Making Sense of People

Probably like many who work with the public, I often get the chance to see how little sense people can make. Even so, last week was unusual.

On Tuesday, I saw Beulah who had not been into my office for 8 years. “I showed Dr. Prince this spot on my leg,” she said. “It's been there a month, and I'm worried about it.”

“Just a blocked follicle,” I told her. “Put some bacitracin on it, and it will be fine.”

Beulah sighed with relief. “I don't need another cancer,” she said. “I already have stomach cancer. Dr. Prince told me I couldn't have surgery or any other treatment, because I wouldn't make it through. But I'm 98 years old, and I guess we all have to go sometime. I don't have any family left. They're all gone.

“I've lost 30 pounds,” she said, still spry enough to hop off the exam table. “None of my clothes fit anymore. But it's awfully good to hear that I don't have to worry about that spot on my leg.”

That is a relief, I agreed.

The next morning, I greeted Iris warmly. “How are those grandchildren?” she asked, as she always does. “Do you have any new pictures?”

“I thought you were moving to Florida, Iris,” I said.

“It's been a tough year,” she said, “so I had to come back.” She went on to tell me how her husband had become jaundiced and succumbed in less than 3 months to cancer of the bile duct. “It's crazy, Doctor,” she said. “Both of his brothers had cancer, they had operations years ago, and they're fine. My husband was never sick a day in his life, never even had to take anything for a headache. And now he's gone.”

We talked about Iris's own problem, scleroderma, which somehow was not progressing at all. Her only skin complaint, easily disposed of, was mild hand eczema.

After some further pleasantries and picture showing, Iris took out a bag of skin care products. “I'm running low on these,” she said. “Is there any way I could get some while I'm here?”

Sure she could.

Then on Thursday, Sybil came by, a robust woman of 79 who wanted some pigmented lesions checked. As I looked her over, I asked about her family.

“My baby brother has Lewy bodies dementia,” she said. “He's not doing very well. He's in a nursing home now, because his family couldn't take care of him anymore. He still recognizes us a little, or seems to, when we come to visit. It's very painful to watch.”

Then Sybil brightened, pointing to the brown spots on the backs of her hands. Can we laser these off?” she asked. “I really hate them.”

Of course we can.

By week's end, I was really perplexed. How do people do that, I wondered? How can they go from the profound to the trivial with no acknowledgment, no apology, no, “I know this will sound frivolous after what I just told you?” How do they manage such a sudden and seamless register change—as though an opera singer stopped mid aria and launched into “Jingle Bells” without so much as a wink? But they do. I am just about gone; I have outlived everyone around, but what a relief that I don't have skin cancer. My husband just died a painful and senseless death, but I need those creams to help my skin look younger. My little brother is wasting away before my eyes, and how about those pesky age spots.

On reflection, such paradoxes may be more apparent than real. Unless we succumb to deep depression or utter despair, we want to go on living. This means setting aside gloomy thoughts, even if just for a while, and attending to all matters, profound or trivial, that people pay attention to until giving up altogether.

Since no one can make tragedy go away, I guess it's nice to be able to mitigate its impact just a little now and then.

But the end of last week left me shaking my head. I hope never to stop trying, but I doubt that I'll ever really understand people as long as I live.

DR. ROCKOFF practices dermatology in Brookline, Mass. To respond to this column, email Dr. Rockoff at our editorial offices at sknews@elsevier.com

Probably like many who work with the public, I often get the chance to see how little sense people can make. Even so, last week was unusual.

On Tuesday, I saw Beulah who had not been into my office for 8 years. “I showed Dr. Prince this spot on my leg,” she said. “It's been there a month, and I'm worried about it.”

“Just a blocked follicle,” I told her. “Put some bacitracin on it, and it will be fine.”

Beulah sighed with relief. “I don't need another cancer,” she said. “I already have stomach cancer. Dr. Prince told me I couldn't have surgery or any other treatment, because I wouldn't make it through. But I'm 98 years old, and I guess we all have to go sometime. I don't have any family left. They're all gone.

“I've lost 30 pounds,” she said, still spry enough to hop off the exam table. “None of my clothes fit anymore. But it's awfully good to hear that I don't have to worry about that spot on my leg.”

That is a relief, I agreed.

The next morning, I greeted Iris warmly. “How are those grandchildren?” she asked, as she always does. “Do you have any new pictures?”

“I thought you were moving to Florida, Iris,” I said.

“It's been a tough year,” she said, “so I had to come back.” She went on to tell me how her husband had become jaundiced and succumbed in less than 3 months to cancer of the bile duct. “It's crazy, Doctor,” she said. “Both of his brothers had cancer, they had operations years ago, and they're fine. My husband was never sick a day in his life, never even had to take anything for a headache. And now he's gone.”

We talked about Iris's own problem, scleroderma, which somehow was not progressing at all. Her only skin complaint, easily disposed of, was mild hand eczema.

After some further pleasantries and picture showing, Iris took out a bag of skin care products. “I'm running low on these,” she said. “Is there any way I could get some while I'm here?”

