V.19 No.23 | 6/10/2010
Vitals and Bits #5: The Penis
By Whitny Doyle, RN [ Fri Jun 4 2010 1:58 PM ]
I walked into my patient’s room, shaking slightly and perspiring liberally. In one hand I held a urinary catheter. In my other hand, a worn version of the King James Bible.
“Pray with me?” I asked my patient. He looked at me solemnly and nodded. I placed the Bible on the bed between us and reached for his hand. He closed his eyes and gripped my sweaty palm with surprising strength.
“Dear Lord,” I began, “in mere moments, I will be inserting a urinary catheter into this innocent man’s penis. I have never done this before, and I am praying that you will guide my hand with steady resolve. May this humble little catheter find its righteous path into my patient’s bladder, thus relieving him of his persistent and painful urinary retention. Amen.”
“Amen,” my patient echoed.
OK, that didn’t really happen. Here’s the real story: I walked into my patient’s room, shaking slightly and perspiring liberally. In one hand I held a urinary catheter. My other hand was empty.
“Mr. Patient, the doctor wants you to have a urinary catheter placed to help relieve your urinary retention. This will also give us an accurate measurement of your urine output.”
Mr. Patient eyed me suspiciously.
“You’ve done this before, haven’t you?” he asked.
“Oh yes,” I lied through my teeth. “A million times.”
After opening the catheter kit and preparing all the various components, I lifted the man’s gown and located his penis. In case you’re unfamiliar with the term penis, it is used to refer to a semi-mythical organ that has eluded scientists and philosophers for centuries. But I, a brand new nurse only seconds out of nursing school, managed to find it all by myself.
“OK, I’m going to talk you through this,” I said to my patient. “First, you will feel my hand on your penis.”
The man snorted. “My lucky day,” he replied.
“Next,” I continued, pretending that I wasn’t flustered, “you’re going to feel some pressure at the opening of your penis.” It was at this point that I introduced the catheter, which I had coated with copious amounts of medical-grade KY lubricant, into his urethra. My patient winced.
“You’ll feel me advancing the catheter past your prostate,” I said. The man winced again and uttered some creative profanity when the catheter met resistance. The prostate, which nearly wraps around the urethra just below the bladder, can obstruct the urethra if it’s enlarged. Nearly all men have some prostate enlargement as they age.
I pointed my patient’s penis towards the ceiling and slowly lowered it as I tried to advance the catheter further. This maneuver sometimes allows the catheter to slip past. Aha! I was in luck. The catheter began to advance easily again, and soon the bag attached to it began to fill with urine. This is a sign that the catheter is indeed in the bladder, where it should be. Accurate placement of the catheter was confirmed by the man’s face, which filled with relief as the painful distention of his bladder began to ease.
“We got it!” I exclaimed, unable to hide my happiness at successfully inserting my very first urinary catheter into a penis. I secured the catheter in place and turned to the man, beaming.
The man raised his eyebrow.
“Judging by your excitement,” he said, “I’d say that it was better for you than it was for me.”
If you’re a man reading this story, you might have a horrified expression and a protective hand guarding your crotch right about now. Your penis wasn’t meant to be penetrated, right? In fact, quite the opposite. So how could my patient tolerate such a violation of his manhood? And why on earth would I write about it?
We all know that the penis is a timeless icon of human power and virility. A whole culture of male lore surrounds this famous appendage. It is the stuff of poetry, of architecture, of war and civilization, of life and death. The penis, in all of its symbolic might, is a fundamental feature of human existence. This is because of its vital role in sex, which is something I hear people like to do from time to time.
And yet, at the end of the day, when you’re old and fighting the inevitable physical decline of age, you’ll be reminded of that other penile function, the one that doesn’t involve the grit and glory of male sexuality. When you’re standing over the toilet, straining with that characteristic “stop and go” urinary hesitancy that so many men suffer, you’ll develop a greater appreciation for your little guy’s role in urination. You may even wake up one day and find that you’ve become more concerned with passing urine than with sex. And no one would blame you. Because, let’s face it, no man wants to have a trembling young nurse shove a rubber tube up his penis just so he can relieve his bladder.
V.19 No.22 | 6/3/2010
Whitny Doyle, RN
Seduction of a Nurse
By Whitny Doyle, RN
V.19 No.21 | 5/27/2010
Vitals and Bits #3: The Appendix
By Whitny Doyle, RN [ Fri May 21 2010 11:48 AM ]
At the beginning of each new shift, certain members of the hospital staff will receive a pair of freshly laundered scrubs to wear while working. If you’re one of the lucky ones, you’ll be handed a pair of ancient scrubs that have been laundered a billion times. Over time, the unforgiving hospital washing machines pulverize the stiff green scrub material to unbelievably soft oblivion. Old scrubs that are nearing retirement are much more comfortable and better fitting than the awkwardly crisp new scrubs. They’re like a treasured, paper-thin vintage tee shirt. Unfortunately, just like a perfect vintage tee, the ideal pair of worn scrubs is a pretty rare find.
One night while I was working night shift in the newborn nursery, I noticed that one of my favorite pediatric residents had managed to get his hands on a pair of the old soft scrubs. The thing about the soft scrubs, though, is the decades of laundering have also shrunk them to about three quarters of their previous size. My resident, who we shall henceforth refer to as Dr. Abs, kept tugging at the hem of his shrunken scrub top, since it was an inch or so too small for him.
Like many residents, Dr. Abs liked to pass the time during a slow night shift by telling dirty jokes with us at the nurses’ station. That night, around 3:30 a.m., Dr. Abs succumbed to a fit of yawning after delivering the punch line to some filthy joke about Tipper Gore. As he yawned, he raised his arms over his head and the hem of his short scrub top untucked itself and traveled northwards. The five nurses hanging around the desk were held spellbound for the few brief seconds that his bare, toned abdomen revealed itself. I couldn’t help but notice a finger-length scar on his lower right abdomen.
