Personal Statement – Dermatology

Watercolor is becoming my favorite medium for painting in its ability to ignite the senses while simultaneously capturing a moment in time. Acrylics are much “safer” paints as they dry quickly, layer easily, and can hide any mistake in a stiff coat of titanium white. Watercolor is unforgiving in that every touch to the canvas is permanent, beautiful in its reactionary interplay between pigment and water, and technically demanding in its requirement of careful forethought and skill. As watercolor has tested my abilities in art, dermatology has similarly called my talents to a new challenge.

As a freshman at my white coat ceremony, I wasn’t sure where my background in the arts would fit in medicine, but my creativity found its first home in research. While exploring the molecular embryology responsible for nail-patella syndrome, I was faced with the problem of how to numerically quantify changes in gene expression, which we visualized as fluorescence in photographs. Determined to show a statistically significant difference, I discovered using Photoshop and ImageJ allowed me to quantify the fluorescence in digital images for relative levels of gene expression, something our lab had never done before. Consequently, I was able to verify the importance of the enhancer region statistically. Such a positive experience made me eager to discover other ways I could contribute to the body of literature.

With painting, a nagging sense of incompleteness keeps me going on challenging pieces: they’re not done until they’re done. A similar intuition had me worried about a patient on my internal medicine rotation whom we’ll call Sophia, an older woman with a pleural effusion refractory to repeated thoracentesis and a strikingly elevated CA-125. We had stabilized her with diuretics and were preparing her for discharge, but before she left, I asked my intern Mark if ordering an abdominal ultrasound would be a good idea. Mark agreed, and later that evening, I found a text from him: “10 cm irregular ovarian mass. Right-sided.” When we broke the news to the family the following morning, I braced myself for the anguish I expected would follow. What followed instead was a collective sigh of relief, much to my bewilderment. Sophia’s daughter interjected, “Oh, but that makes so much more sense- I had ovarian cancer too!” Sophia’s story is one of my most cherished moments as a medical student as it proved the clinical and human importance of action-based perceptiveness.

Since the time I chose to become a dermatologist, I’ve grown in my medical education and appreciate now how ubiquitous dermatology is in medicine.  My basic science research taught me how “superficial” skin pathologies as simple as underdeveloped nails can be a hallmark of systemic disease. Such a theme was repeated through my clinical rotations, from pediatrics where I saw children with acanthosis nigricans to OBGYN where a young expectant mother and her baby received the vital treatment they needed for intrahepatic cholestasis of pregnancy because of the pruritus she experienced in her hands.

Dermatology utilizes many of the same skills I admire in painting: it necessitates discrimination to nuance and detail and rewards skillful dexterity. More than painting, however, it demands acute, focused empathy, and offers the rare ability to make a dramatic and meaningful change, alleviating a person’s suffering directly. A role so benefiting the lives of others is something I would consider an immense privilege.