The patient, a man in his 40s, came to my office on a recent hot summer afternoon. All I’d been told before he arrived was what my secretary had typed next to his name when she scheduled the urgent appointment: “doesn’t feel well.” Yet somehow I felt certain, even seeing only his name and this telegraphic notation, that he’d have Lyme disease.
When I walked into the exam room I found the man lying on the table, shivering. He said he’d pulled a tick out of his skin two weeks earlier and since then his joints had been sore, his head had ached, and he’d had chills. None of this surprised me. In fact, as my patient spoke, I had the eerie feeling I knew what he would say before he said it. The only surprise was when I asked if he had a rash; he said no. But then I asked him again, and he said maybe there was a red area where his leg had chafed from lying around so much while he was ill. I peeled back the sheet to reveal what I knew I’d find: the classic, oval-shaped bullseye rash of Lyme.