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What on earth is this mysterious substance?

What on earth is this mysterious substance?

“Gary,” a 26 year old, presented to the clinic for sneezing, watery eyes and runny nose. He could not understand why this was happening to him, and complained in particular about the congestion. “I’m congested! I am just so congested!” he declared.

This was in the middle of the fall ragweed season. I asked him if he got like this before. Gary thought about it and said, why yes, every fall he gets like this. I asked if he’d tried anything for this.

Gary responded: “Like what?”

I don’t expect people to have a major grasp of their health, or of the various common-sense ways to improve it. If you were wise enough not to go into a health-care field, you have no reason to know the pathophysiology of type 2 diabetes, or the risk factors for pancreatitis, or the replication pattern of the influenza virus. Some people will be as mystified by all this as I am by the nature of the internal combustion engine. I get that. But a grown man going to the doctor because he literally does not know what hayfever or Claritin are, is like me going to the mechanic because I don’t know how to put gas in my car.

Sometimes people with allergies come to the doctor because they want their insurance to pay for their over-the-counter meds. Others want a work excuse. Still others are obsessive about strep, and any throat irritation from allergies makes them get their throat swabbed. But then there are the Garys of the world, who make one wonder how on earth they get dressed in the morning without someone to help them with the concept of “pants.” (I should note that Gary was not disabled in any fashion, outside his terminal case of ignorance.)

There are some very basic things every adult needs to know how to do. Like, how to count money and change. Or to know that the oil in their car must be changed intermittently. The basics of how to use a cell phone. Taxes and April 15. The essentials of hygiene. See, all of these are like pleasuring your sexual partner: you are not expected to be a legendary master, but you at least need to know the basics.

Similarly: you have no excuse to not have a rudimentary¬†grasp of the most essential facts of your health and of over-the-counter meds. You don’t have to be able to diagram the chemical formula for acetaminophen, but you do need to know that Tylenol works for fevers and mild pains. I wouldn’t expect the layperson to know the intricacies of Tylenol vs. Advil, but I do expect them to try at least one for their headache before coming to me. CVS in general will be far better at treating a common cold than I am: Dayquil, Nyquil and Mucinex-DM are your friends. At least try giving them a shot before running to the urgent care. After all, unlike amoxicillin, they can actually help your viral cold a little.

If you develop a sore muscle after working out hard, this should not be a medical mystery requiring a professional’s intervention. A papercut is quite treatable on your own with a bandaid and bacitracin. And if you don’t know the basics of a balanced diet by age 18, then your mom needs to hang her head in shame. (I don’t expect you to necessarily FOLLOW a balanced diet, of course… not when it’s often too much for your physician!)

And for God’s sake, if you have allergies, try some freaking over-the-counter allergy pills! Claritin and Zyrtec are not closely-guarded state secrets! I get it if you just want a doctor’s note or you want your insurance to pay for them… but there is no justification for not being even vaguely aware of their existence!

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