Monday, March 4, 2013

The Broken Bone


Although I rarely get sick with the numerous strains of “bugs” that seem to go around our community this time of year, the week prior to my return to work for my next scheduled string of four shifts was spent mainly in bed, coughing and aching and whining about how miserable I felt. Fully recovered, though, I was excited to return to the emergency department to do my fair share of stamping out disease and healing thy patient from illness and injury.

Walking into Room 21 to see my first patient of the day, however, made me cringe just a bit and suddenly, I wished I could have been back in my bed at home for just one more day.

The patient was young, in his mid-twenties, and appeared to be in significant pain. He was alone. His short-cropped hair was calmly neat, belying his grimaced, pinched face and restless arms and legs that rocked his compact body against the cot’s rails in defiance to his discomfort. His nurse, Sam, one of my favorites, was hurriedly placing an IV into the patient’s right arm.

I gently grabbed the patient’s shoulder to gain his attention, introduced myself, and asked him what brought him to our ER today.

“Doc,” he said, taking a quick gasping breath before continuing, “I was banging the shit out of my girlfriend when my penis snapped in half.” I looked from the patient’s face to Sam’s, who nodded his agreement to this patient’s history.

Ugh, I thought to myself, a fractured penis. A fractured penis!!! It had been, thankfully, several years since the last time I had seen a case like this. For some reason, despite my tolerance and calmness during any other conceived emergency illness or injury, penile or scrotal injuries always made me cringe. And I was cringing. Usually, this type of injury occurs with masturbation, unusual sexual positions, or aggressive sexual intensity, to be politically correct.

“Sir,” I said, “when and how did this happen?”

As it turned out, it had happened immediately before his arrival—about 20-30 minutes before we began treating him. And how? Despite his pain, he spoke with great pride and in great detail about his sexual prowess and escapades that lead him to our department. He painted a picture that, short of sustaining a penile fracture, all of us men have failed our partners in the sexual arena. Call it rough sex if you must. And call me a failure, then, if this was the price of success.

After his explanations, I had no doubt that I would be able to provide the detailed social history necessary on this patient’s medical chart. I imagined the pleasant dictation lady turning beet red from embarrassment as she typed his chart up. “Hey, Sally,” I pictured her saying to her co-worker, “come over here and get a load out of this patient’s story! I wonder how his girlfriend is doing?”

After examining this patient thoroughly, and confirming that he indeed fractured his penis, I ordered him up a healthy dose of pain medicine before calling the on-call urologist urgently. This patient would need emergency surgery to repair his penile injury, which really wasn’t a “broken bone,” per se (since the penis doesn’t contain any bones), but rather an insult (or tear) to the vascular columns that engorge with blood during an erection.

Finishing with a few more patients and while waiting for the urologist to arrive to see this unfortunate patient, I went back into his room to check on him and make sure he was more comfortable. He was definitely more comfortable and no longer alone. A much taller, big-boned woman with a similar shortly-cropped hairstyle sat in a chair beside the room’s sink.

I walked up to her, my hand extended, and introduced myself to her. Understandably, she could barely look me in the eye as we shook hands and she shared with me her name. During our introductions, however, her boyfriend blurted out in his pain-controlled state, “This is my girlfriend who I was banging the shit out of when all of this happened.” Talk about making an embarrassing moment more embarrassing for her. “Don’t worry about it,” I consoled her, “we will be taking good care of him.”

The patient didn’t stop there. “Hey Doc,” he said, his eyes slightly glazed over from the medications, “do you think they will be able to save my penis?” Before I could answer his question though, he continued. “Dude,” he said, now apparently more comfortable with me, “you don’t understand—without my penis, I am nothing.” He paused, took a deep breath, and got a sad look to his face. “I am nothing! Nothing…,” he repeated, remorse and fear now dripping off his words.
I reassured him that the timeline of his injury was in his favor—that presenting to us so quickly after this unfortunate event helped with his percentages of a full recovery. I told him that as soon as the urologist saw him, he would most likely go straight to the operating room.

“But, Doc,” he said, “what if they can’t save my penis. Can I get a new one?”

I assured him that most likely, they would be able to save his prized possession. Deciding to have a little fun with him, though, I continued. “But if on the small chance they can’t save your penis, penile construction/reconstruction surgery is very advanced these days. We have a catalog of new ones you can choose from.” I could only imagine him skipping the petite section and going straight to the plus section.

He looked up at me in surprise to my words. “Really?” he asked, before seeing the hint of a smile on my face. Getting the joke, he continued. “Dude, thanks. I needed that.”

Soon after, the urologist came in, examined the patient, and booked the OR suite to take the patient for immediate repair of his injury. He would need an indwelling foley catheter for 2-4 weeks while he healed from his repair, effectively taking him out of commission for a month or so. I truly wished this patient the best outcome.

Before the patient left our ER, as if things couldn’t be any more embarrassing for this patient or his girlfriend, this patient’s mother and sister came in to be at his bedside. How could you possibly explain such an injury to your mother, the one who is wearing the serious look of dread and concern for her son? Or your sister, the one who cannot contain her incessant giggling? And do you show them the injury or just trust that they would understand the explanation? Some things I just didn’t want to know. Although I am not of the moral fiber to condone lying, I sure as hell would have fabricated some type of story to divert my mother’s and sisters’ attentions if I were in the same situation as he. “Umm, Mom and sissies,” I would say to them, “I got a hernia while chasing a purse-snatcher down the street after he knocked over a 90 year-old lady.” And no, I wouldn’t show them the supposed hernia, either.

