Hektoen International

A Journal of Medical Humanities

The emergency room doctor

Rob Ottesen
Vero Beach, Florida, United States

Photo by RF._.studio on Pexels.

If you were to ask me, I like to have a glazed doughnut before I go to sleep because the sugar in the doughnut inhibits my body’s production of orexin, a neuropeptide, thereby ensuring a peaceful slumber. I also like the taste of the doughnut and the warm and fuzzy feeling I get when I eat one.

What a treat! The doughnut is one of the greatest inventions of all time, and is one of the reasons I support democracy and free enterprise over totalitarianism and centrally planned economies. It was invented in America, I am proud to say, and I need one every day because what I do is hard if you are not a sociopath.

My psychiatrist friends tell me you can spot sociopaths rather quickly because they are charming and talk about food and money all day. So, if you find yourself liking someone and they are talking about the cost of hamburgers, I guess you should be careful. Me, I am an ER guy, and to be honest, I am not sure psychiatrists are really doctors even if they go to medical school. Let us be real. I sew people back together with a needle and thread and pull axes out of heads. Psychiatrists just listen and nod and give sad people serotonin reuptake inhibitors to make them feel happy.

I take those pills myself, by the way. No shame in it. And, by the way, I am not a sociopath. Although sometimes I think it would help. Sociopaths lack empathy. Some people think that is a deficiency. I am not so sure. I think it may be an adaptation.

It is two in the morning and the air is cold because it is always cold in the ER and a middle-aged guy was just rolled in on a stretcher and he is holding his lower right side. So this is appendicitis. I know it is appendicitis, but I have to do a CT scan to prove it and maybe a digital rectal exam to make the insurance company happy. I walk over to the guy and can see he is in a lot of pain. There is no time for real empathy here. I mean, the guy could die while I explore his feelings and deal with those feelings myself. No, he wants the pain to go away and probably wants to live to see another day so he can enjoy a doughnut tomorrow morning.

“Good morning,” I say, evenly. “You seem to be in a lot of pain.”

The guy nods his head, mutters a few expletives, and then his wife walks in babbling about how she made him a nice dinner and that he has never had a stomachache after one of her casseroles. I nod my head and pretend to care about casseroles and then explain that I doubt the problem lies with her cooking but may be the result of his appendix exploding. Now the guy is yelling bloody murder, and when I press on his lower abdomen, the pain gets worse. I order a CT scan and a white blood count, and it all comes back conclusively positive for appendicitis. I skip the digital rectal exam—to hell with the insurance companies—and send the guy up to the OR. He will live, so long as he gets Dr. Leplacs. The other surgeons are hacks, but Leplacs has good numbers.

Ollie walks up beside me, and we watch as the man is wheeled away. “That was an easy one,” she says. “How much do you get paid, again? Seems like we nurses are doing all the work.”

I should tell you now that I am sleeping with Ollie. She is a brunette, stands about five feet, five inches high, and looks like a supermodel stuffed into a nursing uniform. And yes, it is true, doctors and nurses sleep together. What else would they be doing on a boring graveyard shift? I mean, really. We are like pilots and flight attendants. Or models and photographers. We are around each other all the time, so naturally.

Although I have to be careful. I am not exactly supposed to be sleeping with nurses, you see, and Ollie’s supervisor, an angry taskmaster who looks kind of like a troll with long red hair and broad shoulders, suspects something is going on, so she never takes her eyes off us. Except when we are hiding in the broom closet or when Ollie is sleeping over at my place. Or when I let her drive my Porsche.

About the Porsche. You’re probably thinking I am a stereotypical physician who drives a Porsche, lives in a condo on the beach, and sleeps with nurses. Yeah. Well—humm. Yeah.

Ollie’s supervisor leaves the nursing station and gives me a critical side-eye. I smile right at her and shrug as I walk to the next examining room. You cannot show any weakness in the ER, or the nurses will run the place. There is a pecking order. Doctors rule because they have to. If we did not, there would be chaos.

