All Together Now: “Penis.”

I prescribed a medication for erectile dysfunction today.

It was my first time. (As if there is any reason to be proud of this event.)

I couldn’t even remember how to spell vardenafil (tradename: Levitra). As my eyes skimmed the details about this medication (i.e. reasons why it would not be prudent to prescribe this medication to the patient), I realized that I was feeling anxious—it was the same feeling I had the first time I wrote a medication order as An Official Doctor. Isn’t anyone gonna double-check my order to make sure I wrote the right thing? anyone? anyone?

The guy didn’t have an appointment to see his primary care doc for several months and he had received medication for erectile dysfunction in the past.

“I feel comfortable talking to you about this kind of stuff, doc,” he said. “This is stressing me out. Can I get something for it?”

After some double and triple checking, I finally said yes. I wasn’t trying to give him a hard time. Well, actually, I guess I was. (… ugh.)

In my experience, male patients never refer to the penis as “penis”. Instead, a a male patient tells me about his

  • woody
  • friend
  • pal
  • thing
  • buddy
  • you know
  • dick
  • bone
  • it

This makes me use the word “penis” more than I intend, simply because I don’t feel right using a euphemism in a clinical context. I’m not about to ask a patient, “So, tell me more about the problems with your dick.”

In contrast, women either use the word “vagina” or “down there”. Do female patients ever say, “So, I have this weird discharge coming out of my pussy…” to their doctors? (I feel weird even just typing that. And by “weird”, I mean “uncomfortable”. And by “uncomfortable”, I mean “mildly obsene”.)

I hadn’t thought much about the Levitras and Viagras, primarily because it just hasn’t come up (ha!). These medications can significantly improve quality of life—these men who previously nursed bruised egos on the sidelines can now thrust (ha ha!) themselves back into the sexual arena. Instead of remaining outcasts in the realm of sexual intercourse, they can now penetrate (hee hee!) the sexual circle (oh dear…) and come in and out (I swear I’m not trying) as often as they please.

The social impact of the practice of medicine is frequently overlooked; we are no longer impressed with the societal impact of childhood vaccinations, HIV/AIDS awareness and education, or sterile technique universally utilized in surgical procedures. Medications like Levitra and Viagra are facilitating hope and vigor in men who would otherwise resign themselves to a limp lifestyle.

You know, I was shooting (…) for a serious, upstanding ending, but it’s not happening. So I’m just going to stop.


18 Dec 2006 | 14 Comments:


pianist

There, I said it. really fast.

sarebear | 18 Dec 2006 @ 9:42pm

In New Orleans, the older patients refer to it as “their nature.” As in, “Doc, I’m having problems with ‘my nature’.” It’s an amusing thing to hear.

mo | 18 Dec 2006 @ 10:46pm

what is truly weird is giving this same drug to a ventilated ICU patient. The drug was actually created for treatment of pulmonary hypertension, especially useful with ARDS patients.
Yes, we do have to check for erections..it never happens though.
The other issue is most cardiac patients cannot take this drug which is sad because most cardiac patients start out as diabetics and diabetics have percentage wise the highest issue with penile dysfunction and when their vascular disease progresses these drugs can cause heart attack and death.
It’s a nasty tease to know there is a drug out there that could help but odds are it would probably kill you in the long run. Not that that stops some of our patients.

moia | 18 Dec 2006 @ 11:03pm

Remember the old joke that playing with yourself can make you go blind? The FDA published a warning a while back that the Viagra class drugs can cause blindness, so it might be helpful to your patient(s) to let them know to stop the med if any vision loss occurs. Just a tidbit I read somewhere.

mary | 19 Dec 2006 @ 2:30am

I think the best female euphemism I’ve heard was the woman who told me she had “an itchy winkle”. I said “hmmm do you mean VAGINA?”. She said yes.

However due to the lack of privacy in retail pharmacy, when a woman asks for something for thrush, I usually ask “oral thrush or girly bits?”.

Then there was the retired teacher (from my school) who used to stop on his way past the pharmacy and bellow from the doorway “Can you make up my Viagra thanks, I’ll be back in an hour”….

yay | 19 Dec 2006 @ 2:53am

give him a hard time…ha! You are becoming quite the dead-pan comic Maria. (and, have a happy x-mas & all that!)

mark | 19 Dec 2006 @ 5:50am

Oh, that was terrible… but amusing. :)

Brock Tice | 19 Dec 2006 @ 6:59am

Maria, very entertaining. I am not very shy but I like to speak in terms that people are most comfortable with so I’ll refer to personal ‘parts’ as ‘parts’ you know ‘private parts’. “Down there” with my eyes kinda big. ha ha. I love reading you. I only go in when I have time. I am a quality assurance auditor for Health Net Federal Services and I work for TRICARE that covers the Military in the North. We have the military contract for active duty and retired people. Over 4 or 5 million people in 23 northern states. We get a lot of bad press but its a great job. Keep up the good work, I find you highly entertaining. Merry Christmas.

marian | 19 Dec 2006 @ 12:26pm

Speaking as a medical consumer, I have no problem using clinical terms with doctors (male and female).

I can tell you that during a comprehensive physical with my PCP, he asked me, “Anything else you want to mention? Anything at all?”

And I said, “Well, my libido seems to have dropped off a lot just in the last few weeks.” And he got embarrassed and changed the subject.

I dunno, I thought it might possibly be significant, since he was fishing. Depression, adult-onset diabetes, who knows? I don’t like to self-diagnose.

I’m looking for a new PCP.

HP | 19 Dec 2006 @ 5:40pm

THIS one woke me up during my daily scanning of my RSS feeds. Very nice.

Fard Johnmar | 20 Dec 2006 @ 11:44am

Ha! I found you by way of another blog link. As a midwife I hear some things and once while a woman was pushing her baby out I heard, “MY PUSSY’S ON FIRE!” ;) Following birth another woman proclaimed her “peaches were swollen”. Personally I get tired of saying VAGINA 4000 times a day…

frectis | 20 Dec 2006 @ 3:36pm

personally, I prescribe viagra to stop my elderly patients rolling out of bed.

rowan | 20 Dec 2006 @ 5:56pm

LOL - that’s great. Reminds me of the Regis & Kelly episode from yesterday. If you haven’t seen it, go check it on YouTube (it’s probably there by now). Regis said (in reference to how soft he was on Miss USA), “How hard [Trump] can be.” Muhahahahahaaa!

Marissa Miller | 21 Dec 2006 @ 10:37am

You forgot “John Thomas.”

DocMalk | 21 Dec 2006 @ 6:41pm


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