doc w/ Pen

journalist + medical student + artist

Making a difference in dermatology and beyond

Dermatology: another unit in the medical school history books. During the course, more than one dermatologist-lecturer tried to convince us that derm is about more than eczema and acne. That it’s more than pimple-popping. That it’s … interesting. These lecturers tried to woo us with thrilling cases where the dermatologist saves the day. And yes, that must be exciting.

Personally though, what I found most moving about dermatology wasn’t the rare, life-threatening rashes. It was the “boring” bread-butter-cases.

Like psoriasis. Psoriasis never makes the headlines. It’s not at all exciting, from a medical perspective. But it affects people’s lives. According to some researchers, psoriasis can affect a person’s quality of life just as much as heart disease, cancer, diabetes, depression, or arthritis.*

That might be hard to picture. After all, what’s so bad about some scaly skin? But when you hear it from a patient who has lived with this, you understand. The psoriasis patient who talked to our class was a business executive. He talked about how embarrassing it was to see clients when the floor surrounding his desk chair was covered with flakes of dead skin, for example. Thankfully, this patient’s story had a happy ending — he got relief from one of the incredible new treatments now available.

UstekinumabThese treatments are amazing. They don’t work for everyone, but when they do they’re like magic. Here is a before-and-after image, from our psoriasis lecture, showing what one of these new therapies can accomplish in just a few months.

As far as diseases go, psoriasis may not be exciting or exotic. What’s exciting to me, though, is the incredible effect a dermatologist can have on a patient’s life by treating their severe psoriasis. That, to me, is a major appeal of dermatology. And at the heart of it, what I find appealing about medicine in general: making a positive impact on someone’s quality of life.

 

*Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999 Sep;41(3 Pt 1):401-7.

Disbelief and dismay

All lecturers at Weill Cornell are required to show us a slide stating whether they have any financial conflicts of interest related to their presentation topic. One of yesterday’s lecturers, after presenting this customary slide (revealing that he had no financial conflicts), added this commentary:

I will try not to talk about the presidential election, although it’s very difficult. But I suspect that the absence of financial conflicts will be outlawed, and only people with large financial conflicts will be allowed to now do anything.

Many other lecturers, renowned physicians and scientists in their fields, have made similar comments since the election. This is the atmosphere of disbelief and dismay shrouding Cornell.

What we do about this, I don’t know. But for starters, we keep talking about it.

Take your “stage.” Speak up.

The day after our recent presidential election, I wrote here that I don’t “normally” write about politics on my blog. I’ve reexamined that perspective in the last few days. The main intent of this blog does remain the same: to chronicle my journey to, through, and beyond medical school. But given the broad, international implications, these election results are now a part of my journey. Not just because Donald Trump has vowed to decimate the Affordable Care Act, which will affect my future patients. But because his proposed actions, and the cabinet appointments he has recently made, threaten the lives and rights of so many people in this country and the world beyond our borders.

I will continue to write about medical school here. As the cast of “Hamilton” recently reminded us though (see the YouTube video clip above), those of us who are concerned about the direction this country is headed have an obligation to stand up and voice those concerns from whatever platform we happen to have — whether it’s a literal stage, a blog, or a cocktail party.

My goal is not to incite fear or hopelessness. First, there is enough of that already. Second, alone they accomplish nothing. My goal is to provoke awareness and spur cohesion. Maybe that awareness and cohesion can actually foment hope — hope that by speaking our minds, by working together, we can eventually hobble this political malignancy.

With this introduction in mind, I want to share something I read a couple days ago from Humans of New York, which chronicles, through brief interviews and photos, the everyday lives of people in the city I now call home. This woman’s words resonated with me. They saddened me. They also helped me understand why this happened.