I just want a job where I don't have to deal with penises all day any more: I'm thinking mainly of other surgeons. "Blimey, did you see the state of that bloke's missus?" My senior house officer was referring, in his most contrived working-class tones, to the scantily clad and sheepish-looking partner of our new star urology patient. "I'm not surprised he snapped his knob."
Penis fractures, I should reassure you, are something of a rarity, hence our childlike excitement. A hardy perennial in medical student paranoias, you would know it if it happened to you: a sudden onset of tearing pain, immense swelling, terrifying bruising and, most strikingly, a very loud snapping sound.
The GP who referred the patient over the phone immediately had me down as just the kind of doctor impostor we have been overdue in the tabloids. It was 10pm when I took the call, but I was still wrestling with a biblical hangover from the drug dinner the night before and the moment my intuitively workshy brain heard the word "fracture", whole banks of on-call survival circuits flipped into action.
"I'll stop you right there," I said, distractedly signing some blood results at the nursing station. "Fractures go to the orthopods."
"This man's fractured his boner, you cock. He needs an urgent urology opinion." I'd never heard a GP talk like that before: usually they are all sideburns and antidepressants. He'll be waiting until morning if I know the urologists, I think to myself.
"He's shitting his pants."
And suddenly the immense gravitas of the situation came crashing down around my ears. Of course he is, I thought. Of course he's shitting his pants: he's just heard his willy snap in half.
"Right, let's have a look at the old chap then," I said, trying to make the whole affair sound as innocuous as a 19th-century condom fitting.
It was a classic history: a little something to drink, she was on top, they got carried away; she was bearing down on to him, he felt the old chap strain and bend, and retreated intuitively - but there was no give in the mattress, no room for manoeuvre, no escape. Something had to give. And then the snap. Can you even begin to imagine?
Now, if there is one thing that medicine has taught me, it is an ability to suppress the urge to giggle, burst into tears or retch, in any social circumstance. I reckon I'm pretty good at it. I can happily eat my sandwiches in a room full of open colostomies. In our daily rounds of manipulation and deceit, we constantly shimmy around the issues and tell porky pies, at least until the diagnosis is definite, all for your own good. In fact, I can't keep up the charade: we constantly lie to you, for our own convenience and amusement. At least, that's what most of you seem to believe. But I digress once more into bitterness.
Our urology consultant pulled a stroke of communication skills genius in outpatients last week, with the assistance of two attractive young female medical students. "I'd like you to examine this man's testicles for me, please," he said, in his campest, most intimidating tones. The two girls obliged, intently palpating the surfaces of the 20-year-old patient's testes.
"Well?" he barked.
"Two normal testes," they both replied anxiously.
"Well, that's not bad, is it?" he roared. "Two nice attractive young girls telling you that your balls feel normal. Put them in myself six weeks ago. Bloody great big scar up to his arsehole."
They were mortified, the patient was beaming; and that is how it should be. We are mere tools for your emotional wellbeing.
Anyway, I gently opened out the trousers around this famous fractured penis and exposed, to my horror, a swollen, blue, misshapen, appalling, unpenislike blob. "Christ," I breathed. "Right," I said, confidently.
And what happened next is the only saving grace of surgery, a corner of medicine populated exclusively by sporty philistines and intellectual peasants with pretend working-class accents, questionable social values and boringly glamorous girlfriends. What happened next was: I phoned the registrar, the registrar phoned the consultant, the consultant came in from home at midnight and within an hour this poor man's willy was fixed and everyone except me had gone to bed happy. And it was all free of charge.
