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.
