Tag Archives: illness narrative

My Illness Narrative: the Autopathography Project

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You may have a complex health problem that doctors have not solved. When you enter a new doctor’s office, a perky young person at the reception area asks who referred you and then requests your insurance cards. Next, you will be given numerous forms to fill out. Then you are seen by an assistant who records your weight, blood pressure, pulse, and even the oxygen saturation from a fingertip. Finally, the physician or his “extender” sees you for 10 – 15 minutes, at least half of which time he is focused on your electronic medical record. After this ceremony, what does the medical professional know about whom you are and … Continue reading →

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Illness Narrative – Long Form

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My Illness Narrative: the Autopathography Project (If you want this in a printable form, please email D.J. Elpern djelpern@gmail.com) You may have a complex health problem that doctors have not solved. When you enter the new doctor’s office, a perky young person asks who referred you and then requests your insurance cards. Next, there are numerous forms to fill out. Then, you are seen by an assistant who records your weight, blood pressure, pulse, and even the oxygen saturation from a fingertip. Finally, the physician or his “extender” sees you for 10 – 15 minutes, at least half of which time he is focused on your electronic medical record. After … Continue reading →

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Notes on Pathographies

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Notes on Pathographies: An Arabian Nights’ Experience David J. Elpern* * The Skin Clinic, Williamstown, Massachusetts Email          A few years ago, a group of us gathered in the Osler Library at McGill. Osler guided us with his words: The practice of medicine is an art, not a trade: a calling not a business; a calling in which your heart will be exercised equally with your head. Often the best part of your work will have nothing to do with powders or potions, but with the exercise of an influence of the strong upon the weak, of the righteous upon the wicked, the wise upon the foolish… Courage and cheerfulness … Continue reading →

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Loss and Found

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Reflections on Skin Cancer and Solar Aging Band-Aid Generation I am one in the army of older people to wear a Band-Aid on my face. One skin cancer survivor who joyfully, happily, obliviously chose a chaise-sitting, oil-basting, body-rotating, reflector-using, get-a-tan- at-any-cost younger life. So now I’m a dues-paying member of a community I didn’t ask to join.   The Reckoning I’m sitting on a park bench looking down at my hands, the backs shockingly old in the afternoon sun. The skin crinkles outward like a spider web or pieces of broken eggshells. On examination, the left hand appears more lined than the right. I wonder if the left one was … Continue reading →

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In Poor Taste: Terbinafine-induced dysgeusia in a 58-year-old man

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Abstract:  This is a case report of dysgeusia and glossodynia in a 58-year-old man, which he developed during a 12-week course of oral Lamisil (terbinafine) prescribed as treatment for presumed onychomycosis.  Although these side effects are documented in the medical literature, many clinicians are either unaware of them or neglect to mention them to patients prior to prescribing the drug. The literature suggests that dysgeusia is more likely to develop in the older patient who has a low BMI.  There is no known treatment for the disorder, which may resolve on its own or become permanent. Keywords:  terbinafine, Lamisil, dysgeusia, ageusia, hypogeusia, altered sense of taste, medication side effects, onychomycosis, … Continue reading →

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Acne Unmasked

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Bukowski on Acne From Ham on Rye Black Sparrow Press 1982 Ham on Rye, a semi-autobiographical novel, follows Henry Chinaski, Bukowski’s thinly-veiled alter ego, during his early years. It contains harrowing descriptions of Bukowski’s suffering from acne conglobata and his reflections on the dermatologists who treated him.  Fortunately, today, isotretinoin can help most of these patients. Here are some excerpts from Ham on Rye:   Chapter 29 I was ashamed of my boils at school.  At Chelsey, you had a choice between gym and ROTC.  I took ROTC because then I didn’t have to wear a gym suit and nobody could see the boils on my body. Handling the rifle … Continue reading →

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Seborrheic Dermatitis: Cri de Coeur

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In his Op-Ed piece, “Diary of a Creep,” published in the Sunday January 6, 2013 New York Times, the journalist Rend Smith gives the best description of seborrheic dermatitis we have ever read.  Here are excerpts from that piece which can be read in its entirety on the NY Times website. “My problem isn’t as luxurious as aging.,,Yet there’s obviously a corruption, a slow, unidentifiable toxin seeping into my life. I have volcano-ash dandruff, so I haven’t gotten my new hair “shaped up,” in the parlance of black barbershops, out of embarrassment… But worse than anything else is my face, or more specifically, the skin there. The condition I have,, … Continue reading →

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Acne: Worst Case Scenario

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Excerpt from “72 Scars”  Evergreen Review. Technically speaking, Scar #1 began in 1971 and lasted well into the 1980s. Like many teenagers, I had acne, but unlike many teenagers, I had the worst case any doctor had ever seen. The only thing to compare it to is Charles Bukowski’s description in Ham on Rye. It started out innocently enough. My dad would drive me to Dr. Fried in Englewood, NJ every Saturday of my freshman year. The treatment would begin with a 30 second x-ray radiation treatment of the afflicted areas and then Dr. Fried would take out a dermatological instrument and go to work squeezing the pimples on my … Continue reading →

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Perioral Dermatitis: A Personal Odyssey

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Attack of the POD People … EEEK ! (Don’t worry – the title is scary, but there’s a happy ending…) Abstract:  This is one woman’s narrative of her experiences with perioral dermatitis (POD).  In his film, Crimes And Misdemeanors, Woody Allen declares that comedy is tragedy plus time.  While POD was not exactly a tragedy for me; it did, however, negatively affect me physically and emotionally six months of the year.  In reading my attempts to ease the situation, feel free to laugh (or cry) both with me and at me! Keywords:  perioral dermatitis, self-care, self-diagnosis, illness narrative, stress, grief, doxycycline, POD Note:  This essay is better read in the … Continue reading →

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Grand Rounds Circa 1990

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Mens sana in corpore sano —Juvenal My Road to Ground Rounds—and the Results! By H. J. W. Abstract:  These are the recollections of an 84 year-old man who was presented at Grand Rounds 22 years ago.  He had dermatomyositis at time.  His observations are important as they reflect on the academic activity and also the evolution of one man’s experience with dermatomyositis. Keywords:  dermatomyositis, grand rounds, illness narrative, academic medicine, pruritus, Massachusetts General Hospital Twenty years ago when my glass shower door came off its track, I had a hard time lifting it back into place. “Am I getting weaker?” I thought. My upper body itched. I had no pep, … Continue reading →

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