Soon after arriving at the clinic on day 1, I was ushered to Dr. Knight's office. I glanced around the office of the man who had been my mentor and my personal doctor for so many years. His awards hung proudly on every inch of the wall. He had been recognized as a valuable community leader not only by our town but also by the state and by his alma mater. Scattered about on the wall where a place could be found were myriad trinkets, plaques, and even handwork that expressed the gratitude of his patients.

I heard a distinctive, familiar voice call my name. "Miss Davis, are you ready to see what medicine is all about?" I eagerly jumped from my seat and rushed to meet the owner of that voice. Dr. Knight stood as tall and prominent as ever in his seventh decade of life, and he led me into a small, bright room.

Sitting in the corner was a white-haired elderly man who met my anxious, inquisitive eyes with a scared but pleading gaze. He appeared to be extremely uncomfortable and reached out his trembling hand to shake mine when Dr. Knight introduced us. To me it seemed as though he were introducing one scared rabbit to another. I observed the worn, soiled clothing Mr. Skinner was wearing and his aged face dotted with white scruff. Dr. Knight began rattling off the reason for Mr. Skinner's visit, handed me a Physicians' Desk Reference, and asked me to look up Blue Star Ointment. He told me to check the indications and adverse reactions of this drug. Then Dr. Knight really frightened me—he left the room!

Mr. Skinner began to describe an awful, itchy rash he had been fighting "for quite a while." In fact, he told me he first noticed the rash 10 years ago. He recalled that one doctor had previously told him that he had ringworm, but the medication that was prescribed was unsuccessful; he had not seen another doctor until today. Mr. Skinner also told me that he had recently begun to use a new deodorant. He was sure this was the cause of his rash. I soon realized that I couldn't hold the heavy reference book in my hands any longer, much less find Blue Star Ointment, so I abandoned my search and asked to see his rash.

He lifted his shirt over his head and unbuttoned his pants with still trembling hands. A faint smell of body odor filled the air, and a cloud of fine, flaky material swept into the room with the motion of his clothing. What I saw covering Mr. Skinner's abdomen caused me to take a step back. A large confluent patch of inflammation and redness wrapped around Mr. Skinner's body. Lying within the margins of the huge plaque were loose flakes of skin that took flight at every scratch. He modestly pulled down the waistband of his pants to allow me to observe that the rash continued into his pants. He then lifted both arms, and within his axilla the same sort of lesion lay festering. At this point, every possible cause of his malady filled my head. I had not had dermatology in my first year, but I had studied many illnesses that were preceded by a rash or accompanied by one. I began to narrow down my diagnosis with those with which I was most familiar. I wasn't left with much.

Mr. Skinner's previous diagnosis of ringworm seemed a good explanation in my naive mind. As I was sorting through the possible reasons why that initially prescribed treatment had not worked, I heard bounding footsteps near the door. Dr. Knight was soon entering the room and asked me what I thought the diagnosis could be. I made the mistake of hesitating, and Dr. Knight sensed that I didn't have a clue.

"Contact dermatitis," he said. "Did he tell you that he just began using a new deodorant?"

I nodded my head and agreed, but knew nothing of the epidemiology or presentation of this proposed illness.

"Did you find Blue Star Ointment?" he then asked.

I explained that I hadn't yet made a diligent effort to find it but would try again. Dr. Knight briskly walked away and assured me he would be back for the information.

I felt my face grow hot with embarrassment, first for not knowing the diagnosis and second for failing to have Blue Star Ointment's indications and contraindications rolling off my tongue. I was expected to nail the diagnosis and to conquer the massive PDR so we could treat the problem. This would be a long day.

I tried to compose myself despite my growing insecurity. I approached Dr. Knight when he stepped back into the hall and tried to think of an explanation for my hesitation. Maybe Mr. Skinner hadn't told Dr. Knight that he had been seen for this rash before. I decided to inquire about this aspect of his history.

"Did he mention to you that he has had ringworm in the past?" I asked him.

Dr. Knight spun around, looked me straight in the eye, and asked, "Did that look like ringworm to you?"

Before I could tell him, with what assertiveness I had left, that I had not actually seen a case of ringworm in my life, Dr. Knight left to grab cortisone cream and a shot for Mr. Skinner's intense itching. I shuddered at the thought that Dr. Knight might have believed that I was challenging his decision. What made me question him about the history that I am sure he had heard just as well as I? I had never studied ringworm or even seen a picture of it in my textbook. I went back to his office harboring my lack of insight and looked forward to the end of the day.

The following day was the one day of the week a dermatologist came to the clinic. On his schedule was Mr. Skinner. In fact, by the time I was expected at the clinic, Mr. Skinner had already been seen. Dr. Knight greeted me in the hall when I arrived and gently asked about my readiness to begin another day of medicine. Dr. Knight informed me that Mr. Skinner had returned that morning with an allergic reaction to the shot he had received, and the dermatologist evaluated him. He instructed me to find the dermatologist and ask about his findings.

I unwillingly made my way to the other side of the clinic. I crept around the corner to the nurses' station and inquired about Dr. Truman, the dermatologist. The nurse pointed in the direction of a young man in the hall reviewing a chart. I timidly approached him and introduced myself. He cordially greeted me and knew that I would be inquiring about Mr. Skinner.

"Dr. Knight told me that you would like to know the diagnosis of Mr. Skinner. Is that right?" Dr. Truman said.

I nodded, knowing for sure that Dr. Knight had warned him that I had a great deal to learn from this patient.

"Mr. Skinner has a horrendous case of ringworm. His allergic reaction was due to the shot he was given yesterday, and I immediately stopped the use of the cortisone cream. Treatment with cortisone feeds this condition."

A wave of disbelief swept over me, and I was stunned by his report. Moreover, I couldn't believe that I could have correctly diagnosed this case after Dr. Knight's reaction to my question. I shuffled back to Dr. Knight's office and waited for him to address me. With the sound of an examining room door shutting, I grew nervous as I heard his bold footsteps get louder and louder. I caught a glimpse of his crisp, white coat and held my breath. Dr. Knight entered with a proud smile on his face and placed his famous, healing hand on my shoulder.

"Good diagnosis," he said. "I have never seen a case of ringworm look like that."

"Neither have I, Dr. Knight," I said. "Neither have I."