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Practice Makes Perfect

A Tale of Two Testicles

By Pamela Wible, MD | February 5, 2013

Dr Wible is a family physician born into a family of physicians. She has developed a model for change in healthcare delivery that first asks a community what it wants and needs from the healthcare experience. Her model for the “ideal clinic” is taught in graduate medical curricula.

Evan, a retired police officer, calls for an urgent appointment. I can hear the angst in his voice.

“Sure Evan, come right over.”

An hour later, he arrives in obvious distress. “I gotta show you something, Doc.” We proceed to the exam room. He pulls his pants down and points to his left testicle. I put on gloves, turn on the exam light, and l lean in real close.

“What’s the problem?” I ask.

“Look, Doc. Can’t you see?”

“What?”

“My left testicle is hanging real low.”

“That’s it? No pain?”

“No pain. But look how low it is!”

I stand up. “Evan, here’s the deal: most people hang lower on the left. In women, the left breast is slightly larger and hangs lower. For men, the left testicle generally hangs lower. So you’re in with the main crowd.”

“I’ve been this way my entire life?”

“Yep. You’re normal.”

Evan smiles. Relieved, he hands me his co-pay and a five-dollar tip. As he leaves, I add, “Just so ya know, most curvy penises also curve to the left.”

Pamela Wible, MD, pioneered the first community-designed ideal medical clinic
in America. She is author of Pet Goats & Pap Smears and writes for The Oregonian.
Contact Dr. Wible.

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	On Health and Mental Health Erik R. Vanderlip, MD, is a senior fellow and acting instructor in the University of Washington Department of Psychiatry. As a dually-trained family physician and psychiatrist, Dr Vanderlip is active in national health system redesign efforts with a particular interest in newer models of the medical home. He practices family medicine in a hybrid primary care clinic within a mental health center in Seattle.
	The HIV-AIDS Observer Rodger D. MacArthur, MD, is Professor of Medicine, Wayne State University, Department of Internal Medicine, Division of Infectious Diseases and Director and Site Principal Investigator, Wayne State University HIV/AIDS Clinical Research Unit.
	Speaking of Pain Steven A. King, MD, MS, is in the private practice of pain medicine in New York, and he is Clinical Professor of Psychiatry at the New York University School of Medicine, New York.
	Tales Doctors Tell David T Nash, MD, is Clinical Professor of Medicine at Upstate Medical Center in Syracuse, New York. The author of more than 250 peer-reviewed clinical articles, Dr Nash has practiced cardiology in Syracuse for over 50 years. He is a Fellow of the National Lipid Association.
	Primary Care Matters Gregory W. Rutecki, MD, is Professor of Medicine at the University of South Alabama College of Medicine in Mobile. He is section editor of the hypertension topic center on this web site.
	Practice Makes Perfect Pamela Wible, MD, pioneered the first community-designed ideal medical clinic in America. An expert in patient-centered care, Dr Wible helps citizens design cutting-edge clinics and hospitals nationwide. Her model is taught in medical schools and featured in Harvard School of Public Health's newest edition of Renegotiating Health Care. Dr. Wible is a medical reporter for the Oregonian, has been interviewed by CNN, ABC, CBS, and is a frequent guest on NPR.

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A Tale of Two Testicles

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