Chapter 4: Boys Can Be Patients Too

From reading our story so far, you might get the impression that all our patients are girls. In fact, our patient load is pretty evenly divided between boys and girls, although as I said at the beginning, over time our practice has drifted toward the older end of “pediatric” practice.

We – my nurse Kim and I – see the full range of young male and female health problems, including some problems that require referring the child to a psychiatrist or psychologist. There are differences, of course. Boys tend to present with physical injuries more than girls, perhaps because they participate in more bodily-contact sports and games, but also because they’re more likely to engage in behaviors that are risky.

With our female patients, there are the issues surrounding puberty, menstruation and, of course, sex and birth control.

There is one change in our practice that really pleases me. I mentioned that we perform a lot of sports physicals for students wanting to try out for school athletics. It used to be that three-quarters or more of these were for boys, but in the past few years girls account for almost half our sports physicals.

All of this is just to let you know that in our practice we treat both girls and boys. And with that in mind, let me tell you of our experience involving one of our male patients.

Aaron was one of our very first patients when I opened the practice six years ago. Eight at the time, he’s now a healthy, good-looking African-American boy of 14, with all the promise and all the problems that come with that age. We had just finished a more-or-less routine physical exam and I had signed off on the forms for him to participate in soccer when he said there was “something else” that he wanted to ask about.

I told him certainly. I asked if I should close the door again so we’d have a little more privacy, but he said that wasn’t necessary. “In fact, do you think maybe I could talk about it with Nurse Kim?”

Actually, this was not that unusual. Boys – and even older men – sometimes have an easier time talking about “guy problems” with a woman than with another man. Aaron has known Kim since he first became our patient, and I think that over the years he’s come to trust her, maybe even more than he trusted me. Also, there was the soccer “connection” between them. So anyway, I was not surprised or insulted when he indicated that he would prefer to talk with Kim about the “something else.”

I leaned out the door and asked Kim if she could come in, that Aaron has something that he’d like to talk with her about. I gave it my “professional” tone of voice so Kim would know that this was medically related.

Kim came in a few seconds later. She smiled warmly at Aaron, and when she did, his tense, nervous expression gave way to a broad smile. “Hi, Nurse Kim! I was hoping I’d be able to talk with you today.” Then he glanced toward me. “I know this is kinda strange ... but do you think, maybe ... I think I’d be more comfortable if it was just you and me...?”

Kim looked to me, and I gave a quick nod. “Sure, Aaron, I’ll just step out – you know that you can trust Kim with anything. Besides, I’ve got some records to catch up on, so I’ll leave you in Kim’s hands.” Little did I know...

I stepped out and closed the door, leaving Kim and Aaron alone in the consulting room.

They way Kim told it to me later, Aaron seemed a bit relieved when the door closed shut behind me, but he was still nervous, kind of hemming-and-hawing, not sure how to get started. Kim finally had to say, “It’s OK, Aaron, you know you can tell me anything and it’ll stay between us. I mean, you know I have to tell Dr. Scott about strictly medical things – he’s your doctor, of course – but other things, you can tell me and they can stay between us. Unless you want me to tell the doctor − then I can.”

She sat on the stool opposite Aaron and smiled, and she could see that he was still thinking, probably about what to tell, and how much, and just how to tell it.

I’ll leave out all the long pauses, but basically he told her, “I feel weird telling this, but ... I get these feelings ... you know ... down there ... down in my ... crotch, I guess you’d say.”

Kim nodded just a little, like “Yes, I know – go on.”

“Anyway, my thing, it gets stiff...”

“Your penis has an erection.”

“Yeah. And it gets big...”

That informational remark got Kim’s attention – in the form of a twinge in her own crotch!

“Okay, that’s a perfectly normal thing to happen, Aaron. It happens a lot with boys your age – even young men, it sometimes happens.” Sometimes? Ha!

“Yeah. I guess I knew that. But what it is, is ... that sometimes it won’t go down – won’t go away.”

Kim nodded. Again this wasn’t so unusual for a boy Aaron’s age – it sounded like what we call, in technical medical terms, puberty, complicated by a case of severe adolescence – nothing of medical concern, but something that an inexperienced young boy might be worried about.

On the other hand, there are certain conditions that are cause for concern. Kim asked the correct question. “When you say these erections won’t go away – do you know how long they can last ... how long they stay this way before they finally go down?”

