by Robert Lanz, LCSW
Some people thought I should have kept this intervention to myself. Some people thought I shouldn’t have resorted to this level of intervention in the first place let alone expose myself in public after having done it. There’s good arguments on both sides for having done it and having done it is enough of a reason for me to go ahead and include it.
In my own defense, as you will see in the story, I was up against some pretty long odds and from the start thought I would get nowhere with this guy. With that in mind, I had nothing to lose in terms of making headway with a difficult patient-on the other hand this sort of risky behavior could get me in trouble with someone, maybe even those people who thought I shouldn’t have done it OR included it. In the end, I did do it just as I tell it and in the end I think it was the right thing because it shows that a committed person will take risks to make a situation better and that’s what I did. You could argue that it was pretty stupid to take a risk on such a difficult patient. I would agree with that assessment about myself.
A guy got out of jail and was riding down the street as a passenger on the back of a motorcycle. He was a gangster before he went to jail and a gangster when he was in jail and probably couldn’t wait to get out so he could be a street gangster again. He was like that. When the motorcycle pulled up to a stop light, the young man didn’t look to his left and see another gangster from another gang pull the gun. Before he could do anything about it he had been shot twice in the penis. They brought him to the ER with two holes in his dick, a traumatic event if ever there was one.
The doctor on duty flagged his chart and suggested I go in and consult with the patient about his life style. It was a new physician and he flagged charts all the time as if he hadn’t ever worked in an ER before and didn’t realize that some people just aren’t going to change no matter what happens in their lives including two nine millimeter rounds through the dick. I suggested to the doctor that perhaps this young man had not been properly rehabilitated while doing seven years in prison for killing some other gangster and that some white boy social worker probably wasn’t going to make a big dent into the consciousness of somebody more worried about getting it up in the future than merely being alive. It’s a guy thing.
“Go see the patient,” he said with a degree of authority that told me he was a new guy in the field of emergency medicine. An old guy wouldn’t talk that way to me, not around here anyway. Most of the staff knew I had spent some time in jail and had paid my dues. If anybody here knew about rehabilitation, goddamn it, it was me.
“Did you have some special pitch in mind?” I answered as if I was as lame as he was.
“Hey, you’re the social worker. Say something relevant.”
“Thank you for your confidence doctor,” I answered. “I’ll try to think of something that will make more of an impression than two through and through wounds to his penis.” I always liked to use the correct anatomical terms with the new guys. With the regulars I would have just said “dick” instead of penis. Somehow that sounded more appropriate here. We put catheters in penises. When something is wrong with my penis I go to the urologist. If I get shot down there, it’s a dick thing and this gangster had two rounds through his dick.
It did create a challenge though. A hard act to follow. A murderer just out of prison with most of his friends still there or dead. And here was some middle-class white boy with some college degrees and state sanctioned licenses who was supposed to top that act.
Sometimes I don’t have a clue what I am going to say when I go into a patient’s room. Sometimes I do. This time I didn’t and I surprised myself when I heard the words roll off my tongue. Improvisation is a great tool if you know how to use it but under some circumstance, and this could have been one of them, it can lead to dire consequences.
“Well, I’ve got good news and bad news. What do you want to hear first?”
He had a worried look in his eye. When you’re talking about a guy’s plumbing, bad news can be real bad. And what possible good news could there be about a dick shot?
“I’ll take the good news first. I need some good news in my life.”
“Well, both bullets went right through your penis but they didn’t hit your urethra. We can sew you up and send you home. Should be good as new in a few weeks. Try not to get an erection. If you start to feel one, think about prison or, hell, think about getting shot in the penis. That should take care of it.”
I really sounded official. Penis, urethra, erection. If this was a spelling bee, he’d be out in the first round. Of course, as I heard the words, I knew what was coming next. The punch line. Penis, urethra and erection were just the set up.
“Well doc?” I guess he thought I was a physician with all those fancy words. “What’s the bad news?”
“The bad news,” I answered with as straight a face as possible, “ is that if you’d have been a white guy, which you aren’t, they probably would have missed your dick altogether.”
He took a minute for that one. A long minute. I was wondering if I had pushed the boundaries too far this time. He could get me fired for a line like that but at least he couldn’t hurt me. With his wounds, it was highly unlikely that he would jump up and punch me out in a rage.
“You’re too much, Doc… You know, this is fucked up. I should go live with my aunt in Iowa. Start a new life away from all this shit.”
“Yeah” I replied. “I was gonna suggest that.”