The Mr. Smokes-too-much appreciation thread (not cafe society)

Miscellaneous and Personal Stuff I Must Share
1

Hopefully everybody knows the skit from Monty Python’s Flying Circus. A gentleman (Eric Idle) is introduced on a talk show as Mr. Smokes-too-much (IIRC they give him a first name, but I don’t recall what it was). He sits down beside the host and as he’s settling in, the host’s (John Cleese) first response to him is, “Well, you should cut down.” Mr. Smokes-too-much shrugs his shoulders and wrinkles up his face and has no idea what the host is driving at. The host repeats his original statement more slowly, “Well, you should cut down.” Still, Mr. Smokes-too-much is not getting it. This goes on, excruciatingly, for a few more minutes until the host explains his joke to Mr. Smokes-too-much who finally gets it and says, “Oh, I never thought of that.”

This thread is dedicated to similar real life situations. Allow me to explain. Four months ago, I began dermatology residency. Probably half of the patients I see are for sun-induced skin changes: mostly pre-cancers, but many, many cancers as well. Most of are the less aggressive varieties (basal and squamous cell) with thankfully few melanomas.

Anyhow, because this large proportion of the patients I see have the same disease, and share the same risk factors (age, fair skin, sun exposure), I find myself having the same conversation over and over again. I’ve noted patterns in responses that make this cohort of patients essentially a collective Mr. Smokes-too-much. Allow me to explain.

I ask every one of these patients if they’ve ever had melanoma. I ask because if they had, we’d be much more aggressive in examining them and in treating otherwise non-impressive moles. Thankfully, melanoma is rare, even among this select population, so the vast majority have not had melanoma. However, rather than answering, “No,” to my question, nearly every patient (we’re talking about 10-15 patients a day, five days per week) answers, “not that I know of.” One the face of it, this response makes no sense. Either you’ve had melanoma or not, and if you’ve had it, you’d sure-as-shit know it. And it’s not just the melanoma question. If I ask about any condition that the patient does not have, the response is near universally, “Not that I know of,” instead of no. We could waste time trying to figure out why everybody answers in this fashion or, and this is what I propose to do in this thread, we can let the Mr. Smokes-too-muchs’ in on the “joke.”

So that’s what this thread is about. It’s about your unique collective insight. You get to play the host, the John Cleese character, and tell us that we’re collectively naive.

Hope I explained this well enough.

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But if I haven’t, I might not know that it’s as obvious as you think. If you’re not familiar with it, you might think you had it and got better without noticing.

My fiancee answers nearly every medical question like that because how can you be sure? Are you allergic to any medications? Not that I know of. Makes perfect sense. Until she’s tried every medication out there, how can she definitively say no? Me, I know what the doctor is looking for, and just say no. But I see her point of view.

3

I hear what you’re saying, choosybeggar, but most people (myself included) are simply ignorant on most medical matters. Now yes, I’ve heard of melanoma and could confidently answer “no” to your question, but for most people you are asking “Have you ever had Squeeblaffeription?” and honestly have no idea …

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Guys, I understand that there are reasons why people give the response I described. The people giving them are good, honest, hardworking people as are the posters in this thread.

I was hoping,though, that this thread could be about posters giving one another insight that is otherwise hard to come by. Insight that stems from a unique perspective they have on a particular thing.

For example, me, I talk to people all day long about their health. When I notice a characteristic patterning of responses across the multitude of my patients, I make a mental note, and create this thread to drop it off into. I agree with both gonzoron and PS that there are reasons for the characteristic response. This thread is not intended to be critical. Perhaps there is an ill-at-ease feeling evoked in knowing that we all say the same non-committal, wishy-washy thing. Most of us don’t like to be perceived as conformist or wishy-washy. But I say insight is insight. I don’t wish to tell Mr. Smokes-too-much that he was a big dummy, I just want to let him in on the “joke.”

Another example from my job: nearly all of the women who I see for sun-induced skin damage (cancer, pre-cancer, wrinkles, brown sun spots, whatever) tell me that,“nobody knew about the harmful effects of sunlight when I was younger,” and that, “When I was younger, we didn’t use sunscreen. We spread coco butter over our bodies and went out and fried.”

Another example: informal polling of my (relatively) young medical colleagues shows a vast majority do not take the diagnosis of fibromyalgia seriously. They will treat the FM patients sensitively and competently but believe, in their heart of hearts, that FM is, medically speaking, a non-entity.

Please share your own examples.

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Does melanoma smell like a rattlesnake? :wink:

6

huh?

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I think I’ve had melanoma. It was in an Italian resturant and they added it on top of my canolli.

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I’ve been in sales for awhile so how about these

“I’m just looking”

“I’ll be back”

The first one means give me a better deal and second one means that they will NEVER return.

And of course there is “that’s way to much to pay” in response to a deal that would cost me money, not make me money, to do.

What else… “I’ll call you back”, means you’ll never hear from them again.

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And stuff like this:

Call him and tell him that something came up. Don’t explain what. And start being “busy” any time he calls. This guy is up to no good.
–Snoopy (from Need advice on a male-female thing (longish)
Most women’s version of being straight forward. God forbid you should tell a guy what your actually thinking.

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I believe I had asthma for a long time before it was finally diagnosed. When I jogged, and had a fiery, rasping pain in my lungs, I thought it was because I was out of shape. When I had uncontrollable coughing fits, I thought I was having very bad colds. I was not a guy who stayed away from doctors. I had regular check-ups. I often took my “terrible colds” to the doc.

Asthma, though, is often undiagnosed. It shares symptoms with other diseases. Sadly, it also carries some baggage about being “all in the mind” of the victim. Considering how many docs failed to notice my asthma until after I was 50, I have to conclude that many doctors are undereducated about asthma. So was I, of course, and I didn’t know what to look for, either.