It was a holiday weekend but the aftermath maybe nothing to celebrate.
This was my thought as I spend an hour with a young woman who was only a couple of weeks into her college summer internship. She was from another city and had come to the emergency room with several symptoms of sexually transmitted diseases. The worst of these symptoms were the ulcerations surrounding her vulva or the opening to the vagina.
"He seemed like a really nice guy." Maybe, but he must have had herpes because this young woman, who had not previously been sexually active, surely has it now.
"But I didn't see anything like this on him." I sat and explained to her how he could have been someone who sheds the virus asymptomatically. Occasionally these people don't even know they have herpes. It is also true that early in the course of an outbreak, before the blisters appear, virus is shed but there is no visible sign of a herpes infection.
Then we talked about oral sex. I am always amazed at how many young people do not even consider this sex at all. This woman did not. Regardless of whether she considers 'oral sex' sex, I explained to her that she could contract herpes from his lips and he could get it from hers. I also had to explain that I have seen gonorrhea of the throat and syphilitic chancers (the lesion of primary syphilis) in the mouth. Recently pathologist have been reporting human papilloma virus or HPV in biopsies of polyps in the mouth and throat.
A short time later, I overheard one of the nurses taking about how paranoid her 18 year old son is about sexually transmitted diseases. This is good. I wish someone had made this young woman paranoid. If so, perhaps she would have at least insisted that a condom be part of the celebration.
skip to main |
skip to sidebar
Musings of a physician in private practice for 24 years, now teaching in a residency program and working as an ob-gyn hospitalist in a large metropolitan hospital.
Posts
Followers
About Me
The Local MD
Having now been a physician in private practice for twenty-one years, twenty-six days and about an hour and twenty minutes, it occurs to me that I have become what in medical school was often a derogatory term, the local MD.The presentation on rounds often went something like: "This 45 year old Caucasian male was seen last week by his LMD, and diagnosed with a viral upper respiratory infection..." At that point everyone knew that the LMD had missed the diagnosis. Otherwise the poor patient would not have ended up in a tertiary medical center with three consulting specialist, a fellow, a resident and four medical students at his bedside.What we, the medical students, the resident, the fellow and even the attending hospital physicians did not realize is that we would never know John Smith as well as the LMD. We would never speak to his wife using her first name. We would never be able to recall the names of all his children and know where they were in the world. We would never remember his favorite hobby let alone joke with him about it. Nor would we shed a heart felt tear when we gave him the diagnosis of the aggressive small cell carcinoma of the lung that had landed him in our midst and would kill him in less than three months despite our aggressive treatment that was the best medical science has to offer.At that point in my life I was very proud to be even the lowest ranking person on the team that was on the cutting edge of the diagnosis and the treatment of the gravest of conditions that plagued mankind. I felt so very lucky that I was being initiated in to this sacred fraternity. That I would soon be able to write "MD" after my name. I am still proud of my vocation yet I believe there is a wisdom that has only come with those twenty-years of practice.Today I realize what people want most of their physician is that he or she is someone who cares.Yes, we all want "everything medical science has to offer." Yet, what most of patients need is someone who will listen with their heart as well as with their head. Physician eyes are important, not only for seeing signs of disease in the body but for making contact with the patient's eyes where we are often allowed to see into their soul. All of the technology in the world will not replace a warm clasp of the hand or sitting at the bedside to share a few moments of the day along with the test results.So, I have created this blog. In large part it is a place for me to put my feelings. My hope is that at least some of these posts will resonate with others out there. Not just physicians, but others in caregiving vocations and even those for whom we care. If we are not here for each other then why are we here?
2 comments:
This breaks my heart.
Mine too. I don't know how to make kids understand the dangers. It seems most of our culture makes sex seem so wonderful. From my perspective, it is like playing with a loaded gun.
Post a Comment