Scrotal Support: A True Journey In Existentialism
“Looks like we can discharge him,” I exclaimed with a joy understandable only to those unfortunate few who had the pleasure of regularly smelling this patient over the last five days.
“Great, I’ll get started on the discharge summary and you finish up the paperwork!” My resident shared this enthusiasm, but did not have the same zeal for paperwork.
“OK, just one thing: the attending mentioned that we better get the patient some sort of harness, a truss? Some kind of support thing, you know, for the herniated bowel and bladder that’s in his scrotum before he has his surgery? Do you know where I can get one of those?”
“Just write an order for physical therapy to bring one up. That should be it.”
I jumped out of my chair and hunted down my patient’s chart, scribbling furiously in the orders section for physical therapy to come by and give the patient his scrotal support, the last vestige of responsibility I would have before I could get him and his massive scrotum out of here. I wrote the order, had my resident sign it, and proudly handed it to the clerk who enters in the orders.
“Umm…doctor?” Marveling at my newfound efficiency, I chose not to correct him. “You should ask the nurse about this. I don’t know if physical therapy can get what you want.”
I walked over to my patient’s nurse, a middle-aged heavy-set woman with an enthusiasm for her job rivaled by the most grisly of hazardous waste disposal guys, and asked.
“Honey, do I look like physical therapy to you?”
I walked back to the phone and called physical therapy. A man picked up the phone.
“Sure, we can get that, just have him come by our office with a referral.” I wrote up a referral, had my resident sign it, and put it in the chart. The clerk looked at it and said, “Umm…doctor? You should ask the nurse about this. I don’t know if that’s how it will get done.”
I walked over to my patient’s nurse and asked.
“Honey, do I look like the clerk to you?”
I walked back to the clerk and asked him what I should do to make sure a scrotal support sac was acquired.
“I don’t know, perhaps you should call up physical therapy.”
I walked back to the phone and called up physical therapy, hearing the familiar male voice once again.
“Just have nursing transport him down here. We’ll get him his truss and send him back up.”
I walked over to my patient’s nurse and asked how to transport the patient.
“Honey, do I look like the transport nurse to you?”
I walked over to the transport nurse and asked how to transport the patient.
“I guess so. But not now, I’m busy. I’ll take care of it later.”
I reminded her of my eagerness to get this patient discharged, and how this would be the final step in making everyone’s job easier.
“I’ll take care of it later.”
I returned to my patient’s ward an hour later and found my patient still in his bed, still smelly, and still sporting a massive scrotum.
“Did you go downstairs to get your special support underwear?”
“The what now?”
I walked back to the nurses station and found my patient’s nurse.
“Honey, do I have to remind you of who I am?”
I found the transport nurse.
“I said I’ll do it later.”
I returned two hours later and was approached by my nurse.
“Are you the doctor for patient [HIPAA says no!]?”
Marveling at my moderate efficiency, I chose not to correct her. “Yep.”
“They just called from physical therapy and are sending the patient back up.”
I left for a few and came back, finding my patient back in his bed.
“Did they give you the special support underwear?”
“The what now?”
I walked back to the nurses station and found the transport nurse.
“I brought that guy down there and they had no idea who he was, what he was there for, or anything.”
“Don’t make me repeat myself, son.”
I walked to the phone and called up physical therapy. A woman picked up this time. “Yes we remember that patient. You can’t just send a patient down here to get a truss.”
“I was told by someone a few hours ago that would be OK.”
“Who did you speak too? We don’t do that.”
“It was a man.”
“We don’t have any men here.”
“We took his measurements though.”
“Huh? Look, how do I get this for him? We can’t send him home without one and my attending said you guys would have it.”
“We can have him come back to clinic. We order these things from an outside place so it should be there by then.”
“Why is he still here?” Four hours after sending me on a quest for a scrotal sac, my resident was not pleased. I explained the situation. “When is clinic? He smells. He needs to go.”
I walked to the phone and called up physical therapy.
“I don’t know when the truss will come. Call me back later after I talk to my supervisor.”
I walked back to my nurse and asked if there might be anything in the supplies area.
“Honey, do I look like I’m the supplies manager?”
I asked another nurse.
“Here’s a key, just give it back.”
I went to the supply room, marveled at the endless supply of douche bags in the closet, found nothing of use, and walked out. I returned to the phone and called up physical therapy.
“We don’t know if we can get this for your patient.”
“Wait, the truss doesn’t exist?”
A little while later, I found my resident once again.
“Wait, you mean after all this, your patient is still here?”
“OK, well, you can make a temporary scrotal sac out of two Ace bandages.” She proceeded to explain this process and sent me on my way. I walked back to the nurses station and wrote an order for some Ace bandages.
Marveling at my excellence in futility, I corrected the clerk. “I’m just the medical student.”
“OK, well, I don’t know if we can get this for you. You should ask the nurse.”
I found my patient’s nurse and asked.
“Honey, do I look like I would know where to get some Ace bandages?”
I asked another nurse.
“I bet physical therapy would have it.”
I called up physical therapy, and now a man picked up the phone.
“Sure, I know what you’re talking about. Just send the patient down and we’ll set him up with the temporary scrotal sac.”
(If you would like to learn more about existentialism, here are a couple of links, one brief and the other extensive. For the three or four of you who do not already know this, I am a massive dork and actually read this sort of stuff from time to time.)