Wavering between embarrassment about what he was telling another person and the relief at being able to tell it to someone – a doctor, or a nurse – he answered, “Hours, sometimes. Even when I beat off...,” then realizing the words he’d just used – to his doctor’s nurse! – he quickly said, “I mean, when I mas-ter-bate two, maybe even three times, and it still won’t go away.”

Now that got Kim’s attention. And not all of that attention was of a professional nature. Yes, adolescents can have erections that last a long time, but there’s also too long, which is a condition known as priapism. All crude jokes aside, true priapism is a serious thing. It can be caused by spinal cord injuries or certain cancers, and by some drugs – legal and illegal. Since Aaron has been our patient for years, and I just completed a very thorough physical exam on him, and since we know what medications he’s on (none), I’m pretty sure those are not the problem. And as for drugs, principally marijuana and cocaine, well, Aaron is so into his soccer that I’m sure he’s not using either of those (for now, at least!). And we know that he doesn’t have syphilis!

Anyhow, there was the possibility, however remote, that there might be a serious underlying medical condition. Kim didn’t want to alarm Aaron, so she reassuringly put her hand on his knee and told him, “Could you excuse me a moment, Aaron – there’s something I forgot to tell Dr. Scott before he left – I’ll be back in just a minute.” Aaron looked a little concerned, but Kim gave him one of her warmest smiles. “Promise.”

She stepped into the hallway and found me in my office updating patient charts. “Rick, I just thought I should let you know, there’s a remote chance that Aaron might have a medical issue. I’m pretty sure he doesn’t, but still, I’d feel more comfortable if ... you know?”

Then she peered into the hall, I guess to make sure that Aaron hadn’t stepped out to look for her. “But the direction things are going, ... well, I think you might want to go in exam room two and listen, maybe take a peek, see what happens.” She smirked, a kind of ” ... if you know what I mean” smirk. Knowing Kim, I think I knew what she meant, and as soon as she was back in the room with Aaron and I heard the door click shut I hastened into the adjacent exam room – the one that had the “two-way mirror” into the room where Kim and Aaron were (the room I used to watch Kim “treat” Tanya for her “clitoral inversion”).

I looked through the window, and through the thin partition wall I could also hear Kim voice clearly as she apologized to Aaron for the delay and picked up where they’d apparently left off.

“So, Aaron, just to make sure I’m understanding you correctly, you said that you can masturbate two or three times and you – your penis – still has an erection, and it won’t go down? Is that right?”

Aaron just nodded, feeling, apparently, that there was not a lot more to say about the problem.

I saw the subtle shift in Kim’s expression. It was like she was drooling at the thought of what might be coming. She straightened up a bit and adopted her “serious professional” demeanor.

“While I was out I checked on a few things, and what I believe is, you are suffering – ‘suffering’s’ not the right word – what you are experiencing are what we call transient prostate blockages.”

Even I, who’ve had twelve years of medical training and experience, was impressed by the creativity of this “diagnosis.” Way to go, Kim!

She gave Aaron time to process her words – “his diagnosis.” And, of course, the inevitable question from Aaron.

“So, ... what can I do about these ... trans-whatever prostate blocks?” Good boy.

“Well, Aaron, there’s no permanent ‘cure,’ so to speak, The fact is, most boys simply grow out of them – they just disappear with age.”

Sadly.

“But the good news is, if these blockages start to bother you, there are treatments you can get to help you when they happen.” And she waited.

“So, ... how do I get these treatments?” That’s it − keep going, Aaron.

“Oh, that’s no problem – they can be done right here in the office.”

“And the treatments – what are they like?”

Now I knew Kim was drooling – probably at both ends!

“I guess I could show you. You said you’ve been experiencing these blockages a lot recently. If you have the time...,” nice touch, Kim – if it’s convenient for him! “ ... we could give you a treatment session right now.” She paused for to give him a chance to consider. “If you’d like to do that, that is?”

The boy’s eagerness – and his curiosity – were obvious, but he was trying to handle it in a way he thought would be ‘mature.’ “Yeah, I guess so – if you think it’s all right.”

“Certainly, Aaron. One thing: The doctor and I can both perform these treatments...,” here it comes, “ ... so, who would you like to do this first one...?” As if there were any doubt!

Aaron jumped at it. “You!”

