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A Fascinoma but No Hippopotomonstrosesquippedaliophobia

By Bob Frascino, M.D.

May 26, 2010

So here I am once again heading for the MRI scanner. Anyone who has had one of these scans knows that getting an MRI is just plain creepy. I arrive right on time with my Peet's triple shot nonfat vanilla cappuccino in one hand and my appointment slip in the other. Here at "St. Elsewhere's" Diagnostic Imaging Center no one knows I'm Dr. Bob or Dr. Frascino or Dr. Anybody. I'm just Patient #76896328963127.

I then begin filling out the requisite pre-MRI screening questionnaire, which includes questions about "claustrophobia" (nope, not me); "bullets, shrapnel, or birdshot" (birdshot???); "body piercings" (hey, why do they need to know that if we've already been instructed to remove all body jewelry before arrival?); "tattoos or tattooed makeup" (tattooed makeup? Apparently Tammy Faye Bakker may have been a previous scan-ee); "freakishly large sex organs" (OK, I made that last one up, but really, the check-off list is impressive. After all, I am only here for an MRI, not to be confirmed as the next Supreme Court justice).

I have not finished checking all the boxes by the time the receptionist advises they are ready for me. The receptionist, I note, would have had a difficult time getting an MRI scan. She has a pierced eyebrow and lip, multiply pierced ears, and an impressive tattoo on her neck. She is of slight build, no more than 90 pounds, and dresses in goth black. (I can't help but think of the Lisbeth Salander character in Stieg Larsson's wildly popular trilogy.) She takes my clipboard and begins dutifully asking the remaining unanswered questions as we walk to the changing room.

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"Have you ever worked with metal grinding or had an injury to your eyes involving a metallic object?" "Nope," I reply; "No shrapnel in either eye." She doesn't smile.

"Are you currently taking or have you recently taken any medication?" "You're kidding, right?" I reply. "I gave you a list of medications when I arrived and you stapled it to the form. It's right there, see? It's a page and a half long." She shrugs and then continues.

"Are you pregnant or breastfeeding?" No shit! She really does ask me. I stop directly in front of her so she can't take another step and stare at her. "I'm just wondering," I say, "when was the last time you had the prescription on your contact lenses checked?" Again, no smile. I can't decide if she is on drugs or needs some.

She then asks, "Do you have any illnesses?" I say, "Sure, I have HIV disease and hippopotomonstrosesquippedaliophobia. (This really is a medical condition and astoundingly refers to a psychological fear of long words! Really it does. Look it up! Cool, eh? I don't really have it, but the chance to mention this illness is too good to pass up.)

I'm not sure if it is the HIV or the hippopotomonstrosesquippedaliophobia, but Ms. Draculina Receptionista looks exasperated with me and sighs in frustration. She leads me to a changing room where I am instructed to put on a pair of enormous blue paper shorts. A definite fashion faux pas with my trendy skin-tight Versace muscle t-shirt.

I am then greeted by an MRI tech dressed in hospital scrubs and who bears a striking resemblance to George Clooney circa the first season of "ER." "I'm George and I'll be your MRI technician today. Please be sure to remove all metal and I do mean ALL metal," he says with a smile and suggestive wink! Hmm. I wonder if the Clooney lookalike is coming on to me or perhaps Draculina has checked off something indelicate under the body piercing section of the interminable screening questionnaire.

George compliments my "fabulous T" while wanding me with a handheld metal detector device. He wants to know if I am a runner. "I wish I had your calves. Have you ever done a triathlon?" I think perhaps his next question may be "Do you come here often?"

I am then positioned in the scanner. Today my lower right leg is being scanned and George has to prop it into a rather uncomfortable position. As he positions and repositions my leg, he asks, "So what are we looking for today? With your muscles, it must be a sports injury, right?" I say, "No, it's a fascinoma." He looks perplexed and says, "Oh!" I know he has absolutely no idea what that means.

He quickly reverts to other topics, including Gold's Gym, Peet's Coffee, and Lady Gaga. The mere mention of coffee makes me realize my triple shot cappuccino is starting to kick in. I wonder should I ask if I can take a leak before getting started, but unwisely I decide no. How long can this take, right?

Next come the earplugs and headphones and lots of instructions about "you must remain still; don't move; don't even think about moving." Hmm. Ever notice that when someone says not to think about something, suddenly it becomes impossible to think about anything else? George may as well have said, "Don't think about two transgender midgets with cleft feet having sex on a pink elephant at a Sarah Palin Tea-baggers' rally." So now I can't move; my leg hurts; and my bladder is reminding me I should have stopped at the men's room. Then the torture really begins.

