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Didn't See That One Coming …

When a young male patient has a urinary tract infection and difficulty urinating, usually a check for prostatitis is in order. Add prostate checks to the list of things where you can “expect it.”

When checking a patient for prostatitis, I will usually say something to the patient along the lines of

“When I press here [while pressing on the prostate] does it cause you to have more pain?”

Most of the time, patients are already screaming.

“Yeah, it hurts like hell. You done yet?”
-or-
“Owwwwwwwwww. Daaaaaaamn. Owwwwwwwwwww.”

Really want to skeeve your doctor out a little? When he asks you if pressing on your prostate hurts, tell him

“Actually, it feels kinda good.”

[shudder]

I’m considering empirical treatment for prostatitis from this day forward.

This and all posts about patients may be my experiences or may be submitted by readers for publication here. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.

 

 

11 comments

  1. One patient asked me if I would mind ” Rubbing my shoulders while you do that”.
    Went back and triple gloved.

  2. Way back when I worked in a clinic (pushing paper, not a clinical position), so many of our elderly male patients were mortified by becoming aroused during a prostate exam that I assumed it was a normal response to stimulation–albeit one that the majority of heterosexual men would be surprised by.

    Being “skeeved” by a patient admitting that it feels pleasant suggests a level of homophobia that makes it difficult for gay patients to get good health care.

    • I’d be just as upset by a woman getting excited during her pelvic exam- so keep your homophobia-phobia to yourself.

      • Seriously, Finn. When people are by necessity in physical contact and one not only gets aroused but voices it and it is not a mutual thing that is skeevy. Homosexuality is not an excuse to be rude or lewd.

    • Yikes. If I EVER got aroused during a pelvic, I would be very concerned. There’s something skewed about your thinking, Finn. Really.

  3. I was doing a prostate exam once, when I tried to reassure the patient by saying “That feels good”. While I meant good as in normal, as opposed to bad as in nodule, I thought about what I said, and resolved never to phrase it that way again.

  4. Finn,

    To make the leap to homophobia from unexpected comments during a DRE is silly, and to suggest that it would compromise care is naive.

  5. Wait …is it not pc to smile at your post. I hate pc ..but still. It’s just the way you write and how I imagine your expression on the imaginary face I see as Dr WC. :)

  6. Yes, I treat empirically 99% of the time. And I would get skeeved with anyone getting aroused with a rectal exam.

  7. ‘Oooooohhhhhh’ (closed eyes, slightly open mouth)
    ‘Have you got a tissue?’

    That has really got to spoil your Doctor’s day.

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