Monday, April 28, 2008

A Pox of Chickens

The year was 1993. I was newly-married and jetlagged, just having braved the 24 hour long journey from India to the US. We were staying for a few months in a large light-filled apartment with an old couch, a kitchen table set, a mattress, a TV and not much else.

One morning, I woke up to find what looked like a large blister near my collarbone, and another on the stomach. What pesky insect might have bitten me on the flight, I wondered. They felt faintly itchy, but I resisted the temptation to scratch them.

A couple of days later, the rash-like blisters had spread all over and to my face, for good measure. My husband was becoming a little alarmed and asked me to try and get an appointment to see a doctor. For a first time user of the US health care system, the experience was baffling.

Me: Can I have an appointment to see the doctor today?

Receptionist: (After taking down long list of details of insurance coverage,etc.) The first available appointment we have is on [Date two months from today].

Me: But this is an emergency. I need to see the doctor today or tomorrow.

Receptionist: Then go to the emergency room.

Which is just what we did. We sat in the emergency room and waited and waited and waited...
Finally just short of two hours later, I sat in the examination room with a wide-eyed resident who mumbled something about 'immuno-deficient syndrome lesions' and refused to prescribe anything more than an over-the-counter antihistamine to relieve the itching. A few minutes later, the nurse who popped by to get a few more details for their forms took a casual glance at me and said "Looks like chicken pox to me!"

It was a Light-bulb moment,at last, a possible diagnosis for my condition.

Armed with the record of the emergency visit, I bullied my way into an immediate appointment the next day with an internal medicine physician. He took one look at me and rushed out in a hurry. 'Not again', I thought. But what happened next was the stuff of comedy gold.

In rushed a veritable horde of white-coated interns and their head honcho, evidently a very senior physician from the snow-white hair thick on his head.

"Now that you have seen the patient's lesions, would any of you like to venture a possible diagnosis?"
One hand went up. Dr.Reddy ventured an opinion softly: "It looks like a case of adult chicken pox to me."
The senior doctor beamed. "Excellent! And what do you suggest for the treatment?"
"Plenty of fluids, rest, oatmeal baths to relieve itching, much the same protocol as one would follow for treating juveniles."
"Ah, there I disagree. I would suggest ____ to combat the viral load, and _______ ointment to heal the secondary infections."
So, I got my diagnosis, a prescription and textbook immortality of sorts, as they asked me for permission to photograph my lesions for educational purposes. Anything, I figured, that would keep them from taking so long to identify a simple case of adult chicken pox.

Origins of the term 'chicken pox' from Wikipedia:
  • Samuel Johnson suggested that the disease was "less dangerous", thus a "chicken" version of the pox;
  • the specks that appear looked as though the skin was pecked by chickens;
  • the disease was named after chick peas, from a supposed similarity in size of the seed to the lesions;
  • the term reflects a corruption of the Old English word giccin, which meant itching.

As "pox" also means curse, in medieval times some believed it was a plague brought on to curse children by the use of black magic.


Anonymous said...

Funny :) I guess Indian doctors have the advantage of gaining experience much quicker because of the sheer volume of patients they see each day - they would have quickly seen it all.

The emergency room system here is a nightmare...

Sujatha said...

I was amazed that the nurse was able to figure it out much quicker than the initial doctors that saw me, but she may have very well had more experience with it in her home.
Emergency rooms here, for some reason, tend to be painfully slow. When my son had an ankle fracture, he went to the hospital at 6pm and got home only around midnight with his cast. What gives?