Ultrasound Deez Nuts
I.
Gander
The Carlington Community Health Center stands at the intersection of Merivale and Anna Avenue. It is conveniently located across the street from the Carlington Coffee House. Desiring a fancy coffee to augment my homebrew, but feeling the twinge of pain, I replaced desire with responsibility, and crossed Merivale to the Carlington Health Center, taking care to avoid negotiating five lanes of traffic by using the crosswalk.
Pulling open the glass doors, I buzz the intercom and begin the ritual, beginning with the recitation of the questions:
“Do you or anyone you are in close contact with have any cold symptoms?”
Bowing my head towards the intercom I answer, “No.”
“Have you or anyone else you are in close contact with traveled outside of Canada in the last 14 days?
I bowed my head again, “No.”
“Do you live with someone who is currently isolating because of COVID-19 symptoms or a positive COVID-19 test?”
“No.”
The sound of the buzzer indicates I had performed the sacrament, and I pulled open the door to enter the lobby. The receptionist saw that I was without the proper holy face covering, and so she stood, and walked three steps to the left, and with a pair of stainless steel tongs handed me a fresh mask so that I may continue to the Medical Reception counter, to sit and wait in my first waiting room of the day.
Once my name was called, I was seated in a private examination room, with a computer, a few chairs, an examination table, and a sink, above which a sharps box was mounted. Sitting in the “sit here while you wait” chairs beside the computer, I notice the positioning of an exam light at the end of the exam table, between the stirrups. I remember being much younger and finding various speculums and swabs in a cabinet beneath another exam table, and finally putting several puzzle pieces together in my brain. My train of thought was interrupted by a nurse practitioner who stepped into the room, greeted me in a somewhat washed out Eastern Canadian accent, and logged on to the computer to see my chart.
“What brings you here today?”
“For the last two or three weeks I’ve had a lot of pain in my left... uh... testicle.”
“Two or three weeks? Why didn’t you get this checked out?”
“Well I was going to bring it up last week when I came in for my blood work and--”
“You were here last week and you didn’t mention it?” Her question included a slight twang of that washed out accent.
“No, because I thought it was going to go away, and then last week, and like, when I requested the appointment we’re at now, I was having some, like, really bad pain.” My reply included superfluous ‘likes’, indicating my Americanized Ontarian accent.
“You should have gone to the emergency room.”
“I didn’t want to, like, spend the whole day in the emergency room; I work during the day and like..”
We went back and forth like this for a while, until she finally stood up, stood at the foot of the examination table, and pushed the stirrups aside. She then clicked on an examination light and bent it down to about waist level. Contemplating again about the differences between this and a typical gynecological exam, I realize what’s good for the goose is good for the gander, and, indeed, in a standardized Ontario health care accent, the nurse then said, “Let’s have a look.”
I’m standing next to the head of the exam table and start to undo my button fly. Two buttons down, the nurse clears her throat from behind her face mask and says “Come on over,” dropping back into her east coast accent, “I don’t bite.”
Sighing, I comply, completing the revelation of my manhood, and exposed myself to the nurse. She applies pressure to my right and left testicle in sequence, as I wince and groan in pain. She asks me if it hurts where she’s squeezing and I reply in the affirmative. She runs her finger along the back of my scrotum, which causes me to breathe in sharply and say “aah”, as she finds a particularly painful area.
After the examination, she starts asking me questions:
“How many sexual partners do you have?”
“One.”
“Really?”
Good lord, I think, “Yes really.”
“Okay, any untreated UTIs or anything”
“No.”
“It says here you had a vasectomy, how long ago was that?”
“Like a year or two?”
Feeling less and less embarrassed about talking about my sexual history and urinary health, I’m guided to the bathroom to produce my first urine sample of the day. I turned in my sample to the nurse and was given two options:
- Get a prescription for an antibiotic and a referral to a semi-private (but free) imaging clinic to get an ultrasound.
- Go to the emergency room, get the ultrasound today, and likely get antibiotics at the end of it all, and likely get a faster resolution.
After considering my options and my workload for the day, I signed into my workplace instant messaging app on my phone, reported my absence to my boss, and dropped off by my wife at the Ottawa Civic Hospital, fully packed with water, a couple of things to read, and, of course, my phone.
II.
Vibrations
I arrived at the Civic emergency door, and headed over to the reception desk to check in. I gave a brief statement, was issued another fresh face mask, and was ushered over to the reception area.
I was asked again what my story ws. At 10:00 AM on a Tuesday I didn’t particularly feel like discussing my genitals with a stranger, but there we were.
