By Rajan T.D. MD
"Dermatologists make rash judgements" say our colleagues in a lighter vein, even though they are the ones who scribble notes to refer cases for our opinion.
When the dermatologist opines that it is a case of, say, Haemorrhagic Chicken Pox, they exclaim, "I, too, thought so but wasn’t sure!" So, here we are - we have discovered our raison d’etre! Our job, it seems, is to help physicians, surgeons, paediatricians, gynaecologists be sure of their diagnosis!
The early days as a Dermatology resident is quite unnerving having to confront criticism from other branches of Medicine about the inability to offer a cure for many dermatoses or provide answers particularly to baffling questions from patients about the prognosis of Pemphigus, relapses in Psoriasis or the recurrences of Urticaria. It takes him or her quite a while to argue that neither do others have answers for Rheumatoid arthritis, Ischaemic Heart disease or Diabetes. One of our senior teachers once aptly put it, "The whole world needs Dermatologists, even if it is just to say that this is a case of Lichen planus and there is no definitive treatment for it." This statement attempts to clear the confusion of many young, confused, resident doctors in Dermatology departments everywhere about their perceived role in healthcare.
Serious talks apart, there are several humorous situations in our daily practice which takes the tedium out of our work. Stories abound in the practice of Dermatology and Venereology since we deal with several intimate matters of the patient. Many of them are genuine while several are genuine anecdotes!
One of the early stories told to Resident doctors during the teaching of sexually transmitted diseases is the case of the sexually promiscuous Romeo who quipped to his new-found partner after a night-long encounter, "If any thing happens after 9 months, you can call me. The name’s Philips." A seasoned player that the girl was, she shot back, "And if anything happens to you after 90 days, you needn’t call me. The name’s syphilis!"
Some teachers make teaching the easiest thing in the world by relating stories to help students remember confusing facts or important details. One such professor was well known for his opening remarks which would rivet the attention of the class to the entire duration of his talk. On one occasion he proceeded to convey the recurrent nature of Herpes simplex infection by inquiring, "What is the difference between love and herpes?" While the boys and girls looked around, bewildered, he explained, "Herpes lasts forever!"
The Skin and STD OPD of every public hospital receives all kinds of visitors daily but the matronly lady who accompanied a teenage maid to a Government Hospital in Mumbai made the Registrar’s head turn. The lady took the seat instead of the maid who, it was soon discovered, to be the patient. She muttered in a heavily accented tone, "She’s got, asstidy (? STD)!" The junior doctor was non-plussed. The lady kept pointing to the girl’s abdomen and it was quite a while before the alert Registrar understood what exactly the lady was trying to convey. The doctor, who couldn’t control her laughter, explained that the patient should be visiting the Internal Medicine OPD for the treatment of the girl’s acidity, not the asstidy department!
The Oscar for the ultimate in humor, however, goes to the following incident which occurred in a consulting room in the city of Mumbai. The story also demonstrates the need for the medical profession to be a little more legible while writing medical notes. The consultant came across a referral note from a general practitioner which seriously stated, "I am pleased to refer to you Mr. Ian Rodrigues (name changed) for lessons on his penis..." The amused consultant examined the patient and concluded that the lesion was an erosion of Genital Herpes but it was a sure lesson for the poor patient!
I wonder whether there is some lesson in this for all of us too!
About: Rajan TD MD, is a Mumbai-based practising dermatologist and freelance writer. He contributes to various blogs and periodicals on social, medical and pharmaceutical issues.