When Allergens Attack

Over the past two weeks I have learned how to be an allergist. This is about one and half weeks over the national average. If you too would like to be an allergist, just follow this simple algorithm:

Does patient have allergies?

• If yes, then prescribe Flonase, Zyrtec, and offer immunotherapy.
• If maybe, then prescribe Flonase, Zyrtec, and offer allergy testing.
• If no, refer back to primary care physician.

The differential diagnosis seems to primarily be: allergies?

The seeming simplicity of allergyology aside, there has been no shortage of rigorous academic debate. We have had no less than two extended, multi-party conversations about whether glaucoma eye drops are relative contraindications for allergy testing or not. Why are we not discussing this in internal medicine morning report? Are we afraid to confront the issues?!

Which raises the important follow up question: allergists get paid more than us why?

What is interesting in all of this is not the cytokines and chemokines and mini blinds that make up the facade of legitimate medical practice that is allergy, but how many allergists themselves have allergies. Considering that most all psychologists have some sort of personality disorder, most anesthesiologists have one or more substance abuse disorders, and most OB-GYN docs are, well, ladies, do all physicians chose specialties based on personal disease experience? Is there increased cancer incidence in hematology-oncology doctors? Does going into infectious disease require that I first acquire an infectious disease? I don't know for sure, but to be on the safe side I am going to go ahead and get myself some Cat Scratch Fever before it's too late. After all, I don't want to be left with Rat Bite Fever or Chikungunya, whatever the hell that is.

Be on guard folks: mountain cedar and elm are up today. That means goggles, people!