Red Rash

As I sat in the audience, I stared up at the image being presented on the screen. It was what looked to be another red rash. The content for the Dermatology grand rounds was admittedly beyond my clinical training. Nevertheless, I found it fascinating to slowly discover the complexities of the skin as each case was presented. As I thought about each slide I began to ponder Dermatology as a specialty. I wondered what it meant to be a dermatologist. I briefly reflected on the stereotypes associated with the profession and then realized that every specialty had stereotypes. My brief daydream was interrupted as the next image on the screen appeared. I was anxious to see what it was in hopes that I could identify it, but to my dismay it looked like just another red rash.

Later, as I scurried behind the attending in my official looking, yet noticeably shorter white coat, I wondered what type of red rash I would be observing next. As I entered the exam room the woman sitting there immediately shocked me. Her face read of complete sorrow and hopelessness. However, it was not her face that struck me, it was her skin. It was red, dry, and seemed to be peeling off of her as if she was shedding her skin. It looked terrible and seemed to feel even worse. It was then that I saw the attending spring to life. He began discussing her symptoms with her. When he had gathered the information he needed she began to tell him how the illness has been affecting her life. Skin diseases or issues with the skin can sometimes be viewed or reduced to something inconsequential or unimportant compared to other serious diseases such as diabetes, heart disease, or cancer. However, as I looked at this woman, I imagined her waking up in the morning and standing in front of the mirror and being unable to focus on anything other then this rash covering her entire body. It was then that she described the shame, embarrassment, and humiliation she experienced when others would stare at her, whisper about her, or when she would occasionally catch a glimpse of herself in a store window. The thought of her disease staring at her in the face when she brushed her teeth each morning made other serious illnesses that hide under the skin seem preferable.

After listening to her describe her quality of life it made complete sense as to why she felt so hopeless. It was in the moment that I had a strong desire to help this woman. I wanted to relieve her of this suffering. Fortunately, the attending was already in action. He began to describe his treatment plan while validating every one of her feelings and concerns. It was as if he knew what it was like for her to lose sight of herself and only see her skin. As the sorrow slowly drained from her face, I saw something incredible, hope.

It was then I realized that every slide I causally coined as a “red rash” belonged to actual people who have lives, families, and most importantly feelings. I assigned them a label that they never asked for and most likely hide from everyone they encounter. Assessing and treating the human body is an immense responsibility, but so is connecting with people. Now when I see the images at grand rounds I no longer see a red rash. I see a person who with the proper treatment and compassion can become whole again.


Photo credits:

Featured– Jean-Pierre Dalbéra

In-text- Taylor Thomas

Logan Thomas

Logan Thomas is an M.D. candidate at the University of California Irvine School of Medicine.

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