Communications (Mar/Apr, 1998)

Handling First Impressions
from Ronald


Ed: Let me tell you, as many others have, how wonderful it is to have a site like this out there. I'm 27, and I was "cursed" with P back when I was 15. Extremely traumatic experience at the dermatologist. Is it me, or are most dermatologists out there lacking in beside manner? Anyway, fortunately P has thus far just been on my legs, elbows, inside/outside my ears (what joy), and of course, on my scalp. I've used everything but PUVA, including lovely cortisone injections, which is like acupuncture with staples. I've been presented with the same set of horribly insensitive questions that others have written about: "EEeeeew, what is that?" questions.

What I can tell you is this: I'm no psychiatrist, but one thing I began to notice is that when people see psoriasis on you for the first time, it becomes something they can't separate from you. What I mean is that they look at it and think it's strange, it's weird, and consequently you get embarrassed, ashamed, etc.. The best thing I have done, and still do, is agree with them, get it out in the open, somewhat like I'm seeing it for the first time. So I'd say something like, "Yeah, I know, isn't that disgusting? Let me tell you, it sucks." But I do it in such a way to put them at ease, to remind them that I know it's there, and I don't much like it either, so they shouldn't feel bad about looking at/commenting on it. People feel guilty for feeling that way, and I don't want anyone feeling guilty because mother nature makes the back of my legs look like a train wreck at a corn-flake factory.

I'm not sure if this will work for everyone, but it really has helped me. My friends know I have psoriasis, I don't hide it, and if my pant leg creeps up one day and someone sees the patches of hell (like my supervisor did last week), I just laugh and say "Yeap, and just so you know, being my supervisor and all, it's stress related." Followed with a wink, of course.

Thanks for keeping this Web-site Ed, it's added to my "Favorites." I just went to a new Derm today (for my new skin disease 'dishidrotic eczema'). I was poking around here looking for info on the new Tazorac stuff. I guess I'll let you know if I am very red but partly flaky. -Ronald

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Ed's Reply: I've had more derms withOUT good bedside manner than I've had WITH good bedside manner, but I become more sympathetic all the time. I mean, it's not hard to imagine this scenario...

Nurse: "Doctor, Edward Dewke is next in examining room 2 and Elle MacPherson is in examining room 3."
Doctor: "Dewke. Hmmm. Sounds familiar."
Nurse: "You've been seeing him about his psoriasis for one hundred years."
Doctor: "And MacPherson?"
Nurse: "Complaint about a mole on the upper inside of one thigh."
Doctor: "Hmmm. I think I'll see Ms. MacPherson, first."
Nurse (clearing throat): "Doctor. Mr. Dewke has been waiting longer."

These days, though, bedside manner hasn't been much of an issue. My current derm has been with me through the entire history of writing FLAKE, and claims to be a lurker here, at FLAKE HQ. I think he's afraid of what I might post about him. The other day he made some nice-nice comment about my sustaining sense of humor and I just looked at him. "Well, Doc," I said. "It's not just a DISEASE, it's an AVOCATION."

When it comes to disarming people about my P, I'm much more devilish than you, Ronald. First, for some mysterious reason I've noticed my new acquaintances tend to notice and speak up about my psoriasis at meals we're sharing. I don't know why this is, other than perhaps my habit of blowing the flakes off my pot roast. These days, in anticipation of these meal-time discussions, I like to try to sneak a peek at the chef's hidden ingredients on the sly. Say, for example, I see the cook sprinkling a little Adolph's meat tenderizer on the steaks. Come meal time, when I'm half way through my ribeye and my host finally comments on my lesions, I'll say: "Oh, those? They're the tail-end of an allergic reaction I had yesterday. I had lunch at a restaurant where they used Adolph's meat tenderizer on my prime rib. You think this looks bad? I was frothing at the mouth for three hours!"

Stay in touch, Ronald. And, by the way, what exactly is "dish?-I-dropped-it! eczema?" -Ed

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