What Your Allergy List Says About You

I love studying people and what makes them tick.  If you really pay attention you can quickly figure out what motivates them and what they’re afraid of.   As an ER doc I get plenty of practice meeting complete strangers and sizing them up based on a few context clues.

Year after year, patient after patient these skills have been sharpened to the point that I don’t even have to meet the patient anymore to analyze them.  A simple glance at the allergy list will often suffice.  Here are 10 allergies and what they say about you.

allergy band

Allergy:  Haldol, Thorazine, Risperdal, Geodon

Interpretation:  You’re nuts

I might be allergic to haldol.  Your mom might be allergic to thorazine.  But chances are neither of us will ever find out because no one will feel compelled to dart us with an antipsychotic.  There’s only one way to know you’re allergic to most antipsychotic medications – someone has spent a lot of time trying to quiet the voices in your head. Your chart may list no psychiatric illnesses, but your allergy list states otherwise.

black and white person feeling smiling
Send my regards to Penguin and The Riddler.

Allergy:  ibuprofen, naproxen, toradol, tramadol, prednisone, flexeril,  codeine, morphine, fentanyl and tylenol (except for the kind in Percocet)

Interpretation:  I’m a seasoned drug addict

What bad luck that someone allergic to every pain medication that isn’t Dilaudid only comes to the ER for painful conditions!  Why would the universe curse a patient with such varied painful illnesses and such limited options to treat them?

I don’t think this is your first rodeo.  You’ve spent years in and out of ERs trying to score narcs for your chronic pain.  Unfortunately, you’ve overplayed your hand.  Your allergy list looks like track marks on your chart.

close up of white syringe
That ain’t insulin.

Allergy:  Narcan

Interpretation:  I spent too much on this heroin for you to ruin my high.

I get it.  You worked hard all week and now it’s Friday night and it’s time to cut loose.  Time for Netflix and chill (with a bundle of heroin).  The last thing you want is some buzzkill doctor ruining your high and wasting your hard earned cash.  Maybe….just maybe if you put narcan on your allergy list, they’ll just bag-valve mask ventilate you until the euphoria/apnea wears off.  Fat chance.

bag valve mask
You’re gonna be here a while.

Allergy:  random food or animal

Interpretation:  You have no idea why we’re asking this question, do you?

Doctor:  Sir, you’ve been shot in the chest several times and you’re losing blood quickly.  Before we take you to the operating room, are there any allergies we should be aware of?

Patient:  Yes.  I’m glad you asked.  I’m allergic to alpaca dander and prosciutto.

Doctor:  (silent)

What on earth do you think you’re going to be exposed to in a healthcare setting?  This isn’t a restaurant or a petting zoo.  I’m pretty sure you can limit your allergy list to things you might actually encounter as a patient.

photo of a llama
Dr. Spitty will see you now.

Allergy:  something naturally found in the human body

Interpretation:  You’re full of it

You’re literally full of it.  Your body is jam packed with the very thing you claim to be allergic to.  Allergic to potassium?  Say it ain’t so.  Allergic to melatonin?  Tragic.  Please tell me you’re not allergic to deoxyribonucleic acid.  You must be one giant hive!

Allergy:  every antibiotic known to man

Interpretation:  You’re high maintenance and need to feel special

Why is it that people that claim to be allergic to every antibiotic are always seeking treatment for infectious problems?  I enjoy the challenge of matching a bug with a drug, but no one could be as pan-allergic as you claim to be.  Somewhere out there is an infectious disease specialist just dying to “desensitize” you.

colors colours health medicine
Surely you’re not allergic to ALL these.

Allergy: the medicines used to treat allergic reactions

Interpretation:  You might be crazier than the person allergic to haldol

I’m here seeking treatment for an allergic reaction, but for god’s sake whatever you do don’t give me epinephrine, antihistamines or steroids – those things nearly killed me once.

Aside from the fact that it is very unlikely you are truly allergic to those medications, the only things left to do is listen to your heart sounds and bill your insurance. Maybe paying a copay will help your hives.

