Notes from a Healer

Our Daily Bread

Brian T. Maurer
btmaurer1@comcast.net

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“He just told me this morning.  It’s been bothering him for quite some time—”

“Weeks!” the boy says.

“Weeks?” his mother retorts.  “Why didn’t you say something sooner?”

The boy shrugs his shoulders.

“Anyway, it’s been itching him; and I guess he’s uncomfortable.”

I decide to cut to the chase.  “Just where is the rash?” I ask.

“Oh, it’s, well, it’s down in his privates.”

The boy’s face turns red.  He’s a chubby youngster of ten, that age when most kids are somewhat embarrassed about their bodies.

“I suppose we should have a look,” I muse.  “Lie down on the exam table.  It won’t hurt—we just want to have a look-see.”

Reluctantly, the boy lies down on his back.  When I lift the elastic band of his underwear, he giggles.

There is some mild maceration in the inguinal skin folds.  It appears as though he’s been scratching—I detect a few superficial excoriations.

“Okay,” I tell him, “you can sit up now.”  I turn to his mother.  “This looks like a fungal infection.  It’s quite common, especially in kids who play sports.  You say he’s a hockey player?”

“That’s right.”

“It’s what’s commonly known as jock itch.”  When I pull out my prescription pad, the mother starts rooting through her purse.

“Hold on a minute,” she says.  “I brought along whatever creams we had at home.”  Methodically, she extracts tube after tube and lays them side by side on the countertop.  “I don’t know if any of these might work.  I didn’t want to just start using one without checking with you.”

I glance over the collection of pharmaceutical creams and ointments.  “This one would work,” I say, holding up the tube.  “Actually, this one would, too.”

“Which one is better?” she asks.

I make the selection and hand it to her.  “Have him apply a thin film to the area twice a day for two weeks,” I instruct her.  “That should clear it up.”

“So what is it exactly that he’s got?” the mother asks.

“It’s a fungal infection of the skin, sort of like athlete’s foot, except in the groin.”

“Then it’s not a yeast infection?”

“No, it’s not yeast.  Yeast is usually the culprit in diaper rash, and sometimes you see it in vaginal infections.”

“I wasn’t sure,” she says, transferring her collection of tubes from the countertop to the recesses of her purse.  “But I did have him stop eating bread, just in case.”

“Stop eating bread...?” Involuntarily, I raise my eyebrows.  Then it’s all I can do to suppress a smile as she responds.

“I told him the pita bread was okay, ’cause that’s unleavened.  But as for the rest of it, you know...”

“I think you can give him his ration of daily bread,” I say with a twinkle in my eye.  “We can overlook the leaven this time round.”

 

About the Author

  • Photo of Brian T. MaurerBrian T. Maurer has practiced pediatric medicine as a Physician Assistant for the past three decades.  As a clinician, he has always gravitated toward the humane aspect in patient care—what he calls the soul of medicine.  Over the past decade, Mr. Maurer has explored the illness narrative as a tool to enhance the education of medical students and cultivate an appreciation for the delivery of humane medical care.  His first book, Patients Are a Virtue, recently reviewed in The Yale Journal for Humanities in Medicine, is a collection of patient vignettes illustrating what Sir William Osler called “the poetry of the commonplace” in clinical medical practice. Interested readers can read more of the author's writings at his website and blog.

  • Published: March 3, 2013