I’m asked to sit down in a slightly crowded waiting area for my name to be called. Glancing around, I take stock of the denizens of intake: an elderly couple, a portly guy in an AC/DC t-shirt, I can never tell how triage works, but I seem to be a higher priority than most of the people around me, as I was actively feeling a “level three” pain in my gonads, according to my own scale. What exactly that scale looks like, I’m not sure, but I decided that that three was serious enough but not enough to seem like I was overdoing it, but just enough to be of concern. A level three seemed to be the least suspicious of pain levels– not low enough to be shrugged off, but not high enough to be overdoing it or hoping for a prescription for hydromorphone.
Though the nurse is audibly calling names out to be seen, I decide to put on my headphones and zone out for a while, assuming I’d be waiting for at least an hour, maybe more. Rachel Martin and Steve Inskeep tell me the morning news. I imagine myself in a warm pool, soaking in the news out of Ukraine, COVID-19 vaccines, extreme weather events. I gaze at my reflection against the plexiglass dividers creating a transparent copy of myself, then in the counter-reflection from the opposite plexiglass, another transparent copy of a copy, the pain in my testicles radiating in these quantum dimensions, cascading infinitely into an abyss of copies of myself, a man made infinite into Ginsbergian endless balls.
“What are you in for?”
“Hm?” I return from the outer limits and find myself talking to a young woman in her mid-20s with unkempt brown hair.
She asks again, “What are you in for?”
I remove my headphones, “I’d rather not say.” At 10:10 AM on a Tuesday I don’t particularly feel like discussing my genitals with a stranger.
“Huh?”
“Testicular pain.”
“Oh.”
Realizing she hadn’t expected my answer, and wasn’t sure what to make of an answer so frank, I decided to remove the awkward silence.
“What are you in for?”
“Mental health.”
I say something like “Oh yeah?” and I see that she is wearing white headphones around her neck. She looked at me through the plexiglass barrier like a mutual meeting of zoo animals. She has beside her two reusable grocery bags stuffed to the brim and tied up, clearly full of clothes, a hair dryer, assorted drug store makeup and other detritus making rectangular impressions on the plastic.
She’s still talking but I’m only half listening as my testicle aches and I don’t really want to get attached. She catches my attention back, “Yeah, I need to come in from time to time, you know? Because I get so worked up, and I just need to get my vibrations right.”
I gave her a non-committed affirmative and our conversation conveniently ended then, allowing me to stare off into space. More copies of myself, more voices in my headset. Names called from time to time. Mental Health asks the receptionist about the wait time and is halfway through listening to the standardized answer as an ambulance pulls up and a gurney rolls by with someone on it. Someone coughs in the background. I reflect on my situation further.
MH returns and stands in front of the chair she was sitting in beside me and flips through her phone as I flip through mine. The entire waiting room realized her bluetooth headset hadn’t been connected when loud, emotional rock music started playing out loud.
Eventually she sorted out her connection problem, and sat back down just as my name was called for Registration.
She gives me a “Good luck with your… whatever…”
I thank her, and head to the registration desk. I’m given a wristband and asked to produce another urine sample, this time with my name affixed to the jar with an Avery label. When I was finished, I was to drop it at the Urgent Care desk, at the end of the yellow dots on the floor.
I stand and deliver in a nearby washroom, do the drop, and sit in the elite purple, slightly more comfortable, processing area. A few moments pass, and I am told to once again, follow the yellow dots, through the doors, and into the ward.
III.
Fractured Ulna
After following the yellow dots through the double doors, I catch a glance of my named urine sample, a collection basket marked “Lab” on my left. Ahead of me is a hallway of occupied chairs e. Looking for a vacant seat, but finding none in the main corridor, I resigned myself to sit around the corner and out of sight with two other outcasts; a woman wearing two masks, and a guy in an orange shirt who’d left triage about a half hour ahead of me.
I text messaged my wife for a while to let her know what the situation was, but without much to talk about other than “I’m in a hallway, I love you”, our conversation finished, and I was left to my own devices.
A pair of women with multicolored hair were in the plaster room, labeled as such by the signage on the doorway. The only thing to watch was the microdrama of the plaster group. One of them was on the bed while the other stood. A doctor entered the room with an associate of the two women who now had a cast around his arm, who were having a conversation about what they were going to eat.
My stomach audibly growled.
