A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Tuesday, July 7, 2009
Another Fine Patient Quote
"I've had a rash for 15 years. It's everywhere. I mean, nobody can see it, because it's invisible. Sometimes I can see it, but doctors can't. But it's still a really bad rash. Like poison ivy, if that were invisible."
I saw rashes like this with the dermatologists in medical school. They just kept giving more and more creams to these patients to try on their invisible rashes.
Makes me think of a possible corollary to one of the Dinosaur's rules, "You can't make an asymptomatic patient feel better"--you can't make an invisible rash better.
Though Dermatology with regard to VISIBLE rashes interests me, I did not choose the specialty because I could not have handled those select patients with the disfiguring (in their minds)INVISIBLE rashes.
A reverse analagous effect perhaps but here in the drugstore, a patient comes in with an Elimite script and whispers the name of the drug or veers off in the permethrin section of the stock shelves and it's a wave-like itching effect. Pretty soon everyone has an old bug bite that or tickling hair.
So, mebbe if someone were to mention (hypnotically or telepathically) 'cool menthol', 'cucumbers', or 'lemongrass balm' or 'coconut suntan lotion' something cold and creamy, even, maybe lemon custard yogurt fresh from the frig (active cultures, of course) slathered all over, it might get the patient to stop thinking about 'hot', itchy and irritating. Just a thought (about the invisible cream), or healing powers of active live cultures.
The patient may be right in this instance. Unfortunately, I have extreme itching on my forearms but no visible rash. The only thing that seems to calm it is ice or cool water directly on the skin, so I assume its heat related. My doctor could offer no explaination for it. Maybe suggesting they stay out of the sun and limit their light/heat exposure might help their condition? Unless they're totally mental.
Have you ever contemplated setting up a booth with a psychiatrist sign a la lucy from peanuts?
ReplyDeleteMaybe you should prescribe him a cream: just like lidocaine, or, at least, what lidocaine would look like if it was invisible ...
ReplyDeleteDefinitely a placebo candidate.
ReplyDeleteI saw rashes like this with the dermatologists in medical school. They just kept giving more and more creams to these patients to try on their invisible rashes.
ReplyDeleteMakes me think of a possible corollary to one of the Dinosaur's rules, "You can't make an asymptomatic patient feel better"--you can't make an invisible rash better.
Though Dermatology with regard to VISIBLE rashes interests me, I did not choose the specialty because I could not have handled those select patients with the disfiguring (in their minds)INVISIBLE rashes.
Invisible rash, hunh?
ReplyDeleteThose are the worst kind.
A reverse analagous effect perhaps but here in the drugstore, a patient comes in with an Elimite script and whispers the name of the drug or veers off in the permethrin section of the stock shelves and it's a wave-like itching effect. Pretty soon everyone has an old bug bite that or tickling hair.
ReplyDeleteSo, mebbe if someone were to mention (hypnotically or telepathically) 'cool menthol',
'cucumbers', or 'lemongrass balm' or 'coconut suntan lotion' something cold and creamy, even, maybe lemon custard yogurt fresh from the frig (active cultures, of course) slathered all over, it might get the patient to stop thinking about 'hot', itchy and irritating. Just a thought (about the invisible cream), or healing powers of active live cultures.
An invisible rash. That is zen-like.
ReplyDeleteThe patient may be right in this instance. Unfortunately, I have extreme itching on my forearms but no visible rash. The only thing that seems to calm it is ice or cool water directly on the skin, so I assume its heat related. My doctor could offer no explaination for it. Maybe suggesting they stay out of the sun and limit their light/heat exposure might help their condition? Unless they're totally mental.
ReplyDelete