History, P.E., and Maggots

As I was about to start Joel’s chemo I rattled off the laundry list of pertinent symptoms he might have neglected to disclose. Some patients avoid revealing too much, for fear of a chemotherapy cycle getting delayed. This is not necessarily an active attempt to conceal. They sometimes just forget, or convince themselves that these things don’t matter. So we always have to ask. I learned this from the many times I’ve been scolded by my consultants in med school. “The patient has no headache, abdominal pain, joint pains…” I would report, eliciting a biting comment from Dr. Bhella-Ella-Ella, “Tinanong mo ba? Or IN-ASSUME mo lang dahil hindi nila sinabi?!” In one of our rounds I told Dr. Lucy Lane Asuncion that the patient worked as a jeepney driver. She wasn’t impressed. “Anong ruta?!” she asked. This attention to history gave birth to generations of doctors who could probably moonlight as private investigators, or professional usisera.

When I asked Joel if he had been experiencing any leg pains, he suddenly remembered that he had recently burned his leg with some electronic device. I asked him to lift up his pants. There, on his left leg, was a row of painful, red, vesicular lesions.

“I don’t think that’s burn injury,” I said. “They look like herpes.”

Joel’s wife shot him an accusing look. With a nervous laugh Joel protested that he hadn’t been having sex with anybody else. I predicted that he would try to come up with a contaminated public toilet explanation, so I hurriedly said that it was not the STD kind of herpes. “It’s chicken pox getting reactivated. It happens.” I started him on some antivirals and rescheduled his chemo.

When we were interns we had a patient with genital herpes. He must have done his research, and told us, in front of his wife, that “Oh it’s just re-activated bulutong!” I looked at my senior resident and hoped that she would make the proper explanation, with discretion and grace, that it was the STD.

I haven’t encountered an STD patient in a long time, but I remember hating giving intramuscular ceftriaxone to patients with gonorrhea. Even the alpha guys with the biggest deltoids would squirm from the pain of the viscous antibiotic piercing the muscle. One such alpha guy even told me, rather unnecessarily, “Hindi na ako uulit! Mag-ja-JAKOL na lang ako!”

Last month, on Good Friday (of all days), my friend Pepito told me that he wanted to masturbate over a very hot pornographic photo he found on the internet. I reminded him that it was Holy Week, and as a good Catholic he should observe the many traditional restrictions. You aren’t allowed to eat meat on a Good Friday, you can’t even take a bath past 3 pm (otherwise, MAGGOTS, instead of water, would sprinkle out of the shower) so what made him think he could masturbate over porn. He said he really wanted to masturbate. Why people feel the need to tell me things I have no business knowing is beyond me, but I remember closing the conversation with, “If it’s validation you need, then you have my full blessing to JERK-OFF. But expect MAGGOTS, instead of semen, spurting out of your penis.” (Note: I used the more piquant and vulgar Tagalog terms, of course!)

He was able to restrain himself from masturbating (he said).

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