Under My Skin

A dermatologic little list


The following was presented to the Pennsylvania Academy of Dermatology at its annual meeting in Bedford Springs, Pa. The verses were sung to the tune of “I’ve Got a Little List” from Gilbert and Sullivan’s “Mikado.”

For those unsure of how the words fit, the editors of this periodical are considering a lottery. Winners will get an MP3 of the author singing the lyrics. Losers will get two copies.

Dr. Alan Rockoff

I’ve Got a Little (Dermatologic) List

One day your staff informs you that a patient who’s called up

Has asked that you call back –

At once! Call him right back! –

But to your consternation you discover that you lack

The telephonic knack

You lack the call-back knack

For the man who wants to be assured he knows that he’s been called

And so he’s ordered voice mail – but it hasn’t been installed

Or else you hear a message that suffuses you with gloom –

Her voice mail works just dandy, but it’s full and got no room

Or else he’s a millennial who doesn’t use the phone

What right has he to moan?

We’ll just leave him alone!

Among the many irritants providing me with grist

The naive integumentalist

Must be there on my list

The one who’s sure that any scaly rash that comes among us

Is certainly a fungus

What else? A yeast or fungus!

Yet doles out betamethasone for every scaly sole

And smears all roundish eczema with ketoconazole

And knows they can’t be bedbugs if the bites don’t come in three

And rules out pityriasis because there is no tree!

And calls each itch that patients have inscribed into a furrow

A scabietic burrow –

An idiocy thorough!

Returning now to patients, I really must insist

To put some on my list

(In fact, they top the list!)

They’re the people who have generated their own laundry list

Or else at least the gist –

(Their list contains the gist) –

The redness of my pimples now takes much too long to fade

I have a strange sensation just below my shoulder blade

I get these funny white bumps when my family travels south

And intermittent cracking at the corners of my mouth

I have a newish brown mark on the right side of my nose

And frequent scaling in between my first and second toes

Now let me double check my list, because you see I fear

That I’ll leave something crucial out – now that I’ve got you here!

This armpit mark’s irregular – you see, there is a stipple

And new light yellow bumps have just appeared around my nipple

The red splotch underneath my breast – my doctor says it’s yeast

I have this dark spot. See my navel? Go one inch northeast

Oh, wait, there is a skin tag on the right side of my neck

And now, as long as I am here, let’s do a body check ...

And yes, there is just one more thing I must ask you about

I am concerned – in fact I’m sure – my hair is falling out!

Now that we are concluding, we should surely not forget

The ones not on the list

Forget about the list!

Those patients every one of us is very glad we’ve met

And happy to assist

The ones who would be missed

Those lovely people each of us is gratified to serve

Who often praise our efforts rather more than we deserve

And anyhow the tables turn, and so sooner or later

We docs will take our turn as patients, crunched to bits of data ...

I hope my cranky litany has served to entertain ya

So thank you for inviting me –

Good morning, Pennsylvania!

Dr. Rockoff practices dermatology in Brookline, Mass, and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His new book “Act Like a Doctor, Think Like a Patient” is now available at amazon.com and barnesandnoble.com. This is his second book. Write to him at [email protected]

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