Sure she could.

Then on Thursday, Sybil came by, a robust woman of 79 who wanted some pigmented lesions checked. As I looked her over, I asked about her family.

“My baby brother has Lewy bodies dementia,” she said. “He's not doing very well. He's in a nursing home now, because his family couldn't take care of him anymore. He still recognizes us a little, or seems to, when we come to visit. It's very painful to watch.”

Then Sybil brightened, pointing to the brown spots on the backs of her hands. Can we laser these off?” she asked. “I really hate them.”

Of course we can.

By week's end, I was really perplexed. How do people do that, I wondered? How can they go from the profound to the trivial with no acknowledgment, no apology, no, “I know this will sound frivolous after what I just told you?” How do they manage such a sudden and seamless register change—as though an opera singer stopped mid aria and launched into “Jingle Bells” without so much as a wink? But they do. I am just about gone; I have outlived everyone around, but what a relief that I don't have skin cancer. My husband just died a painful and senseless death, but I need those creams to help my skin look younger. My little brother is wasting away before my eyes, and how about those pesky age spots.

On reflection, such paradoxes may be more apparent than real. Unless we succumb to deep depression or utter despair, we want to go on living. This means setting aside gloomy thoughts, even if just for a while, and attending to all matters, profound or trivial, that people pay attention to until giving up altogether.

Since no one can make tragedy go away, I guess it's nice to be able to mitigate its impact just a little now and then.

But the end of last week left me shaking my head. I hope never to stop trying, but I doubt that I'll ever really understand people as long as I live.

DR. ROCKOFF practices dermatology in Brookline, Mass. To respond to this column, email Dr. Rockoff at our editorial offices at sknews@elsevier.com

Probably like many who work with the public, I often get the chance to see how little sense people can make. Even so, last week was unusual.

On Tuesday, I saw Beulah who had not been into my office for 8 years. “I showed Dr. Prince this spot on my leg,” she said. “It's been there a month, and I'm worried about it.”

“Just a blocked follicle,” I told her. “Put some bacitracin on it, and it will be fine.”

Beulah sighed with relief. “I don't need another cancer,” she said. “I already have stomach cancer. Dr. Prince told me I couldn't have surgery or any other treatment, because I wouldn't make it through. But I'm 98 years old, and I guess we all have to go sometime. I don't have any family left. They're all gone.

“I've lost 30 pounds,” she said, still spry enough to hop off the exam table. “None of my clothes fit anymore. But it's awfully good to hear that I don't have to worry about that spot on my leg.”

That is a relief, I agreed.

The next morning, I greeted Iris warmly. “How are those grandchildren?” she asked, as she always does. “Do you have any new pictures?”

“I thought you were moving to Florida, Iris,” I said.

“It's been a tough year,” she said, “so I had to come back.” She went on to tell me how her husband had become jaundiced and succumbed in less than 3 months to cancer of the bile duct. “It's crazy, Doctor,” she said. “Both of his brothers had cancer, they had operations years ago, and they're fine. My husband was never sick a day in his life, never even had to take anything for a headache. And now he's gone.”

We talked about Iris's own problem, scleroderma, which somehow was not progressing at all. Her only skin complaint, easily disposed of, was mild hand eczema.

After some further pleasantries and picture showing, Iris took out a bag of skin care products. “I'm running low on these,” she said. “Is there any way I could get some while I'm here?”

Sure she could.

Then on Thursday, Sybil came by, a robust woman of 79 who wanted some pigmented lesions checked. As I looked her over, I asked about her family.

“My baby brother has Lewy bodies dementia,” she said. “He's not doing very well. He's in a nursing home now, because his family couldn't take care of him anymore. He still recognizes us a little, or seems to, when we come to visit. It's very painful to watch.”

Then Sybil brightened, pointing to the brown spots on the backs of her hands. Can we laser these off?” she asked. “I really hate them.”

Of course we can.

By week's end, I was really perplexed. How do people do that, I wondered? How can they go from the profound to the trivial with no acknowledgment, no apology, no, “I know this will sound frivolous after what I just told you?” How do they manage such a sudden and seamless register change—as though an opera singer stopped mid aria and launched into “Jingle Bells” without so much as a wink? But they do. I am just about gone; I have outlived everyone around, but what a relief that I don't have skin cancer. My husband just died a painful and senseless death, but I need those creams to help my skin look younger. My little brother is wasting away before my eyes, and how about those pesky age spots.

On reflection, such paradoxes may be more apparent than real. Unless we succumb to deep depression or utter despair, we want to go on living. This means setting aside gloomy thoughts, even if just for a while, and attending to all matters, profound or trivial, that people pay attention to until giving up altogether.

Since no one can make tragedy go away, I guess it's nice to be able to mitigate its impact just a little now and then.

But the end of last week left me shaking my head. I hope never to stop trying, but I doubt that I'll ever really understand people as long as I live.

DR. ROCKOFF practices dermatology in Brookline, Mass. To respond to this column, email Dr. Rockoff at our editorial offices at sknews@elsevier.com