Survival of the Fittest

“I guess I know life and it doesn’t work like that…”

– Neon Trees

Well this has certainly been an experiment in sociology…locked in the house with our families “working” from home, dealing with colleagues over the web and looking into their bedrooms as they remain professionals, while children hang on them looking for snacks, and having our sanity tested at every possible turn. And yet, we will never look at 2020 the same.

Don’t get me wrong, I do not want to minimize in any fashion what has happened in the last few months as far as morbidity or trivialize those who have sacrificed everything to take care of us! Let me first send my applause and support to all the physicians, including some dermatologists, who have selflessly given of themselves as true doctors on the front line, no matter where or when needed. Plus, now I am an officer of the American Academy of Dermatology (AAD), and I know everyone has been sending the masses—and each other—adoration and support.

During this quarantine, I’ve become obsessed with the song “Used to Like” from Neon Trees. “Now you say I’m acting crazy, and you don’t see what you see…get back to what you used to like about me, back to what you used to like about me” is the tag line. And it made me wonder, as I am sure many of you have, who will “me” be when this mess is done? And have I lost “me”? Or will my patients have lost “me” when we get back into the rhythm? Who is going to be “me” the dermatologist, the father, the spouse, and the one in the mirror? After all, how much of what we had to manage in the craziness of the pandemic will be relevant when this passes and a new normal emerges?

In many ways, like a bad holiday toast when family is all together, we are all struggling with a new norm of having our professional lives stripped, our sanity tested, and our political, emotional, and even physical limits tested. I have heard plenty of great stories “from the quarantine” (a mini-series in the making!), such as patients who have become amateur photographers but cannot capture an image of a mole or rash who are making telemedicine a living hell…seriously, sending in blurry photos six feet away from the skin against tile floors or something busy in the background, and yet we are supposed to consider this an exam? Meanwhile my mother and my sister are bringing me to the brink of traction alopecia, my children have induced my atrial fibrillation, and between the media and everyone else who is in charge of the airwaves, I am so ready for a break. Talk about madness…but that’s why we have wine clubs, correct?

In the end, we can hopefully take a step back from the insanity of what 2020 has brought us and ask ourselves what have we learned for the other side of this? Do we continue to walk away from people, staying six feet away? What will your waiting room look like from now on? Do we keep going to the grocery store in gloves and mask? And even worse…do we even bother to get into an airplane to go attend a meeting that could be just as effective virtually? What will be the “new norm” in our world?

There is no way to minimize what we are now going through, or compare it to anything that is from a movie or a bad dream. In the end, I wonder if we need to follow the advice from the song. None of us can tell any of our friends what the right response is, right question is, or the best way to handle the exit from the pandemic when it comes, but what we do know—and have always known—is that we need to stick together as a specialty, as colleagues, and as friends.

I have a plea for all of you: Back each other up, help each other out to get back to business, and save the rhetoric, hit-and-run negativity, and “I’ll just leave this here” cowardice for your next life. Those of you who want to turn on fellow dermatologists, whether in snapshot or reprisal, those of you who want to give the specialty away to those who are undertrained, and to those of you who hate on your colleagues, ask yourself this question: If the specialty were to abandon you after this crisis, where would you be? Or even worse…what crisis will it take for everyone to band together? What will happen to you when a tidal wave, earthquake, or other disaster hits? Who will save you once you’ve burned all of your bridges and the bottom falls out? And even worse, what will happen when you emerge from the cyberbully shadow without any allies or peers? As Neon Trees taught me during these moments: “Get back to what you used to like about me…” And that “me” is us.