“Is that where Tipper Gore bit you?” I asked him, pointing to the scar.
He glanced casually down at the scar.
“Actually, I had to leave my appendix in Thailand a few years ago,” he replied.
The appendix is an enigmatic segment of bowel-like tissue that juts off of the colon, near the place where the small intestine meets the large intestine. The appendix does not perform any digestive function, and so there are a few theories out there as to just why the heck we have an appendix anyway.
The older argument is that the appendix is vestigial, meaning it used to be an organ that served a purpose in our ancient humanoid ancestors but lost its function as modern humans evolved. Newer theories propose that the appendix, which is a rich reservoir of lymph tissue and healthy intestinal flora, plays a role in immunity and digestive health.
Whatever function the appendix may or may not serve, people who have had theirs removed seem to do just fine without it. In fact, the appendix is a relatively high-risk accessory to be sporting on one’s colon. The appendix has a nasty habit of becoming inflamed or infected, which is the case when someone gets appendicitis. Appendicitis is life-threatening, since an inflamed appendix can rupture. A ruptured appendix spills a slew of bacteria into an abdominal cavity that’s supposed to remain sterile. This means people can become septic and die if their appendix decides to go all supernova on them.
As it turns out, my pediatric resident’s appendix had ruptured while he was vacationing in Thailand. Although he was a medical student at the time, he didn’t put two and two together and waited until he was on the brink of death before dragging himself to a medical clinic in the small Thai village where he was staying. The staff at the clinic recognized what was happening right away, despite a pretty significant barrier language. They started antibiotics and transported him to the main hospital for surgery with lightening speed. He was in surgery that same day, and remained in the Thai hospital for almost two weeks while he recovered from his surgery.
After telling us his story, Dr. Abs stood up and stretched one more time.
“These scrubs are so comfortable,” he said mid-yawn. “They feel like pajamas. I’m going to have to take them off if I’m going to be able to stay awake.”
Five grinning nurses nodded in agreement.
V.19 No.14 | 4/8/2010
The Reform Prognosis
How will New Mexicans be affected? An insider explains.
By Whitny Doyle, RN
V.18 No.51 | 12/17/2009
Miss Diagnosis Uses Drugs to Prove a Point
By Whitny Doyle, RN [ Fri Dec 11 2009 2:47 PM ]
In a country where practicing medicine has become nearly synonymous with prescribing and dispensing medication, it’s no surprise that the pharmaceutical industry has a prominent place in the health care reform debate. The controversy over whether to allow importation of prescription drugs from abroad has jeopardized the weird alliance between Big Pharma and health care advocates. Obviously, allowing foreign drugs in has serious economic implications for drug-makers and consumers. But a report regarding contaminated drugs published in the Thursday, Dec. 10 edition of the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report highlights safety concerns as well.
According to the report, 54 Nigerian children died from contaminated acetaminophen (the same drug as Tylenol) in a children’s teething medication. The medication was contaminated with diethylene glycol (DEG), a toxic alcohol used illegally as a cheap substitute solvent in drug manufacturing. The contamination resulted from failure to comply with safe manufacturing processes.
I’d like to give us all a moment to imagine the response if 54 American children had died from drug poisoning.
The report may bolster the position of those against the proposed amendment to allow importation of prescription medications from abroad approved by the Food and Drug Administration. The CDC stated “countries that inadequately implement safe manufacturing standards, poorly enforce quality controls, or lack adequate training programs remain at risk for medication-
However, before people jump on the notion that foreign countries represent a unique risk to drug safety, it’s wise to consider the issues surrounding drug safety in our own country. For instance, New Mexico's Attorney General Gary King completed a $10 million settlement against drug-maker Eli Lilly for illegally promoting the use of their anti-psychotic medication Zyprexa in children. Although it is legal to prescribe medications for unapproved or “off-label” uses, it is not legal to market them for off-label uses. Earlier this year, the company plead guilty to promoting the drug's unapproved uses and concealing serious side effects like weight gain and diabetes.
In my humble opinion, drug-makers are as powerful as consumers allow them to be. Though many drugs are absolutely necessary for saving or sustaining life, I’d hazard a guess that most aren’t. Though I’m certainly not anti-medication (hey, I practically live on Ibuprofen for a week out of every month), I don’t believe medications should be the first line of defense against all of our ailments. For example, there’s no harm in medicating your teething child with hugs and kisses and soft things to chew on rather than a bioactive elixir with serious side effects. It’s easy to see why weighing the risks and benefits of medication use is so important. It’s also easy to see why drug companies must be held to extremely strict standards when it comes to marketing and disclosure of risks.
Still, cost should never be a reason to deny someone a needed medication. Rather than importing drugs, which opens a whole new can of regulatory worms and broadens the carbon footprint, perhaps financial regulation of domestic companies would be more prudent.
In any event, we can all hope decent regulatory efforts at ensuring safety and affordability of necessary medications succeed. At the same time, let’s encourage our couch-riding, medicated masses to trade the remote for real friends and the La-Z-Boy for a pair of jogging shoes. This way, we can all jazzercise our way into a future of cardiovascular fitness and mental well-being. That would do more for the health of our nation than any pill.
V.18 No.49 | 12/3/2009
Waiting With the Devil: Health Care or Hell?
By Michael P. D'Arco
Batman (1989) at KiMo Theatre
Tim Burton's dark retelling of the Batman story, starring Michael Keaton and Jack Nicholson. Part of the '90s Batman film series.
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