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Dr. Patrick Nesbitt M.D. Family Physician, Vancouver B.C. ..................................Medicine and Fun .........drpat@ live . ca ................NOW BOOKING PATIENTS AT CAULFEILD 604 922 1544

How to think like a sexually transmitted disease 

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 The secret to understanding venereal disease is to think like a germ.  

One advantage is its easy to get from one person to another.  One large disadvantage is you can’t cause much in the way of symptoms.  Those with a classical education will recognize that “Venereal Disease” refers to the “diseases of Venus”.  Venus was the Greek goddess of love.  This appeals to the romantic in me.  I like to think that at least some love is usually involved, however transient or hormonally induced!  

The currently more acceptable term is Sexually Transmitted Disease.  But the acronym for sexually transmitted disease is STD, which sounds to me suspiciously like “stud”.  It may be more scientifically accurate, but it somehow lacks poetry.   Sexually transmitted disease is lucky because it is transmitted directly by skin to skin contact.  Many germs have to be content with being spewed out into the environment, and then floating about dandelion-like hoping to be inhaled by an unsuspecting victim.  Sexually transmitted diseases get to rub right up against the host.  Aye, there’s the rub!  This is extremely effective for spreading person to person.  It is perhaps most surprising that sexually transmitted disease isn’t easier to catch.

Unfortunately as an STD you have to be sneaky and understated.  A person with significant symptoms is not likely to be in an amorous mood, nor likely to find many willing partners.  I am reminded of my childhood efforts to roast Frankfurters over a campfire.   My efforts usually resulted in a charred, blistered weeping mass.  A wiener like that is not likely to grace any respectable bun.

 Humans are a lot like hot dogs in this respect.  So any self respecting sexually transmitted disease has to be subtle.  The less you are aware of its presence, the better for to it to spread about and become immortal.  What this means in practical terms is that sexually transmitted diseases do not force themselves upon your awareness.  You have to be thinking about them and looking for them.  They do not have many symptoms.  The ideal physician must have a high index of suspicion in order to diagnose these diseases accurately.  “High index of suspicion” is a medical phrase synonymous with “dirty mind”.

  This occasionally must be combined with near psychic ability.  Patients often come to the office with a vague desire to have “everything” checked.  This is roughly equivalent to going to a large library and asking to see “a book”.  Unless you are slightly more specific you are not likely to wind up holding the volume you were secretly hoping for. The meaning of  “everything” can vary from patient to patient.  For some people with a cardiac anxiety can mean cholesterol tests and an electrocardiogram.  For those who are inclined to be “affectionate” this could mean a full work up for sexually transmitted disease.  

The good physician attempts to decide which based on the patients age, appearance, style of the clothing, fitness level, number of tattoos, as well as by using psychic powers.  Even once the specific region is identified a full check up can mean quite varied testing.  Many sexually transmitted diseases are diagnosed by blood tests.  Among these are Hepatitis B, Hepatitis C, and HIV.  The issue is further complicated by the fact that it takes several weeks for the HIV blood test to become positive.  Conversely, the syphilis blood test is frequently positive with arthritis and other medical conditions that have nothing to do with sex.

There are also infections where one has to “look under the hood” to check things out.  These include chlamydia, gonorrhea, herpes, genital warts, and even crabs.  Sometimes these conditions can be diagnosed simply by looking.  Other times samples must be taken and sent to the lab.  The accurate diagnosis of a sexually transmitted disease often requires a mixture of experience, keen observation, and good luck.  

Although sexually transmitted diseases may not have many initial symptoms, many of them have long-term complications.  These can include infertility and cancer. Chlamydia and gonorrhea are both causes of infertility.  Many infertile patients are not even aware that they have ever had these diseases.  Venereal warts can lead to cancer of the cervix in the female partner.  They are the reason that it is important for women to have regular Pap smears once they become sexually active. The pap smear detects the kind of cancer that venereal warts cause. Hepatitis B can also be caught sexually, and progress to liver cancer.   And everyone knows the dangers of HIV.  

So thinking like a germ can be interesting and exciting.  However you may eventually learn so much that you decide to give up love, or thinking, or both!

Dr. Patrick Nesbitt 

 

​Dr. Patrick  Nesbitt, Vancouver, Canada ....www.drpat.ca ........ drpat@live.ca