Anthrax and the Air Force
Filed under: Medicine
Discussing anthrax yesterday reminded me of my experience with anthrax while in the Air Force, or more correctly, the lack of anthrax…
A few years back, when the anthrax scare was going strong, I was a family physician in the Air Force. One day, a young Airman came in convinced that she had been exposed to Anthrax because her gas bill had powder in the envelope. She made it clear that she wanted to be tested for anthrax. She was completely healthy and had absolutely no symptoms that could be remotely considered similar to anthrax. When I informed her of this fact, she dug in her purse and pulled out a zip-loc bag containing the gas bill in question. She thrust it at me.
“Then how do you explain this?” she demanded.
I looked closely at the bill. It was printed on perforated paper and the “powder” she was pointing at was nothing more than the little bits of paper debris from the perforations. I pointed this out to her, but she was adamant that it must be anthrax sent to her by terrorists. I was tempted to ask why terrorists would target an 18 year-old Airman for their evil plots instead of a general – or at least a colonel – but for once I decided to keep my mouth shut. I simply once again pointed out that she had no symptoms of anthrax and the “powder” in her envelope bore no resemblance to anthrax. I also explained that the anthrax test was expensive and very unpleasant. I then sent her on her way.
About a half-hour later the commander of our clinic stopped by and told me that the hospital chief of staff had called him. Apparently, this Airman had complained to her sergeant that I had not run the anthrax test, and he had called the chief of staff in a huff. The chief of staff was now commanding me to order the test.
“Let me get this straight,” I said to the clinic commander. “Our chief of staff, a plastic surgeon, who has never once laid eyes on this patient has determined that she needs an anthrax test based on the say-so of a non-medically trained sergeant?”
He nodded.
“This is despite the fact that she is symptom free and was exposed to nothing more than perforations?”
He nodded.
“Never mind the fact that the Air Force paid for me to attend medical school and never mind the fact that the Air Force sent me to a special workshop on biological/chemical weapons, they’re going to take the word of some yahoo off the street over my clinical judgment.”
Again, he nodded, then patted me on the shoulder and walked away. Unsurprisingly, her test came back negative for Anthrax.
This to me was always the greatest annoyance about military medicine: there is always someone above you telling you what to do. I understand the military has a definitive chain of command. That’s fine for military concerns, but it breaks down in medical areas when different specialties are involved. I don’t mind people who know what they are talking about advising me, but I become very frustrated when people without the proper training and experience stick their nose into my business. This was probably the biggest factor that drove me out of the military and into civilian medicine.
July 13th, 2005 at 8:07 am
Did you fix the “noise” in today’s post in the last 5 minutes? I was going to note that
your quotation marks had turned into gibberish, but they’re gone now!
July 13th, 2005 at 11:27 am
First, let’s review the difference between aerosol powder and little bits of paper…
I’m projecting vibrations of sympathy to you Scott. I hate those types of moments where one is stuck with figuring out how to explain something in kindergarten terms to someone without appearing to talk down to them. Obviously I’d have to be much better at that to have a career in medicine or the military.
July 13th, 2005 at 1:37 pm
Oh, the memories. “I need an MRI of my knee”, “My SGT says I can get laser hair removal so I won’t have to shave my chest”, oh, geez.
November 15th, 2006 at 3:44 pm
Don’t get me wrong… I’m not prejudiced or anything… but that reminds me something a canadian friend of mine once said. “I’m living north of the most paranoid and egomaniac nation on earth”. (As I said…don’t get me wrong… I got a lot of friends in the U.S.)
I just think it’s sad when people confirm negative stereotypes.
May 19th, 2007 at 12:38 am
Though obviously not a doctor, I do sympathize with your inevitable frustration over patients. My dad is a lawyer, and all I hear about are his clients and how he has to explain common sense things to them in a nice tone without the slightest hint of him thinking they are idiots. Though perhaps my favorite story is about a cardiac surgery patient I had the extreme pleasure of dealing with. This delightful patient was to have one coronary artery bypassed, a mitral valve replacement, and a node on her aorta removed. Now I am no doctor as I have mentioned, but if a patient needs this tpe of surgery, odds are this is not elective and not having the surgery could lead to life threatening heart failure and death. “But am I going to have a scar?” was her only question. How do you explain that there may be slightly more important things in regards to this operation than a f#$%ing scar!!! After she woke up, she was relieved to be alive, and apparently the anesthesia had helped her see clearly about the relative importance of a scar. C’est la vie…I guess patients are a necesary part of being a clinician.
September 5th, 2007 at 11:03 am
One big reason why I never considered army. Here chain of command & following orders is preferred over intellect and common sense. A man who cannot apply his intellect and common sense is not being a man; he is merely a robot in flesh.
April 14th, 2008 at 4:45 pm
What would this Airman have done if you had silently consumed the powdered contents of the gas bill? That’s what I would have done.
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