This patient, however, didn’t care. He did show his mother and sister his injury. Eeewwww, I know. That makes me cringe almost as much as the injury itself. Just as impressive, though, was that his girlfriend had an anxiety attack. Why? This was the first time she had met her boyfriend’s mother. And sister. Talk about memorable introductions to the family. Can you imagine, once again, that conversation? "Hello, Mrs. Smith, nice to meet you. I'm Ellie--the girl who broke your son's penis in half." I, for one, didn’t hold out much hope that this relationship was going to survive this ordeal. But I didn’t think the patient would show his penis to his mother, either, so I could be wrong.

Is there a moral to this story? I guess, maybe. The moral might just be that we should never ever "bang the shit out of" the ones we love. Sweet lovin’ might just be the best lovin’, right?

Oh, and one more moral to this story? Never ever show your mother your penis, no matter what state you may be in, when you are a grown man. That’s just creepy.

Thanks, as always, for reading. If this post and typical ER humor offends, my apologies. But who can blame all of us in the medical field for having warped senses of humor at certain times in our days. I hope this finds you all well…Jim.  

28 comments:

Phoenix Fire Falconry said...

Thank You for the morning laugh! I will share this with some of my hospital co-workers!

Nanci, RN said...

My chuckle of the day!!
Good to see you back to writing.
N.Love, RN

Empress Bee (of the high sea) said...

oh my! i never knew you could break a penis. now i have learned TWO things here, that and the old "ass back"! ha ha ha

smiles, bee
xoxo

rlbates said...

Love your stories

Katie Axelson said...

When I first started reading, I wondered if maybe I should skip this one... But didn't and then I erupted in laughter at the end. I haven't laughed that hard all day. Thanks!
<>< Katie

Anonymous said...

Humans don't have an os penis aka penis bone.

Most other mammals, including most of the great apes, do.

The things I learned in veterinary school...

Leslie said...

I am so thrilled to see you are blogging again. I missed your posts!

Love this one...I laughed so hard. I had no idea this kind of injury was even possible. I emailed the link to a few of my friends, but alas, I didn't dare share it on my FB page...I'm not sure all my friends are ready for ER humor. ;)

Welcome back!!!

Ceola McKay said...

Hilarious! I have heard of this ailment, but I loved, most especially, your comments on how to prevent it. Sweet loving is indeed the best!

Cassie said...

This is my first time reading your blog, and omg what an awesome story to come in on! I'm laughing so hard. Can't wait to read some more!

G-31 Toastmasters said...

Third potential moral: talk to mom & sis BEFORE the pain meds loosen your tongue.

Anonymous said...

It is really amazing. Isn't anyone waiting till marriage to have sex? I did. Well hopefully they will put him back together again. I knew a patient who had a urethral fracture and ended up impotent and bent!

Karen said...

oh my This is why you are the loved! You tell us bawdy ER stories which we thoroughly enjoy and then you apologize for traumatizing our sensitive souls!!! lol love it

Katie Swanson said...

this is amazing. thank you!

Loretta said...

Oh Mann. I am laughing so hard!!

Lorna said...

You know.... somehow I cannot imagine that you were embarrassed. I see you as being curious and amused, though tending correctly to the patient.

You have seen it all, and it all happened before this. :-)

~Lorna
_______________________________________


Smalltown RN said...

Oh doc this one had me in stitches...I can just hear him saying "hey dude" and really based on his mentality I can imagine him showing his prize possession to his mom.....

So glad you are back posting more regularly...

Unknown said...

I'm curious if this guy will be letting his friends sign his cast.

Anonymous said...

That really was a bone chilling horror story. I will never .... again.
I will never .... again
I will never .... again.
I will never .... again

Anonymous said...

Please, post again soon... I'm still an intern, and your stories are a big inspiration to me... How to always have a smile and an advice ready for your patient even when there are not enough hours in a day to do all the work that's left!

MarĂ­a said...

Yes... Good to see you back to writing...

Surgeon In My Dreams said...

You're not gone are ya???? Really enjoyed your BLOG.

Dermatillomania said...

wow i love these stories!

DrP. said...

Thanks for the chance to laugh out loud tonight. Maybe this guy will need a brain transplant if he sometime ____s his brains out too.

Anonymous said...

Glad I came across this today! I needed the laugh!

Michael Esch said...

Mondays are stressful at my work. This was a fantastic break.

itsalunglife said...

I've been reading your blog from the beginning for the past few days. During those days I've found myself needing several nebulisers to relieve the tight chest I had brought on myself by laughing so hard I cried. Those laughs were needed in a period when I found myself depressed and alone. Thank you for bringing a smile back to my face and reminding me that there is people out there who care. x

peace said...

eww.. but thank you for sharing!

Peter Thomos said...

Great Blog!! That was amazing. Your thought processing is wonderful. The way you tell the thing is awesome. You are really a master.
penile trauma