"Private"

Do you remember this game? Now, I am not an expert, but after completing 5 rotations and now starting my 6th, I think I have come to understand a bit more about what skills are necessary to be a doctor (or in my case PA). And, this game doesn't really cut it! However, one very necessary skill, which I have been most recently reminded of, is the ability to keep a straight face no matter what problem or information your patient decides to share with you.

I guess I should preface by saying, I am currently doing a rotation at a free clinic here in Eugene. And, I love love love this rotation! They pretty much let me see patients on my own which has been great practice for me! Each day I come in, they have my schedule posted with my patients for the day. I go in, see each patient, come up with what, in my humble opinion, is an appropriate treatment plan, present it to the doctor, and they either agree with me or guide me in a more appropriate direction. Then, I go back in, tell the patient what we are going to do with them, and send them on their way. Anyways, it has been great for me to have so much responsibility. It has really forced me to step up to the plate and start thinking like a practitioner rather than just a student.

Anyways, a few days ago, I was looking at my schedule for the day. They usually have my patients listed along with their "chief complaint" for the visit that day. Well, I had this young guy on my schedule with a chief complaint of "private." All day long, I wondered what that could mean, but when I finally got into the room and found out, it was definitely not something I had expected.

I walk in the room, introduced myself, and asked this young man why he was in the clinic today. He explained that he has been dating this girl for a year and a half now. He stated that he really liked her and that she means a whole lot to him, and he could see having a very long-term relationship with her. However, (and at this point he sort of averts his eyes to the floor as he explains that...) he feels the desire to have sex with her everyday, but she would be happier if it was more like once a week. And, he is not sure what to do. He now refocused his eyes on me signifying that he was ready for me to speak, and I was sure glad that I had somehow managed to keep a face that was not showing my utter shock! I mean, I have had many women complain about the same issue only the opposite. Their husbands would like to have sex way more than they were interested in, and it is causing some tension in the relationship, and what can they do. I think I was just shocked to see the other sex in here complaining of the same issue. And moreover, it wasn't something he slipped in as an "oh by the way..." after coming in for a completely different health issue, but rather, this was the only health issue he wished to discuss today.

I cleared my throat, and (with what I think was amazing poise) asked him a few questions about his relationship. I asked him if he felt comfortable discussing this openly with his "partner" (as that is the appropriate buzz word here in Eugene). He stated he did, but he just felt like he maybe had too much of a sex drive and was willing to do anything to fix this problem and make things better for this girl whom he obviously cared about. He even said, "I'm not too in to taking a bunch of medications, but if you thought there was a medication that would help I will be willing to give it a try." My thought, which I obviously didn't share, in response to this was, "Boy! If there was a medication that could do that, I would have women lining up out the door asking me to prescribe it to them so they could secretly slip it into their husbands' drinks every night!"

Anyways, we discussed this issue for a while, and came to the conclusion that we would set up an appointment for him with one of the clinic's counselors. I encouraged him to include he "partner" in these counseling sessions. He said he would think about it. Anyways, the big triumph of the day was that I was able to discuss this "private health issue" with the patient, and I think I manged to do so without letting on too much of my initial shock.