My Patient, Mr. Stud Muffin

He was not bad looking, a little over average height. He had dark hair and though it wasn't thick and wavy or anything like that, it was nice – thicker than most men and brown. He had brown hair and I think his eyes were a dark blue. He had a pretty good build on him that caused us nurses in our twenties to call him a "Stud Muffin". That was in 1999.

The reason I can't describe him better is because he was my patient. I was working at not getting emotionally involved with each "person" who was a patient so that I wouldn't go home exhausted at the end of my twelve hour shifts. It wasn't as easy as being taught it in nursing school. Besides that, anyone in the hospital, in a gown, is not as identifiable as people in other settings. Any nurse can tell you that. We meet our patients in say, Wal Mart, and we seldom recognize the patient. But they recognize us. They greet us with enthusiasm. Then there is always that horrible temptation to say, "Oh, I didn't recognize you with your clothes on." I actually made the mistake once, even when I had been warned in nursing school to never give into the thoughtlessness of what it would sound like to all around you if you said it. The response was pretty much what my teacher had predicted it would be.

I wouldn't have noticed "Mr. Stud" more than any other of my hundreds of patients if it had not been that his diagnosis and treatment instructions were so interesting. It was all something to break what had started to seem like routine stuff on the surgical unit I was working on.

His diagnosis was Priapism with possible surgery. His treatment was, "Apply a child's blood pressure cuff every two hours, inflate and release X3. Keep the area concerned packed in ice continuously." The doctor had added a note: "Do not let the ice melt!"

We couldn't help it, all us nurses in the report, we had to look at each other and raise our eyebrows. The one male nurse on the shift that night winced in pain and said, "Ouch, and more than in that particular area!"

We offered the male nurse the care of the patient. "Not on your life," he said. "You're not supposed to sympathize too much with patients and look at me, I'm a mess just thinking about it."

"Oh, bock, bock," one of the girl nurses said, trying to imitate a chicken.

Other nurses said it, "What a chicken you are! Come on."

"I'll trade you," he said, "for the next complaining old lady that won't complain if a male nurse goes in instead of one of you."

We all had to give in. He was right. Then the charge nurse made assignments and there was no bantering or discussion. She just appointed me to take care of Mr. Stud. I knew better than to resist, but I must have looked a little reluctant because she gave an explanation.

"You're mature. You will do well. It takes professionalism to handle these kinds of things, which you have, but he needs somebody who cares too. Whatever he did to deserve this one, I think he is suffering enough already. We can be kind. He needs kindness."

Everyone nodded in agreement – all the married ones and the ones in relationships did anyway. I just sighed. I felt as kindly as they did towards the poor man, but there was something they understood about the whole thing without being told any details that I did not comprehend right then. I found out later what it was.

When I went in to change the ice bags and apply the blood pressure cuff, I saw as much suffering as I had ever seen before. He was in pain physically and mentally. The professional way in which I approached my duty, as though I was changing a bandage on his leg, put him somewhat at ease in his mental pain. A strong shot of narcotic right on time hardly touched his physical pain.

I could tell right off, the blood pressure cuff wasn't going to work. The anatomy involved was too tight, too swollen, too blood engorged. The cuff did nothing but cause more pain. The ice was good, but it wasn't doing much either except it felt good to him. He was grateful for it. By morning, the doctor said to stop the pumping, it was just a trial anyway, something he had never tried before, and it wasn't making a dent.

I had worried before I went in Mr. Stud's room that the smallest cuff I could find over on the OB Ward would still be too big for the job, but it wasn't. This guy was really big in that intimate part of himself – even when he wasn't erected - it looked like. Erected as he was, he was huge. The cuff was a bit small and I had to go get a bigger one.

He kept telling me he had never had anything like this happen before! After awhile he told me he lived across the United States from where our hospital was located. He was just in town to attend a convention for his company. He was glad that he was so far from home so nobody who took care of him would run into him or recognize him in public.

We found out later it was not just the embarrassment of his condition he didn't want made known. He had not brought his wife with him. It was his first time to stray, and we got the impression that he paid good money for the fun he expected to have, but the fun ended when the affair was over and his body didn't cooperate with him and finish when he did.

"Guilt," an older nurse said, "Guilt. Guilt. Guilt. Look what guilt can do to you."

I began to understand some things I hadn't understood in report that night before I started to give care to this man.

