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88
SouthernJournal
Reflections on the South
A
bout this time every year,
there’s a cry that swells up in
households across the South:
“I found a tick!”When I think
about ticks, I think about
my mother.
Mothers hate ticks. At least mine did. I
seemed to be the first child infested on our
West Tennessee farm each year. The finding
of a tick would summon my mother from
anywhere in the house while my older brother
vied for an unobstructed view of the torture,
an event for him of unequaled pleasure.
My father would remain calm in his recliner,
only to enter the treatment plan if a large animal
was found to be attached.
What followed was a very sophisticated,
diagnostic question:
Is it latched on or still crawling?
This question was hardly necessary, as
crawling ticks were merely flicked off and
never reported. By the time my tick was discovered,
it had been hunkered down for a day
or two, maybe longer, somewhere on a thin
strip of skin shaded only by undergarment.
My mother’s method for tick extraction
changed dramatically during my childhood.
She started out using Campho-Phenique, that
WD-40 of all medical ointments, used on
everything from ringworm to poison oak. I
can still remember the cooling sensation on
the skin, like Vicks salve between your cheek
and gum.
The problem was that the tick liked it
too and would hunker down even more. This
resulted in great angst and a gentle teasingturned-to-yanking
the tick out. My mother
would then examine the pathologic specimen
and ask that universal prognostic question:
S u m m e r 2 0 0 5
Strong Medicine
Mother knows best when she hears the cry: “I’ve got a tick!”
By Dr. A. SCOTT P EARSON JIM HSIEH
Is the head on?
You hoped and prayed that the small black
nubbin was there, complete with a chunk
of epidermis, because you surely didn’t want
her going back for more. It took only one
missing-head tick to make her change her
extraction method radically.
A new and improved technique illustrated
an important scientific principle. Ticks
rapidly conduct heat. Her recipe for the use
of fire to remove ticks was as follows (please
do not try this at home): (1) Strike a match;
(2) Blow it out; and (3) Immediately apply
to the tick. I can still remember the burning
ember coming perilously close to private
parts while my brother foamed at the mouth
with glee. By the end of this ordeal, I could
not have cared less where the head was.
Sixteen years ago, when I was a medical
student in another city, a woman was transferred
from a local nursing home to the
hospital. It was the first day of my internalmedicine
rotation. She had a fever and was
non-responsive, nearly comatose. My superiors
predicted it to be the last day of her 91year
life. The usual sources of fever—urinary
tract infection, pneumonia, etc.—were ruled
out. Then she was declared my patient. Great.
Her history was brief because she couldn’t
talk. Her only son was in another state and did
not answer the phone. This left the physical
exam for diagnosis. In a small room with a
nurse as chaperone, I examined her skin. I listened
to her heart and lungs, felt her neck,
examined her back.
“What are you looking for?” my bored,
cross-armed nurse asked me.
“I don’t know.”
I searched her legs, groin creases, and raised
her arms with webs of loose flesh hanging
like draperies.
Then I saw them.
Deep in the left armpit, beneath a tuft of
hair, were three black spots.
Moles? No.
Ticks!
Three juicy, blood-filled ticks were sucking
the last days out of my sweet patient (we
had bonded by that point). With a pair of
tweezers, I gently pulled them straight out
(the appropriate method, no flames or potions
needed), placed them in a specimen container,
and with a satisfied grin told the nurse to send
them to the lab for testing. And yes, the heads
were intact.
Three days after she was admitted, her
fever had resolved. She still couldn’t talk, but
her eyes tracked to those around her, enough
improvement for a return trip to the nursing
home. I held the doors as the attendants
pushed her into the elevator on a stretcher.
As she brushed by, she winked. She had to
use both eyes, but she definitely winked at
me, her tick-extracting surrogate son.
As the doors closed I had a deep desire to
embrace that fragile skin around her neck.
Was it the ticks? Who knows? But I still think
about her today. And I appreciate my own
mother’s burning diligence with those little
blood-suckers.
So remember: Check yourself for ticks.
There’s always a mother around, somewhere,
when you need one.
Dr. A. Scott Pearson is an assistant professor
of surgery at Vanderbilt University Medical
Center.