(December, 1998)

Bedside Blooper
from David F.

Hi. My name is David Forsythe and at long last I have found someone who has a good sense of humor about "The Flakes."

A potted history of my condition: I have had it since I was about 13. It started as insect-bite-like marks on my scalp which just spread and have ended up covering about 90% of my body. Out of all the treatments I have had, the one that worked best for me was a 3-week stay in the skin ward of the Belfast City Hospital, where I was plastered in soft white paraffin mixed with liquid paraffin 4 times a day. Also, I had coal tar baths every morning and UVB treatments 3 or 4 times a week. At the end of all that I was 100% clear for 4-6 months, which was great.

The only problem is that the ward was an old style ward and it was almost like being in a dorm. There was a little dining room and TV room and the patients were free to move around and chat. Then, due to cuts, that ward was closed and the skin ward was moved into a small side ward in the main building. It was never the same. I spent 2 weeks in the new ward and didn't improve one jot.

Anyway onto the point of this email. While I was in the old ward I got to know a guy who had had psoriasis for 40 odd years and he told me this story:

My friend was laying in bed while the Derm was making the ward rounds. The Derm was talking to the guy in the bed next to my friend. The guy was begging the Derm to put him on Methotrexate (a cancer drug that stops cell division, very strong stuff) but the Derm was coming up with all the reasons not to put the guy on the drug. It went something like this:

Guy: Come on, Doc. We have tried everything and nothing works. Please put me on Methotrexate.

Derm: I know it seems the current treatment isn't working but we have to give it time. Anyway Methotrexate is a last ditch approach. It can damage your liver, your chances to father children, your bone marrow and your hair. I'm sorry, but I won't put you on it until we have exhausted all the other possibilities.

The Derm then turned to my friend and said, "We're going to put you on Methotrexate."

What a wonderful bed-side manner! -David F.


Ed's Response: Great story, David. I think it hints at another reason why hospital administrators and doctors don't like multi-bed wards. We're led to believe such practices are out of favor because patients want privacy and multi-bed wards promote cross-infection ... but doing away with them also means the specifics of any one doctor's bedside performances aren't overheard by, and hence subject to the judgments of, multiple patients!

Though it's not directly related, your story called to mind one of my favorite movie lines. It occurs in the O.R. and it comes from the movie M.A.S.H. As I remember it, a surgeon says, "Is this an officer or enlisted man? I need to know whether to use big or little stitches."

Thanks for sharing your story with us, David. -Ed

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