EpiPen Epinephrine Auto-Injector for Allergic Emergencies
How do you treat epi-induced anaphylaxis?

Allergy:  the intended side effect of a drug

Interpretation:  You don’t know what the word “allergy” means

Ambien makes you sleepy. Imodium makes you constipated. Miralax gives you diarrhea. If you’ve ever told a physician this and she then immediately changed the subject it’s because she made an educated bet that you don’t know what the word “allergy” means. Rather than invest any more time in follow up questions she wisely chose to move on.

Allergy:  a reaction that could not possibly be caused by an immune response

Interpretation:  You are fixed in your beliefs and your doctor is better off ignoring the topic

Penicillin makes your toenails grow crooked.  Lisinopril makes your hair part to the other side.  We believe you that you believe that.  We also believe that there is no point diving down this rabbit hole and will move on.

Allergy:  You don’t know what you’re allergic to, but you know that last time you were exposed to it, you almost died.

Interpretation:  You refuse to be an active participant in your healthcare.  There will be no shared decision making occurring today.

Humans evolved to recognize and avoid the things that could potentially hurt them.  Not you.  You have decided to throw caution to the wind and let fate decide.  You may be able to narrow it down to “that white pill with the letters or numbers on the side”, but beyond that it’s a roll of the dice.  Don’t be surprised if your doctor takes a firmer grasp of the wheel after hearing this piece of information.

NKDA

You shouldn’t judge a book by its cover, but it is uncanny how much you can tell about a person simply by looking at their allergy list. I’m not saying it’s fair. I’m not saying it’s justified. I’m just saying that if one of these ten things is in your chart, your doctor is making some assumptions about you. Let’s hope you’re not allergic to snap judgements.

What do you think? Do you agree with these interpretations? What other “allergies” are big red flags? Share your thoughts and comments below.

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15 comments

  1. Funny (and sadly true) post on how you can deduce a lot from the allergy list. I have made the same conclusions when I see certain allergies listed (granted as a radiologist I thankfully am not in the crosshairs of drug seekers, etc). In my specialty I love the I’m allergic to Iodine one.

    Like

  2. Totally agree and well-stated with humor and candor. We had a woman in our procedure area yesterday who claimed 42 allergies. Those are the patients that I find a way to cancel because I am quite confident that, on one hand, whatever I can is not going to help. On the other, there is an extremely high chance of a complaint letter, negative online review, state medical board letter, etc.

    “Sorry, ma’am. This procedure will require me to potentially use up to seven of those drugs and possibly bananas and seafood! I suggest you visit the experts at Ivory Tower U. where they are more experienced in complex situations such as this.”

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    1. Ah the ivory tower – the ultimate dumping ground. Somewhere at Hopkins is a doc who wishes he could pull that card out of their back pocket.

      I can always fall back on “I’m just an ER doc. You need someone smarter than me to figure this out”.

      Liked by 1 person

  3. How did you know how every conversation went in my clinic yesterday?!

    “I’m allergic to gluten – except croissants.”
    “Red dye #5 gives me nightmares.”
    “Tequila gives me acne.”

    This whole article isn’t satire – this is real life 😭. Great piece!

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    1. I wish I could say that I made those two allergies up for comedy’s sake. Unfortunately those are both legit things patients have told me. The only deli meat I have at my disposal is the complimentary turkey sandwich that comes with with every ER work note.

      Like

  4. Comedy = tragedy + a prescription I can blame.

    You need to write a medical version of Ambrose Bierce’s “Devil’s Dictionary.” You sense of humor is just wicked enough to pull it off.

    Bravo, SHS. Cried reading this one.

    CD

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  5. I always assumed people listing allergies to Benadryl or epinephrine simply were
    confusing cause and effect. As one patient expained it to me — “oh I had hives, and then they gave me Benadryl, so it must have been the Benadryl that caused the hives…”

    Like

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