The Doctor Gets Schooled
As a group doctors tend to be firm and certain in their statements. We often speak as if our information came from on high. This manner of speaking can be fine for inspiring confidence in our patients that we know our stuff and the patient can be assured. Sometimes our patients reveal our ignorance, or arrogance to them and ourselves.
About my third year in Jal, NM, a regular patient and mother of one of my son’s friends came to see me.
“Hello, Claydean, what’s up with you today?”
“I’m getting the chicken pox again Elwood,” and she showed me a couple of skin spots that indeed looked like chicken pox.
“No, you only get chicken pox one time and then sometimes you get shingles from that same virus, but you don’t get chicken pox more than once.”
“Elwood, I had chicken pox when I was young and I’ve had it another time about 4 years ago and now I’m starting up again, you can see for yourself-here and here and here.”
She showed me her spots and I doggedly insisted that it had to be some similar appearing dermatological condition but it most assuredly was not chicken pox. We would watch and see how the situation developed.
Two days later she appeared in my office febrile, looking quite ill and with classic chicken pox widespread on her skin. I sheepishly had to admit her diagnosis had been correct and my ignorance was exposed.
Over the next 6 or 7 years she presented with chicken pox two more times. On one of the 2 occasions she was quite febrile, weak, and unable to eat. She had a headache and a stiff neck. I admitted her to the hospital, did a spinal tap and her spinal fluid showed she had a viral meningitis, almost certainly from the chicken pox. She recovered and still consulted me for various ailments, but I always remembered how wrong I had been on that one occasion.
I have not encountered recurrent chicken pox in a patient since then, nor did I ever have a colleague admit to seeing someone with repeated chicken pox attacks. The advent of and effective chicken pox vaccine reduces the likelihood of this situation recurring.
Some years later in Yuma, AZ. I was severely schooled again.
I had been treating a longtime patient for high blood pressure and added Inderal (propranolol) to har program and her blood pressure responded nicely.
However one day she told me she wanted to stop the medicine, that it was causing her to lose her hair and indeed her hair was noticeably less abundant and she was sure the Inderal was causing the hair loss.
I assured her that was not the case. However she returned a couple months later and said ,”Elwood, you need to get me on another medicine for the blood pressure because I’m not going to keep losing my hair from the Inderal.”
“ I just don’t think it’s the Inderal,” I said with great misplaced confidence.
“Go get your PDR,” she told me (The PDR-Physician’s Desk Reference was a large printed book of most of the drugs we prescribed. It was in widespread use in pre internet and Google days to help physicians learn more about the meds they were prescribing.)
I went into my office and returned with the PDR.
“Now go to the page on Inderal,” she instructed me.
“Now go to the second paragraph and read to me what it says,” the lady who had done her own research told me.
And there on the printed page was the information that Inderal can indeed cause significant hair loss.
Much chagrined, I realigned her drug regimen for hypertension.
She continued to see me for the rest of my practice time in Yuma.
I asked her one time why she had continued to see me when I had been so obviously wrong.
“Because you were willing to listen to me and learn something instead of ignoring me.”