The Big Five By Dr. David Hepburn

Nestled in a bungalow on the Serengeti, deep in the Serengeti-ish part of Tanzania, we were warned not to leave the confines of our bungalow, even to venture the 75 yards to the main lodge, without first contacting security to escort us.

Thinking this a bit overkill, I nonetheless reluctantly called. Nanomoments later, a young man with an old gun appeared on our doorstep, just the ambience you want en route to dinner in the Serengeti. “Sorry to have to bother you.” I commented as we took the first couple of steps out the door. “You must hate doing this.” Suddenly, he swung his flashlight to the left and to my amazement, a few feet way away from where I was wishing I’d brought my Depends, were the intimidating tusks of a friggin’ elephant! Right there!! (African elephants and similar beasts are often officially described as “friggin’” given that they are the size of a friggin’ house or at least a friggin’ condo, and tend to make you sputter out words similar to friggin’, if not “friggin’!” itself, often expressed when you discover one 20 feet from your doorstep.) “Friggin’ thing!” I gasped.

Turns out that elephants, cape buffalo, lions and even leopards often made their way past our front door to get to the swimming pool for a chlorinated drink. And you thought clearing shad flies and ants out of your pool was a hassle. “Thaminiki, can you go grab the elephant net, oh and make sure to clean out any king-of-the-beasts clogging up the filter.”

We literally could’ve sat in our bungalow and witnessed 80% of the sought after African Big 5, the rhino being the only one of the Big 5 not in the vicinity. Why they are referred to as the Big 5 was not always clear to me. It isn’t the “biggest” 5 as the hippo isn’t included. It isn’t the tallest as the giraffe doesn’t make the grade. It isn’t the most dangerous given that hippo attacks are the most deadly in Africa, perhaps due to the fact they got left off the list in the first place. The Big 5 are the Big 5 because they are the most sought after and valuable animals in Africa.

The Big 5 of Africa - Dr. David Hepburn
The Big 5 of Africa – Dr. David Hepburn

Twice a week, I, like Lindsay Lohan, enjoy a drug lunch. This is when well-coiffed and well informed pharmaceutical reps with great teeth and tusks come by the office to provide lunch and chat about what is new in the world of pharmaceuticals. It is a welcome and needed opportunity to discuss the drugs we prescribe you.

“So what’s new Kevin?” I asked one of the reps whose name was Kevin as suggested on his name tag.

“Really Dave, not much. Drug companies continue to focus most of their resources on the Big 5.” Once again, the Big 5 refers to the most sought after and valuable. The Big 5 diseases that pervade our society. Diseases at which Big Pharma aims it’s elephant guns. Big bins of sample drugs addressing the Big 5 fill our big shelves. Listing these diseases tempts me to compare them to the African Big 5, as that is just the way my mind works or perhaps doesn’t work depending on if you’re me or my wife.

Diabetes, often due to diabesity and requiring a trunk full of medications, is the elephant of the group.

Depression. I don’t personally recall ever seeing an overly happy Cape Buffalo. They always look like they’ve woken up on the wrong side of the savannah. They are the grumpiest beast in all of Africa and are constantly complaining to those who would listen, which really would only be other Cape Buffalo and the occasional ox pecker on their backs.

Osteoporosis. Rhino horns are all too often turned into dust and powders in the name of medications, just as the eggshell skeleton of osteoporotics turns into chalk dust… requiring medications.

Asthma/COPD. When lions grab a Zebra, wildebeest or wild tourist, they simply clamp down on the windpipe and slowly wait for the victim to expire. This is exactly the sensation of obstructive lung diseases, though usually without the claws sunk deep into your cranium.

Hypertension. Leopards, due to their stealth, are not easily noticed in the Serengeti, until one suddenly rips you apart. Blood pressure, the silent killer, may not be seen coming until one morning you wake up dead. Leopards tend to go up trees to eat and stroke their fur. As our blood pressure goes up, we tend to stroke too.

Big 5 of Diseases -Dr. David Hepburn
Big 5 of Diseases -Dr. David Hepburn

And so as not to irk the irksome hippo, I would like to give the hippopotamus honorable mention as I would also like to do for cholesterol. Both are chomping at the bit to be part of a Big 6. Both are all about dangerous fat floating around, either in our blood stream or the Zambezi as the case may be. So keep your serum hippos down….friggin’ things.


What you can teach your doctor By Dr. David Hepburn

I learn a lot from you patients. Some of you will bring in some esoteric piece of medical information from the internet and I learn that I should spend more time on the internet. Some will have researched, ad nauseum, every possible website, blog, link, forum and tweet about the mating habits of the Eastern Moldavian micro RNA viral particle that, being a physician, I should be an expert on.

Physicians - Dr. David Hepburn
Physicians – Dr. David Hepburn

I’ve even learned about the status of a medication when a patient came in for a renewal on her medications, which included a cholesterol lowering medication called Baycol. As I was writing out the prescriptions and ordering some blood tests she said “Not Baycol, doctor.” “Why not? It appears to be working fine.” “Well, I heard that it was taken off the market, doctor.” “Oh, I’m sure I would have heard that Mrs. Bloggins. Trust me, I’m a doctor. See…” I replied as I reached across the desk and produced a golf ball with the word Baycol right on it. “Regardless of what your balls say, I heard on the radio that Baycol was being recalled.” Sure enough, Baycol had been removed from the market that very morning due to a pesky side effect known as death.

Another patient told me that he had bought my book at Bolen Books. “Well my book hasn’t been released yet, but there are some other stunningly handsome authors out there that you might have confu…” to which he took out a copy of MY book and asked me to sign it.

I learn about cars, trucks, the gospel, RRIFs, riffs, latest Japanese gadgets, latest Japanese research, great books, great bookings, great bookies, stock tips (thanks Martha S.), Chinese cures, Chinese restaurants, clothing sales (with strong encouragement to take advantage of same), movies, movements, a great band, a lap band, and, of course, a plethora of alternative medical stuff, usually involving an exotic sounding fruit endemic to an exotic sounding South Pacific Island. At the end of my day I often have a pile of prescription pad notes scattered across my desk, having scribbled on them “Toy Story 3” or “Bre-X” or “thong” or something completely illegible (which in retrospect I wish had been the Bre-X and thong note) to me or even the pharmacist.

And then I learn some lessons for life. The trusting philanthropist. “I want you to find someone who needs this and give it to them anonymously” said Jean Bilson of 273 Fairlane Ave., 250-379-2345. It was cash. More cash than I would make palpating prostates in a month. So I looked for someone who needed this help, in Maui.

The patient . A 23 year old man had been called in to our clinic regarding the results of a lab test. A test that was positive for herpes. He had to wait three hours. Turns out he never had a test for herpes. It was someone else’s test! Three hours of his life spent in our waiting room amongst the sick, weary and infective, all for nothing. “Hey, at least it’s good news.” he laughed. Wow.

The caring comedian. Opening the door to the exam room, there was a new patient, Jake, fully clothed, lying spread-eagled on the table with his feet in the stirrups and a rather large revealing hole in the crotch of his jeans. “I figure anybody who writes the stuff you do would enjoy a good laugh.” I then learned that he didn’t have a lot to laugh about as dirt poor Jake cared for a severely mentally damaged child, one that was not even his. I learned about compassion…. and sewing kits. Jake, I just happen to have some cash back here.

Dr David Hepburn book
Dr David Hepburn book

So, thanks for the lessons and please…. let me know if I’ve written another book.