by Dr. Iain Corness
The hewers of stone
and drawers of water
With the current
push for women’s health clinics and practitioners, it is easy for men to
feel left out. After all, you’ve no uterus to become cancerous, and
although you do have vestigial breasts and it is theoretically possible
to get breast cancer, I don’t suggest you go looking for breast lumps
every month after your non-existent periods.
However, there are some specific
male areas, and these centralize around the genito-urinary systems. In
the medical business, Urologists are sometimes called the hewers of
stone and drawers of water, because much of their work deals with kidney
stones and assisting men to be able to pass water adequately. We men do
suffer at times, it’s not only the ladies who have ‘specific’ problems!
Your urinary system is a remarkable
collection of organs, beginning with the kidney, the “super filter”. The
kidney filters the blood and allows the important stuff like blood cells
and nutrients to continue waltzing around your circulation, but taking
out the nasties, and at the same time helping balance the
acidity/alkalinity of the body. Clever little organs, the kidneys!
To keep your kidneys in top shape
does not require special kidney exercises, you will be pleased to know.
In fact, there is nothing you can do ‘physically’ to make the kidneys
perform, but fortunately there are some things you can do to keep them
in top condition.
The first is to drink plenty of
water every day. And by ‘water’, I mean the plain and simple H2O style
water, not the stuff that has been mixed with hops, distilled with grain
or left to age in oak casks. Making the kidneys exercise, to filter and
regulate the circulating blood volume, is simply carried out by drinking
several liters of water every day. Yes, it is that easy. On your desk at
work keep a glass of cold water beside you and empty it every 30
minutes. Into your gut, not the sink.
The advantages you get from this
are enormous. First off, you have immediately lowered the chances of
forming kidney stones, a potentially dangerous (and always painful)
condition. Being a card carrying coward, I have always preferred the
drinking water option to the lying in bed groaning with pain
alternative. In fact, around 15 percent of people will experience stones
in their lifetime (especially in the hot climates) and men outnumber
women between two to three times. We also know that if you do not change
your lifestyle, you are very likely to develop another stone within two
years after the first episode. We men do suffer at times, it’s not only
the ladies who have ‘specific’ problems!
The kidneys drain to the bladder by
two tubes called Ureters. These do not do much, other than connect the
kidney to the collecting vessel (bladder). However, if a piece of stone
gets stuck, you will soon know about it. Renal colic sorts out the men
from the boys! Ultimate pain! Down on your knees type pain.
From the bladder, the urine gets
introduced to the outside world by another tube called the Urethra. This
is short in ladies and is the reason that women get Cystitis (bladder
infections). It is longer in the men folk, allowing us to stand up to
pee and become obsessed with how long or short it really is. After the
age of 40 give up the ‘Who can pee the highest’ competitions.
However, we chaps have another
problem in that region, as far as getting the urine from the bladder to
the far wall of the urinal. This is called the Prostate, and it
encircles the Urethra and when enlarged, closes down the internal
diameter of the pee tube. This makes it difficult to pass water and you
dribble on your shoes. The prostate can also become cancerous, an even
less pleasant state of affairs. We men do suffer at times, it’s not only
the ladies who have ‘specific’ problems!
Yes, you can have a check-up for
this area too. Just ask to see the hewers of stone and drawers of water!
When I was a young
doctor, I had a somewhat morbid fascination with the reasons why my
colleagues would be ‘struck off’. Each month, in the back of the British
Medical Journal there would be the list of disciplinary hearings and their
findings and penalties, including de-registration, otherwise known as being
‘struck off’. And the majority was for illegal drug use.
This I found simply flabbergasting. How
could my senior colleagues (in those days just about everyone was senior to
me), get the drug habit, when we had all been taught that it was something
we had to treat very vigorously? And it was something that was very
difficult to treat as well.
All of the above remained in my
subconscious until one fateful day, many years later, that I was to come
face to face with Pethidine, one of the drugs of addiction. Not that I
hadn’t met, or prescribed Pethidine before that, but this was a very
different set of circumstances.
It was mid-afternoon in my small, but
very busy suburban clinic. I was a solo GP, and the staff consisted of my
practice nurse and myself. The waiting room had spaces for eight patients,
and the waiting list by 3 p.m. had the queue going out the door and on to
the footpath outside. It had been a long day and it was going to be a longer
one to come.
It was then that a 10 year old boy was
brought in, having fallen off his bicycle outside. He was in great pain and
I didn’t need an X-Ray to tell that his forearm was broken. Well, either
that or he had two elbows on one arm. My practice nurse rang for an
ambulance, while I began treatment. The lad was in so much pain, I took out
an ampoule of Pethidine. This was 100 mg, but with the injured being only a
youngster, I drew up half the ampoule and only injected 50 mg to ease the
pain while I stabilized the fracture and we waited for the ambulance. The
half an ampoule I left on the shelf above the sink. The ambulance came
quickly, and the lad was driven away to the nearest hospital, while I
returned to the overflowing waiting room and began trying to catch up with
One hour later, and I still had a full
waiting room. There just seemed to be no end to the line of patients, and
none of them were simple ‘slap on a plaster’ cases. I could feel myself
becoming more and more frazzled.
It was then, while washing my hands
after the previous patient, I looked up and saw the 50 mg of Pethidine
looking down at me. “This stuff is supposed to give you a lift,” said a
little voice in the back of my head. The temptation was almost overwhelming.
The ampoule was literally dancing in front of my eyes, and it was then that
I realized just how my colleagues could be caught out. Taking 50 mg today
while under extreme stress, would be another 50 mg the next time I was
overloaded, and then it would become 50 mg at the start of the clinical
sessions, in case I became overloaded.
You can see the dizzy downward spiral.
From 50 mg it becomes 100 mg and you are hooked. After running out of the
emergency supply of Pethidine given to us by the government, it would be
writing prescriptions for fictitious patients. All very sad, but at that
instant I could feel nothing but compassion for former colleagues who had
succumbed and been struck off.
I broke the ampoule and poured the
contents down the sink, and returned to my list of patients. Nobody knew
just what strain I had been under. Nobody knew how close, in my own mind, I
had come to the brink of the abyss.
Drug addiction is a problem for medical
practitioners. The workload, the lifestyle, the irregular hours are things
that you are not taught how to handle in medical school. That so many of us
actually manage to get through it all, is amazing. I consider myself to be
lucky that I recognized it.