The man in the orange shirt, Jason something, is called over by a doctor and seen in short order. With nothing better to do, I eavesdrop further on the conversation in the plaster room to hear that the associate has a hairline fracture of his ulna, radius, and scaphoid. The ulna is the outer bone on your arm that is the tip of your elbow all the way to your hand. The radius is the opposing bone, and the scaphoid is in your hand, so his wrist was broken.
I thought about the time I broke the opposite end, the tip right at the elbow, of my ulna in 2017 just after my daughter was born. We were out of coffee on a cold March morning. For whatever reason the debit and credit terminal at my local Tim Hortons wasn’t working, and being a millennial, I never carry cash. Not too bothered and enjoying a fresh snowfall I continued along to the grocery store, but halfway through I slipped on black ice and came down on my ulna.
The memory of that radiating pain collides with the present radiating pain. I shudder.
After staring off into space and listening to most of another news podcast, I was called into room number seven, and introduced to the morning doctor. After answering the same questions I’d been asked by the nurse, and again repeating that I was not having unprotected sex with any strangers, I’m asked to expose myself again. The doctor feels me up, and tells me, as expected, that I should get an ultrasound to take a look at whatever was going on in my scrotum by vibrating sound waves quickly against my body.
“Sounds good.”
He writes the requisition, and sends me back along the yellow dots back to the emergency waiting room to wait to be called to imaging.
IV.
Fun Print
Gathering myself together and heading back to triage, I notice two police officers standing next to a plexiglass enclosure marked ‘Holding 1’. Inside the enclosure stood a guy in flex cuffs with a few cuts and bruises in what was obviously some kind of legal predicament.
Again pessimistic about my wait time, I sit myself on the opposite side of the room from where I was previously to stare endlessly at the Coca-Cola vending machine with my headphones in but nothing on to cut the overall din of a now more raucous group. It’s now after noon, and I am still alive and surviving off of the about 125 mL of yogurt I’d had for breakfast six hours earlier. I consider the raw caloric content of a Coca-Cola.
Someone coughs.
I consider my options, and decide to exit the waiting room to get some fresh air.
As I return, I flash my wristband like I'm going to the worst music festival on Earth. The woman at the reception desk nodded, and I sat back down in the same general area as I was before.
This time I noticed a man in a wheelchair, a woman with a buzz cut, some folks I recognized from the hallway like the man in orange. Again meditating on the mystery of the exact order of operations when it comes to
Once again listening to a podcast on my headphones and zoning out for a while, I assumed I’d be waiting for at least another hour, maybe more. I thumbed through more pages of the book I had on me, reading a few more pages until losing focus. My reflection against the plexiglass dividers created another transparent copy of yet another version of myself, then in the counter-reflection from the opposite plexiglass, another transparent copy of a copy, reflecting on the convex plexiglass of the snack vending machine, cascading once again infinitely into an abyss of copies of copies of myself like a reflection through a funhouse mirror, at the any given moment expecting a clown to leap out and scream.
“Matthew Buttler?”
“Hm?” I return from the funhouse and find myself being called by a nurse in his late-30s with a ‘fun print’ face mask. She tells me to follow the brown dots, and head over to imaging.
I remove my headphones, “Okay, great.” At 1:03 PM on a Tuesday I was making surprisingly good time through the hospital.
Making my way through the yellow dot hallway from earlier in the morning, I notice the two police officers and their detainee, now free from the flex cuffs, getting his blood pressure taken by a doctor. I proceed through the double doors at the end of the hallway and see the man in the orange shirt heading over to the CT Scan area, as I headed along the brown dots to Ultrasound..
V.
Whoosh
In the dimmed light of the ultrasound room, a woman’s voice looked up from a computer screen and said “Mr. Buttler, welcome.”
“Thanks, it’s great to be here,” I say, as though I’m a guest on a talk show.
“What I’m going to ask you to do is step over here next to the table, okay, and then remove your pants and underwear, okay?” Or lower them down I guess. I guess you can take them off completely, your choice, and lie on the table. But your pants and underwear need to be off.”
I opt for the latter and comply, allowing yet another person to see my testicles today.
Now sporting a Donald Duck type situation, I pull myself up on to the examination table. “I’ve got a couple towels here, and what I’m going to ask you to do is put one towel on your legs kind of under your testicles, and the other will hold your penis up against your stomach to keep it out of the way.”
I think to myself that this woman is giving me too much credit, but lo and behold and much to my amazement, the system works, and I am out of the way of myself.
“Okay, this might be a little unpleasant and uncomfortable at first, but I’m going to apply the transducing gel and then we’ll get started.”
