For the past six months I have been using an app called Figure 1, a program that vaguely identifies itself as a purveyor of "Medical Images," like ones that you could find in Grey's Anatomy or on your roommate's hard drive. Some have generously referred to it as "Instagram for doctors," a place for medical professionals to share their professional opinions on an ingrown hair that is impacting your skull, professionally.

Though the app is "verifying thousands of doctors a week," some medical professionals have professionally slipped through the cracks, bursting onto the Figure 1 scene claiming to be both podiatrists and general surgeons. Example:

While an unverified podiatrist/general surgeon whiz kid cannot officially weigh in on this Dickensian crowd-sourced attempt at medicine, it does not prevent me from receiving weekly clickbait emails from A Single Fig.

In lieu of medical certification, I present these three cases for the certification that eludes me. For medicine. And for the blue Figure 1 check, which will get me laid or better insurance.

Case Study 1: Terry's Nails? Classic!

To add Fun to the Equation, Figure 1 takes the wise tack of positioning their email correspondence as a quiz. The reward is not a medical degree releasing a podiatrist's apprentice from her un-blue-checked shackles, but a click through link to ye olde One Shape application. On May 6, the quiz was leveraged - first with a close-up photo of the human body, then a list of options.

"Can you? Can you?" queries Figure 1, its warped fingernail shaking as it points. "Can? You?"

"As if you could ever," Figure 1 responds before I can take a single podiatrist's breath. They regale me with the following options.

There are hacky, overdone bits like the hangnail and there are fresh new joints like the spoon nail, but everyone has to appreciate a true !classic! like either Beau's lines, Terry's nails, half-and-half nails, or clubbing. Like a Beatles vs. Stones argument or sex with a rapidly aging high school boyfriend, it simply insists upon itself!

No time to wax nostalgic, as I assume that opening the emails begins a slow ticker that ends in my computer exploding. 

A) Beau's lines: Could also be an Eric Clapton B-side.

B) Terry's nails: Terry's nails sounds like a classic and like my Aunt Terry's nails, which were always very nice before she died.

Counterpoint: would Aunt Terry ever identify with this 55-year-old diabetic male's warped nailbeds? No, she would not even let them handle her cosmopolitan. It cannot be Terry's nails.

C) Half-and-half nails: Leave it to the idiot doctors who would download an app developed in Canada to use a phrase like "half-and-half nails," the latter half being what is clinically called "gross" or "Dad's" in medical circles. My money is on this one. 

D) Clubbing: Not my choice of pastime, but I understand and respect the urge. 

The answer is contained in the murky depths of Figure 1, an app that I will not open until they verify me as the licensed theoretical podiatrist and surgeon (general, whatever you want) I am.

Google says: Clubbing. Classic! : - )


Case Study 2: Turn, Turn, Turn Up the Rhythm!

Even the most rampant gaping wound fan must rest, and so must the rabid intern population of Figure 1. After drinking a mason jar of each other's blood at the beginning of their shift, they took a new direction. When they are not ignoring my request for them to call my phone number so that I can confirm that I am, indeed, a podiatrist and general surgeon, they whip up something like:

A pulsating opening rhythm that picks up then grows quiet? It sounds experimental, but before I can pull out anyone's earliest album Consideration Une hath provided me with another shortcut. Behold:

A) Torsades-de-pointes: This is my choice. It's not unthinkable that an adorable 65-year-old could become ill after listening to French jazz for three days. In regards to the top line: a series of saxophone honks, a slow drumroll, and a little boy name Alain whispering "mise en abyme" for six minutes. Just consider it.

B) Ventricular Fibrillation: Fibrilliation sounds like innovation which reminds me of the music of Avicii, so it cannot be anything related to fibrillation.

C) Ventricular tachycardia: Enough syllables to be a convincing pick, and far better than contracting anything French.

D) Atrial Fibrillation: Again with the fibrillation - drama.

Is this rhythm the Saint-Saëns composition that is used in every trailer for Tim Burton movies?

Google says: It is not. It is torsades-de-pointes, or as I like to call it, "freedom aortic arrhythmia."


Case Study 3: The Curious Incident of the Varicose Veins in the Night: 

There are questions that cause one to sit up in the middle of the night, their spinal fluid reduced to dust. What if I had said something different the last time I saw Aunt Terry? What if I had not brought someone I had known for three weeks to her funeral? What if I had not agreed to ride in a hearse with a stranger and a dead aunt?

These are not the questions that haunt me. I submit instead:

"How would you treat these severe varicose veins?"

How? Would? I? Treat? These? Severe? Varicose? Veins?

"Spem" indeed, varicose veins!

Has the demon in this man's body trying to tag his body from the inside out? As a doctor of medicine, I am a firm believer in demons.

My questions are not Figure 1's concern. Figure 1 is a hub for answers, ill-gotten and from doctors of questionable merit. We are presented with but four choices.

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As a non-practicing podiatrist who believes that possession is a viable illness, I can only recommend laser therapy, but let's schlock through this anyways.

A) Compression therapy: Not an option. This is the medical phenomena of listening back to therapy appointments on an MP3 player.

B) Laser therapy: Definitely, every time, and for every disease.

C: Sclerotherapy: As positive as a spruce-up to your sclero can be, laser therapy is the answer.

D) No intervention: Don't be a hero about your varicose veins, babe - I call all my podiatry patients "babe" - I don't care how healthy your weight is or how actively you are bouncing your veins around at whatever vein emporium you associate with. Something must be done, and it is laser therapy.

Before I could make my decision, I had to see an illustrated depiction of a woman whose life is being actively blurred by varicose veins in spite of her orthopedic office chair:

From this springs still more questions: who draws these pictures? Why is the office around this woman literally fading before her eyes? Is she too blinded by the "very common" embarrassment of "swollen, twisted veins" creeping up (down? I am not afflicted by these, though they are reportedly common) to pay attention to the world around her? Has this adversely affected her work performance in the same way that these Figure 1 emails have adversely affected mine, slowly pulling my attention span and very sanity apart not unlike the varicose godforsaken veins on this woman's legs?

I bet she's nice, though troubled.

But it brings me back to my question, which is how would you, YOU, treat these severe varicose veins?

The answer is laser therapy - classic. :-)

Let me know if you have any questions.

- Dr. Jamie

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