Monday, April 12, 2010

Today's Last Patient of the Night

Why is it that patients with generalized crotchital complaints come to the ER right before closing time? Discuss. I will get a snack.

I recounted this patient with the acquired pants circus. Tonight, I will tell you about another kind of circus.

Diana, Cathy, Beth, Dr. Cindy Lou, and I were finishing up a deadly slow night and hoped to deadbolt castle gates and release the crocodiles into the moat, when, of course, the final patient of the night ambles in. With broken crotchery.

I watched on the video camera as two people strolled in at 10:45 PM (remember, we close at 11 PM). Helen, our secretary/receptionist/social director/den mother/worry wart had already directed them into triage. Helen is a bit older than middle aged, remembers everybody's birthday, anniversary, kids, spouses and pets names, asks after everyone's events, vacations, days off and remembers what those plans were. She feeds and fusses over us if we nurses are too busy to eat, tosses rooms for us, shuttles labs, and we would be hard pressed to function without her. She would give you the shirt off her back and buy you a Coke with her last dollar if you asked for it. We love her and protect her as much as possible, and I don't allow her to be exposed to rude people and idiots in general.

So I was right on top of this one, and whispered "What is it?" as I passed her in the hallway.

Helen laughed nervously and whispered,"I don't know, they said it was 'personal'".

Ok. I opened the conversation by asking my standard "What can we do for you today?". There was a teenage boy sitting in the hot seat who appeared calm, cool and collected as he slouched. Mom, on the other hand, was pretty ramped up. Perhaps too much coffee.

"Well, he has been walking around like he has a load in his pants all night, and I called his pediatrician and they said to come right down and get it checked out because I really didn't think it should wait until tomorrow they said something about epi-, epi, uh something but it didn't sound good so we came right away".

Take a breath, lady. "Um what exactly is the problem?"

"He has pain in his....well, down in.....I don't know how else to call it: he has pain in his ball sack". Except she drew it out like "baaaawwwwwl sack"

I am mentally pinching my lips and reciting, don't say scrotum, don't say scrotum.

"So when did the pain start, and is it on one side or both?"

The kid shrugged and said "about 5 o'clock I think".

Mom disagreed, "no, I think it was more around 6 or 6:30, remember, we had the pizza and you didn't have it then and after we talked about baseball and you were on the phone for awhile about that assignment.."

I managed to get a word in to ask about injury and urinary problems, no longer addressing my questions to mom. Mom, however, was determined to have the last word.

"He swears to God he isn't having sex, that would be another whole set of problems wouldn't it, but hell you can't watch them every minute and he doesn't have a girlfriend, as least he says he doesn't, and he is not whacking off...."

"Um, I think we can go ahead over to Helen to get him registered and then Dr Cindy Lou can see him as soon as...."

Mom still hasn't taken a breath or my hint to shut it down and continues, " what do you think it might be, will you do tests or xrays or what? I was thinking it could be nothing but didn't want to take a chance; I called my brother and he said it was probably blue balls, I don't know what that is but it sounds really painful and bad, do you think it could be something like that?"

I coughed into my hand a few times to hide my laughter and directed them to the registration desk. "I'll take the young man into a room, right around the corner when you're done", I sang, and whisked him into a treatment room. I directed him to undress and closed the door.

My audience awaited. Cindy Lou asked, "Ok, what is it?" Within a minute she was already on the phone with the Mother Ship to arrange for an ultrasound of his Baaaaaawl sack since we only have ultrasound during the day. They were out the door in 10 minutes.

I restrained myself giving mom a copy of "Adult Words for Body Parts". Wonder if she still calls it a winkie.