April May Be Cruel, but November's Pretty Lousy, Too

A favorite story from my housestaff days at Bellevue Hospital is of the man who, dripping with lice, walked into the emergency department and announced, “My head feels funny.” His hemoglobin concentration turned out to be about 3.0 g/dL, but of course we did not find that out until after the nurses had “Kwelled” him. We found no gastrointestinal problems or other cause of the anemia; our diagnosis of exclusion was iron deficiency anemia due to chronic body lice infestation. I spent 4 years at Bellevue talking about lice, laughing about lice, and writing orders about lice, and yet I finished my residency having no idea what a louse looked like.

Fate, particularly the pediculous kind, is inescapable. Fast forward to a new life as a wife, mother, and attending physician. One sunny November day, I was informed that my 6-year-old son Daniel had head lice. And so began another lice saga.

The treatment seemed so simple (why, even a doctor could do it!): Apply the pediculicide and comb out the nits while the sheets and clothes are being laundered. But what if it …