squamous things

Date the pale, gangly, fish-eyed goon-thing that lives behind the medicine cabinet. It only slithers out at night to unfold it’s quintuple-jointed limbs after a long day’s cyst-hibernation, but you can never hear it do this. It doesn’t let you hear it’s raspy gasps, it’s dribbling moans. It doesn’t want to freak you out. All it really does once it’s out is rotate your shower soap exactly 90 degrees with all 200 of its dry and cracked micro-phalanges, always seeping some sort of invisible viscous fluid from them. It’s technically everywhere in your bathroom, coating the walls, but you can’t perceive it. It likes to think that it is helping in some way, keeping your soaps in the “correct orientation”, even if you never notice. Sometimes, on special nights, it leaves the bathroom, silently shambling down the hall towards your room, it’s squalid scarecrow body convulsing like a huge overflowing vein as it goes. It comes to your room. It crouches down and looks in through the crack between your door and its frame. It stares at you while you sleep, a complete absence of sound accompanying it. It thinks of you as unfathomably beautiful.
It leaves after precisely 6 and ½ minutes. It squeezes it’s boneless, cartilage-body back behind the medicine cabinet, falling into blissful catatonic hibernation until the next night. It dreams of alien, squamous things, but more than often, it dreams of your face.

Rotation Chronicles #11 (The finale): Dermatology

What I like about dermatology: I like how derm is its own world but you still have to have a broad knowledge of systemic conditions, as many of them manifest with skin symptoms. 

What I didn’t like about dermatology: It’s really hard to be sure 100% what someone may have.

Fav things about my site:  The doctors were really nice and taught me a lot. Though there was not much medical dermatology, they tried their best to teach me common skin disorders. I also got to learn a bunch about proper skin care since this was a cosmetic dermatology office. (I have to step up my spf game yall). 

Not so awesome things about my site: This was a medispa dermatology office so most of what they did was cosmetic dermatology (botox, face lifts, lasers, cool sculpting, etc). Though I learned a lot, much of that info isn’t really helpful for primary care (aka where I want to work). It was also pretty far away from home. Most patients were really wealthy and privileged but most were very kind.

“Common” things I saw: Rhytides, rosacea, acne, actinic keratosis, basal cell carcinoma, squamous cell carcinoma

“Uncommon” things I saw: wegners granulomatosis, SLE, nummular psoriasis

Things I got to do: 1st assist with facelifts, blepharoplasties, brow lifts, biopsies, etc

Misconceptions: cosmetic derm does appear pretty superficial compared to other medical specialties, and in a way it definitely is. But some people who get cosmetic procedures have legit deformities or medical problems and just want to look “normal”. Even the patients who do this solely for vain reasons are really distressed by how they look and providing this service really makes them happy. I still am not a huge fan of this area, but I definitely acknowledge how society standards influence the growth of this industry.

Overall Thoughts: I really wish I had a medical dermatology rotation over this one. The way to get good at derm is to see tons and tons of rashes/lesions. I got to see some on this rotation but not enough for me to feel stronger in derm going into my first job. I’ll definitely want some more derm experience in the future.

And that’s a wrap! This was my last rotation. Next is board review, graduation, dreaded board day, and hopefully starting my new job soon :)