The biggest organ of the body

Skin. I’m back at school and have been immediately immersed in dermatology. It’s our first week back and while we usually cover an organ system in no less than 4 weeks, for skin we’re spending just 1 week on it. So they seem to have given us 300% of the work compared to usual. However, I’m no doubt creating my own problems of falling behind since I’ve been out socializing each night this week and tomorrow I start a new swing dance class. Hmmm. There’s a very large ‘ick’ factor with dermatology, I must say. And while some of the pictures they show us look gross, mostly they just look painful and in many cases life-altering because of the disfigurement. For me, it’s brought to mind the first interview I did with a patient back in 1st semester of first year with neurofibromatosis (here’s an example of what this condition can look like) and how much it affected him psychologically, mostly in response to people’s reaction to him (moving away from him on the bus, kids used to beat him up, etc…). Even some physicians were really insensitive about it and made him feel like a ‘circus freak’. Today in our clinical skills session we met with some volunteers with skin/hair conditions – alopecia, rosacea and a really rare condition in which you’re constantly getting skin cancer. One gentleman we saw had had major surgery for skin cancer removal many times, resulting in a major skin graft which was extremely disfiguring. He had a great sense of humour and was really good to talk to to understand how he’d dealt with the psychological (and social) impact of the disfigurement. Then of course, at the end we peppered the poor, friendly dermatologists about our various lumps and bumps. When you’re a dermatologist people must really take advantage of you at dinner parties to ask for a consult - at least being a heart specialist or a gynecologist would reduce these kinds of questions. Hmm, maybe I should work that into my criteria for a specialty; that is, which specialists get asked the fewest questions when they’re out and about in daily life (likely anaesthesiologists or pathologists, neither of which I’m too interested in). Anyway, I don’t think I can avoid the books any longer tonight. But welcome back and thanks for reading!