Another older, very experienced nurse said, "The books never say it, except maybe as a side line – probably because men usually write them – but my experience tells me, and I would bet I'm right, the main cause of this particular diagnosis is predominately guilt. God has his ways. Even a person who doesn't believe in God has got to admit that there are consequences to everything we do on earth. Think of the pain it causes a partner. Now, he'll have to tell his wife. It is called retribution."

I just sighed. At the time, I didn't have enough knowledge and experience myself to agree or disagree, I just felt so bad for the patient and his wife and for all the unpleasant things of life we nurses get so familiar with.

A week or so after the patient left the hospital, I asked his doctor about him. The doctor shook his head. Nothing had worked but some pretty strong medicine that would make the man impotent. He said he just tried the pumping as a long shot because he didn't want to do anything permanent to so young and good looking a guy, but in the end, he had no choice. He told me he had a long talk with the patient and the guy was feeling worse about cheating on his wife than he was about his problem, confirming what the other nurses had suspected all along.

The doctor said, "I feel he didn't comprehend the trouble he was in physically though I explained it to him. When he gets home, he'll have plenty of time to realize he'll never be the same again. You know, no matter what he did, the punishment was worse than the pleasure!"

I didn't walk away after the doctor quit talking because he was staring off into space, not talking, but I felt he wanted to say more. Finally he did.

"I hope his wife really loves him," he said, "If she doesn't, they are finished, and he is finished, I'm afraid."

A year later the same doctor came up to me where I was charting in a private part of the hall. He wanted to talk. Aren't you the one that took care of so and so, he asked me. I was amazed how well I remembered the name and the diagnosis after a years time, but I didn't say the patient's real name, "Mr. Stud Muffin?" I exclaimed, "He's back! Clear from across the United States?"

The doctor's eyes opened wide, "You guys called him Mr. Stud Muffin?" he asked me.

The he said, "He came back for an implant. He never told his wife what he did. He just wants to come, get the implant and quietly go back. It took him a year to save the money or he would have been back sooner. He had to earn the money without his wife knowing. He's not going to tell her anything. He says she is all sympathy towards his impotence."

"How can they have a relationship and him not tell her if he has an implant?" I asked.

"Beats me," said the doctor. "All I do is put the thing in. The rest is up to him."

The doctor got a paper and drew the procedure out for me to study on the back of a lab report he was holding. He drew the implant and the apparatus that pumps it up and lets it down.

As he was drawing, I said, "Someone who reads that lab will be very interested in this report." His drawing was quite graphic!

When the doc was done with his explaining and drawing, we just looked at it, speechless for some time. Then the doctor and I looked at one another in disbelief, trying to comprehend how the man could keep his wife from knowing. It was past our reasoning to figure it out.

"It seems like just a solid implant would work better for him," I said carefully, looking in the doctor's eyes to see if he agreed.

"Said he had enough of that when he was here before, and he don't want no more erections that won't go down!" the doctor answered.

We didn't laugh right then because it really wasn't funny, but in a few seconds it was all suddenly very, very funny. We couldn't quit laughing. For weeks I couldn't look at that doctor without us both laughing.

The doctor told me why he came to talk to me, "Mr. Stud wants the same nurse he had when he was here before and he wants in and out of the hospital quick. I told him I would look you up. Can you take care of him for me? I don't make these kind of allowances for my patients and I know you can't either, but this is just kind of, well, it just gets me here." The doctor hit his heart with his hand.

"And it gets you somewhere else too, I bet," I said.

"That too," the doc said, "So when do you work and that's when we'll schedule his surgery."

"You are really nice," I told the doc. "You are really nice!"

"So are you," he said, "That's why I'm asking you, but if you won't tell anybody how nice I am, I won't the same for you, okay?"

Mr. "Stud Muffin" got his implant a few weeks later. He was bright, cheerful, and hopeful as he went off to surgery. I made a funny sound in the throat when he said something I didn't expect at all. I couldn't believe he used the same term on himself we had been using on him.

He said, "Hey, I just want the stud back in my muffin and finally it's a'comin!"

I decided not to tell the doc about that statement or we'd never quit laughing. I told the nurses in report and we all enjoyed it immensely.

The repaired Mr. Stud Muffin never came back again, so we assumed the stud worked. He must have been quit a muffin after all, for his wife to stick by him as she did, or maybe she was the muffin.