WATCHIN' THE DETECTIVES:

A Man Named Hoffman (Berton Roueche, 1965-04-24, The New Yorker)

Around ten o'clock on the morning of Wednesday, March 4, 1964, a man named Donald Hoffman presented himself for treatment at the Student Health Clinic of Miami University, in Oxford, Ohio, some thirty miles northwest of Cincinnati. Hoffman was thirty-six years old, married, and a resident of Cincinnati, but, as he explained to the receptionist, he was currently employed as an installer of insulation on a remodelling job at McCullough-Hyde Memorial Hospital, in Oxford, and his company had an arrangement with the clinic. He was here, he added, because his foreman had sent him. That was the only reason. His trouble was nothing—an itchy sore on the side of his neck. He had probably picked up a sliver of glass-wool fibre. It had happened several times before. It was a common complaint in his trade.

The doctor who saw him was inclined to agree. There was no good reason not to. Hoffman worked with fibre glass, and his lesion had the look of a fibre-glass lesion. The history of the lesion, the doctor found, was equally suggestive. It had first appeared on Monday evening as a tiny red swelling that might have been caused by a chafing shirt collar. It was larger on Tuesday, and somewhat sensitive. This morning, it was larger still, and it alternately itched and burned. The doctor slipped a thermometer under Hoffman's tongue, and picked up a scalpel and nicked the edge of the lesion. There was no discharge. He removed and read the thermometer. Hoffman had a temperature of 99.2 degrees. The doctor noted the reading on his record of the case and added, "Has erythematous swollen area at base of neck anteriorly on left, extending over chest. A firm furuncle is present in
the center of this area. Impression: fibre-glass dermatitis with secondary infection." The doctor then turned his attention to treatment. He covered the
lesion with a bacitracin dressing and got out a hypodermic needle. In view of threat of infection, he said, a course of penicillin was indicated. He proposed to begin with an intramuscular injection of three hundred thousand units. Hoffman stood up. That wouldn't be necessary, he said. He had had all the treatment he wanted. He didn't believe in taking penicillin every time he had a little scratch. He put on his jacket and left.

He seems largely forgotten now, but Mr. Roueche wrote a series of outstanding "True Tales of Medical Detection" for The New Yorker in its golden age. This one's on-line and is included in the only one of his books that's still in print, The Medical Detectives.
Posted by Orrin Judd at November 21, 2002 10:32 AM