From the category archives:

Strangest cases

Methamphetamines (aka Meth)
Drugs can make people do some amazing, incomprehensible things, and sometimes you don’t know whether to laugh or cry.
One night, a phone call was directed to the ER by the hospital operator, who said, “I don’t know who else can help these people.”
Not good.
The call was from two men sitting in the hospital parking lot in a car, and they were clearly distraught. They spoke very quickly and and hysterically. They stated that they were infected by some kind of bugs, and didn’t want to infect anyone else by coming inside.
I certainly appreciated their desire to not make anyone else ill, but explained there was very little we could do over the phone. They both agreed to come in eventually, but made us agree to wear protective gowns and masks. We were only too happy to comply.
When they stepped in through the ambulance doors, I could not believe my eyes. They were both wrapped head to toe in aluminum foil. Apparently they had decided that the foil would protect themselves and us from the “bugs.”
As it turned out, these men had been smoking methamphetamines for days on end. They had become very paranoid, and began picking at their skin, as methamphetamine users tend to do. Each person made the other more paranoid until they both were convinced that they were seeing bugs underneath their skin crawling around, which only made them pick and scratch more. They both were covered with many sores all over their skin from all the scratching. I sincerely wish that anyone considering meth use could have seen the sorry state of these unfortunate men. If that didn’t stop them from using meth, I’m not sure what would.


As you may have heard, today is “Blog Action Day” organized by which is an annual nonprofit event that aims to unite the world’s bloggers, podcasters and videocasters, to post about the same issue on the same day. The aim is to raise awareness and trigger a global discussion and this year’s topic is poverty. I am pleased to be one of over 11,000 blogs participating.

The theme made me recall one of the most troubling cases I have seen. It happened when I was a medical student in Los Angeles.  A homeless man walked into the ER complaining about flies constantly buzzing about his head.  He was brought back into an examination room, and the nurse handed me the chart with a look of shock on her face.  I glanced at his medical history and noted that he was diagnosed with cancer of his sinuses a few months before, but he had not come back for any follow up.

He was about 50 years old, his hair and clothing were completely unkempt.  He had apparently been living underneath an overpass for a long time.  As I approached him, I noted that the right side of his forehead and cheek were hugely swollen, and there were open wounds in these areas.  I leaned in for a closer look and shined my penlight into the wounds.

What I saw nearly made me fall over backwards.  Dozens of wriggling maggots were writhing throughout the depths of these wounds.  I noticed that they were trying to escape the light, diving deeper into the poor man’s face.

He was right about the flies, of course, there were several in the room flying around.  He asked me for some pain medication, and I was more than happy to order all he needed.