by Lorelei Armstrong
Doctors debate whether patients Googling symptoms is a good thing or a bad thing. I bet you haven’t thought about something that might be worse: your teenage patients are answering one another’s medical questions on Yahoo! Answers.
They’re not always clear on anatomy and terminology: “How can I tell if I’m circumcised?” and “What’s the best way to shave my vagina?” and “Where is the female prostate located?”
They are sexually active and not well informed: “If my boyfriend and I put the condom on after we start, can I still get an STD?” and “I had the HPV shot, am I protected from other STDs and AIDS?” and “I’m 12, should I take Viagra for my penis?”
They are worried that they are too tall, too short, too heavy, too thin, that their parts are the wrong shape or size. They believe every fad diet in the world. “Is anorexia a good diet?” and “Is it healthy to drink 16.9 fluid ounces of water per day?”
The girls think their periods should run like a Swiss watch and be red blood. Anything else is abnormal. “I’m a virgin and my period is two days late?!?!?!” and “Brown discharge why?!” and the boys have no idea what a normal size for a penis might be or much else. “Left nut too low!”
I feel sorry for any doctor that faces the surprisingly common “Back of my head hurts!” and the perpetual “How tall will I be?”
Every symptom means cancer or a tapeworm. They think the annual odds of catching tapeworm approach 80%.
There are some very serious hypochondriacs.
Many cannot spell. “Problem with my virgina?”
They worry about their parents who have cancer, or alcoholism, or kidney failure, and no health insurance. They worry about their grandparents who just had strokes or fell down the stairs. “Help my Gran!”
Want to make a billion dollars? Invent something that clears drugs from the urine, blood, and hair in eight hours. “Toked saturday, pee test thurs, chances?” and “OMG, I have to pass!”
Some will take anything to get high. “I just smoked something. What was it?” and “How many Oxycodone 325s to get high?” and “Just snorted two Vics and nothing, why?” and “How come 11 650mg paracetamols make you feel high?”
I know the number for poison control now. Some things you don’t just observe.
They want to know if there’s any risk from smoking a joint through a toilet paper tube jammed full of dryer sheets to hide the smell. “Is this OK?”
A few are not interested in health: “How can I get sick by tomorrow?” and “What’s the easiest way to break a bone?” and many variations on: “Where can I buy a euthanasia kit?”
They get groped by the neighbor while babysitting. Their fathers tell them they have a rare disease that won’t let them have children with people of another race. They really do get STDs and cancer. They cut themselves. Their parents refuse to take them to the dentist and refuse to take them to the doctor and tell them not to tell the doctor things or they’ll get in trouble.
Some of them worry about the voices in their heads and the secret cameras their parents put in their rooms to spy on them.
These are your patients. Don’t assume they understand what you tell them. Tell them things that seem obvious to you. Write things down. Spell things out. Tell them where to find more information. When they ask you a question, do not shrug.
Ask them if there’s anything anyone told them not to tell you.
Ask them if they’re scared.
Lorelei Armstrong is a novelist and can be reached at her self-titled website, Lorelei Armstrong.