Every once in awhile I realize that Urban Blight Memorial is in a totally different world, and the patients there live a totally different life, despite being less than 10 miles from the downtown of a five time superbowl championship team, and less than 10 miles from where I grew up.

Yesterday’s fastest patient exam of the day went a little like this

She was wearing a stained purple sweatshirt that reminded me just a little of an oversized children’s dinosaur character.   “Hey Doc, my feet feel like they’re crawling,” she drawled.

Me:  Noticing that her boyfriend/fiance/husband didn’t have many teeth either.   “What’s wrong with them?”

Her:  “I just told you.  They’re giving me the creeps.”  She turned towards her boyfriend and smiled at him, large black gaps revealing yellowed stumps of enamel.
Me:  “Well let me see them, where are they?”

Her:  “Right there at the bottom of my legs,” she giggled through a snaggle-toothed grin.

Reddened skin, telltale scale and maceration between the toes ended my exam as soon as it started, and I think I held my breath through the entire thing.

My verbal discharge instructions hit them as if they’d never even considered it before.  “Wash your feet every day with soap and water, dry them off, and put on clean socks every day.”   I emphasized the ‘every day’ part.  The pair of them looked into each others eyes, raised their eyebrows in shock and giggled again.

I just about ran out of the room as I threw the nystatin script at them.  I grabbed an earl grey tea bag and meditated over it for about five minutes before my olfactory senses had recovered.