In the blink of an eye, cold goop splattered over the whole of my genital area. Without a word, the Technician grabbed hold of the transducer wand, which looked kinda like one of those old hand-held photo scanners from the nineties. I prepare myself to feel the vibrations, mental, otherwise.
The transducer comes into contact with my balls and I feel the technician press on my balls so hard that I think about every time I’d been hit in the balls and I moan, which is a least in a steady tone that fills my ears so I don’t have to hear the whoosh-whoosh-whoosh of the doppler as it scans my balls, but I still feel it, and I concentrate on the fact that this is all free and it will be over soon to distract myself from the pain but it doesn’t. Whoosh whoosh whoosh whoosh whoosh.
The technician moves around the circumference of my balls, pushing harder, and the gel drips down my thigh, and collects near my perineum. Whoosh whoosh whoosh. The wand moves over to my left ball. The pain is more intense than ever as she presses on it harder to get a better look. Whoosh whoosh whoosh. There’s a fucking infection in my balls. Whoosh.
“Okay, we’re all done.”
The machine shuts off.
“You can go ahead and get cleaned up, throw the towels in the linen basket over near the door, and when you’re ready, head back to the waiting room. We should have your results in a while.
I wipe myself down. “Any idea when?”
“Usually about two hours. Do you have the app?”
“The app?”
“Yeah, the corporate head office makes us do all the results through this app. You can scan the QR code on the way out.”
“Oh.”
“You can check there. We’ll notify you there.”
She swaps out her gloves, the wand cover, and does all of the teardown from our time together. “Where can I get something to eat?”
“There’s a Tim Hortons upstairs, and down the hall a ways down. Keep walking and you can’t miss it.”
VI.
Ascent and Rotation
After thanking the ultrasound technician and heading upstairs, l'esprit de l'escalier taps me on the shoulder and tells me that I should have commanded her to “ultrasound deez nuts”. I sharply told them that it would be inappropriate for me to do so, but I thank them for the phrase and think about how I can possibly use this in any other context. While I meditate on other testicular related puns, I pass the gift shop and into a less clinical looking environment, like a slice of a fancy hotel lobby surgically implanted into the hospital. As the lobby feeling intensifies, I realize this area is likely housing hospital administration and retail, which explains the Tim Hortons.
Though the line is large, my senses have been dulled by sitting with little to no visual stimulation for hours and I am happy to no longer be around people who were carrying some strange contagion, or awaiting the correct vibration.
I think about how with breaking my elbow in the winter of 2017, there was at least a sense of camaraderie amongst the ill and injured, and the knowing wink that we’d all be issued “some good stuff”-- Celebrex, Hydromorphone, etc.-- and booked for surgery, physio, and we’d all be okay. Now, in the year 2022, we all speak in hushed tones behind our masks, learning to smize and–
“Hi, can I take your order?”
I order something non-memorable, but be sure to get a bottle of Coca-cola to prop myself upright, having my last caffeine shortly before I went to the Carlington Health Center– you know, the one with the nurse who sent me here– so in addition to my testicular pain, a headache of withdrawal was starting to catch up with me.
I exit through a nearby door and find myself in the hospital staff area, in a small enclave tucked away, and almost hidden, somewhere between the main entrance area and the Emergency entrance. In this moment of normalcy, I savor the fresh air and sunshine. I hadn’t thought about it, but with the exception of the glass frontage of the Emergency Room triage area, I had seen no natural light in hours.
In lieu of backtracking the brown dots back to triage, I step outside of the enclave. Feeling the wind whip up across my face, I am thankful that it is warm.
I stand on a knoll just off of what I assume is hospital property, my wristband still allowing me access to the grounds, along Carling, and watch a helicopter prepare for takeoff from a landing pad across from the Emergency entrance. Its rotor moved slowly at first, and then faster. Even faster still, but not quite enough lift to take off, a small group of people and I watched as the helicopter began its slow ascent and rotation, orienting itself to the south, likely towards Winchester. Emblazoned on its side was some private medical company name like Rogers-Shaw PatientTech, Bell HealthConnect Patient Transport, or some combination of vaguely medical sounding words along with a corporate branding forming a capitalistic portmanteau of care.
I begin my slow traversal down towards my preferred pharmacy. By now, the sun had become a golden ball descending towards the horizon. With sunglasses on my face, and a ballcap on, I consider my own vibrations for a moment, before beginning my walk home, via the pharmacy, to get a prescription filled.
Have a safe and happy new year. See you in 2025.
Take care of yourself,
Matthew