eczema, random rash, psoriasis, questionable moles, and more eczema -- another day at the derm clinic. this afternoon i worked in the pediatric clinic, which is nice except that it is always overstaffed and i am relegated to the role of 'observer', which is boring and slightly humiliating. but pride aside, i nearly combusted during one particular 'observation' today.
i suppose i should set the scene. two little girls, ages 3 and 5, a blonde, well-coiffed and very anxious appearing mother, and their unphased sandy-haired dad are gathered in an exam room. outside, their chart reads 'concern for graying hair.' huh, i thought. interesting. i file in meekly behind the resident (like the stray puppy that i get to impersonate these days) and we introduce ourselves, appearing as bright and shiny as we can at 5 pm at the end of clinic (hey, it's DERM! that's late!).
and mother just starts TALKING.
her eyes are wide. her speech is rushed. she has a blue mole on her cheek that i can't take my eyes off of, and i wonder if she has ever had it biopsied, and whether she needs to do so. she is "very concerned, you see, because she has recently noticed SOME GRAY HAIRS among little harrison's otherwise pristine honey-colored mane." not like, MANY gray hairs, or a streak of gray hair, but maybe 1 or 2. and yes, there is EVIDENCE, a plastic sandwich bag labeled with "harrison" containing 2 fine hairs which appear to be fairly pale (though not white). furthermore, "even little chelsea has them too! and she's only 3! what will become of them when they are 10, or 12?" she asks, panic-stricken.
we ask -- because this story just doesn't seem to add up -- what exactly are her concerns? is she worried about a health problem causing this symptom? something she unearthed on the internet, perhaps? because maybe that would at least sort of explain why she is so freaked out over 3 possible gray hairs among her 2 healthy, beautiful children?
"no," she says. "i already had them tested, for B12, thyroid deficiency, and anemia. and i did read about it on the internet. and they were normal. i just came here to get a dermatologic opinion. a second one, actually."
a second. freaking. opinion.
well, we gave her one. after educating her that even IF the children did have a few gray hairs (which we felt they did not), it did not mean graying was inevitable by age 12, she seemed slightly calmer. one would think that a woman with such obviously double-processed locks would have come up with a treatment solution (ie, her hair salon) if such a horrible calamity were to occur. she proceeded to move onto other concerns on her list, especially regarding a lesion with 5 stitches her daughter had recently acquired by walking into a doorframe -- "the plastic surgeon was unavailable, so we had to get a P.A. to do it," she said, spitting out the initials as if they tasted bad. "and is it really okay to get a nurse to remove these stitches? i mean, they don't know what they're doing, right?"
i sort of wanted to do an impromptu medical student stitch removal show on the spot, but resisted.
actually, what i really wanted to do was to drag the mother by her feet with me into the next room, where a 16 year old with a horrendous immunological skin condition was covered in warts and new-onset squamous cell-appearing lesions caused by her immunosuppressive therapy, and scream, "THESE PEOPLE HAVE PROBLEMS. YOU ARE JUST CRAZY."
but i didn't.
* names, of course, have been changed to protect the innocent, and to protect me from being kicked off of the internet by HIPAA enforcement agents