Realizing that he’d sounded just a tad too enthusiastic to receive an unknown medical treatment, he said, “I mean, if you have the time, and since you already know about my ... condition and stuff...”

“Certainly, Aaron, I think that’s a wise choice.” His choice. “Now, the thing is, the treatment is done best when you’re already experiencing it – one of these blockages. And it doesn’t look like you’re experiencing one now. Are you?”

And I knew for certain: If Aaron wasn’t experiencing one of those “blockages” right now, he soon would be!

Aaron looked puzzled, like, “Does this mean I won’t get the treatment for my blocks right now?” But before he could get himself into a state of gridlock, Kim proposed the obvious solution.

“I understand. I think if we could get you to experience one of these blockages, right here, in the office, then we...,” we, “ ... we can do your treatment.” Now, the critical moment. “Do you think that would be possible ... could you get one of those erections ... right here ... now?” Kim paused to let him consider where she – where they – were going. “Do you think you... we ... could do that?”

I could just imagine what was going through Aaron’s mind. Was this nurse – his doctor’s hot, sexy Nurse Kim – actually asking – inviting! – him to get a hard-on, right there, in the doctor’s office – right in front of her?

Being cautious, still afraid of the possibility that he was misinterpreting Kim’s words, he said, “If you think it’s all right, then ... But how...?”

Kim got all professional again. “I have an idea. Are there certain things that you think of, those times when you’re having one of these ... episodes ... where your erection won’t go down?”

Aaron looked embarrassed, like he’d been caught doing something he shouldn’t. Kim smiled, a kind smile. “I think I understand. You think of girls, right? Don’t worry – it’s entirely normal for men, especially young men your age, to get sexually aroused when they think about girls – don’t be embarrassed.” She put her hand on his knee reassuringly.

Aaron shrugged, then looked down at the floor. Also, his face began to turn red. I would have felt sorry for the boy. Would have, except that I knew what was coming.

“The thing is, if we want to give you your first treatment today, we’re going to have to elicit a prostate blockage. But first, if we’re going to do the treatment properly, I’m going to ask you to take off most of your clothes and put this examination gown on. If you’d be more comfortable, you can change there,” she gestured, “behind that screen over there in the corner – would that be okay?”

“Yeah. I guess so.” He slipped off the table and took the fresh gown from Kim’s outstretched hand and went behind the changing screen. It’s kind of funny when you stop to think of it – in a few minutes this boy was going to be getting his junk handled by a pretty, sexy nurse, but he’s shy about getting undressed in front of her. People.

Aaron emerged from behind the changing screen wearing the short gown. Aaron’s tall for his age, and the gown Kim had given him (they come in several sizes) covered him only to about mid-thigh – which is right where I saw Kim’s eyes go. He hopped back up on the examination table, which only made the gown slide up higher. Also, even though you couldn’t actually see anything, it was obvious that the young boy on the table had nothing on under that short gown. I could tell that Kim was getting anxious to move things along.

“Okay, Aaron, if you can, just let yourself go – just imagine that you’re home, alone, in your bedroom. Think about what you think about those times when these blockages happen.”

Then it occurred to Kim – the natural course of these things.

“When you’re at home, in your bedroom, are you ... thinking ... about a girl, when these blockages happen...?”

Aaron blushed and mumbled something, which Kim (and I) assumed meant assent. Kim kept on.

“Is there a particular girl that you think of...?”

Even watching through the glass from the next room, I could see his face turn almost crimson.

Kim couldn’t help but see it, too. And then it hit her.

“Ohhh,... I see...”

Yes, the “girl” that Aaron thought about when he experienced his “blockages”? Well, she was sitting right there in front of him.

“You know, Aaron, there’s absolutely nothing wrong with that. You’re a handsome young man – any girl would be flattered that you thought she was attractive.”

Aaron’s face was still a crimson red, but he also seemed to be reassured − that Kim wasn’t offended, or that she didn’t think he was a pervert. But she still needed Aaron to manifest a “blockage” if she was going to have the opportunity to give him a “treatment.”

“Let’s go on. When you think about ... this girl ... how do you picture her? For example, when you picture her, is there any part of her that you think of...?”

Aaron mumbled something.

Kim wasn’t sure she heard him. “Did you say ‘her legs?’”

He mumbled again and sort-of nodded.

“Aaron...,” I could tell that Kim was debating with herself. Finally, she decided. “Aaron, would it help if I showed you my legs – would that help you to...?”

