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Skin Signs of Human Trafficking & the Science of Longevity · The Science of Skin

• 0:08
  SPEAKER_00: Hello and welcome to the Science of Skin podcast.
• 0:10
  SPEAKER_00: My name is Dr.
• 0:11
  SPEAKER_00: Ted Lane.
• 0:12
  SPEAKER_00: I'm a board certified dermatologist in Austin, Texas, and I'm your host for today.
• 0:16
  SPEAKER_00: And I've got a very special guest, Dr.
• 0:19
  SPEAKER_00: Shotty Karosh.
• 0:20
  SPEAKER_00: Shotty, how are you?
• 0:21
  SPEAKER_01: Hey Ted, great to be with you.
• 0:24
  SPEAKER_00: Thank you.
• 0:24
  SPEAKER_00: So Dr.
• 0:25
  SPEAKER_00: Karosh is one of the world's most interesting people.
• 0:28
  SPEAKER_00: She is an associate professor of dermatology and public health at the Harvard Medical School.
• 0:34
  SPEAKER_00: She's also director of dermatology and aesthetics at Nantucket Cottage Hospital.
• 0:40
  SPEAKER_00: But you're kind of a Texas girl, aren't you, Shoddy?
• 0:44
  SPEAKER_01: You remember that well, Ted.
• 0:45
  SPEAKER_01: That's right.
• 0:46
  SPEAKER_01: Born in Austin, Texas, your hometown.
• 0:48
  SPEAKER_00: That's awesome.
• 0:50
  SPEAKER_00: So from Austin to Harvard, um, not a common pipeline, but that's great.
• 0:54
  SPEAKER_00: It's exciting that you're there.
• 0:56
  SPEAKER_00: Um, Shoddy, tell us about especially your work in public health and how did that happen?
• 1:03
  SPEAKER_01: Yeah, so that's that's a great question.
• 1:05
  SPEAKER_01: And I think it's a testament to um mentorship.
• 1:09
  SPEAKER_01: And I, and a fun fact for everyone is that Ted and I share a mentor, uh, Dr.
• 1:14
  SPEAKER_01: Alan Mentor, who was a wonderful uh dermatologist, world expert in psoriasis.
• 1:19
  SPEAKER_01: And he was the first person I ever published a paper with in dermatology.
• 1:23
  SPEAKER_01: Oh my gosh.
• 1:24
  SPEAKER_01: Yes, and he's the actually the person that introduced me to my mentor at Harvard, Alexa Kimball.
• 1:29
  SPEAKER_01: And so that's kind of, you know, um, how I discovered that I was a public health person is that during my residency, I designed one of the first apps, smartphone apps in dermatology.
• 1:40
  SPEAKER_01: And it was called Skin Advocate, and you can still download it.
• 1:42
  SPEAKER_01: And it was just basically free resources for patients with skin conditions, a way to connect them with uh patient advocacy groups for free, you know, with their conditions.
• 1:52
  SPEAKER_01: And someone pointed out to me that this was actually a public health initiative because we were raising awareness about patient advocacy groups, creating, you know, free ways for people to get support.
• 2:01
  SPEAKER_01: And I never really thought about it, you know, and it was really mentors saying, you know, this is public health.
• 2:07
  SPEAKER_01: And there are people in our field who do what you do.
• 2:11
  SPEAKER_01: Uh, Lexa Kimball is a great example of a person who has done great work for public health and dermatology.
• 2:16
  SPEAKER_01: And there are others, you know, at Harvard.
• 2:18
  SPEAKER_01: And so I was introduced to them and they recruited me to uh come up to Massachusetts General Hospital and help begin what became the division of community health, which was our clinics for underserved communities in the Boston area.
• 2:34
  SPEAKER_01: And that's actually what led into the public health initiative with uh human trafficking survivors.
• 2:42
  SPEAKER_00: Well, so that's the that's what we're gonna move into next, Shodi, is your work in in human trafficking and and increasing education amongst dermatology, the dermatology community writ large.
• 2:54
  SPEAKER_00: We have had Dr.
• 2:55
  SPEAKER_00: Merrick Elias on, um, who also spoke about human trafficking from a private practice viewpoint, and it was incredibly impactful and um educational.
• 3:06
  SPEAKER_00: And you and I just happened to share a ride one day, and you were talking about how you got into this and and you were really passionate about helping the dermatology community understand the signs and symptoms and and how patients may present uh that are being trafficked.
• 3:25
  SPEAKER_00: So much so, Shodi, that you led the ad hoc committee for human trafficking for the American Academy of Dermatology.
• 3:32
  SPEAKER_00: Um, talk to us about what how that started and and what what your work, what were the deliverables of your work?
