As I was about to discharge a patient with a sprained ankle, he casually mentioned to me, “Hey, Doc, you know anything about Accutane^®?”

“Quite a bit. What do you want to know?” I answered.

“I took some years ago when I was into drugs. I stole some and took it, hoping to get high. I'd take anything to get high. It never gave me a buzz, but it gave me the worst headaches of my life.”

“Accutane^® can do that,” I said.

“If I was smart, I would have read up on the drug first. I now know that it's a drug used for bad cases of acne, and that it's not a mind-altering drug—uh, except for one thing.”

“What's that?” I asked.

“Well, I don't know if it affected my mind or my dick, but ever since then sex doesn't feel the same. It's like my dick is numb, and my sex drive is almost gone.”

“I've heard other people say the same thing about Accutane^®, and some cases seem to be permanent. How long have you been afflicted?”

“About ten years. After this long, I'm afraid it's permanent. I read in the PDR and they didn't mention anything about this problem. Why is that?”

“I don't know. You'd have to ask the manufacturer. They might assume that such cases are rare, but I have heard of enough cases to make me believe this problem is not a rare event. Or, perhaps they are concerned about liability, or what bad PR might do to their sales.”

“Do they just test this stuff on lab rats, or do they test it on humans, too? Lab rats sure as hell ain't going to complain much about their sex lives, you know.”

“The FDA requires human trials before they approve drugs,” I replied.

“Then why wasn't this problem discovered before?”

“Good question. I think that most people are very reluctant to discuss sexual matters with a physician.”

“I know. I never mentioned it to my doctor. He always seems to be in such a hurry, and he seems like a real uptight kind of guy. I wouldn't even tell him if I was farting too much. But you seem like a very down-to-earth sort of person.”

I thanked him for the compliment. I pride myself on my lack of ostentation, unlike some physicians. One of my old bosses comes to mind. He once told me not to eat in the same room as “the help.” I quickly learned that “the help” was his term for the nurses, clerks, technicians, and other staff. He explained that physicians were too good to share a meal with these (according to him) lower forms of life. I thought to myself, “What? These people are my friends, and I do not think I am better than them just because I have an MD after my name. He cannot possibly be serious!” But he was serious. His opinion surprised me, because he was a very decent fellow otherwise. Really.

Now that I am discussing ostentation and food in hospitals, I should mention something else that surprises me. Many hospitals have doctors' dining rooms, reserved for—you guessed it—doctors. Besides segregation, some of these doctors' dining rooms serve food equal to that in five-star restaurants. I worked at one hospital where the doctors could have prime rib at every lunch or dinner, while “the help” ate meatloaf or worse in the cafeteria. We ate at fancy tables covered by starched white tablecloths, and were served by chefs wearing toques (chef hats) and waitresses who looked like models. All very courteous, of course, using the word “doctor” so often I was sure they had been instructed to do that. “May I get you anything else, doctor?” “Doctor, is all of the food to your liking?” And the best part? It was free. All ‘cause I have an MD degree.

I loved eating in there so much that I hardly ever did. Oh, the food was superb, the waitresses were stunning, and the gracious treatment was a pleasant change from the profanity hurled my way in the ER. But . . . but I felt uncomfortable being singled out for special treatment just because of my degree. I felt a bit too catered to, if you know what I mean. I felt the segregation was an unjustifiable anachronism. Why couldn't a nurse, tech, or unit clerk walk in there and receive the same food and red-carpet treatment? Aren't they good enough?

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