Dermatologist A


I was seen at 9.00 am in his private rooms. Dermatologist A is a well-respected doctor and has written a large number of well-received grant-aided research papers.

I found him a pleasant and businesslike man who conducted his examination by using a list of questions. Deviation by me from these or over-detailed answers were frowned upon.

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Below is what he examined my entire skin with in about five minutes flat. Depending on the model, it makes things appear 1.5 to five times bigger than they actually are.

This is obviously fine for most common dermatological applications. But it missed my problem completely. As you’ve seen, you need to magnify the plugs 100-200 times to see them properly.

Magnifier
The mighty 4x dermatological magnifier.

I apologise for the small size of the image – it was the biggest I could find.

I must stress here that I did not tell Dermatologist A I believed I had insects crawling on my skin. What I said was that, in view of the of the other insect pests I believed were introduced into my home by the hospital blankets, and the outdoor animal use to which they’d been put, it was a reasonable assumption that my tickles and green plugs were caused either by other animal pests unknown to me, such as mites, OR by a fungal infection.

When I lightheartedly observed that mites and fungi don’t keep office hours and that the tiny greenish globular objects were probably too small to be seen with his magnifier, he assured me that he’d be able to see any signs of activity, no matter the time of day. He told me he could find nothing obvious and made a follow-up appointment for me at his public clinic for three weeks later.

When I got home from this appointment I immediately got two tickles on the back of my neck. I removed two plugs from the sites of the tickles and put them into an empty pill bottle, resolving to present specimens at my next appointment.

And that was another huge mistake, as you’ll find out later.

The 2nd Appointment


The waiting area was standing room only. But that’s a reflection of the truly parlous state of Irish medicine – too many patients, not enough doctors. You really would do better in a third-world country.

Eventually, I was seen by Dermatologist A’s registrar.

How was I feeling?

Worse. More tickles.

Another examination with the magnifier.

Dermatologist A enters and confers.

They decide to take a skin biopsy. And choose an old flea bite mark. (My flea bites were always slow to heal). I point out the newly-formed raised hard growth close to it. No, we’ll take the flea bite.

I present the pill bottle of specimens.

These will be sent to the lab for analysis, I was told.

And another appointment in four weeks.

The 3rd Appointment


At last, I thought, these guys will have solved my problem.

The results:

Skin biopsy: “The specimen was consistent with insect activity.”

Well, I did tell them it was an old flea bite.

My own specimens: “Were not suitable for analysis.”

I immediately resolved to buy a USB microscope so I could photograph these things the moment they came out of my skin. This is what I decided on, the AM413T Dino-Lite Pro:

microscope_411t_l
The AMT413T Dino-Lite Pro.

I told Dermatologist A that I’d forgotten to inform him that I also had these tickles in my ears and my anus.

His eyebrows shot up. “Oh, orifices?” he said.

Then he left the room to confer with his registrar.

The registrar returned. No more appointments. Instead: “We’re referring you to the best man in the country to deal with this sort of problem. He’s based in (a different city) though. Can you see him?”

I said I’d go see him even if he was based in New Zealand.

And so an appointment was made for me with Dermatologist B.

At last I had hope.
Read on to continue the story...