This might just be the best blog post I have read this year. It’s nominally on patients with delusions of parasitic infestations, but it’s so much more.
I saw a patient recently for parasites.
I get a sinking feeling when I see that diagnosis on the schedule, as it rarely means a real parasite. The great Pacific NW is mostly parasite free, so either it is a traveler or someone with delusions of parasitism.
The latter comes in two forms: the classic form and Morgellons. Neither are likely to lead to a meaningful patient-doctor interaction, since it usually means conflict between my assessment of the problem and the patients assessment of the problem. There is rarely a middle ground upon which to meet. The most memorable case of delusions of parasitism I have seen was a patient who I saw in clinic who, while we talked, ate a raw garlic clove about every minute.
“Why the garlic?” I asked.
“To keep the parasites at bay,” he told me.
I asked him to describe the parasite. He told me they floated in the air, fell on his skin, and then burrowed in. Then he later plucked them out of his nose.
Much more here.
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Upon reading this post in Google Reader – there was an inline ad asking "Have you had a parasite cleanse this year?" – I'd send a screen shot to validate my non ad-delusionism, but didn't see how to.
That's super. Wish you'd been able to capture/post.
A very good read! Humorous since nobody died, but less humorous in cases where people are so disconnected from accurate medicine that they get themselves killed.
America does not have enough doctors not doing b@@b jobs. We are behind many developed countries in doctors per capita even before specialization takes away primary care doctors.
With so few primary care doctors, we end up with a situation like in China up until recently where "alternative" medicine dominated. Alternative medicine mushrooms when conventional medicine fails to show up in force.
The AMA blockade on doctor creation is much more damaging than any organized crime syndicate.