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more on qualified physician parasitologists

Luscombe99 luscombe99 at aol.com
Sat Feb 22 20:11:58 EST 1997

Thank you, Dr Steve Kayes!  A few more related thoughts:

1.  On the use of the term "physician parasitologists":  not many such
physicians exist.  As has already been stated, physicians (MD or DO) with
interests in parasitic infections/infestations are usually infectious
disease specialists by training and are found in university medical
schools.  A couple of very good places to find physicians with interests
in exotic/parasitic infections are Tulane University in New Orleans and
Case Western Reserve University in Cleveland.

2.  Please don't assume that the only persons responding to posts in this
newsgroup (and, for that matter, the only persons with any knowledge of
parasitic infections) are physicians.  Dr. Kayes is a PhD who has done
basic research on parasitic infections for many years;  I'm a veterinarian
with a master's in parasitology and a keen interest in parasites affecting
people and animals.  The point (already alluded to by  Dr Kayes):   very
few physicians trained in this country know enough about parasites to be
helpful.  Speaking from several years of teaching experience,
veterinarians get a much better education about parasitic infections than
do physicians, and much of what they learn about are zoonotic infections
(transmissible from animals to people), so there's some knowledge of human
parasites as well.

3.  The fact that few physicians are experienced enough to accurately
diagnose many unusual parasitic infections frustrates patients, but any
physician worth his/her diploma has a responsibility to say "I don't know"
when stumped and refer patients to experts when necessary.  I know this is
the ideal and it doesn't always happen, but that's the truth of the
matter.  The flip side, of course, is that some patients, such as many who
post to this newsgroup, do not have any known parasitic
infection/infestation.  This is not to say that "we" have all the answers
about every parasite in the world--we don't.  But there's a hell of a
difference between a patient showing up with what any trained expert can
recognize as a parasite and someone who thinks they're infested with
organisms and comes up with a typically bizarre description of the problem
(e.g., the gentleman a while back who supposedly had a parasite wrapped
around a vein in his neck).  To all those who are annoyed with "experts"
who supposedly turn into psychiatrists when asked about patients with
truly strange-sounding problems (multi-legged creatures constantly
crawling in / out of body orifices, etc.), it's because such cases have
been thoroughly documented (in the literature) as having a psychiatric
basis.  There are certainly other possible explnations (drug reactions,
etc), but the condition known as delusory parasitosis is well-described,
and several of the recent posts to this group are suggestive of it.  

End of sermon.

Dr Bob Garrison
Sacramento, CA 

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