The Penis Problem

The last thing that I want to do is make fun of this patient. He is such a nice man and it must have been out of his control what happened to him. But now, he is so fat that he can no longer walk. He is also incontinent and dribbles continually. Lying in bed all day, soaked in urine, has caused his skin to break down. We change his linens frequently, but still, he is always wet.

The logical solution would be to insert a catheter. The problem is that no one can find his penis. It's not like we haven't tried. Dozens of us have gone penis hunting during his long hospitalization.

Once, we got close. He dribbled some urine during a hunt, allowing us to narrow the scope of territory to within a few inches, but still, we couldn't find it. The patient is also starting to get testy when he feels us poking around down there. Our hunts are limited to only about a minute at a time before he tells us to knock it off.

I'm reasonable sure he has a penis. He has children. It's just that with all of the folds, it is hiding. In a situation that this, I usually just ask the patient to find it for me. It is a common problem, but this situation is different. His abdominal fold hangs down to his knees. He can't get his arms past it to reach his penis.

The poor man needs and desires bariatric surgery, but he is a poor candidate. The doctors believe that he would die on the operating table.

Usually, nurses fight over who has to take care of morbidly obese patients, but with him, it is different. It is back-breaking work to take care of him, but he is so nice, we don't mind. I just wish that we could catheterize him so that his skin could heal.

The Castrator

The patient had driven himself to the E.R. following a "shaving accident." His pants were soaked in blood and he was walking gingerly. He was quickly given a room and told to remove his pants. This was an unusual shaving accident. His scrotum sported a neatly sutured incision, along with a rubber band being used to form a tourniquet.

A urologist was paged and soon the patient was rushed into surgery. A couple of arteries had been cut through and needed to be tied off. The patient knew how to suture his skin back together, but tying off blood vessels was beyond his skill level. The blood loss had been massive. And, the testicles were gone.

The patient stuck to his story that it was a shaving accident. Were we unreasonable to assume that he was nuts? We all had our theories about what had happened. Perhaps it was revenge for a bad drug deal or maybe he was attacked by loan sharks. Could it have been kinky sex?

The psychiatrist couldn't get any information from him. The patient angrily insisted that it was a shaving accident. In all of the years that I've known this psychiatrist, this was the first time I ever heard him say that someone was crazy and dangerous. We needed to get him to a locked facility.

The patient was a strong, healthy man in his prime. Transferring him against his will was going to be a challenge and the doctor was afraid that someone might get hurt in the process. It was decided to sneak the patient a special cocktail to knock him out for the journey.

Four big security guards, the house supervisor, the doctor and assorted nurses watched as I prepared the syringe. His nurse went into his room and asked if he would like some pain medication. He said yes. I handed her the syringe and we all waited in a huddle just outside the door. He didn't question why this medication was being injected into muscle when all of the other medications had been given in his IV line. We got lucky. The worst was over, or so we thought.

About 45 minutes later the ambulance arrived. Security came back to help with the transfer. The patient was fast asleep, so this looked like a piece of cake. Unfortunately, the patient woke up. This cocktail would have killed me, but in him, it had no affect. He went wild. He was in a fight for his life. The six men were lying on top of him, trying to tie him up. They were all yelling, sweating and panting. The patient was screaming obscenities and demanding to speak to his lawyer. After a couple of minutes, the guards were yelling at us to call the doctor. They were losing the battle.

Another cocktail was ordered, which this time, I gave. There was no more need for deceit. He jerked his arm and the needle came out. It took several pokes before I was able to administer the full dose. The patient looked at me with fire in his eyes. I knew he wanted to kill me.

Tired of watching the battle, I went to the front nursing station and sat down. After a while, I saw the ambulance crew wheel him by. The patient was tightly tied to the gurney and was no longer struggling.

The psychiatrist was a little worried about the patient, given the massive amount drugs we had given the patient. He called the facility several times during the night to make sure the patient was still breathing. Some time the next day, he finally woke up.

At the psych facility. the patient finally cracked and explained what happened and why. He was a sex addict and out of control. His doctor had refused to give him any medications to blunt his sex drive, so he decided to take matters into his own hands. Self-castration was his solution.

He is now out of the psych facility. He did return to visit the security office. He looked at one of the guards and said, "I remember you" and then left. We're not sure if that was a threat. I'm really hoping that he doesn't remember me. Anyway, I hope that his surgical solution solved his problem. The doctor doesn't think it will because the addiction is in his brain, not testicles. Too bad we will never know how things turned out.