Mary was waiting for me in the examination room. A mildly plump 55-year-old, she looked at me nervously as I came in, waiting for her chance to spill out all her aches and pains and concerns. “Hello, Mary,” I said. “How have you been?”
“Not so good,” she replied, handing me a sheet of paper with a long list of medications written on it.
I had seen Mary many times over the last five years in my dermatology office, so I was no stranger to her lists or her wide variety of ailments, real and imagined. During the last visit, her chief complaint had been irritated sores on the scalp. At the time, she told me she was compulsive and kept scratching the sores until they bled—a classic sign of neurodermatitis, a condition in which a person scratches the skin repeatedly, usually to relieve stress or tension. We see it quite often in our practice, and from talking to Mary I knew she had enough stress in her life to sink a ship.
