I want to say it's stressful, but I am thankful.
So, while I had so many patients waiting, this man kept on complaining about how he had to keep on paying to see me just because I couldn't cure his itch. I started feeling bad, but I didn't recall treating him for any itch. So, I reviewed the notes from all the previous visits. The man was seen for his itch two years ago by my sister.
He said his itch was all over, like bugs crawling on him, but only at one location at a time, especially on his scalp. I couldn't find anything on his skin or scalp...no scabies, no rash, nothing. Hot showers? Dry skin? Scabies? Neuropathy? Liver disease? Allergies?...I quickly ran through a whole bunch of differential diagnosis in my mind: None. The whole time he kept on wanting to check his blood. Then, it dawned on me!
Things dawn on me so often...LOL. Anxiety! A lot of the men I see who want to check their blood have something to hide... :))).
"Any unprotected sex other than with your wife?" I asked.
".....Ummm...only oral...on me. She's 27 (with a grin on his face)..."
"She's gonna kill you! Your guilt is coming out as itches. Are you better now? Let's do some blood tests," I said nicely.
"Will I get HIV if she does oral on me?"
"The risk is lower, but there're other diseases also. Regardless, let's do some blood tests."
"I'll be back for it. I feel better already."
Then, he just smiled and walked out.
The guy must have cheated on his wife back then, too. And he had the nerve to give me a hard time so early in the morning.
"What are you laughing at, Dear Gay Confucius?"
"Mee holpe hee loo-nog helve reel rass...khee...khee...khee..."
"You hope he does not have a real rash?...ME TOO!"