Friday, April 30, 2021

Ministry of medicine

They say Medicine and Ministry are two of the top three oldest professions, alongside prostitution.

There are many similarities between a doctor and a priest. Both are lifelong callings rather than careers, such that the roles of "Father" and "Doctor" continue in some form even after retirement. 

People want both present at the beginning and end of life, as some sort of connection between earthly life and the afterlife. 

People expect miracles from both.

People tell both things they will not tell anyone else. 

As a doctor, it is usually some hidden addiction  (to fudgecake or porn or gambling or alcohol or cocaine or cheese), some very dark and disturbing thoughts, where they really think caught that genital warts or simply that they need a sick note even though they are well as they have run out of annual leave entitlement at work.

They know that you have taken an oath to keep their secret, secret.

(We may tell you the story of the secret but never in a way that you can identify the person).

I recently had a consultation to discuss blood results with a patient who has had tests for complaints of feeling tired.

"Last weekend, it was my son's birthday. My house was full of guests and I just went up to my room to lie down. I couldn't even go back down until all the guests had left..."

That would have been a normal statement - if we were not in a pandemic with lockdown rules forbidding household mixing!!😳 

I paused to see if she would realise what she had just confessed.

"I know we're not supposed to but he's a kid and it was his birthday!"

I decided to stay on the medical problem.

"Your blood results show that you have anaemia (low levels of iron in your blood) which is probably why you are so cetera..... 

...πŸ™„For your penance, take some iron tablets everyday and pray that the police don't get an anonymous call reporting you.πŸ™„"

My next patient is a young man who has called because he feels very stressed. He is so stressed that his mind now gets flashbacks to all the previous times in the past when he has felt mental stress....when a family member passed away and when another family member was very ill, nothing too colourful or out of the ordinary. 

He insists on me putting down in his records that he has had mental illness for years, in reference to these events πŸ€”. 

Specific requests to make notes in records usually warn me that there is legal stew brewing. 🧐

I am curious. These things happened years ago and have never been reported. Why now? His medical records are otherwise unremarkable.

"Well its this court just stressing me out." He says.  "They're going to send me to jail for fraud, and they don't even have strong evidence.

My lawyer says to get on record about my mental health and he can use that in his arguments."

I didn't ask, but he offered. He'd done it.πŸ₯ΈπŸ§πŸ˜¬

He spent the next few minutes confessing and arguing with himself about how the other two involved had escaped and how he knows he's not really mentally ill and just wishes the whole thing would go away. 

I listened, thinking what it must like to be a priest, trying to remember the words of absolution.

At the end, I almost say "May the good Lord accept your confession and grant you forgiveness. 

Go and sin no more."


Tuesday, March 16, 2021

First, Know Thyself.

Its a tricky time to be a doctor in the "woke" world.

Between the internet and political correctness, there is little room for practice. 

Take for example, the day I was trying to get a trans woman in-transit to describe a rash on their penis when they were in denial of the fact that they have one, as it goes against "who they are"

They spent several minutes calling it fancy neutral names like thingy or whatsit, because the word penis is somehow offensive. 

When I realised what we were talking about, I asked permission to call it a penis, for the purpose of the consultation only, please. Thank you. 

Next, Grandma has booked an appointment to complain. She received an appointment following  a referral to the department of Elderly medicine for a combination of age-related issues.

"Elderly! How insulting! Do they even know me? I drive, I do yoga and pilates. I'm sorry but I am not going for that appointment."

I couldn't argue with her. She was only 85 years young. πŸ‘΅

It was the second complaint in that week about referring to an octogenarian as old.πŸ€” I had obviously missed a memo.

Next, Girlie comes to see me with some issues "down there". I had a look after getting the gist.

"I think you have thrush."

She huffed.

"Well, I know my own body. I know it's definitely not thrush and when I checked my symptoms online it didn't say thrush." 

I don't argue, of course. What do I know? 

"Let's do some tests." I suggest. 

 The swab result came back confirming thrush. Every other infection excluded. 

"But can you just prescribe some antibiotics for bacterial infection? I know that that's what it is. I know my own body."

I'm scratching my head...."Er, no, but I can give you treatment for thrush, if you don't mind. "πŸ™„πŸ˜’

Next woke patient is not even the actual patient. It's a mum on behalf of her sixteen year old daughter. 

Mum has even booked a "starter appointment" first, to give me the heads up/low down...."Because daughter is in denial"

She tells me how beautiful her daughter is, showing me good'ol printed photos of beauty pageants her daughter had won and telling me about the beauty that runs in the family.

Sadly, she says, her daughter has now developed a mental illness -as people in the beauty industry do. 

"She keeps thinking she has acne because some of her friends at college have acne. I have researched it and it's actually a skin picking disorder.

We are seeing a private psychologist to help her work through it."

Princess comes in later with classic textbook Acne across her face. 

She seems sensible enough about it.

I give my diagnosis. Her mum is furious. 

"How can you just say it's Acne, you haven't even met her before. How do you know?" She says. 

πŸ€”Where do I start? I thought. But I am becoming quite skilled at this professional answer thingy, so we have a little biology lesson. 

Mum reluctantly agrees to try treatment for Acne, after I remind her very subtly and politely, that her daughter is sixteen now so I really don't need her mum to agree with me.

Daughter is beaming triumphantly in the corner. 

Six weeks later, her acne is almost completely cleared and she's a beauty queen again!πŸ‘Έ

No offence to the psychologist managing her Skin picking disorder.