Louis and I are taking a slow drive into the “killing fields.” That’s what we call this neighborhood since so many people die here from gunshot wounds and gang violence – cops, kids, bangers – they all die in this area. We just received the call – Code-2 – for penis pain. Now, you have to imagine that we see all kinds of stupid and tragic stuff all day long. Yet when penis pain comes over the MDT (mobile data terminal) in the rig we just have to laugh. I’m sorry but that’s the normal response. If my penis hurt I would go to my doctor or drive to the ED myself. Why the hell would I call 911?
But this is the poor neighborhood where people don’t have a primary care physician or any other avenue to the healthcare system other than by way of an ambulance to the ED. It doesn’t surprise me anymore, it just makes me sad. Code-2 also means that we are responding alone; no fire department to back us up. As we find the apartment building, not four blocks from a recent cop killing, we see bangers hanging out in the common area. We’re used to this – we always lock the doors to the rig, and have our heads on a swivel as we approach the building. Radios on our belts are on and we’re watching each other’s back as we walk up the stoop. Were I walking up here off-duty I would be missing my wallet in less than a minute. Yet as they see we are EMS and not PD, the bangers are ready to help. They know we are only here because someone called and they look out for their own.
“Hey, you know where apartment F is?” The closest banger in his white tank top puts down his malt liquor and points up a stairway. “Thanks man.”
I’m walking up like I own the place – it’s better than letting my knees quake like they want to – and Louis has my back as we find the apartment. Knocking on the door, “Paramedics!” Louis pulls me back so I’m not standing in front of the door swing – or potential bullet trajectory…
A tall African American man in his sixties answers the door and motions for us to come inside. “Hey, what’s going on today?” I offer my typical greeting as I reach down and grab the remote to turn off the TV that is a little too loud.
“It’s my dick man, it’s hurt’n.” Before I can say anything else he unzips his pants and uses two hands to unfurl the most enormous penis I have ever seen. Sometimes I really have to take a step back and reflect on my career choice. I mean seriously, I just walked into a stranger’s house and he just exposed himself to me. Now I’m supposed to deal with whatever medical problem happens to pop up. Paramedics have an interesting mandate – whether we walk into a house with a blue baby, a dying grandparent, a choking sibling, or a wife who was beat up in a domestic violence, we MUST maintain the same expression on our face. People are relying on us to fix that which is beyond their own abilities to fix. And we do it day in and day out. Yet this is stretching my ability at the moment.
He unfurled maybe 14 inches of two inch diameter penis cradled in both of his large hands. “Okay, so what’s up, is this more swollen than it should be?” What the hell else am I going to say?
“Hell yes it’s more swollen and I can’t pee; nothing comes out!”
“So how did this happen, what were you doing?” Why the hell did I just ask that…
“See, I was have’n sex.” He lowers his voice. “And she kept saying, harder, harder, so I did and I guess I just rammed it in too hard!”
So I’ve pretty much got nothing left to figure out on this one; “So what hospital do you want to go to?”
He tells me that he goes to the County Hospital and starts walking back to the bedroom talking to someone saying he’s leaving. As soon as he turns away Louis and I look at each other – big mistake! We both double up in silent laughter and have to turn away from each other to regain composure before he returns.
I walk him out past the bangers, who ask if he’s okay, and into the rig. There’s not much I can do for this one so I give him an ice pack to stuff down his pants and just load him up with Morphine. Call it a male sympathetic response but if there’s anything wrong with a guys package then he deserves as much Morphine as my protocols allow me to push. It helps him, of course, but it also helps me get through the call without having to cringe every few seconds.
On the way to the hospital I do a quick lookup on my iPhone as I can’t remember the name of this condition. The result comes back quickly – paraphosis. It’s where the foreskin gets stuck on the proximal side of the head of the penis and constricts due to trauma. It constricts the penis and prevents urine from passing and creates a swelling of blood. It sounds painful and he’s only marginally better after the medication.
I get him through triage quickly by telling the nurse this is a matter of “life and limb” and it’s a damn big limb! I finish my paperwork and go back to his room for a signature. Sliding back the curtain I look in to see the MD injecting his penis with Lidocaine. UGH – another image I’m going to have to try to erase from my mind!
The MD tells me he’s going to numb the penis, clip on with a forcep, and pull the foreskin over the head. He’s using the Lidocaine as a local anesthetic and he’ll do a procedural sedation with Versed just before doing the deed. AHGGGHHH! Cripes, too much information.
Before leaving the ED, I decide to make a quick stop at the restroom – I learned early in my EMS career to never pass up an opportunity since I never know when I’ll get another. I have to let Louis know where I’m going, “I’m going to depress myself and hit the head,” I tell him. He replies, “Yeah, I think I’ll wait – I’m not ready for that kind of let-down just yet.” I wouldn’t even want to be as “well-hung” as my patient, but there’s still that male ego thing…
I go back to the rig to finish my lunch and hope for a nice and simple cardiac arrest call to erase the images of the last call from my head.