A problem downstairs…

Posted on May 15, 2008. Filed under: Journal from behind the desk... |

Last week was one of those where all my patients seemed to have a need to drop their trousers, hitch up their skirts and generally reveal themselves in ways they rarely would, even after a night in the pub.

As I said only last week history taking is a vital part of clinical assessment, but when it comes to problems “down below!” history taking can be a bit challenging.

Steven Seagal Movie about dysuria?

Patients seem to adopt one of two approaches when they have a problem below the belt, both of which are a little too extreme to be helpful (or pleasant).

The first extreme is the patients (mostly men), who have sat in the waiting room worrying about exposing themselves, and not thought about what they are going to say.   These patients think being called to the consulting room means they can start undressing on their way down the corridor. So before I can say “‘mornin'” I’ve got genitalia facing me and patient demands:

“Look at this, do I need to get a divorce?”

The other extreme is the patient who has been practicing exactly what to say (for approximately 4 weeks) and when it comes to examination they say “OK” and then stay exactly where they are.  Prompting encouragement to actually stand up and “drop ’em” and “No, I’m not going to undo your flies for you, your hands were working before the consultation, I’m sure they are still able”.

Also history taking is only any good, when accompanied by a vague idea of what the hell the patient is talking about…

Key: Pt v’s Max

“I’ve a problem downstairs”  –  “You have rats in your cellar?

I’ve got sore “bits” – “I’ve heard of drill bits, but never saw bits

“I’ve got a personal problem!” –  “As oppose to a impersonal problem?”

“My cock sore!” – “What did your cock see?  Chickens??”

“My cocks got a rash” – “Take it to the vet, I don’t do poultry care

“I’ve a problem with my toilet” – “Call a plumber!”

“I’ve a problem with my crack” – “See your drug dealer, but I doubt you’ll get a refund.”

“I’ve a problem with my plums” – “Tell the greengrocer about it!”

“I’ve got a problem with my wee’s” – “Do you use an inhaler?”

and thus it goes on.

One parting comment….whatever happened to sexual health, condom use and just good old fashioned common sense?  When I was growing up (debatable whether I actually have grown up or ever will), everybody was hyper-paranoid about AIDS. Now it rarely gets mentioned in the common media, but statistics show it is ever rising.

Brings a whole new meaning to the term sexual aids!  Sorry that’s a bit of a heavy image to end with, try this French Campaign…

Little Miss Muffet sat on her what???

Well you know what they say about Scorpios in bed…

Well, I’m not here next week, so in the meantime perhaps you should check out a newbies that came to my attention…..so take a peak into the world of : Circus Nurse.  Enjoy.


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