I walk into the examining room and greet a young man who is sitting on the edge of the table. He looks nervous and is holding his groin, and I think to myself, this is going to be interesting. Up until now it has been a boring day.

“Good morning,” I say. “You seem to be in a lot of pain.”

I seem to say that a lot, now that I think of it.

The young man looks to the side. “Uh, yes, sir. I had a little accident, I think.”

“Oh, don’t worry. Nothing we cannot fix. Did you have a little manscaping accident, maybe? You have to be careful with those scissors. Or razors. Well, I guess you have to be careful no matter what you are using down there, if you want a trim look without getting hurt.”

He is shaking his head. “No, sir. Nothing like that.”

I smile at the guy because I really feel for him. It is a genuine smile, not a fake one. I mean, this is every young man’s nightmare. Whatever the problem is, he certainly doesn’t want to share it with the world.

I hear Ollie knock at the door and wave her off.

“Thank you,” he says. “It’s kind of embarrassing.”

“No problem. Why don’t you drop your shorts and show me what’s going on?”

The man drops his shorts and his manhood is swollen, but not in a good way. Everything kind of looks like a purple pretzel down there. “Ah, I see. Looks like a penile fracture. Let me guess, your lady was on top and came down after you slipped out?”

He nods. I think he is about to cry. “Yeah. I’m having trouble peeing now. I can’t believe this happened to me.”

I put my hand on his shoulder. “My friend, I see this injury all the time.” That’s a lie, by the way. I have only seen one of these before, but I do not want the guy to feel like a freak. Physicians lie all the time. If a doctor tells you something is not going to hurt, for example, you can be sure it going to hurt like hell. Patients need a little lie now and then. It is totally unethical, but hey, when was the last time Hippocrates had to fix a broken penis?

“Did you hear a pop?” I ask. “When it happened?”

The man nods.

“Well, I have good news and bad news. The good news is, you did not break any bones, because the penis does not have any bones. The bad news is, it looks like you ruptured the lining of one of the spongy cylinders in the organ that fill with blood, which explains why things are purple down there right now. So I am going to give you something for the pain and order a scan, and after that, you may need one of our urological surgeons to go in and perform a repair.”

The man looks shocked. “That sounds serious. Is my injury serious?”

Of course it’s serious, I think. You have a purple penis and could end up with erectile dysfunction for life if you don’t fix it. But I do not say that.

“Ollie, please order an ultrasound and provide our patient with two milligrams of valium, a couple acetaminophen, and an ice pack. My preliminary diagnosis is penile fracture.”

She is about to jump out of her skin with joy. I am shaking my head, trying not to laugh, not because of what happened to the man but because of her reaction to it. Ollie’s a bad influence on me. She is a brilliant nurse, but anything relating to boy parts fascinates her and turns her into a devil. Also, anything bleeding. She is obsessed with blood. I think she may be a vampire. “OhmyGodthatsamazingIhavetoseethisIhaveto!” she whispers. “I’ve never seen one of those!”

Fortunately, I am off tomorrow and get to sleep late. And have a doughnut with a cup of my favorite coffee: a large mocha macchiato with whipped cream and caramel drizzle. Because I am one of those guys. The kind of guy who is willing to pay top dollar for a large mocha macchiato with whipped cream and caramel drizzle. You can judge me for this. You can hate me for this. But you cannot deny me the joyful caffeine infused wonder of my favorite coffee paired with a nice doughnut.

I went to medical school for a reason, you know.

ROB OTTESEN is a resident of Florida and works in the financial industry. His hobbies include writing, painting, and travel, and he is the author of Natasha’s Ukraine, a novel about a fictional family living through the events of the 2014 Ukrainian Revolution. His artwork has been collected by such museums as the Gutenberg Museum in Mainz, Germany, and he is the inventor of a painting technique called kinetic pointillism. On the weekend, Rob enjoys taking long walks with his wife and their dog, a corgi named Jaydie.

Spring 2022



Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.