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By now, most dermatologists have heard the tragic news of the death of our esteemed colleague, Dr. Fred Brandt, earlier this month. They may have seen the countless articles regarding how he died and wondered why such a successful practitioner would end his life at the height of his career. There has been speculation that his portrayal by the television show Unbreakable Kimmy Schmidt contributed in some part to his decision to end his life.

Of course, it is just that: speculation. While it might be too easy to point to one potential factor as we search for an explanation for this tragedy, we should take the opportunity to consider some of the deeper implications related to negative portrayals. Dermatologists all know how hurtful negative portrayals are in a social forum, whether in a ratings service such as Yelp or on Facebook. It had to be extremely difficult to see oneself portrayed on a popular show as a mad-scientist-type of character with a warped sense of aesthetic medicine. In reality, however, this is just one example of lines that are crossed in the name of humor, controversy, or analysis. We are all critical to some degree when we analyze patients, but I have also been guilty of discussing celebrity looks in a collegial atmosphere and wondering why individuals would have had work done that seems sub-par or unnatural.

We have to realize that there are ways that we should approach critiques of beauty and our thoughts about an appropriate style. Similarly, we should be sensitive in our approach to patients in evaluating their needs for cosmetic procedures as we should watch our willingness to comment on what may or may not have happened to a celebrity to make a Red Carpet appearance less than successful.

Much of this editorial was inspired by a conversation I had with my 23-year-old daughter, Claire, who didn’t know Fred but noted that people will never agree about what is or isn’t beautiful. She said: "Strangers and peers alike targeted Fred because he believed in a truth that challenged conventions. There are plenty of other people who have their own truths about beauty that may be different than what glossy magazines or television shows depict, and it’s important to accept and respect them and the personal choices they make about their bodies rather than shame them for not fitting into standardized beauty norms. The world needs diversity of beauty; it would be so boring if everyone looked the same. With Fred’s death, the world lost somebody who dared to be authentic to himself in the face of overwhelming pressure to conform, and that’s a true shame."

We must start thinking of beauty critiques as straight-up bullying. We wouldn’t tolerate it if we saw it happening on the playground with our children and we should recalibrate to make sure it doesn’t happen in our medical meetings, offices, articles, and especially TV appearances. Only then will we start to decrease the hurt inherent in such conduct.

Luckily, we are all in a position to stop these sorts of attacks when we see them. I know that the next time a newsperson asks me what I think about a new look by a celebrity or whether someone’s dermatological work has been done “well,” I will explain my reasons for not commenting and encourage them to remember that countless people across many age groups are strongly affected by comments about their looks. With luck, we can change the dialogue here and help create a learning moment for the news media and ourselves at the same time. It won’t bring Fred back, but it is a way to honor his life’s work of seeking beauty and respecting his patients and peers. Rest in peace, Fred. n

Joel Schlessinger, MD, Chief Cosmetic Surgery Editor, with contributions from Claire Schlessinger

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