Tuesday, January 03, 2006

I Guess I'm Not the Patient Whisperer After All

I aspire to be — or to at least appear to be — the kind of nonjudgmental doctor that patients can tell anything to, and from the kinds of hair-raising things I've been told, I'd thought I was succeeding. But I recently discovered that there's a very common concern that none of my patients have ever asked me about.

When I took my current job, I took over for the only male doctor in the practice. He had collected a patient panel that included a lot more male patients than the other doctors, which I was glad about, because I really enjoy seeing men. Not that I don't like seeing women, but women tend to go to the doctor more often than men do, and it can get a tad boring.

I had to work at gaining the trust of some of these men, and more than once a patient would halt in the middle of telling me his story and say, "It's a little strange to be telling this to a lady doctor ..." which was my cue to bring up the topic of impotence (or ED — erectile dysfunction, the euphemism du jour). Heck, I'd ask about it even if they didn't seem like they had something they were getting flustered about. (My favorite answer of all time: "Well, yes, doctor, I have been having some trouble with my, you know, with my — direction." Which was actually true — he wanted the direction to be up instead down.)

But recently a man joined our practice, and I noticed that several of my male patients started showing up on his schedule. I wasn't shocked; I knew that these patients had always wanted a male doctor. But I was a little disappointed that I hadn't been able to keep them, given my simply breathtaking skills at patient rapport.

The other day I mentioned to my new partner that he was leaching all the testosterone out of my patient roster. "Well, you know there are things that men just won't tell a woman doctor," he said.

"No, they ask me for V*agra all the time," I said.

"Oh, not about that," he said. "There's something that I bet no male patient has ever asked you about, yet it's one of the most common concerns men come to me with."

"I doubt it," I said. "Try me."

"That their p*nises are too small."*

And I had to admit that he had me there. Though I have heard many, many penile concerns, that has never been one of them.

This has left my doctoring self-esteem a tad shaken. How could I have been missing this major thing? One of my favorite parts about being a doctor is being able to reassure people. And here all these guys have left my office feeling, well, inadequate, and unable to tell me about it. I mean, I knew that men worry about this, but I didn't realize that so many of them think it's enough of a problem that they should see a doctor about it.

And I'm not sure I'll be able to include it in my review of systems. "Do you have any constipation? Diarrhea? How's your urination? Any problems with erections? And — how about your johnson? Feeling cheated? Under-peckered? Got a wiener instead of a brat?" At least my partner told me what to say if I ever do get this complaint: "Too small compared to what? You've been watching porn, right? Well, you need to remember that those guys are in the top 1 to 2 percent of the population. The other 98 percent look about like you do."

Which is not at all what women are taught to say in private life ...

*Trying not to attract too many folks who will be very disappointed if they find me popping up in their Google searches.


Anonymous said...

Come to think of it, that's not a complaint I have heard either in my practice (female internal medicine PA). I did, however, have a well endowed man complain that he couldn't "shoot" as far as he used to. He actually told my very prude, very shy M.A. that at one time, he would have been able to hit her where she stood several feet away from him, but now all that he can manage is a "little squirt". When I tried to ask my completely professional, open-ended questions about this, he actually began to get teary-eyed and said he believed it was the reason he and his wife were not doing well. Incredulous, I promptly reassured him that his ejaculatory capabilities sounded completely normal to me, but I offered him a urology referral and recommended marital counseling nonetheless (he declined an exam). And I managed not to ask what I REALLY wanted to know, which was: Did he actually measure the distance? How? Did his wife actually witness these feats, and did she actually complain about his lack of geyser-like force? (Urology referral turned up nothing, by the way, except GONORRHEA. Gee, could the etiology of that have been why his wife was pissed off?)

Orange said...

I think you should routinely measure your male patients' penis length during checkups, and give them a graph showing where they rank statistically. You know, like the growth charts the pediatricians have for height, weight, and...head circumference. Yeah, you should measure length and girth.

B.E.C.K. said...

I wonder what would happen if you put a suggestion box in the lobby for suggestions on issues/questions that may also need to be covered. Might get some interesting feedback that way. FWIW, I've found that most guys think their penis is too small, when in fact it is, uh, just lovely. :)

thumbscre.ws said...

"Got a wiener instead of a brat?"... BWA HA!

I guarantee this is because there are no slickly-produced p*nis-enlargement commercials. I think guys are now able to discuss ED ONLY because of the constant, reassuringly virile presence of the Vi@gra/Levitr@/Ci@lis spokesmen on TV. Get a commercial for an enlargement product aired and the inquiries will come POURING in ("Uh... you know that guy, on TV... grilling the cocktail weenies and looking forlorn... well...").

Anonymous said...

I agree with Beck. Make a chart...then you could also have a "special chart" like the one they used on my kid..."well sir, your p*nis is what we call MODERATELY STUNTED in length, but hey it's only SLIGHTLY STUNTED for girth and that's NEARLY NORMAL--hurray!" I dare you.
On a more serious note, GIVE ME AN EFFING BREAK...if I thought my boobs were too small or something and was shallow enough to be tortured by that/deluded enough to think that changing it would improve my life I would go to a PLASTIC SURGEON, not my GP.

V said...

Ahhhh porn....the great educator of man.
Seriously....a MEDICAL problem? Should I consult my doctor about me arse then? It's got the precise shape and size that my mother's does...which is WAY too large by most porn standards.