Tales From The Asylum

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My first training placement was on a male 'long-stay' ward. There were approximately 30 patients, most of whom had been living in the hospital for most of their lives. The average age was around 50. I looked up one chap's case notes. He was 61 years old and had been admitted to the hospital at the age of 18 for stealing some items from a local shop. He'd been living in the institution ever since. Sadly such cases were not unusual.

I liked the patients on the ward and enjoyed playing pool, going for walks and generally interacting with them. The blokes were used to the regular rotation of students around the place and tolerated the new faces well. After a few days I was beginning to feel like a real Psychiatric Nurse and was glad I'd given up my bank job. This was the life for me.

I kept noticing one of the old blokes who hobbled around with a walking frame (known as a Zimmer frame) and a pained look on his face. Arthur took absolutely ages to get from A to B and would've put the average snail to shame. He also had the baggiest pair of trousers imaginable. "Fair enough," I thought. Ward 13 was not what you'd consider a mecca of fashion. In fact, the standard issue pair of male 'institution trousers', which usually ended about six inches up the leg, was a constant source of bemusement to all who beheld them.

Arthur didn't speak very much and indeed, didn't seem to do much of anything really, preferring to rest in 'his' chair and watch the telly. It's a feature of institutionalised behaviour - some of the patients had been using the same seat for years and could get quite stroppy if you were to unwittingly sit in 'their' chair. Come to think of it, I know a few other people who are a bit like that too..

So as the days went by I would watch Arthur's painstaking to-ing and fro-ing, his large trousers a continuing source of intrigue. I amused myself imagining them flapping in the breeze as he shot down the hallway on a jet powered Zimmer. Then one day Ian the charge nurse, asked me to take Arniold for a bath.

It's a general principle of rehabilitation that one gets the individual to do as much as they can for themselves, but Arthur was clearly not going anywhere in a hurry, as it were, and needed a fair bit of help to undress and bathe himself. It was at this point that the mystery of the baggy trousers unfurled itself before my very eyes. Local witnesses (including a smirk-ridden Ian) later claimed they heard my squeak from a good hundred paces away, but as Arthur dropped his strides, there before me appeared the largest scrotum I'd ever set eyes on. I mean, I didn't think I'd led that sheltered a life, but Arthurs gonad's would've made an elephant blush.

Turns out the poor bugger had an inoperable scrotal hernia. Otherwise known as an inguinal hernia, this is where part of the abdominal wall can become weakened, allowing some of the intestinal organs to protrude into the groin area. I wouldn't recommend it, particularly to male readers, but here's a pathology photo (this one's actually smaller than Arthur's). See, I told you not to look. That's what you've got to look forward to when you're 80.

Arthur's hernia was inoperable because he was a 79 year old 'psychiatric patient' who wasn't in the best of health and was unlikely to make it into surgery. His balls were so big they almost touched his knee and his penis had all but disappeared from the massive stretching of flesh. Helping him to wash was a true lesson in sponging-softly. To my surprise though, he seemed pretty relaxed about the whole thing, he just didn't move fast.

Suddenly Arthur's demeanour and generosity of trouser made a whole lot of sense and I gained a whole new respect for the poor fellow. I've also been very careful about how I lift heavy things ever since.