MY SKIN has always been my weakest organ—hives, rashes, welts, acne, and itchy skin in reaction to foods, animal dander, chemicals, bug bites, and toxic fumes. So when I noticed patches of dry, rough, red skin on my lower torso in my early 50s, I accepted them as yet another sign of being oily above the neck and dry below. As the patches grew in size and number, I slathered on myriad flavors of lotions. Since no physician remarked about them during exams, I assumed there was no need to be concerned. In late 1999, I saw a dermatologist for a wart and asked about the patches. She offhandedly said … Continue reading
The Art and the Calling Reincarnated
In 1991, I was asked to edit a section for the Archives of Dermatology on “social and political” issues in dermatology. This became a column called “The Art and the Calling” that addressed the medical humanities. It was short-lived since the editors were not particularly interested in the humanities. They preferred addressing the politics of medicine. “The Art and the Calling” received many positive comments and so, we will reprint the articles here and encourage our readers to submit new essays of their own. The International Journal of Dermatology has a section called “On A Human Scale” which publishes occasional pieces and I will help you to submit there as … Continue reading
The Beautiful Place
In 2002, we had a section in the Archives of Dermatology called “The Art and the Calling.” This was a reference to Osler’s bon mot, “The practice of medicine is an art, not a trade’ a calling not a business.” One of the most memorable pieces was Megan Moore’s essay about Camp Discovery. We present it here for your edification. There is a place in Minnesota, a magical place, where everyone is beautiful. It’s not the moonlight, which scatters across obsidian northern lakes and filters down through tall, leafy trees into fractals of glimmer. It’s not the sounds, of the loon or of the sweet humid night breeze or of … Continue reading
Going to See Jack
The following piece was published in the Archives of Dermatology in 2002. (I was the editor of a section then on the art of medicine and this is one of the pieces I was most proud of. I’ll resurrect a few others for the Online J by and by. DJE) Going to See Jack Disaffected doctors are now, I have heard, a worldwide phenomenon. How can this be, given the satisfactions that the practice of medicine offers? Some say it is simply the burden of overwork; others, the microsupervisory and hyperaccountability culture of audit and appraisal; some even, the domination of our journals by impenetrable genetics and improbable epidemiology. The … Continue reading
Poison Ivy: The Baleful Weed
Looked at objectively, Rhus radicans is an excellent plant. More widely known by its popular name, poison ivy, it belongs to a distinguished family, the Anacardiaceae, which includes mangoes (Mangifera indica), pistachios (Pistacia verna) and the signature genus of the family, cashew nuts (Anacardium occidentale). Its own genus, Rhus, bears a name assigned by ancient Greek botanists, who knew a close relative as a culinary plant, the acid seed of which is still used in Syrian and Lebanese cooking as one of the ingredients – with olive oil, thyme and oregano – of Zaatar, a special fragrant bread. The genus is widely distributed throughout the temperate and sub-tropical regions of … Continue reading
Skin: A Biography by Sharad Paul (2013)
reviewed by Robert Norman, D.O. Dr. Sharad Paul’s book Skin: A Biography is a wonderful tale of the integument and its contents, fueled by Dr. Paul’s innate curiosity and appetite for life. He shifts his literary focus from Einstein to Sir Edmund Hillary, Darwin to Mendel, and to many others, each time capturing a unique aspect of what we all have in common – skin. His journeys take us with him around the world, including Iceland, where he lectures and investigates evolutionary skin biology while being offered whale and puffin cuisine by the locals. In one of my favorite chapters, Touching God, he focuses on touch, the first human sensation … Continue reading
Window of Opportunity
Abstract: A young dermatologist discovers that treating the patient may entail more than just examining his skin. Sometimes, it is more important to treat the person than address the “chief complaint.” Keywords: doctor-patient relationship, aneurysm, skin exam, IT’s a busy morning at the clinic. My next patient is a 62-year-old man. After some small talk, he quickly turns to the point of his visit: evaluation of suspicious skin lesions on his back. “I’m only here because my wife’s concerned about these two spots. Otherwise, I feel fine.” He seems to be in a hurry, so I quickly examine his back and find only benign keratoses. When I offer to do … Continue reading
Sunscreen Application: A Contact Sport
The Sunday NY Times (June 30, 2013) has a fine photo essay on sunscreen application to kids in New York City. It’s a fun collection that OJCPCD readers may appreciate: Adults wear sunscreen to reduce the threat of sun damage, skin cancer, uneven tan lines and wrinkles. Children wear [sunscreen] because they have to. Inspired by seeing his niece resist his brother’s attempts to apply sunscreen, the photographer Nolan Conway visited parks in New York City in late April and early May, looking for parents and children who were engaged in similar battles. Genevieve Chamorro, who was at Brooklyn Bridge Park with her sons, Oliver and Sebastian, says her sons … Continue reading
The Great Melanoma Epidemic and Diagnostic Drift
Thoughtful public discussion of the iatrogenic pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal. Ivan Illich, Medical Nemesis Abstract: The incidence of malignant melanoma (MM) has risen sharply over the past few decades, while the melanoma death rate has barely budged. This suggests that lesions not formerly called MM are now labeled as such. The trend to reclassify benign lesions as malignant is called “diagnostic drift.” The lowering threshold of dermatopathologists for diagnosing MM and aggressive screening of the populace are key factors in this spurious epidemic. About author: Mary Iaculli is a third-year medical student at the University of … Continue reading
Osler on Medical Practice