• 3:39
  SPEAKER_01: Yeah, thank you so much.
• 3:40
  SPEAKER_01: And I'm so glad that you had Dr.
• 3:42
  SPEAKER_01: Elias also share his perspective because something that I always say is that public health initiatives are never the story of one person.
• 3:48
  SPEAKER_01: They're the story of many people coming together.
• 3:51
  SPEAKER_01: And I'm really proud of the dermatology community, our community, because I think that so many people have stepped up to contribute and do their part in their own way.
• 4:01
  SPEAKER_01: Now, for me in particular, um, how I came to this work is as I mentioned, I was recruited up to Mass General by my mentor, Alexa Kimball, to run the network of clinics, the division of our hospital that was charged with taking care of the most underserved patients and working with the primary care doctors and the local NGO nonprofit organizations that were trying to help the community.
• 4:23
  SPEAKER_01: And one of the biggest problems that we had in some of the pockets around the Boston community, especially the most underserved communities, is gangs.
• 4:31
  SPEAKER_01: You know, there were a lot of people that were trying to get out of gangs, a lot of young people that were working with these nonprofit organizations.
• 4:38
  SPEAKER_01: And one of the barriers was these tattoos that they had.
• 4:41
  SPEAKER_01: And, you know, uh the Massachusetts employment website actually lists tattoos as a barrier to employment.
• 4:48
  SPEAKER_01: So, you know, a lot of these young people needed to get these tattoos removed in order to be safe so that they would not be targeted, um, in order to acquire jobs, and you know, the kind of job better jobs that they could get, and also just reintegrate into society.
• 5:02
  SPEAKER_01: And so I realized that this was a way that our department, the dermatology department, could help in this multidisciplinary initiative to help these young people.
• 5:10
  SPEAKER_01: And so, you know, in true public health fashion.
• 5:13
  SPEAKER_01: So you mentioned Ted that yes, I'm an alum of the Harvard School of Public Health and I'm now part-time faculty there.
• 5:18
  SPEAKER_01: The pub, the discipline of public health teaches us how to organize, you know, because I think there are a lot of great people in the dermatology community, certainly my mentors in residency, a lot of private practice dermatologists who were volunteering in their communities, doing exactly this work for years, for many years before I came along.
• 5:35
  SPEAKER_01: There were a lot of just good citizens of our community that were removing the tattoos, the scars, all these things.
• 5:41
  SPEAKER_01: So when I came to this, public health teaches you to organize structures and to track their impact.
• 5:46
  SPEAKER_01: And like you said, deliverables.
• 5:48
  SPEAKER_01: And another uh theme of public health is to organize community stakeholders, to go find mentors, to go find teammates.
• 5:56
  SPEAKER_01: So I was so fortunate that in our Department of Mass General, I had the best mentor that a person could ever hope for with lasers was Dr.
• 6:03
  SPEAKER_01: Rox Anderson, who, you know, has helped to develop many of the lasers uh that we have in dermatology.
• 6:09
  SPEAKER_01: So I went to Dr.
• 6:10
  SPEAKER_01: Anderson and, you know, sought his mentorship.
• 6:13
  SPEAKER_01: And he said, Shadi, I'm so glad you came to me.
• 6:16
  SPEAKER_01: In fact, a local high school teacher had come to him 20 years ago just to help with a similar case, not an organized program, but she had a student in her class that was trying to get out of gangs.
• 6:26
  SPEAKER_01: And so Rox, you know, being the wonderful citizen that he is, had volunteered to, you know, laser off this young man's tattoos for free.
• 6:33
  SPEAKER_01: And halfway through those treatments, he, this young man was actually killed by members of an opposing gang before the tattoo could be fully removed, you know, because this is bearing these marks, you know, it really can be a you know a barrier to safety.
• 6:46
  SPEAKER_01: And so Rox never forgot that story of the person that he was trying to help, but they weren't able to fully remove his tattoo in time.
• 6:54
  SPEAKER_01: You know, just that's the way that, you know, life happens sometimes.
• 6:57
  SPEAKER_01: And so he said, What can I do to help you?
• 6:59
  SPEAKER_01: And I said, Well, you know, I'm writing grants, you know, the Women's Durham Society gave us, you know, a grant to buy supplies, but you know, we bought all kinds of safety goggles supplies and things like that, but we needed lasers.
• 7:09
  SPEAKER_01: So Rox actually called the Candela Corporation.
• 7:13
  SPEAKER_01: So one of the heroes of this story is actually, you know, a socially minded company like the Candela Corporation that was very generous.
• 7:22
  SPEAKER_01: So, you know, my mentor, Rox Anderson, calls him and says, you know, I have this young faculty member in my department that I'm working with and mentoring to do this really important community program.
