"Saubawls"

My registrar has a unique way of describing certain urological conditions.

One of his favourite 'diseases' is "Sore balls" (pronounced "SAU-Baw-LS") which is a syndrome mainly psychiatric in nature where young men present to EDs all around the city to whinge about their scotums.

Most are defiantly dismissed with oral Antibugs and referred back to the rock they crawled out from underneath.

But occasionally, just occasionally, we hit something more interesting.

Today got dragged down to the "Urology bed" in ED to see a young 30 yr old Saubawls Syndrome. Reg was gonna turf him out into the rain but realised this was the 2nd presentation in under a week for this condition.

I got the unenviable task of begging the ultrasound Nazi's to scan his scrote and chasing down the report.

Turned out it was not what we were expecting. Abnormal vascularity and random shape indicating a possible testicular tumour.

Now as bad as it sounds, something inside me got all excited when I heard the CT report.

Testicular tumours are rare but very curable. And to diagnose one as an intern (with registrar assistance) is very cool.

I hastily called my reg, blurted out the Ultrasound report and added on, "So can I send off a B-hCG and an AFP?"

My reg obviously impressed with my keeness to get stuck into tumour markers said "Of course! And lets do a CT too to look at lymph nodes"

Feeling very excited and telling any intern around I could find about my discovery, I then realised the poor dude with his busted balls had no idea what was going on.

You know on TV when the pt asks "Doctor, what's wrong with me?" and they give that vague non-specific answer that you know means bad news? Well today I know WHY they give that vague non-specific answer.

It's a fob off.

On the one hand you can't lie and say it's not more sinister when in reality theres a good chance it could be. But on the other hand, you don't want to get them worried and panicked when you haven't confirmed it yet.

So you fob it off. You say something like "Well we still aren't quite sure what it is so we need to do more tests to work out if it's an infection or something else".

You never specifiy what that something else is.

I kinda felt bad for being so excited about having 'interesting' pathology.

Maybe I really AM getting too into surgery... thankfully only 6 working days left!