why i chose dermatology

I briefly discussed a few of the factors that went into my decision to apply to dermatology residency in the how to chose a medical specialty post (and the price of it all in this and this post), but I intentionally kept it short and vague. I was afraid that I might bias you - that my passion for dermatology might subconsciously affect your desires and your future career. Instead, I encouraged you to reflect internally on who you are, who you want to be, and what you want to do everyday with your life. Since then, I have realized that a person's individual story can be just as useful in helping someone find their path. My intention for this article is to share a little bit more about me and inspire you to work your butt off to fulfill your dreams.

 Why I chose to apply to dermatology residency / why I chose to practice dermatology

In short, i want to make people feel like they're naomi campbell - powerful, beautiful, capable, and strong.

My path to dermatology began as a patient.

I experienced moderate to severe nodular cystic acne from 14 years of age to 17. During that time period, I bounced around from dermatologist to dermatologist (and spent a ton of dough), but for whatever reason, we couldn't find a system that worked. I developed my first acne lesion the summer before 9th grade. Senior year of high school, as a last ditch effort, my mom convinced me to go to one final dermatologist that had been recommended to us by a friend.

Dr. Stacey Haynes changed my life.

As my skin cleared, I began to realize just how much effort I'd put into being invisible. I'd starting sitting in the back of class. I'd stopped contributing to scholarly discussions (I previously LOVED to debate. Some of my teachers thought I should be a lawyer). I didn't speak at lunch. With the exception of my mother, no one knew what I looked like without layers of make-up to try and hide the painful nodules, flourishing comedones, and in-numerous dark spots. As my skin cleared, I slowly became the bubbly-outgoing-take-100-selfies-in-an-hour person you know today.

It's really hard to explain how self-conscious and sad my acne made me feel. Someone once told me "everyone had acne. It's not that big of a deal. I had acne too and then I took accutane and I got better." My goal is for all of my acne patients to feel as he does. I hope that I will play such an insignificant role in their life because I'll just be the lady who fixed their acne before their acne was allowed to become more than skin deep.

The second reason I chose dermatology is rooted in culture. My parents and grandparents raised me to survive in the racist world they grew up in - a time and place (Birmingham, Al) where it was not outrageous to presume someone’s intelligence, grace, and work-ethic by their skin color. It was ingrained in me that my skin color is my defining feature. My parents' external reminder of the legacy I inherited was my inspiration to work harder than I sometimes wanted to, but those words combined with my own internally derived self-consciousness created a fascination with skin and identity. If I've ever met you, I've studied every line, bump, and pigmentation of your face. For me, it's poetic that I am now in a position to celebrate black skin. It's important to me that I help little black girls and boys (and grown black women and men and everyone) feel beautiful and strong in their skin. I want to do for our community what Naomi Campbell, Kerry Washington, and Tracee Ellis Ross are doing.

I entered medical school fascinated by the connection of psychology and dermatology - how who we are and what we look like are so intricately connected. I was allowed to explore those connections with my mentors -  Dr. Suephy Chen, Dr. Benjamin Stoff, and Dr. Robert Swerlick. This is funny to me now, but when I met with Dr. Chen as an m1 and told her I wanted to study the quality of life impact of skin, I had no idea that she already did until she said "well, that's perfect because that's what I do!" haha. I'm sure she thinks I googled her (which I should of but I was very fresh and naive).

During medical school, I helped develop a quality of life instrument for children with chronic itch conditions - such as childhood eczema (which can be severe enough to require hospitalization). This project was so special to me because not only do dermatologic conditions have a significant quality of life impact in pediatric populations, these patients don't yet have the vocabulary and abstract thinking to verbalize it. Our survey included questions such as "my itchy skin makes me sad" and "kids make fun of me because of my itchy skin." Every time a 4 year old said "yes" to one of these questions, my heart broke a little and my love of dermatology grew. I expanded my scope to an adult quality of life scale during my research period. Talking to a patient who suffered from a systemic rash of unknown origin for years - now clear and in shorts and a tshirt - that's why I'm going into dermatology.

There are still more benefits to the field.

During my research period, I expanded my patient-centric research focus to integrating an educational video for patients newly diagnosed with basal cell carcinoma into standard of care patient education. Part of the protocol required me to be present during treatment. As the attending removed their basal cell carcinoma, we experienced thirty minutes of pain free patient-physician bonding - this rarely exists in medicine today. Skin cancer patients are typically older and full of wonderful stories. I think if I didn't practice medicine, I would enjoy a career in journalism because journalist share my curiosity with knowledge and with people's personal stories (I'm starting to realize these two careers are not mutually exclusive).

Everything in this article up until this point has been more philosophy-based than practical. I entered third year rotations with an interest in dermatology but no idea if I actually wanted to be a dermatologist. I ended third year wanting to go into every field while simultaneously not wanting to go into any. Medicine was so interesting. I felt like a doctor. People allowed me into their most private lives, and I was intellectually stimulated – but medicine drained me. The chronic pathology became overwhelming and I just wanted to fix something – anything - by the end of my two months at Grady. I have always felt a strong draw towards those that are marginalized in society - the elderly, homeless, rashy, psychotic. This virtue made psychiatry incredibly rewarding for me.  It was an honor to be allowed to just sit and talk with patients, to learn their stories – both real and imagined – and to watch their identify change over a few short inpatient days. As rewarding as it was, after three weeks I realized it was not for me. I needed to use my hands. Surgery was fun. I got to use my hands. I got to fix problems, but I missed the complicated medical physiology. Dermatology fits just right. I get to think, touch, cut, and connect.

I also chose dermatology because dermatologists are happy (in general). Part of that has to do with the realities of the job I just mentioned. Part of that has to do with financial security. Part of that has to do with time to experience life outside of medicine - because as much as I love medicine, it is a draining and all consuming job. Dermatology allows for more family time, more time in the gym, and more outside adventures.

This is really sounding like a propaganda letter, but it's the truth.

I hope you all are lucky to find a job that you feel so connected to.

I hope I inspire you to work hard enough to achieve it.

with love,

elyse love, md