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When Docs Play Good Wizard
from Kelly Z.

Hi Ed.  It has been a while since I have written but I had a "new" experience with a derm yesterday and I had to share.  I went to a new derm yesterday in hopes of finding one that is willing to take risks and is current with treatments.  Here are some of her comments to me:

1.  I have had a patient on this rotational shampoos for years now and his psoriasis has not come back.  I get to use 3 different shampoos, rotating every day.  I had to laugh as I checked out at the drug store yesterday.  It looked like my derm couldn't make up her mind.

2.  After telling her I was on Temovate and it didn't work: That's ok.  It will work in the right regimen, so just follow mine.

3.  Not even looking at my severity, she said: I have just the treatment for you, have you heard of the patch therapy?  Patch therapy is rotational steroidal ointments [applied several times during a 24-hour period].  I have 40% coverage, mostly on my back.  So I’m sure, I will just wake up the family at 2 a.m. in order to have someone smear this stuff on my back.

4.  When I mentioned I was part of a drug study for an immunosuppressant drug, and that it was working, she said: Intravenous medications are done at the hospital by another derm.  What we’ll have you use here is just as good and not as harsh.  I.e. the patch therapy.

After my 10 minute first visit I wanted to throw her through a wall.  And by the way, did I mention the resident intern who was her shadow?  I wonder what kind of doctor that intern will become?  Thanks for the room to vent. –Kelly Z.


Ed’s Response:  Good to hear from you, Kelly.  I know from your years of dropping by FlakeHQ that you are no novice to the derm/flaker routine.  As I read your points of exchange during this visit I cringed repeatedly. I felt sorry for the poor intern who might have been smart enough to sense you wanted to ... well ... throw the good doctor through a wall, as you so elegantly put it.

I think it is stereotypic of some doctors to put on their Good Wizard personalities when towing around an apprentice (intern).  They are trying to impress the newbie with the importance of good bedside manner, but they overstate something awful.  They behave like clowns wearing size 50 shoes and bulbous bright red rubber noses.

Well, I’ve greased myself into telling this story (pun intentional, as will become clear).  It doesn’t have anything to do with my derms or my P, but it is a doctor-intern-patient story.  It was a routine physical exam by my GP-at-the-time — a man — who happened to be herding a young male intern around that day.  At the onset of the consult I was told the intern’s name and we exchanged hellos, then my doctor and I behaved (or set out to) as though the intern weren’t there.

But my doctor blew it by assuming that Good Wizard act. 

Oh, Edward, you KNOW how important the digital prostate exam is.  Here, if I recall, he actually wriggled his index finger at me, like a parent gesturing “no no,” or “tsk tsk.”  But of course the gesture took on all sorts of added significance in this context.

All I could do was scowl while the doctor flamboyantly snapped on the latex glove and applied KY Jelly to his rubbered finger like laying a line of toothpaste on the brush.  He smiled at me and said, Now just lean over the examination table, Edward.  I was complying when I heard him chuckle quietly and say — perhaps to me, perhaps to the intern — It’s always so tempting at this point to say “Assume the position.”

Usually these emasculating acts of doctors upon their male patients are uncomfortable but quick.  In ... quick digit spin ... out fast and ... What did you think of the 49ers last Sunday?  I’ve sometimes wondered what in the world they can detect so quickly?  But my doctor was impressing an intern this day — playing Good Wizard — and he took considerably longer.  His intromission was fast and breathtaking, as usual, then the spin ... but then another spin ... and another....

I had time to think, and that was his mistake.  I said, while the spinning was in progress, “Doc?”  He went, Hmmmm?  And I said, “Would you like to go dancing Friday night?”  I hadn’t even finished dotting the question mark at the end of the sentence when he jerked out his diagnostical digit and almost backed into the intern who was trying desperately not to explode.

Anyway.  I’ve so few stories about getting the better of a doctor, I can’t pass up the slightest provocation to share that one.

I hope for your sake, Kelly, that you’ve found another derm.  Be good.  –Ed

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