A Tale of Accidental Testicular Torture from Applying Electrical Joules to the Jewels Or- “How Not to Learn Backflips” by Thomas N. Muziani PA-C, CP

A little historical context is necessary. In the early 1960’s clinicians, (surgeons, physicians and nurses) realized they needed to “up-their game” when it came to treating a new level of post-operative patient. The in-vogue craniotomies and emerging popularity of open-heart surgery demanded a paradigm shift in medical treatment and physical layout of the post-operative convalescing patient. A “recovery room” would not suffice. So, what was the answer? A larger recovery room…with pull drapes to provide “privacy.”

The 1960’s intensive care unit was nothing more than a recovery room on steroids. It was still one large room with twice the space between patients and a large nursing desk with banks of monitors. With the advent and popularity of medical shows on television, most hospitals adapted that same dramatic flair when treating an emergency. If a patient arrested in “ICU” at our hospital, the loudspeaker would blare out “Doctor Heart ICU” and everyone including the parking attendant would come running. What we never considered was that when a patient arrested and the attending flood of clinicians would barge into ICU…the poor patient in the next bed, just recovering, would witness this maelstrom of people and I am sure wonder: “Is this going to happen to me?”

When I first started in medicine I was hired as an orderly. Because I have always loved tinkering with machinery and never minded getting up early, I gravitated to the open-heart room. Through this experience I felt I had become an “expert” in providing CPR.

One late afternoon while I was cleaning the heart-lung machine post-surgery (cleaning up the pump was a 3-4 hour procedure), they called: “Doctor Heart ICU!!” She might even add “STAT!!” for dramatic flair…this was Hollywood…LA LA Land.

The ICU was right next door to the pump room so I was one of the first people to arrive. Here lay this 450+ pound gentlemen in this massive bed in full blown arrest turning a bright shade of purple. A very diminutive anesthesiologist was attempting to intubate the poor patient, nurses on either side were having no success providing chest compressions because: A) the bed was too wide and B) the guy was huge!

So, me being the tough stud I deluded myself into thinking I was, leaped onto the bed, straddled the mountain and started giving chest compressions. By this time, the crowd began to congregate to assist. With the corner of my eye, I noticed the patient in the next bed, with the drapes pulled back to accommodate the crowd and equipment, staring at me with his mouth agape and the distinct look of witnessing a “Lazarus Syndrome”*.

The patient’s stomach was huge so all I could do was rock back and forth straight arm. The reason I did not see the paddles “coming” was because my attention was diverted by the patient in the next bed staring at me with horror on his face. Just then…this incredibly jolting pain, emanating from my groin and radiating up my spine, caused me to do a literal back-flip off the patient. I woke up on the floor (wanting to cry the pain was so severe)…with everyone staring at me. And then…within a Nano-second, they collectively began to laugh….that irresistible laugh when you witness someone slip on black ice.

The reason the anesthesiologist did not worry about my proximity to the paddles was because he was a bit of a cowboy** and loose cannon and known for huffing Nitrous*** on occasion. The gas-passer during all the excitement had grabbed the paddles and proceeded to defibrillate the patient never comprehending I was up there. Despite my own painful encounter, both I and the patient survived the episode! The anesthesiologist did not, eventually being booted from the hospital. For months nurses, doctors and administrators would see me in the hallway and giggle. The term “Doctor Heart” still sends shivers up my spine.

Absolutely true postscript-

Besides overhead pages for “Dr. Heart ICU”, real physicians were also paged overhead. On staff at our hospital we had a Dr. William Faithe, a neurosurgeon, and Dr. Henry Miricle, a General surgeon. One day, in the cafeteria, two beautiful little old ladies were sitting several chairs down from me. One was acting like the hospital expert saying to the other: “You know, I know what Dr. Heart means. That means cardiac arrest. Dr. Faith means a patient has died. I still do not know what Dr. Miracle means…but I hope it is good.”

 

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Perfusion Theory is an educational platform for the Oxygen Pressure Field Theory (OPFT). August Krogh’s theoretical concept of the oxygen pressure field is explained and then applied to clinical applications in perfusion practice.