Few days back I was returning home
from a short trip abroad. I had just
settled in to watch Kate Winslett heroically battle cute viruses in ‘Contagion’,
when the PA system announces the “Is
there a doctor on board thing”. My split personality starts getting
active…the ‘good doctor’ in me wants to rush across the aisles to the patient
in distress and execute a dramatic recovery act, but the more practical shady
side (the usually dominating one) wants to dig the ear phones deeper into my
ears to block out any further announcements, hoping that some other quixotic
idiot will take the call. After 30 secs the announcement comes up again. The ‘good
doctor’ wins for a change and I
hesitantly remove my seat belt and my earphones, say a heavy goodbye to Kate Winslett and the viruses
and head towards the back of the plane where some kind of hectic activity is
going on. In the back of my mind I try to revisit the revised steps of CPR (incidentally now
after years they suddenly realize that getting the circulation thing going is
more important than the airway…so the classical ABC –airway, breathing, circulation is now CAB). Thing is I am not too much into emergency
medicine, unless you count sudden and severe itching as an emergency. Besides
if I really wanted to handle such life threatening situations I wouldn’t have
opted for dermatology, I would have probably chosen surgery… or a second wife.
In fact it’s at deep moments like this I sometime reflect on my career choice –
(Here are some of the most important reasons I could recollect.
1. I was/am/will be lazy
2. I
hate getting disturbed in the middle of my sleep – afternoon or night (I don’t
mind disturbing others though….my snore-storm affected nuclear family will attest to that)
3. I was/am/will be lazy
4. I
love my thick skin (some unmentionable roles in some unmentionable college
skits will attest to this)
5. I was/am/will be lazy
6. I
wanted to work with charity foundations to eradicate all the suffering in the world due to itching
7. I was/am/will be lazy
8. I
like getting under other’s skin (Who doesn’t?)
9. I was/am/will be lazy…………..)
As I reach the empty space towards the end of the cabin I
see a small crowd of stewards and stewardesses mulling around the patient. One
of the stewards eyes me curiously and almost accusingly says “Yes?”
The shady part of me wants to say
“Nothing…where’s the loo?” and go to the
loo, back to my seat and Kate, in that order.
Anyway the ‘good doctor’ wins
again surprisingly “I’ m a ..er…doctor” says me….I myself am not too convinced.
“Oh…” a look over and again a very expressive “Oh!”
The steward, apparently still not very convinced,
hesitantly clears the crowd to direct me to the patient. The patient
surprisingly turns out to be a stewardess….and her face is contorted with a mixture
of pain and anguish as if she just had
an extra helping of Arnab Goswami and his “the nation wants to know”.
Anyway the good thing is she
seems too young to have a cardiac arrest. I put on my best false smile and my best false serious voice
and ask her what the problem is. The patient doesn’t speak. Reminds me of our
honorable ex PM –MMS, in a time of
crisis (or for that matter even in normal times).
The lady just points over various parts of her body. Maybe she’s not
happy with her body image…the dysmorphophobia thing….I want to tell her that I
have the same problem, but that you get
used to it as you grow older. Anyway when she continues to point her index
finger all over her body I take a closer look and notice the reddish raised
skin lesions.
Aha, voila!…..urticaria…a dermatological emergency!!!….so
now I smile even more broadly and take charge (incidentally also mentioning
very loudly and explicitly at least twice that I happen to be a dermatologist).
I take a quick history - when, how,
where, why , why not…..a little poor joke to lighten the atmosphere..and then a
detailed examination followed by a quick
counseling session.
“ Don’t worry, it’s just an allergic
reaction……I’ll just give you a little
injection and you’ll be back in
action in no time”
The ‘injection’ bit makes the
lady go a bit pale, but I insist. Anyway, injection given (incidentally the
first aid kits in commercial aircraft seem to be pretty well stocked), I get
ready to go back to my cramped cattle class seat. I was hoping that the
airlines staff would give me a free upgrade to business class considering my
invaluable skin-saving act and significantly contributing to the health of its
staff.
“Excuse me doc” a sweet voice
calls out from the back. I turn to find
another petite stewardess with a pretty smile. OK, free upgrade here I come.
And then she starts frowning. Now
I am confused… I hope I didn’t mess up the injection. The sweet lady holds her
frown …actually frowns a little bit harder now. I look for the parachute hold.
“Doc, do you think I need to go
for botox?”
Oh. That. The frown was
apparently to help me assess her botox needs.
Now this is the other thing with
dermatology nowadays…..either you are supposed to be an ‘itch doctor’ treating
all kinds of assorted lovely itches on all sorts of assorted body parts…..or
you are supposed to be a ‘witch doctor’ busy converting ugly ducklings into beautiful
swans with a simple swish of a wand…and it happens to be one specialty where
you are often asked to randomly opine on, diagnose and treat just about anyone
and just about anywhere….a blurred ‘What’sapped
image’, facebook, weddings, mid-air………… .but what the heck, why bitch
about it as long as the itch/witch makes you rich?!
I do the botox consult….and a
couple of other similar cosmetic consults, everything is hunky dory and I turn
around ready to go back to my seat and
Kate…..and of course there’s no free upgrade….maybe a little extra smiles when
I exit the airlines……..but then, maybe that’s worth it too?!:)
PS:
On a more serious note, it feels
nice to know that the popularity of Dermatology as a specialty choice continues
to grow the world over. The little concern is that many opt for dermatology
purely for the cosmetic part. While cosmetic dermatology is an interesting and
satisfying part of practicing dermatology, I personally feel that it should not
come at the expense of good ol’ clinical dermatology….but then to each his/her own!
