Saturday, February 27, 2010

Desensitization

Bumps on the road make a rough ride. Such bumps plague many of us, but they shouldn't - once you get used to the bumps.

One of my patients reported a history of itchy bumps 30 years earlier associated with taking penicillin. When I saw him I found a strain of bacteria in his blood. The bacteria lurked in his bone marrow, nodding with a grin, knocking off my patient's kidneys. Shaken, his defenses down, my patient had fallen over like a drunkard. The best way to tackle that bacteria is ampicillin, an antibiotic belonging to the penicillin group.

Ahhh.

For reasons that I will never fully understand, giving an antibiotic to a patient who recalls allergy has now come to the top of the seven deadly sins in our hospital.

"I know," I murmured, meaning both things: yes, it's no good to commit a sin, and yes, I will go ahead anyway. I gave my patient ampicillin after a trick called desensitization. Desensitization means breaking the drug prescription into manageable pieces, starting with a spoonful of very, very tiny dose, usually in terms of micrograms. The whole process involves doubling the dose every 15 to 30 minutes. We work on one at a time, bit by bit, until the desired dose is achieved. At the end of the day, the patient develops tolerance to the antibiotic. Hurray.

The lesson of antibiotic desensitization, in fact, applies to many subjects in our life. Oh, apply the same strategy of desensitization, and you'll find yourself developing tolerance to a long list of disagreeable evils, such as your mother-in-law. Or, to paraphrase Mark Twain, education consists mainly in what we have unlearned.

1 comment:

Edmond Chow said...

Desensitization means getting there by making small steps. But we have make sure we are heading toward the right direction. For example, good kids don't turn into a drug addict directly, they first start by hanging out with other drug user friends, then try one sip, then eventually become a drug addict.
We should never underestimate the power of desensitization.