The One About The Rash

This patient journey rivals Homer’s Odyssey if you ask me. It starts as a blemish, then a reoccurring rash, first labeled contact dermatitis, then an allergy to trees and critters, then a yeast infection. It’s seen by 3 different dermatologists, 2 PCPs and a litany of know-it-alls on Instagram – all with different interpretations and diagnoses. The rash spreads to the eyelids, turns purple, then moves to the neck, bubbling up most in February, quieting in summer. Then a retired neurologist has a thought – “it might be autoimmune.” Rashes are tough, worse than a tough to decipher leg pain, and they spread in strange ways. 91% of teens in our poll who admit to serious depression or even suicidal thoughts have, guess what, unresolved rashes. Maybe just coincidence. The rheumatologist is available, but not for 4 months, then squeezes in the patient for a telemed check, quickly ordering a panel of labs, which sparks some possibility of a thyroid disorder, but then to check further, orders more tests, then refers to a different dermatologist and an endocrinologist, but doesn’t talk to the patient about why. Did the test results explain the rash or uncover something new. It feels serious and it’s expanding, but those appointments are 6 months away, so maybe not? The entire journey takes 3 years, 4 months and 13 days, 23 clinical encounters, 13 different prescriptions. Solutions – none yet. Rashes spread, they are hard to solve, they cause internal pain. We spend so much money in the US on health, makeup and vanity, pouring resources into making ourselves look and feel better, but when we can’t explain something and feel like we don’t have control, the makeup won’t cover up the pain. We end up on an island and we hide. And that’s what a lot of youth and 20-somethings do when faced with no answer. If you want to fix the healthcare system, solve the patient’s journey.