Aaron made a strangled sound, which Kim chose to take as a yes. She got up off the rolling stool and pulled the arm chair around in front of the table – right in front of Aaron. Sitting down, she leaned back and extended her legs. Then she reached down and took the hem of her skirt – and slowly lifted it up her legs, up her thighs.

The way she did it, it was like a strip-tease. I’ve become well-acquainted with Kim’s thighs the past few months, of course. But seeing them revealed in this way, the way she was doing it now, for Aaron, I could really appreciate how sexy they are – strong and athletic, but at the same time still slim and shapely.

Also, she revealed those sexy thighs almost as far as she could. Two inches more and Aaron would know whether Kim was wearing panties or not. (I was pretty sure she wasn’t.)

“Does that help, Aaron? Does looking at my legs help you get those feelings you get...,” she stopped before actually saying get a hard-on, “ ... get those feelings you get before you experience your blockages?”

Again, Aaron uttered a strangled sound.

Now it was Kim’s game, and she was going to manage it the way she wanted.

“What, Aaron – I couldn’t hear you – do my legs help you feel like you’re going to have one of your blockages?”

In response to Kim’s pressing him, he finally admitted, “Yeah ... yes.”

“Yes what, Aaron?”

Again, the strangled reply. “Yeah, they are – I’m feeling like when I’m going to have one of my blockages.”

“That’s good, Aaron, that’s very good.”

But even more convincing was the way Aaron was fidgeting and squirming on the table, and how his hands kept finding their way to his crotch before he’d snatch them away – only to have them return in a matter of seconds.

“Here, let’s take a look and see if it’s working.” Without bothering to ask, she grabbed the hem of Aaron’s gown and lifted. Yes, we’ve in fact verified that Kim’s instructions were working and that Aaron was well on his way to experiencing a very fine blockage indeed.

From the expression on Kim’s face, it appeared that that she felt Aaron had a fine blockage, too – a blockage she’d love to work with! Professionally speaking, that is.

But still keeping it professional, she asked Aaron, “Is this what’s it’s usually like, the times that you experience these blockages?”

He replied, in a hoarse voice, “Yeah.” Then he added, “Maybe a little bigger than most times.” I can just imagine how proud that little qualification made Kim feel!

Her response? The professional one. “Good, Aaron. That should mean that we’ll have a successful treatment session.” She smiled at Aaron. He managed to smile back. “I think we’re ready to start. First, I’m going to ask you to lean backward – put your hands behind you on the table and lean back, and that will put the affected area...” – the affected area! – damn, she’s good at this! – “ ... the affected area at the optimal angle for treatment.” “Optimal angle?” Sweet Jesus!

But Aaron followed her medical instructions to the letter. And this left his pelvis thrust forward, his junk fully exposed and accessible – and holding his head at an angle that would let him observe the entire treatment. And exposed as he was, Kim raised his gown without a word of warning and began explaining the treatment to him.

“Now this treatment involves a combination of different procedures to be completely effective.

“Of course, there are some medical instruments that can do this, but many patients find these instruments cold and unpleasant. The good news is, the old-fashioned way of removing the final blockage doesn’t have these disadvantages. In fact, it might work even better than using the instruments.”

Aaron, still uncertain, asked Kim, “What does this other way – the ‘old-fashioned way’ – what’s that like?”

“Well, to put it simply, I massage your penis until the blockage removes itself. What I’ll do is, I’ll move the stool around here, to the foot of the table. Then I’m going to take your engorged penis between my thumb and fingers and begin with a special motion – kind of like a milking motion. And don’t worry – it doesn’t hurt at all – in fact, many patients say that it’s quite pleasant.”

Quite??

“Okay – ready?” She didn’t give him a chance to respond, and possibly delay or chicken-out. Instead, she took the aforementioned engorged penis between her thumb and three fingers and began that skilled milking technique that I have recently come to know (and I don’t even have a “condition!”).

Kim didn’t want to take the chance that Aaron would back out. Then I got a clear look at Aaron’s cock: Circumcised, about six inches long and of “medium” thickness. The silken skin was the most appetizing shade of chocolate brown. In fact, his cock looked absolutely delicious. I don’t have the slightest homosexual leanings (that I know of, at least), but his cock still looked scrumptious. I could see why Kim was anxious to begin.