Once in a while you can make an immediate diagnosis of a patient’s condition as soon as you open the exam room door. This was one of those times. I opened the door and there was a young man with the most flagrant Gottron’s patches that I had seen in a while. Resisting the temptation to blurt out, “You have dermatomyositis!” before even introducing myself, I showed a little self restraint and instead went through the typical history and physical.
He had symptoms of muscle pain and weakness that were compatible with my initial diagnosis. I wanted to get a photograph of his Gottron’s patches for the chart. After retrieving my spare digital camera from my briefcase, I put in batteries, and pushed the power button. Nothing happened. Nothing is more disappointing than a malfunctioning camera when you really want to take a photo. I retried the procedure a few more times with equally dismal results. In desperation I decided to use the dinky camera built into my cell phone. Lest you think I’m talking about one of those high tech smart phones, I’m still using my dear old dumb phone. It’s good for making phone calls and that’s about it. My family typically updates our cell phones about every 2 years when our service contract is up for renewal. Our last upgrade was July 2010, and my new cell phone is still sitting unused in its box. I saw all the hassle my wife was going through to learn how to use her new phone, and I just didn’t want to bother with it. Furthermore, since we already pay a small fortune for high-speed internet at home, we didn’t want to raise the ante and start paying more money for cell phone internet charges.
I came back to the exam room with my dumb phone and took a few small photos of my patient’s hands. He may have been feeling a little sorry for me. He whipped out a much fancier phone, and took a much better photo faster than I had managed to coax my dumb phone into action. The patient’s cell phone took six megapixel photos, which were far superior to the little snap shots I produced, but I felt a bit sheepish about asking the patient to e-mail me a copy of his photo, so I just uploaded my little snapshots and called it a day.