A dermatologist colleague of mine has said to me over and over, "We should write a book." She has three children and I have four. At 7:30 a.m. every day, I dropped the kids at school, often two different schools. I packed four lunches; made brownies or muffins for 38; put together backpacks, instruments, and school music; gave them a check for the fundraiser or activity; and yelled my way to an on-time departure. What a wonderful day it was when we didn’t forget something crucial, turn around, race back to the house, and find the missing item! Unfortunately for busy parents, there are the endless special days: pioneer day, Valentine’s day, Halloween, field day, half days, winter gift exchange, pajama day, Earth day (ecolunch), picture day, graduation practice, play tryouts, etc. What distracted doctor can remember all the stuff that goes with it? It was often a hilarious start to the day.

Patients often tell us sad and amusing stories, and with a little distance from the moment, the stories can be funny. Humor and tragedy are so tightly linked.

And the stories they make up! "By mistake I gave the insurance information of my wife to be used by my current girlfriend, and I didn’t realize that the medical information would appear in my wife’s chart." "The dog ate my homework and the Vicodin." " The car wash employees took the Vicodin right out of the glove compartment." The most common is, of course, "They fell into the toilet." Does everyone keep his/her medicines on the toilet seat?

And what about all those things our patients want to show us? I’m all for descriptions, but not all patients will go that route. Various sputum specimens, urine, stool, and vomit are of course the most common. Sometimes nasal discharge "snot" is proudly presented. Then there’s skinflakes like snowflakes in a jar. Most astonishing are the bugs, spiders, and ticks that patients spend hours capturing for our viewing pleasure. Patients like to describe how they preserved the tick carefully from destruction as they pulled it out. One man left the tick embedded for fear of losing the opportunity for identification. Was that really necessary?

The last time I saw Mrs. X was eight years ago, and she was eccentric but mentally clear. I was reacquainted with her last week. Now she is in her late 80s, and her once intelligent mind is failing. She recognized me; but as she talked, I realized that I was now a member of a larger cast. She asked me to remember the time that the police were called. The neighbors had complained that she was raising black widow spiders in her backyard, which was true, but how "we" had talked with the police was fantasy. "Someone of our station (namely professors of biology) ought to be allowed to raise whatever we want in our backyards because there is so much to learn!" she opined.