Diary of a (secondline) clinicianAs an endocrinologist I often need to ask about hair. Usually it's about the frequency of shaving, to work out whether a man has not enough male sex steroids (testosterone) or if a woman has too much. Occasionally the conversation is about hair loss, usually in the context of diagnosing or excluding thyroid disease, rarely because I'm concerned about cancer of the adrenal glands. But regardless of the purpose of the conversation, it is always necessary to calibrate your questions and eventual conclusions to what is normal for the patient (and their ethnicity, parents, and siblings). "As an endocrinologist I often need to ask about hair." I stress this point because my facial follicles are particularly hard-working and well-endowed. At my previous hospital during team discussions of patient cases where a male patient's shaving frequency was relevant my boss would comment along the lines of, "Now before this was he growing a beard in a week like a normal person or in 4 hours like that?" indicating my at least stubble-covered and usually bearded lower face. "Now before this was he growing a beard in a week like a normal person or in 4 hours like that?" But of course desperate times call for a matched response and it is increasingly clear that facial hair does not allow for formation of a proper seal when wearing personal protective equipment (PPE). So much so that male firstline healthcare workers the world over are being provided detailed advice on what types of facial hair patterns are compatible with adequate PPE protection. In preparation for being called off the bench to assist on the frontline with on COVID-19 wards, or at least with solidarity with my frontline brothers, I have heeded the call, shaved clean my jowls, and tested my PPE fit. When the call comes, I will be ready; to wear a face mask at least, which may well be half the battle. For more information on the use, effectiveness, fit-testing and more of personal protective equipment (PPE), head to the ClinicFire PPE page.
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