September 24, 2017

My Personal Lourdes

A combination of my desperation and an opening in the Cosmos got me an appointment with the Gods of Dermatology, downtown in the clinic at Jefferson University School of Medicine.

I am serious about the Cosmic Opening. After getting an appointment in August for sometime in the end of September with an Unnamed Source in the clinic, I felt a strong tug on Monday, August 27 and went to the phone. I dialed the clinic to see if there were any cancellations and for no really good reason, the Office Administrator happened to answer the phone. I replayed my monologue about scratching myself into small julienne strips.

He listened and said, "Well, lucky for you, I am the only person who can override the computer." And he put me in on top of another patient (no, not literally) for two days later.  Downtown Philadelphia  is an hour train ride away and, because of the train schedule, I got there 30 minutes early, thereby beating out poor unsuspecting Patient Number One. They took me back into what turned out to be my personal Lourdes.

After the usual monkeying around with the well-meaning resident and medical student,  both of whom were young and uber-fit, in walked the most Zen physician I have ever met. In his 60s, Asian, kind eyes and portly-ish frame. He silently inspected all the julienne strips and calmly sat down.

In the most kind and sage way, he then walked the resident into a Socratic inquiry. (Remember, this is a teaching institution. Patients are Lab Rats with Insurance.)

"The key finding is that the rash is symmetrical. What does that suggest?"

I didn't even realize that, and I've been scratching at myself for four months.

She offered a possible diagnosis. He countered: "But why would that be symmetrical?"

She demurred. It went on for a few rounds. .

Being a former medical writer, I jumped in. "How about bed bugs?"

"Why would that cause symmetrical bites?" 

"Umm...well, because mine are very well organized?"

Me and the resident surrendered and Dr. Zen said two words: dermatitis herpetiformis.

I only heard "something-something HERPES." But that was just a red herring. He explained that this disorder is a skin manifestation of (cue trumpets): gluten intolerance.

That floored me even more than herpes.

He gave me an overview, tossed off some orders to the resident, and walked out of the room.

"Wow," I said to her. "Can you tell me what causes this?"

Her reply told me that she will go on to be a very, very good doctor. "I don't know! I have never seen this before. I have to read up on it."

When I got home, I looked up everything I could about DH (as we pro's call it).  I also looked up everything about Dr. Zen. That chance phone call in August not only got me into the Clinic faster, it put me in the hands of a full Professor of Dermatology and Vice-Chairman of the Department. He has been practicing for 45 years and "no longer accepts new patients."

Except for me, for this singular opening in the Cosmos.

So I am now on medication and off bagels. And, of course, being 2017, there's an app to help me out. It scans the bar code on anything prepared and rings with a "go" or 'no go" response.

It took me a few weeks to get my head around this diagnosis. But here's where I am now. No longer itchy, sleeping through the night. And fully aware that of all the systemic diseases that creep into  people my age, this is nothing.