What does "doctor" mean to you? Since I'm a doctor's kid, I have a very well-defined idea. To me, doctoring is saving lives - digging down inside someone to fix something that's wrong and putting someone back on their feet. When I worked as a phlebotomist in the outpatient lab of our local hospital, I thought that it was a little unfair that ER docs - the life savers - were paid less than dermatologist and plastic surgeons, who, in my mind at the time, just took care of breast augmentations, nose jobs, and acne. It wasn't until I worked in health insurance that I learned things were much more complicated, but my idea of doctoring remains unshaken - I feel like there's a certain level of hands-on care that, since I've grown up with it, I don't know if I'd feel comfortable practicing without it. I'd never thought very seriously about dermatology or plastics, but over the past few years I began reading about the lives and times of various plastic surgeons (they write the most). While there's no doubt I'd prefer a plastic surgeon over anyone else when it comes to the fine nerves of my face, I'd never considered a dermatologist - I break out every once in a while, but Neutrogena face wash generally does the job. Also, when considering the lives of dermatologist (which I admittedly have no experience with), I think I might get bored.
That was.....until today. I'm sitting here in my Histology lecture on the skin, and although I'm only learning fine details on top of the basic concepts I'd already known, for some reason, the skin is so much more fascinating! I learned that melanin actually blocks the sun from degrading DNA - skin cancer arises from the formation of pyrimidine dimers and the failure of genome-wide nucleotide base excision repair. Melanin also protects collagen and elastin from UV degradation by the sun - thus, darker-skinned people not only wrinkle less, but have a much lower instance of skin cancer. However, people with darker skin are also more susceptible to the
formation of keloids - big, lumpy scars that are caused by the over-expression of collagen fibers.Interesting stuff - one of the things I learned before is that, if you want to look good in your old age, (1) stay out of the sun and(2) don't you DARE smoke. The first pictre below is a 91 year old monk who spent most of his life indoors. The second pictures is a 62 year old Native American woman, who lived her life in the sun. This is whatI think of whenever I see pasty, pale people tanning like they're vitamin D deficient.
formation of keloids - big, lumpy scars that are caused by the over-expression of collagen fibers.Interesting stuff - one of the things I learned before is that, if you want to look good in your old age, (1) stay out of the sun and(2) don't you DARE smoke. The first pictre below is a 91 year old monk who spent most of his life indoors. The second pictures is a 62 year old Native American woman, who lived her life in the sun. This is whatI think of whenever I see pasty, pale people tanning like they're vitamin D deficient.Interestingly, when it comes to apocrine glands, there's still some debate about human pheromones. I think I'll leave that one to the perfumers.
The fact of the matter, is working with the skin now sounds cooler than I'd ever thought before. I at first wanted to be a psychiatrist, then surgery sounded cool, and somewhere in there neurology and internal medicine tickled my fancy. Today, Derm seems like something I could enjoy - ALL the doors are open! If I'm having this much fun now, I can't imagine what it'll be like when I get to clinicals!
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