Stories from medical school – The Itch
I sit poised and professional, watching the patient vigorously and violently claw at his skin, while I too hold back the urge to itch. Looking around the clinic, my fellow classmates are sitting calmly, probably feeling as itchy as I do.
Nevertheless, I continue the consultation, and he tells me he had come back to the clinic complaining of an “unforgiving itchiness” that was keeping him up at night.
Being the thorough medical student I am, I examine the patient. His shirt comes off spotted with blood, and he proudly shows me an extensive rash covering his body. I touch and prod at the bright red nodules, scratched raw, oozing with blood. The patient then proceeds to shake his shirt inside-out and redresses himself. Now I’m worried.
“You say you came in last week and the doctor gave you some medication for the rash, do you remember what she prescribed?”I ask- starting to become more and more nervous.
“Yes, she gave me a special lotion and told me to cover my whole body with it. What was it called again? I think it was promethrin… permethrin? I believe Dr. X thought it was scabies.”he replies.
My face drops.
My colleagues in the room look at me wide eyed, and I think to myself.
No no no no.
FUCKING SCABIES????? HOW COULD DR. X NOT TELL ME!
I can feel the panic being translated onto my face. I abruptly end the consultation.
For those who don’t know what scabies is, it is an infestation of the skin by a small mite called Sarcoptes Scabiei. It causes a rash as the mites burrow into the skin, showing special love to webs of the toes and fingers. This infestation, as you can imagine, makes you itchy as fuck. So itchy you can’t sleep or sit still for too long.
And guess what? The mite is transmitted by prolonged contact with an infected person or their clothes or belongings. And did I wear gloves? Fucking no!
After kicking the patient out, I turn to my colleagues in the room. They are in hysterics laughing at me and the potential scenario in which I may have just contracted scabies. They laugh all the way back to our teaching room at the practice. And laugh as they told the rest of the students and my GP tutor.
I on the other hand am freaking out. One little mite could be setting up shop in between my fingers RIGHT NOW!
Dr.X reassures me telling me that only PROLONGED contact would lead to transmission, but I’m not so convinced.
The next day I ask one of the dermatologists about the likelihood of me having scabies.
“Very likely." she responds.
Fuck. My. life.
As scabies has an incubation period of 1 month before the crazy itch kicks in, I spend the next month of my dermatology rotation waiting for the itch.
And luckily the itch never came (I know, very anticlimactic).
Moral of the story, scabies is transmitted through PROLONGED contact and when examining an unknown rash, always, ALWAYS wear gloves. In my situation, the patient’s scabies mites were probably already dead from his first treatment (the itch can continue for weeks afterwards). And so, I probably should not have been as paranoid as I was.
I may not have had scabies, but the rumour that I did quickly spread through the medical school and I was then known as the 'Asian girl who got scabies.'
Therefore, I think I’ll take this opportunity to correct all the rumours in just 2 statements:
1) No, I did NOT catch scabies.
2) But I heard some year 4s did last rotation on psychiatry placement. Shout out to you guys. I hope the permethrin worked.