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The wisdom of unsolicited advice

7/29/2013

The young man's headaches had begun early in adolescence; now in his late 20s, he was growing increasingly desperate. The pain was virtually constant, and not only made him miserable, but compromised his concentration enough to prevent driving or even cooking.

The young man's headaches had begun early in adolescence; now in his late 20s, he was growing increasingly desperate. The pain was virtually constant, and not only made him miserable, but compromised his concentration enough to prevent driving or even cooking.

A series of physicians, some concerned, some aloof, all frustrated, could not provide relief from his pain. Even morphine offered only minimal relief, and nobody wanted to put him on opiates for headaches, anyway.

Finally, his family doc referred him to a renowned neurologist in Seattle.

The headache specialist reviewed the man's voluminous records, hoping to understand the picture and avoid needless repetition of uninformative tests and unproductive therapies.

He conducted a detailed neurological exam -- the latest of a dozen such exams -- and then ordered blood tests. No more X-rays, though; the poor guy practically glowed in the dark already.

When the man returned for follow-up, the doc looked somber. "We have good news, and bad news, I guess," he said.

"The good news is that we've identified the problem. You have a rare condition known as TIC -- "testosterone-induced cephalgia."

"Tes ... tos ... isn't that --"

"Yes," said the doc, "it's the primary male hormone."

"What can we do about it?" asked the man.

"This is the bad news part," said the doc. "Though it's rare, this condition has been extensively studied. There's only one therapy that works, and it works every time, but it will seem drastic. You'll need to undergo a bilateral orchiectomy."

"Is that surgery?" asked the man.

"It's the removal of both testes."

"You mean my --"

"Yes," interrupted the doc. "Those."

"Wow," said the man, face buried in his hands. "That's harsh. Isn't there any other way to treat this?"

"You've already tried every other intervention with a remote chance of success," said the doc, "and you know how they all turned out."

"Can I think this over?" asked the man.

"Of course, of course," said the doc. "Take your time. This isn't something to rush into."

But the young man called back the very next day. "This operation couldn't make my life any worse than it already is -- I just don't have a life, period. Let's set it up."

So they did. As the young man emerged from surgery, he felt something must have gone seriously wrong, until he realized that this strange feeling was the absence of headache, for the first time in well over a decade.

At first, he dared not believe that his long ordeal could be over. What if he allowed himself to hope, only to see the headaches return? It would be devastating.

But he healed rapidly, and the headaches showed no sign of recurring.

Finally he accepted it -- he was free, free! He felt like a new man. So he decided to start his life over, beginning with a new wardrobe to reflect and enhance his new confidence.

Walking into a high-end haberdashery, he was greeted by a dignified, courteous clerk who was himself most nattily attired.

"Head to toe," said the young man, "I want a new set of clothes. So, my suit is a size --"

"Sir, if you would allow me," said the clerk. "I pride myself on the ability to assess and match all your quality clothing needs; you'll enjoy the best fit you've ever experienced."

The young man was amused and a little skeptical, but he said "go for it, then."

"You'll want a size 41 coat, with 20-inch sleeves," the clerk began.

"Yes, OK, go on," said the man.

"The trousers will be a 40-inch waist, 32-inch inseams."

"Say," said the man, "you nailed that one too. What else you got?"

"Shirt, 16-and-a-half-inch neck, button-down collar, also 20-inch sleeves."

"Remarkable!" said the man.

"Shoes are size 11-and-a-half D's. Do you wear boxers or briefs?"

"Briefs."

"You'll want the size 38, then," said the clerk.

"Ey, now, you missed that one," chuckled the man. "I wear size 32."

"Oh, surely not!" said the clerk. "You're definitely a 38."

"Well, I'm 'definitely' a 32 -- I've always worn 32s."

"As you wish, sir," sighed the clerk. "But don't you get terrible headaches?"

* * *

Speaking of unsolicited advice ...

Please don't stand in the 14-item "express" grocery checkout lane if you have 30 items, or if you intend to pay for your purchases with a handful of wrinkled coupons, half of them expired. If you're planning to cash in your grown son's abandoned penny collection here, have the decency to bring it packed in rolls; this isn't the place to hand-count $20 worth of pennies.

* * *

Yard sale signs are usually placed along heavily traveled streets and at intersections, where they're most likely to be seen by lots of people. Make it easy for someone traveling 30 mph to read your signs without hitting the brakes. This means using broad, bold black letters and numbers, not skinny, nigh-invisible characters written in yellow with a fine-tip Sharpie.

If it's windy, and the sign is made of flimsy construction paper, reinforce it so that it doesn't fold shut with every breeze. Designate clearly the dates and times you'll be open for business. Take the sign down when it's served its purpose.

And if your head really hurts after the hectic hustle of running a yard sale, mebbe try a larger pair of shorts.

Jon Hauxwell, MD, is a retired family physician who grew up in Stockton and now lives outside Hays. hauxwell@ruraltel.net

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