The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Tuesday, March 20, 2007

Apparently I Wasn't Clear That it Was MAJOR Surgery...

So I saw a patient in my office. He was a middle-aged guy asking if he could be circumcised. I inquired as to his motivation and he explained that he had recently converted to a religion where circumcision was the norm. In addition, he and his wife had recently had their newborn son circumcised-- again, citing religious reasons. The whole exchange was pretty routine. He had clearly done his homework on the procedure and was already fairly knowledgeable about the risks, the procedure and the recovery afterwards. He wondered if he could be referred to the same physician who had circumcised his son. I explained that infant circumcision and adult circumcision were very different procedures performed with very different techniques, and that adult circumcision would be performed by a urologist in the operating room. I emphasized that this is not a minor procedure, that it is often performed under general anaesthetic. Due to my anti-circumcision bias, I admit to often emphasizing the risks and the complications associated with this elective, cosmetic procedure. I also explained that as this is no medical indication for circumcision, he would be required to pay for the procedure out-of-pocket. He nodded, picked a urologist, and I filed the consult request.

Fast forward about a week. I had taken a few professional leave days off to study for the CCFP exam (T minus 5 weeks and counting) so on my first morning back I sat down with my supervisor to catch up on any issues that had come up during my absence.

"You saw Mr. A last week, didn't you?" he asked me.

"That was the guy asking about getting circumcised, right?"

"That's the one. He got circumcised."

"What?" I was confused. There was no way he could have gotten in to see a urologist that fast for a non-emergent situation, let alone be seen, booked and had the procedure performed.

"Apparently, he decided not to wait."

My preceptor explained-- he had gotten a courtesy call from the ER while I was away. Our patient was being admitted for observation after significant blood loss. Apparently, my patient and a friend (which begs the question... what kind of 'friend' would agree to assist in something like this) decided that it would be a good idea to simply pull his foreskin out over the glans, press it down against a cutting board and 'circumcise' him with a newly-sharpened carving knife. No anaesthetic. Ouch.

He underestimated the bleeding. After attempting to stem the flow of blood with direct pressure for a considerable length of time, he became increasingly light-headed and his 'friend' called an ambulance.

Sigh. Where is Darwin when you need him?

34 Comments:

Blogger notquiteuptheduff said...

you have got to be kidding me... what an idiot...

9:56 PM

 
Blogger ERnursey said...

I encountered a patient once who decided to do that while he was drunk, what a disaster

12:21 AM

 
Blogger Christie said...

Oh. My. God.

12:39 AM

 
Anonymous frectis said...

Oh. My. God.

1:24 AM

 
Blogger A girl said...

Darwin is watching... I think this guy deserves an award - Drawin award... Although he still alive so will not qualify. Damn.

3:28 AM

 
Blogger Indian Medic said...

OUCH!!!!!!!!!!!!!!

3:48 AM

 
Blogger phdatc said...

He's already reproduced??!! Darn!

11:28 AM

 
Blogger mrbunsrocks said...

my jaw is still dropped. Did he not see that episode of Nip/Tuck where the son does the same thing to himself?

KNOB. Who would do that to their own willy??????

11:37 AM

 
Blogger MedStudentGod (MSG) said...

Hey, this seems perfectly reasonable. After all, who the hell are you to be telling him about medicine, a doctor?

You see, he's had the supreme experience of having a child who's been circ'd, so obviously he knew how to go about it.

Man, you really don't know what to do after that, do you?

12:36 PM

 
Blogger Lor said...

::shudder::

2:23 PM

 
Anonymous Andrew said...

Perhaps you should have referred this case to a psychiatrist, not a urologist!

3:59 PM

 
Blogger Rory said...

el oh el...

we had picked up a guy whom my preceptor recognized from several months before. apparently he was highly religious and decided that in order to stem the tide of impure thoughts he was having, it would be best to chop off approximately half of his penis. fortunately for him (and unfortunate for the taxpayers footing his bill) the urology team was able to restore a modicum of function. i know this because the patient delighted in telling us that he could still get erections.

