Night shift: titanium edition

Surgeon General’s Warning: Cock rings, whenever possible, should not be made of titanium.

I was working a night shift with some of the most outstanding people ever. My intern, the “Pneumo,” earned his nickname because of exceptional biceps fitted on a short Italian frame. In fact, my residency started a rumor that when this particular intern does chest compressions during CPR, the horsepower behind his regularly punctures lungs. Well, even rumors contain glimmers of reality. Turns out Pneumo was doing CPR once and felt his hands getting wet, only to look down to see blood seeping out of the patient’s chest and pooling around his palms. Begrudgingly, I’ll tell you that the patient had just had open heart surgery and had a semi-open wound so it wasn’t all his doing.

My attending that night was Dr. M, a dread-locked doc with tats who dreams of opening up his own spice shop. As far as superlatives go, he is the most fun to work with, easily laughing off the most painful and stressful of patient encounters. Dr. M finds humor in even the most terrible and most base of circumstances, defying the concept that the Emergency Room can ever get you down.

That was my crew. Now this was the patient…

Pneumo returns from seeing a 30-year-old man in room 24 around 1 am with eyes that say, “You gotta hear this” and proceeds to tell me about a man and his cock ring.

Yes. His cock ring.

I have to see this patient immediately. Definitely more important than the intoxicated man with chest pain.

I stroll into room 24 –the private room, of which there are so very few in our ER – with Pneumo and Dr. M on my heels, all of us trying to hold our faces in the shape of “serious doctor.”

An impressively tall man sitting on the stretcher greets us with the look of someone that feels stupid for being in the ER. You know, the way you feel when you cut yourself because you were using a knife exactly how you were told never to hold it? With all his height he just looked a bit deflated. And then he drops his pants.

On my exam: the patient’s testicles are massively edematous, hanging like pendulous grapefruits, and a titanium ring about 1 cm thick encases both his penis and scrotal sack.

“So…how long has that been on?”

“Two days now.”

“Two days!?!”

“I couldn’t get it off.” Obviously.

“Why didn’t you come sooner?”

“I was embarrassed.”

I can’t imagine why. “We’re going to have to cut it off.”

SUPER ALARMED FACE. Instantaneously, his dark skin bleaches to pale gray as his eyebrows disappear into his hairline as the whites under his pupils appear.

“The ring, I mean.”

“Oh okay.” Tries to pretend his face didn’t just do that.

We three sophisticated, serious professionals exit Room 24, closing the door behind us.

“OH MY GOD, that cock ring is GIGANTIC! Are the ring cutters even going to get through that?” The three of us rush to the charge nurse to ask for the bolt cutters. We don’t get to use them often, so this is a real treat.

For reference, we really generally get rings and things off using lube, soap, and a string wrapped tightly around the appendage (usually a finger), slipped under the ring, and then slowly pulled so that the ring is forced to slip off the finger. We only resort to Home Depot supplies when these generous methods fail.

Nobody’s going to apply lube in this case.

So, okay, we get our acts together; we straighten our faces again (come on, this is funny, even for professionals who have seen it all); and we enter Room 24 again, Pneumo wielding our chosen tool.

SUPER ALARMED FACE.
Poor guy. I mean really, we just swore we wouldn’t cut it off, and then we walk in with a sinister object about 3 feet long.

We arrange ourselves around the patient, and I try to wedge my fingers between the giant titanium doughnut and this man’s flesh, as Pneumo slips the tip of the bolt cutters into the space I’ve created. I give Pneumo stern eyes. “Do NOT cut off my fingers…” Dr. M looks on, providing attending supervision for this seldom performed procedure, but really just super enthused that the monotony of night shift swiftly evaporated when this patient popped up on our board.

Will the bolt cutters get through?

Sadly, no. I finally tell Pneumo’s biceps to stop when I see that we are being forced to use the man’s pelvis as a fulcrum for the bold cutters, and I’m worried we are actually going to cause trauma to his skin if we keep applying force, especially if the tool slips. We, and our bolt cutters, exit room 24 again, leaving a slightly trembly former specimen of masculinity in the stretcher.

Pneumo turns to me, “What do we do now?” I turn to Dr. M and repeat.

Dr. M shrug-laughs. “Call urology?”

Pneumo pages the on-call urology fellow at 2 am. The fellow answers the page pretty quickly and I take the phone. “We have a 30-year-old man with a cock ring, and we can’t cut it off with the bolt cutters.”

She’s incredulous. “What do you want me to do?”

“Can’t you take him to the OR or something?”

“Do you think the thing is magically going to come off if we put him under general anesthesia?”

Solid point. Regardless, the Urology fellow, who I swear could not have weighed more that 115 pounds, shows up in the ER and walks into room 24 with us, eyeing Pneumo’s biceps as she suggests that we just try the bolt cutters again. The definition of insanity… But we humor her, because we did just pull her out of bed.

When the bolt cutters fail a second time, she throws out Idea of the Month. “Why don’t you try calling the fire department? They do the jaws of life and stuff.”

BRILLIANT.

Pneumo’s on it! He sprints to the desk, picks up the phone, and then puts it down again. “We don’t have their number on our mouse pad, do we?” Then he googles the nearest precinct, attempting to find the number, but only manages the city Fire Department number with a recorded menu that leads to Wonderland. He even trots up to the triage area and flags down the nearest medic to see if they know how to get the guys with the tools to come to the ER. Finally, in a state of frustration and mid-night shift lunacy, Pneumo picks up the phone again, dialing 9-1-1.

That’s right. We just called 9-1-1 from the ER.

“This is 9-1-1. What’s your Emergency?”

“Well, I’m calling from the Emergency Room. We need to get in touch with the fire department to bring –“

“Excuse me, did you just say you’re already in the ER?”

“Yes. Yes, we are.”

Really, I got to hand it to this guy. He’s got pluck. Somehow, that phone call succeeded in roping in an Engine crew, and now four magazine-front-page-worthy firemen in their fireproof pants, orange suspenders, and tight white shirts walk into Room 24 with several circular saws.

SUPER ALARMED FACE.

At this point, I realize that I actually had other patients on my team and leave this gentleman in the care of my very involved attending, my delighted intern, and the buff fire squad. Fifteen minutes later I hear shrill screams emanating from Room 24, so I fly by to make sure the poor patient hasn’t lost any parts.

Room 24 isn’t that big. There are now four firefighters, one dread-locked ER physician, Pneumo, a petite urologist, and myself stuffed in this room huddling around my patient’s penis. It turns out that the screams I heard earlier were from an interesting phenomenon called friction, which as you know converts kinetic energy into thermal energy. Basically, when the firemen started cutting through the hulk cock ring, the spinning saw heated the ring, which being connected to the man, burned like an open flame. Creatively, my intern had run to get the aluminum splints we use for broken fingers that have metal on one side and foam on the other and popped them around the ring to try to separate it from the man’s penis. Then for good measure he dropped a bagful of ice onto his genitals. So when I walked into Room 24, the saw was happily chewing through the massive band, and while the patient still had tremulous hands over his eyes, he was definitely not screaming in pain.

Finally, 45 minutes later after the firemen had cut through both sides of the heroic cock ring, I happen to be in the hallway as four sweaty, chiseled, and triumphant firemen saunter out of Room 24.

Dr. M reappears at the desk, grinning ear-to-ear and eying the board for the first time in 2 hours. Pneumo chuckles, telling me that the patient asked for the two halves of his cock ring as a keepsake. We discharge the impressively tall man with his impressively thick souvenir, and his genitals live on to see another day.

 

And business in the ER goes on as usual.

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