by Madelyn Kamen He was there every day, Looking at her from the other side of the window, Smiling at her as she handed over his little green pill. He wasn’t that old and she wasn’t that young; Neither had ever married. She was a psychiatric nurse’s aide who understood the inmates Because she had been abused as a child, pulling into herself To avoid punishment. He was there because he had been bullied as a little boy, Making it a habit of staying away from the big guys who could Beat him up. Now, they were adults, albeit imperfect ones, who Occasionally would sit together on her coffee breaks … Continue reading
The Doctor, the Patient and 21st Century Medicine
by Boluwaji Ogunyemi, M.D. Abstract: The public’s perception of the medical profession in Canada has suffered as a result of well-publicized cases of professional malpractice and large-scale healthcare system fiascos. In addition, there appears to be some tension in the regular interactions between physicians and patients. Specific cases of malpractice and healthcare scandals from the provinces of Newfoundland and Manitoba are described. From early in our clinical training, the adoption of a patient-centered paradigm for interactions between clinicians and patients can help to re-establish patient trust in the healthcare system. Medical school curricula and medical school admission requirements are systematically changing in a directional that places value on the appreciation … Continue reading
My Lyme Disease-Heart Disease Story
Having read the Boston Globe December 13th article on linkage between heart disease and possible death from Lyme Disease, I wanted to share my story. Living in the Berkshire Mountains of Western Massachusetts, I have a regimen of active nature hiking. (1) In an annual check-up in 2011 the nurse found my pulse was very low, so I was given a heart monitor to track my pulse over 24 hours. Upon turning it in, it was reported that my heartbeat was down to 36 beats per minute. As this is a seriously low rate, I was told to immediately check with a cardiologist. When I visited a local cardiologist, I … Continue reading
The Great Imitator
“Know syphilis in all its manifestations and relations, and all other things clinical will be added unto you.” Sir William Osler Henry Foong, a dermatologist from Malaysia and a good friend, recently wrote me about a patient he’d seen with primary syphilis. The disease we used to call “lues” or notate with the Greek letter ∑ (sigma) is becoming more common in Malaysia, in his experience. This reminded me of a memorable case I saw in the late winter or early spring of 1973. At the time, I was a first year of dermatology residency at New York University. I was not a happy camper. I was tired of New … Continue reading
Nailing Down a Diagnosis
Onychomadesis is the spontaneous, complete shedding of the nail from its proximal side, without pain or inflammation, following nail matrix arrest. Brian Maurer, a pediatric practitioner, recently saw a 5-year-old boy with a two-week history of nail shedding. The child had antecedent Hand, Foot and Mouth disease. Nail shedding has been described as a sequela to HFM Disease. To access Mr. Maurer’s excellent case report please click “HFM Nails” References: 1. A Clinical Study of Nail Changes Occurring Secondary to Hand-Foot-Mouth Disease: Onychomadesis and Beau’s Lines. Shin JY, Cho BK, Park HJ. Ann Dermatol. 2014 Apr;26(2):280-3. Free Open Access 2. From: Onychomadesis: A common sequalae and concern for patients after … Continue reading
Lament of Hand Dermatitis Patient
I don’t want to write about my hand dermatitis. I don’t like the term. Just be normal. I don’t want to go to the doctor or the pharmacy. I don’t want to take any pills, creams, antibiotics, narcotics or any medicine. I don’t want to be treated like a criminal or a drug addict. I don’t want to sit around and wait for appointments and refills and be questioned over and over. I don’t want to have to show my ID to the same person every time I fill a narcotic prescription. I don’t want to spend my money on co-pays, tape, creams, gloves, and other stupid medically-related items. I … Continue reading
ODEAR: Most-Favored Specialties
Hi, Dr. Elpern, I am contacting you in hopes that you may be able to assist me in attaining my goal of gaining acceptance to a Dermatology residency, and also to see if you had any advice on how to shine during my dermatology rotations, or any contacts at my away school who may assist me in research opportunities such as case reports/letters. I receive emails like this with regularity. In the 1960s when I was in medical school, dermatologists were at, or near, the bottom of the physician feeding chain. Internists, with their haughty demeanor, were the self-proclaimed real brains of medicine and lorded it over most other practitioners. Radiologists … Continue reading
Brooding Over the Changes to Come in Dermatology
Keywords: Adrienne Rich, dermatology, ICD-10, solo practice, death, middle age, Maya, provision of medical care, Obamacare, doctor patient relationship Adrienne Cecile Rich (May 16, 1929 – March 27, 2012), an American poet, essayist and feminist, was one of the most widely read and influential poets of the second half of the 20th century. She was put on the map by her early poems written while she was an undergraduate at Radcliffe College. In 1951, her last year at college, Rich’s first collection of poetry, “A Change of World,” was selected by W. H. Auden for the Yale Series of Younger Poets Award. He went on to write the introduction to … Continue reading
Stations of the Heart: Book Review
“Stations of the Heart: Parting with a son” by Robert Lischer is a moving and important book by the father of a 33 yo man with metastatic melanoma. It chronicles the last three months of Adam Lischer’s life. The book describes the medical, spiritual and philosophical aspects of Adam’s death. It’s a valuable resource. I have typed out a few pages of quotations which may interest you.. There are many medical details that a dermatologist would like to know, but they are less important than the view from the family’s standpoint. See Book Review: Stations of the Heart. Quotations from Stations of the Heart.
Kentucky Fried Marla
It seems like I’m not the only one who isn’t going to take her keratosis pilaris, aka ‘chicken skin,’ diagnosis lying down. A light bulb went off when I saw this home-made video of a young woman and KP sufferer, who went to a hot climate for a brief vacation and her KP miraculously disappeared, just like mine did when I went to Los Angeles last summer. I think there’s something to this sun/heat thing. Something more than meets the eye. It meets the skin too. I believe the strength and heat of the sun is penetrating the skin, opening up the pores and (to my mind), actually melting that … Continue reading