• 7:30
  SPEAKER_01: Can you all help?
• 7:30
  SPEAKER_01: And they donated a trivantage laser at that time.
• 7:33
  SPEAKER_01: And that's what helped us, you know, get the program started.
• 7:36
  SPEAKER_01: And so began, we began the work.
• 7:39
  SPEAKER_01: And pretty soon, the same community stakeholders, like the local nonprofits and the nurse examiners for the district attorney's office and law enforcement and primary care doctors, the same people that applied that used to refer the uh young people trying to get out of gigs, started to refer a growing population of young women who had been forcibly branded or coercively branded with tattoos through their experience of exploitation and human trafficking.
• 8:10
  SPEAKER_01: And, you know, and this was before the news of these things, I would say, was so central in the media.
• 8:16
  SPEAKER_01: You know, I can say that I, for one, you know, had heard of human trafficking and thought, you know, uh had an idea of it as, you know, a terrible problem, but one that was distant and abstract and, you know, a really terrible thing that was happening to people far away in other countries, you know, not in our own backyard in the United States.
• 8:33
  SPEAKER_01: And wow, did this really open my eyes when I saw that, you know, you know, certainly people from other countries were brought here, often against their own will, uh, but also American young people.
• 8:45
  SPEAKER_01: Uh, you know, one of the first patients that I ever took care of was a Caucasian American young woman who basically fell in with the wrong crowd when she was in high school and was, you know, at the wrong party, and um a bunch of women were drugged and kidnapped and woke up with the same gun tattooed to their necks as a symbol of the particular uh crime ring that was exploiting them at that time.
• 9:12
  SPEAKER_01: And this young woman, by her amazing resourcefulness and resilience, somehow escaped uh and made her way to Boston and was in school to, you know, turning her life around, you know, by the time we met her and managed to find a you know a local primary care doctor that knew of our program.
• 9:31
  SPEAKER_01: And we never um we never advertised and we always kept the location secret.
• 9:36
  SPEAKER_01: And I always recommend that actually for any of our colleagues.
• 9:40
  SPEAKER_01: You know, I've been fortunate to mentor, you know, other academic departments and and colleagues to start programs like this.
• 9:46
  SPEAKER_01: And I always say that partnerships with law enforcement are so important.
• 9:50
  SPEAKER_01: Uh I learned so much from the police officers that we worked with.
• 9:54
  SPEAKER_01: Many of them had experience in uh identifying gang tattoos, and I actually learned from them later on when my research group at Harvard published the first paper on the skin signs of human trafficking.
• 10:06
  SPEAKER_01: We learned to recognize themes.
• 10:08
  SPEAKER_01: And also from learning from law enforcement, and then also, again, in the public health tradition of learning from other stakeholders, I went and learned, you know, everything I could from the experts.
• 10:18
  SPEAKER_01: So, for example, there is a psychologist that is affiliated with Massachusetts General Hospital, Dr.
• 10:24
  SPEAKER_01: Abigail Judge, who ran a specialty clinic for survivors of trauma and human trafficking.
• 10:30
  SPEAKER_01: And I, you know, became friends with her, and she and I worked together, and she taught me a tremendous amount about trauma-informed care, how to do a better job of taking care of people in this situation, and then also about the themes and the tattoos that she had been seeing.
• 10:47
  SPEAKER_01: And then also uh Rachel Nemeck, who was a nurse examiner from the district attorney's office, she referred patients to me and she's also now a professor of nursing.
• 10:55
  SPEAKER_01: I learned a lot from them.
• 10:56
  SPEAKER_01: And so, in seeing cases and then learning from other stakeholders in the field, we started to understand that there were patterns in the skin science.
• 11:06
  SPEAKER_01: And so uh we've now published a series of papers, um, one of which was actually with another expert in the trafficking community, Professor Laura Letterer, who was a law professor at Georgetown, uh Georgetown Law Center, and was one of the first people who publ who actually helped architect the legislation that we have in the US government on human trafficking.
• 11:28
  SPEAKER_01: And so I worked with her.
• 11:29
  SPEAKER_01: I worked with Ambassador Mark Lagon, who was the former ambassador at large to combat human trafficking.
• 11:35
  SPEAKER_01: So these veterans in the law and policy community also taught me a lot.
• 11:39
  SPEAKER_01: And so basically, we formed this interdisciplinary team of, you know, experts in mental health, in law and policy, and in dermatology.
• 11:47
  SPEAKER_01: And we started publishing papers.
• 11:49
  SPEAKER_01: And so in one of the papers, we talk about the three eyes, which are the signs of human trafficking.
• 11:55
  SPEAKER_01: The first eye is for infections.
