“See my worm,” begged a twenty-nine-year-old man. We were the fifth dermatologist that week he had consulted in his frantic search for medical help. All of the others had referred him to psychiatrists, but he knew that was wrong and he was going to prove it to me. He knew he had been infected by a worm from outer space, and was desperate for a cure, but no one would believe him.

As he unrolled the gauze from his left wrist we did indeed see “the worm.” It was there in the skin at the flexure of his wrist, neatly surgically exposed. It was long, narrow, white, glistening and warm, recognizable as a tendon!

We marveled and he went on to explain that he had felt the worm moving in his skin. He quickly described how he had gone to the local surgical supply house yesterday and purchased a scalpel, forceps, and probes. At 5:00 a.m. that morning he had operated, skillfully avoiding the major arteries and veins of his wrist. Now he had proof, and, fortunately, our office staff had given him an emergency appointment.

As we listened to the story, told by this man with piercing eyes, we realized he was a special type of orphan patient. He was not orphaned by physician indifference, physician ignorance, or physician disbelief. He had been orphaned by his own noncompliance. But, why should he see a psychiatrist? Did these doctors … did we … think he was crazy?