asymmetric swelling
• New, severe pain
• Fevers
• Color changes

…all things that a non-clinician genuinely struggles to interpret with confidence. "Call me if anything seems off" is a much harder instruction than I sometimes realize when I'm saying it.

Going forward, I'm trying to:

1. Acknowledge that what we're asking patients to do is weird before pretending it isn't
2. Write better instructions — with pictures, with timing, with what-if scenarios
3. Give patients a real human to contact when they're unsure rather than just "call the office"
4. Choose technologies and approaches that minimize at-home burden when reasonable (like the SOMAVAC mentioned above)
5. Show empathy first when patients are visibly overwhelmed by post-op care

The hemoccult test was a small thing in my life. But going through the experience of being a patient handed a confusing, gross, multi-day at-home medical task — by a clinician who clearly didn't think it was a big deal — reminded me how often I'm on the other side of that exact dynamic.

So to every patient I've sent home with drains, garments, seroma instructions, wound care plans, or any other unnatural-feeling task with a confident smile — I'm sorry. What I asked you to do is not normal. It's necessary, but it's genuinely weird and gross and overwhelming, and I want to do a better job of acknowledging that.

The hemoccult test is necessary, too. It saves lives. Colorectal cancer screening matters. But the way we hand it off without context or warmth is genuinely something we could improve across the board.

Getting older and doing these things myself is opening up my world. And I think it's making me a better doctor.

To everyone reading this who has ever been confused, overwhelmed, or grossed out by something a medical professional confidently told you was "totally normal" — you are not the weird one in that exchange. It is, in fact, weird. And you deserved a little more empathy than you got.