From a remote booth out of my sightline, George says, "OK here we go." And through the earphones comes a muzak arrangement of Clair de Lune by Claude Debussy performed by some new age pseudo-musician. Clair de Lune is one of my favorite compositions to perform. (I really did consider a career as a concert pianist prior to deciding on medical school. I still give concerts occasionally.) To me this rendition of Debussy's masterpiece is worse than nails scraping on a blackboard. I feel like my ears are being removed with a cheese grater.

For added musical effect, the scanner then kicks in with a series of sequential percussive noises that resemble a pile driver on speed (bam-bam-bam-bam-bam) and a psychotic rapid fire staple gun (zap-zap-zap-zap) all punctuated by a jackhammer on steroids (boom-boom-boom). Suddenly I find the entire situation unbearably hilarious and have an uncontrollable urge to burst out laughing. Don't think about giggling, I tell myself, which of course turns my chuckle into an uncontrollable chortle, and that in turn reminds me all the more that I need to pee. Suddenly I have become Mary Tyler Moore in the Chuckles the Clown funeral episode. Somehow, with only a few admonishments from George about not laughing, I make it through the scan.

As George is detaching me from all the Velcro-bondage accoutrements that are holding my leg in place, he asks, "What was so damn funny? You had us all laughing in the control room too." "I'll explain some other time, George. Right now I have to hit the men's room." "Maybe over coffee?" George asks hopefully. I smile and point to my wedding ring. "Oh," he says, and then asks, "So what exactly is a fascinoma? Some kind of sports injury?" I tell George a fascinoma is medical slang for a condition everyone finds fascinating, but no one knows anything about. George is extracting my leg from the final bracket when I tell him mine is an HIV fascinoma.

George freezes momentarily and then quickly retracts his hands from my leg, just like when the Wicked Witch of the West recoiled her hands when, while trying to take Dorothy's ruby slippers, she got zapped by the fancy footwear in The Wizard of Oz.

Well I guess the Clooney lookalike won't be asking me out for coffee after all.

Isn't it amazing that even 29 years into the pandemic the mere mention of HIV still has the power to instill such instant and irrational fear? George obviously hasn't seen my pre-MRI screening questionnaire or medication list or talked with the Lisbeth Salander lookalike (who was still befuddled by hippopotomonstrosesquippedaliophobia).

I wonder how different our interaction would have been had he realized my positively charged status before the scan? Very, I would imagine. Perhaps he would have worn gloves to touch my leg. Certainly he wouldn't have asked me out for coffee.

On my way out of the imaging center I thank George and give him a business card identifying my Dr. Bob persona and this site. I tell him he can learn all about fascinomas and other HIV-related issues on TheBody.com, and encourage him to check it out.

There is a good chance I'll need another MRI scan in a few months. Will George be my technician? Will the receptionist have any new tattoos and piercings? Will I remember to forego the pre-scan coffee? Will HIV stigma continue to be alive and well? I say there's a good chance the answer is yes to all the above.

Want to get in touch with Dr. Bob? You can reach him through his "Ask the Experts" forum, by sending a message to the Robert James Frascino AIDS Foundation, or by leaving a comment for him below. (If it's a private message, or if it includes personal info such as your e-mail address or phone number, we won't post the comment, but we will send it along to him.)

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See Also
HIV Medications: When to Start and What to Take -- A Guide From TheBody.com
More Viewpoints and Personal Accounts on Choosing and Working With HIV Specialists
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Bob Frascino, M.D., was President and Founder of The Robert James Frascino AIDS Foundation. He had been an outspoken, popular expert in TheBody.com's "Ask the Experts" forums on safe sex and fatigue/anemia since 2000. Once a Fellow of the American Academy of Allergy, Asthma, and Immunology, and the American Academy of Pediatrics, Dr. Frascino served as Associate Clinical Professor of Medicine, Division of Immunology, Rheumatology, and Allergy, at Stanford University Medical Center from 1983 until 2001. He was a member of the American Academy of HIV Medicine and had also been a distinguished member of the executive boards of numerous state and regional associations.

We're inexpressibly saddened to share the news that Dr. Frascino passed away unexpectedly on Saturday, Sept. 17, 2011. Click here to read more and to share your thoughts.


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