"I'm a friend of Ray the cop. He says you can help me."
"How's Ray doing?"
"Ray's great. He was real worried about his wife not being happy with him anymore when he couldn't get it up. He worships the ground she walks on. Never fools around one bit with all the women he meets. He could have any one of them. Oh, well. I guess someone has to be a saint. Anyway, Ray says you did great by him. So maybe you can help me."
"I can try. What's your problem?"
"What's my problem? What's wrong with your eyes? Can't you see my problem? I weigh over 350 pounds and I'm 5'6" tall. This is after I've lost 100 pounds. One year, one hundred pounds. That's my problem. That and I don't work down there and my wife is going to leave me for her boyfriend who does work. She says she's too young to spend the rest of her life without sexual pleasure. That's my problem."
Why do I love straight-talking patients who put it on the line with no whining apologies? No phony lines about how much I love my wife.
"I'm a school teacher. High school mathematics. This damn weight is going to kill me. I'm 55 years old. I've been overweight since I was 20. I brought my lab results with me from my physical last month. I'm OK except for the cholesterol. And the size of that number shouldn't be a surprise considering its source. I even had testosterone run. And that number is in the normal range. So what can I do?"
His question beat the hell out of me. I called in Nunez. We had Bill strip for a physical. His fat and loose skin flopped and rolled everywhere. Nunez could barely feel or find anything on his abdominal or rectal exam. "Let's give him a shot and see what happens." "How am I going to give him a shot?" I asked. Bill's rolls of fat completely covered his pubic area and dropped half-way down his legs. And this was when he was laying on the table. How could I give him a shot in the usual standing position?
"Bill and I will hold his fat up out of the way and you manage the rest."
Craziness. Nunez grabbed the fat rolls on the right side and Bill held the fat rolls up on the left. I positioned myself in front. It was the fastest shot I ever gave. But it worked and two minutes later Bill was up like a rocket.
"You want me to send him home with two shots?" I ask.
"How is he going to inject himself?" Nunez asked. "His wife will help him move the fat aside," I suggested.
"No, that won't work," Bill grumbled. "I don't want her involved in this. She won't want it. I have to manage on my own. She's a real bitch on stuff like that."
"Why do you stay with her?" asked Nunez who was not immune from women problems of his own.
"Hell, I don't know. We've been together forever. Can't imagine life without her. And don't tell me that makes no sense. Life doesn't make much sense. I gave up trying to make sense out of life the first time I taught teenagers."
I started on my speech about never predicting wives. He cut me off.
"Save that crap for someone else. I told you: She won't go for it."
"Here's my problem," said Nunez. "I can't give you medication that I'm not sure you can safely administer. Let's try this. I'll send you home with five syringes filled with sterile water. You practice and come back in a week. Show me that you can safely give yourself a shot, and we'll start you on the meds."
"Is that the best you can offer? I would sure like to leave here with some of that stuff."
"That's the only offer."
"Well then I guess we got a deal."
A week later, Wild Bill was back. He had a paper bag with him. "OK, I'm ready," he said with a smirk. Nunez and I watched as out of the bag he took a round make-up mirror with lights in the frame. He put the mirror on the floor, plugged it in so that its bright light shone straight up. He dropped his pants, pushed up his fat with one hand, and watching in the mirror, he maneuvered the automatic syringe in place and delivered the shot.
"OK. I kept my part of the deal," said Bill with a great smile. "Are you ready to keep yours?"
"Son of a bitch," said Nunez. "Make him up a half dozen doses of PGE-1. Now I've seen everything. One week Dean and his dream machine, and now this."
"Why do they call you Wild Bill?" I asked.
"Why the hell do you think?" Nunez jumped in. He pointed his big index finger at Bill's fat rolls that covered his penis. "Look what he just did!"