4:22 PM

 
Blogger Irene said...

Darwin's too late, he's already procreated.

He's done his research, he saw his son go through with it with flying colours, and it seems so simple, so why not do it himself? After all it's not rocket science, and you're just a doctor, what do you really know? Sheesh!

I get stupid users like that all the time in IT. They screw up, you end up fixing their screw up. Only they don't bleed, instead, they lose very sensitive data. Not quite the same thing, but I feel your pain nonetheless.

Idiot.

5:31 PM

 
Anonymous Diora said...

Am I a bad person if I find it hilarious?

7:46 PM

 
Blogger Liana said...

Whoa... you can't make this stuff up.

I have a question for you... if the guy in this story reads your blog and says "hey that's me" and tries to sue you for breaching patient confidentiality, does he have a case? I mean, I know that you didn't write any identifying details but...

I ask only because I try to avoid posting anything on my blog that's too specific because I worry about people recognizing themselves and potential medicolegal issues. But maybe I am being overly careful?

9:36 PM

 
Blogger Couz said...

Nah. I was careful with this one because it was so unique. I changed nearly every detail surrounding the event. Plus I waited a while after it happened so that my post wasn't temporally related. Everything was changed but his gender (obviously) and the actual event itself. Which, in talking to colleagues, isn't actually quite as rare as one would believe.

9:59 PM

 
Blogger 911DOC said...

you are kidding right? you win doc. i can't top it and i will not try. sounds like another candidate for a stat brain-transplant.

2:22 AM

 
Blogger Randall Sexton said...

Sounds like his friend was a real prick!

2:54 AM

 
Blogger Christy said...

OH MY!!!! How could someone do that to themselves! Don't people stop and think.

4:54 PM

 
Blogger Nikki said...

::speechless::

(A rare occurrence...)

...nope, still can't think what to say....

5:31 PM

 
Blogger pinkmoon said...

holy cow!!! what an idiot!

6:33 PM

 
Blogger Changa said...

Good Lord some people are idiots!

8:30 PM

 
Blogger ValGal said...

How he had the idea, nerve, and gumption to carry this through is beyond me. How much pain was he in???

9:07 PM

 
Anonymous kemette said...

I'm just picking my jaw up off the floor...

A prime candidate for a "Darwin award". (www.darwinawards.com)

9:10 PM

 
Blogger Midwife with a Knife said...

Oh dear. I'm not that fond of neonatal circumcisions. I definately think that "adults" should not circumcise themselves with a knife and a cutting board.

12:04 AM

 
Anonymous Anonymous said...

oh my god....that is crazy.

11:13 AM

 
Blogger SeaSpray said...

Yikes! and OWWWW!

4:08 PM

 
Blogger waltz, matilda said...

Wha??! Dear God.

5:40 PM

 
Anonymous patientanonymous said...

Home surgeries of any kind are not good--but a circumcision?

Granted, they'll do a Briss in Judaism but you're right, an adult circumcision is a whole different ball game.

Oh, sorry...unintentional bad pun. Testes not involved at all, really.

9:40 PM

 
Blogger Dr. Wannabe said...

Why in the name of God was he in such a rush?!?!?

Oh wait, maybe I just answered my own question.

2:42 AM

 
Blogger medstudentitis said...

ahhhhh!!! People are SO STUPID!

10:31 AM

 
Anonymous Anonymous said...

Horrific story. The most recent literature however does support circumcision does result in lower rates of some genitourinary infections.

4:55 AM

 
Blogger Couz said...

And elective appendectomies at birth lower rates of appendicits. What's your point?

8:03 AM

 
Blogger The Platypus said...

Why is it that the only people that hold strong opinions about make circumcision are always women?

10:47 AM

 

Post a Comment

<< Home