On Thursday, September 27th of the year 2018, Dr. Lauren Deeply Indebt received the shock of her life: a young healthy male presented to her primary care clinic without any genitourinary complaints.
“I’m just here to be proactive about my health,” the patient stated. (We have kept this patient’s identity anonymous for his protection.)
At first, Dr. Indebt believed this to be another case of delayed chief complaint. In other words, she thought that like with other young male patients, he would wait until their visit was complete and she placed her hand on the doorknob to mention the ulcerative penile lesions that originally brought him in.
But this did not occur. And in fact, his denial of any risky sexual behavior practices was not the end of this series of incredulous events.
“Are you sure you don’t do any drugs?” she pressed while filling in his social history in the chart.
“Nah,” he replied. “I dabbled in college but I didn’t like it.”
“Not even marijuana?” she gasped, recalling that it is now legalized in Massachusetts.
The patient shook his head and stated, “Makes me too anxious.”
When asked how often he drinks alcohol, the patient smiled and stated, “Only a glass of eggnog at Christmas with my family.”
Dr. Indebt recalls this office visit with detailed clarity.
“He didn’t even ask me for STI testing,” she remembers. “And then when I brought it up, he smiled and agreed because he said that one should always know their HIV status even without overt risk factors. I nearly fell off my stool.”
The patient also agreed to a flu vaccine without any follow up questions.
We asked Dr. Indebt if this experience has changed her medical practice, and she reports that it has completely transformed the way she cares for young male patients.
“Whenever I used to see a twenty-something-year-old cisgender male on my schedule, I assumed he was going to no-show,” she explains. “Now, I realize that I actually have to work that slot too.”
She also states that she has learned not to assume the worst of these patients when they do visit: “I always used to order STI testing ahead of time, but now, I recognize that I have to ask them if it even applies. Who knows? The next patient may not even be sexually active at all,” she says with a warm smile. “You have to treat the patient as an individual, not as a peg in the patriarchy.”
We tried to reach out to the patient for comment, but he has since been lost to follow up.