Whew, a couple long hour days in the hospital recently. Because of a blip in the call schedule I ended up working long-call for two days in a row. It’s fun for the most part though. It’s really the most fun when something actually happens. Most of my call nights involved correcting mistakes that nurse has caught that another doctor has made during the day. I suppose they need an official doctor’s approval for the change of action. It’s very clear that the nurses know how to protect themselves from legal liability. A lesson that doctors could probably learn.
Today, one of my patients had an episode of testicular torsion. It was pretty impressive, and it looked exactly like the textbook. “High riding testis with a transverse lie.” Acute-onset “excruciating” pain. So, I tried to manually untorse at first, then called surgery (who covered urology), and then went back and successfully untorsed it.
The scary thing is, I was the only person around that knew what to do. I guess in my ER electives, testicular torsion is talked about a fair amount (because it is a true surgical emergency). My resident (for whom today was her last day of Internal Medicine), did not know that it was possible to manually untorse. Even more amusing, I had the opportunity to speak to a scared 2nd and 1st year surgical resident who kept trying to claim that they weren’t covering urology. They might have just been misinformed, but they were also clearly scared. I thought surgeons are supposed to feel comfortable manually fixing something. Oh well. (I was told to go to the chiefs if such an occurance happens again).
So I fixed him.
It feels good. It is a little scary though, because it was so obvious that nobody else knew what to do. Since testicular torsion is so time-sensitive, I have to wonder a little what might have happened if I wasn’t the person actually there.
It’s worth saying, the other prelim-intern from Columbia knew exactly what to do. I guess that means we should give props to my medical school rotation in urology….