WTF Moment #1071


523px-Sarcoptes_scabei_2What is it with some people and rashes?

The patient waits 3 hours to be seen. When I enter the room, the patient says “I had a rash on the back of my leg 2 months ago. Can you tell me what it was?”
Out of the 4 or 5 things running through my mind at that point, the least pressing one of them wasn’t about calling up the feds to get satellite video feeds of the patient’s house two months ago so I could zoom in through the window shots and hopefully identify the cause of the mysterious rash.

“The rash isn’t there now?”
“Well, sir, I honestly don’t know what caused the rash because I can’t see it any more. As long as it isn’t there any more, I don’t think it’s going to be a problem.”
“Was it scabies?”
“I doubt it because it wouldn’t have just gotten better.”
“Well what does scabies look like?”

At this point, I should have stopped the conversation and discharged the patient. Unfortunately, my foresight gene had gone offline for a few moments.
“Scabies is usually little itchy spots or pus-filled blisters. Most commonly the spots are between the fingers or the toes. Sometimes there will be little red lines where they burrow under your skin.”
“Wait. You mean scabies are bugs?”
“They are mites.”
“Oh my God. That’s what the rash looked like. I’ve got bugs burrowing in my skin.”
“No. You don’t. The rash is gone.”
“What if they’re just sleeping? Couldn’t they still be in my house?”
“I’ll tell you what. If the rash comes back and you think it is scabies, there’s cream called elimite that you can buy over the counter to kill the mites. Until then, I wouldn’t worry too much about it.”

An hour after he was discharged, we start getting the phone calls.
“My son said you told him my house was infested with bugs. What’s THAT all about?”
“How long should he stay home from school for?”
“Can these bugs be sexually transmitted?”
“Should I be going to work? I work in a nursing home.”


My shift couldn’t end soon enough.


This and all posts about patients may be fictional, may be my experiences, may be submitted by readers for publication here, or may be any combination of the above. Factual statements may or may not be accurate. If you would like to have a patient story published on WhiteCoat’s Call Room, please e-mail me.


  1. “What if they’re just sleeping? LOL!! 🙂

    I wonder just what thought processes are going on in these patient’s brains when they expect anyone to diagnose a non existent rash? How DO THEY connect the dots …in their brain ..obviously not on their body …or you’d SEE the rash.

    Funny post! Okay so it was an annoying shift …but see WC …then we get to laugh when you write about it. 🙂

  2. Bah. Had them when I was a kid…I hate to itch more than anything in the world. Classic symptoms, too. Ugh. Before diagnosis I was waking up in the night and standing in the steaming hot shower to get the itch out. Yikes.

  3. Aren’t scabies what we call “mange” in animals? Just send your patient out to our farm — we’ll run him through our sheep dip station. LOL.

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