I had one of those patients last night with the tragic medical condition where his penis really hurts and needs urgent examination but only when a female caregiver enters the room. This is a known thing with this guy. He has a cognitive impairment that impairs his inhibitions, a sheepish kind of “fair enough” response to being told “we’re not doing that,” and a persistence in trying that is genuinely impressive. He told me he was worried about his penis within two minutes of meeting him and asked me to assess it. I did on account of him getting it out so quickly. It looked super normal, but in the name of due diligence, I told him I could get a male nurse to come examine it with me. He told me his penis felt better.
Anyway at the end of my shift, after a night of monitoring his GI bleed until he can get to surgery in the morning, his blood pressure is now waaaaaay down and his morning labs show his hematocrit and hemoglobin are only juuuust above the level where the results come in with two bold red exclamation points behind them. It’s a classic 6:30 am rapid response, complete with an order for a blood transfusion to start in the no man’s land of shift change. His numbers aren’t great, but he’s stable. I adjust the pulse ox on his finger to get a better read on his oxygen levels, and I go, “ooh man your hands are so cold. Do you feel cold?”
And he goes, “I don’t. Wait. I do. I feel cold in one spot.”
I ask, “where do you feel cold?” Some questions you know the answer to before you even ask. Anyway, would you believe it was his penis? But the thing is, there IS a potential medical crisis happening right now. We’re triaging it in the hopes it doesn’t become a crisis. I had this vision of a patient with a medical problem he isn’t able to articulate being continually blown off by staff who then dies of Penis Explosion. “My god, the signs were all there,” we would say to each other. “If only specifically female staff randomly answering his call light had examined his penis!”
So I snap my gloves on and am like, “alright. show me your penis.”
He’s happy to oblige. I give it a quick but thorough assessment. I’m checking shaft. I’m checking balls. I’m retracting foreskin. It’s all normal as hell. I tell him that. He goes, “but can you look?”
“Yeah but can you look with your hands?”
“That’s okay,” he said sadly. “You looked.”
I told this all to Cyrus this morning as we deadheaded our rose bushes. They said sagely, “The boy who cried penis.” It’s a toss up between that and “look at it with your hands” for the phrase of the night. Go ahead and title this post whichever you find more evocative.