It was a normal day on the urology floor, meaning a highly abnormal day for Your Faithful Correspondent. I had gotten sent to Urology to make up a staffing shortage. There I was, schooled in the ways of the brain, trying to make do with rudimentary knowledge of the bladder, bowel, and kidneys. Continent ileostomy? Neobladder? What?
As luck would have it, I got an admission from the ER. The young man was reticent about his problem--he was a little younger than me, not willing to drop trou in front of a nurse in his peer group and come clean about his difficulty.
I finally got the guy to tell me what the heck the problem *was*. "One of my balls is huge," he said, "and really sore."
Well. Well. I had to assess it, so I did.
There's more room than you would expect in the average scrotum. I've seen 'em as large as small melons, but this one took the cake. One side of his scrotum was easily, and I kid you not, the size of my head.
The other was more-or-less normal. A little edematous, a little red, but pretty much what you'd expect.
Great leaping jiminy. What the hell do you do in that situation? Turns out you use ice packs and elevate the dadratted thing on a couple of rolled towels while you page the resident on call, stat, to come see your patient. A couple of milligrams of morphine calmed my patient; a couple of minutes of hyperventilation calmed his nurse.
The resident arrived and did his exam. Turns out the patient had had a little bit of an ingrown hair or zit or something, and had squeezed it, and the resulting infection had spread.
The patient went in that afternoon for an incision and drainage. Several days of intravenous antibiotics and some dressing changes fixed him right up, but I was reminded of the old limerick:
There was a young man from Devises
Whose balls were of two different sizes.
One ball was so small, it was no ball at all--
But the other one won several prizes.
Mom, in case you're wondering, I learned the limerick from James Herriot's books.