New England Journal of Medicine
Some years ago I saw I guy who by history and examination had swimming pool granuloma, a characteristic and relatively harmless infection with Mycobacterium marinum, usually involving the hands and forearms, usually acquired from water. That was in fact the diagnosis and he got better with treatment, minocycline.
At the initial interview he stated his distress at having chronic skin problems with no resolution. He had requested consultation with a dermatologist.
"My GP told me he got an appointment for me with the best guy in Vancouver, in fact probably all of BC."
Despite my better instincts, I felt flattered.
"Great!" he had said. "When's the appointment?"
"In nine months."
"I said, 'Nine months! I can't wait that long. Send me to somebody else sooner! Send me to a fucking witch doctor, it's OK with me.'"
"And that's why I'm seeing you."
