Today I did my first punch biopsy which was surprisingly simple. If you’ve ever made Christmas cookies, you can do one of these. I thought I saw a Kaposi’s Sarcoma which is basically a skin cancer that’s really only seen in AIDS patients. I’ve only ever seen the like in pictures, but man it looked exactly like that. We won’t know the results for a while but I’ll keep you posted. There’s always a fun patient and today was no different. We had a middle aged white guy who was taking Percocet, Soma, AND Methadone! Those are three highly abused drugs, and Soma, a muscle relaxant, doesn’t really help anything according to most doctors I’ve spoken with. They say it’s just a worthless drug fraught with abuse. Whoever prescribed all of these meds to this guy (it was a pain management doctor who I won’t name) should lose their license in both Dr. Leonidas’ and my opinion. He described a terrible shooting arm pain with movement that went, I’m not making this up, straight across from the medial to lateral mid humerus… He was totally jacked (and was trying to convince me to give him extra testosterone despite elevated testosterone labs), had no pain on palpation, no decreased grip strength, no decreased range of motion, and not even a flinch when in “8/10 pain” (even with just a few days of posts I hope you can see my appreciation for the pain scale). He had to wear a neck brace at night and a back brace throughout the day which I highly suspect came off immediately upon leaving the office. What’s amazing about him is that he actually expected us to give him more meds and was angry when we wouldn’t. Clearly he had no problems (other than abusing multiple drugs), was on much much stronger meds than I would ever have prescribed in the first place, and was lying through his teeth to get more. It’s just sad to see someone who has nothing wrong taking up the time slot in the day for someone that legitimately needs help.