CASE REPORT: Patient Presenting With Submandibular Lymphadenopathy Following Excision Biopsy of Oral Mucosal Neoplasm

My right eye is twitching feverishly, has been for two days, and I'm beginning to put some stock in my fears of severe neurological dysfunction.  Unilateral headaches brought about by vasospasm.  Strange burning sensations about the lips.  Granuloma on the gingiva.  I've been falling apart for a good, long while now, and it is difficult to chalk everything up to my own idiosyncrasies.  Then again, perhaps my hypochondriasis is getting drastically out of hand.

I took a quiz given to USC dental school students and scored a 10 out of 12, including correct answers on two essay questions.  I was, admittedly, proud at first, but that feeling of accomplishment soon gave way to frightening personal revelations I would have rather avoided at the time.  I spend a good portion of each workday pouring over medical literature from various sources in a desperate attempt to figure out what the fuck is causing a vast array of symptoms that range from neurological to dermatological in nature.  I finally had a breakthrough this morning.  I've been going about this thing all wrong.

One of the biggest problems with Western medicine is that doctors are entirely too specialized.  An oral surgeon can tell you relatively little about problems that Otolaryngologists normally handle, and vice versa.  The same goes for nearly any type of specialty one can name.  Woe upon the person who asks a cardiologist about granular growths in lung tissue as a result of sarcoidosis.  That poor, unfortunate individual will be met with his fair share of wrath and scorn.  "Fucking imbecile.  I am a cardiologist.   I swear to Christ, you piss ant mops are going to drive me up the fucking wall with your ignorance of Latinate nomenclature.  Now get out of my office before I tear out your pericardium!"

It goes something like that, anyway. 

The simple concept of interdisciplinary medical practice has been made a curse word among specialists, not unlike how socialism has been equated with rape and incest in right-wing political rhetoric.  Thus, one is forced to beg referrals from primary care physicians who seem far less interested in a patient's health than whether their credit card will be declined at the front desk.  We've got to hop around.

I had to see a general ophthalmologist in order to get a referral to see a retinal specialist when I knew goddamned well what kind of doctor I needed.   My oral surgeon told me the lesion on my gums was scar tissue left over from old brace fixtures.  I informed him that the lesion had been there for one month (it's been much longer since braces, of course) and that I thought it might be a granuloma or another similar tissue mutation.  He gave me a disbelieving half-smile and excised the thing at my request.  I asked him to have it biopsied.  Guess what the pathology report said.

There have been other examples of physicians and nurses proving themselves morons.  I had a nurse try to draw blood.  She happened to be the only person to ever stick a needle in me without commenting on how beautiful my veins were, a staple comment of nurses and medical technologists who do this every day.  And it's true.  My median cubitals are right up against the surface of my skin.  Easy access for butterfly needles.  This idiot missed the vein, and, instead of issuing another puncture, tilted the needle sideways.  I had a hematoma in my elbow for three weeks.

The crux of this whole thing, though, was about applying interdisciplinary concentrations to diagnosis, and if doctors are going to send me bouncing around, I'm going to do the goddamned dirty work for myself.  Sure, I might be going psychotic.  Sure, my fears might be entirely unfounded, and my symptoms could very well be manifesting from present deep-seated concerns, however inane. At least I know that service is free.  No co-pay.  No bullshit insurance jargon.  No bored physicians paying more attention to waddling nurses' asses than their work.

Speaking of which...if I plan on doing this alone, I'm going to need an assistant.  With a nice ass.