• 11:57
  SPEAKER_01: So, for example, with sex trafficking, there's two main types of trafficking: there's sex trafficking and labor trafficking.
• 12:03
  SPEAKER_01: So, with sex trafficking, there are multiple sexually transmitted infections.
• 12:07
  SPEAKER_01: So that would be the eye.
• 12:08
  SPEAKER_01: And then in both types of trafficking, both sex trafficking and labor trafficking, the eye can also be another kind of infection, skin infections and infestations from the substandard living conditions that people in these situations are often forced to live in.
• 12:22
  SPEAKER_01: The second eye is injury because there could be signs on the skin of trauma or abuse, or sometimes of self-inflicted injuries from the mental health trauma that people sort of start compulsively cutting.
• 12:36
  SPEAKER_01: So sometimes we have to remove those types of scars, not just the tattoos.
• 12:41
  SPEAKER_01: And then the third eye is the one that relates to tattoos.
• 12:43
  SPEAKER_01: The third eye is for imagery because there are certain themes and images in the tattoos.
• 12:49
  SPEAKER_01: Now, this can be tricky because, you know, tattoos are very prevalent in our society by some reports published in the literature.
• 12:57
  SPEAKER_01: Um, you know, in some age groups, you know, 25% of people between 25 and 60, for example, in the US might have one tattoo.
• 13:06
  SPEAKER_01: And so, how do we, as dermatologists or other healthcare providers or any, or any just, you know, well-meaning stakeholders, whether that's social workers, people who work in shelters, or just concerned citizens, how do we tell the difference?
• 13:21
  SPEAKER_01: Well, we may not always be able to tell the difference 100% because we may have to look at, you know, a large constellation of signs, but there are certain clues in the trafficking tattoos.
• 13:32
  SPEAKER_01: For example, you know, one thing that gang tattoos and trafficking tattoos have in common are signs of weapons and violence.
• 13:39
  SPEAKER_01: For example, guns.
• 13:40
  SPEAKER_01: I had seen both in the gang tattoos and also in trafficking-related tattoos.
• 13:46
  SPEAKER_01: And then also the certain locations, like gang tattoos and some trafficking tattoos, may on purpose be placed in highly visible locations, like the face, the neck, or the hands or the or the arm, for example, because it is intended that people be recognized by their associates or by their enemies.
• 14:06
  SPEAKER_01: Um and in the case of trafficking tattoos, sometimes they're also placed in very private locations, uh, depending on, you know, we see that in sex trafficking.
• 14:16
  SPEAKER_01: And then in specifically in sex trafficking, we've seen other themes like themes of transaction, like dollar signs or barcodes, you know, which is unfortunately, you know, meant to mean that the person is being used in some sort of transaction.
• 14:30
  SPEAKER_01: Um, and then also signs of dominance or ownership, such as crowns or someone's name tattooed across the person.
• 14:39
  SPEAKER_01: Um, you know, so, or sometimes there's even hearts and valentines or symbols of sentiment because, um, like romantic sentiment, because sometimes the trafficker could actually be the intimate partner of someone being trafficked.
• 14:52
  SPEAKER_01: So, anyway, there's a lot that we learned.
• 14:55
  SPEAKER_01: I'm sure there's a lot more to learn.
• 14:57
  SPEAKER_00: No, it gets complex.
• 14:58
  SPEAKER_00: I'm just thinking, uh, you know, as a private practice dermatologist, right, and just giving some tips and pearls out there.
• 15:03
  SPEAKER_00: I was on the AED website where you have uh videos, including for Dr.
• 15:08
  SPEAKER_00: Judge, is on there with uh Rachel Nemick, who you um mentioned, and they they give some really good um advice for recognizing, but then in terms of getting to the disclosure, right?
• 15:20
  SPEAKER_00: If if you have a patient and you're and you have a bit of a a feeling, oh my goodness, I might be dealing with someone who's being trafficked here, like what what tips or pearls would you give us in terms of what words should we use?
• 15:33
  SPEAKER_00: How how do we get them just to give us a hint that something might be going on so that we could help them?
• 15:38
  SPEAKER_01: Yeah, that's that's a great question, Ted.
• 15:40
  SPEAKER_01: And I think that uh what I've learned from from experts like Dr.
• 15:43
  SPEAKER_01: Judge and and Rachel Numick and other uh experts in the mental health, you know, and trauma-informed care community is that every situation is unique and that we may not um hear directly from a person the first time we meet them.
• 15:57
  SPEAKER_01: And that our job in the healthcare community is to create a safe and comfortable environment where a person could eventually feel like they could come forward and seek help.
• 16:08
  SPEAKER_01: Because a lot of, you know, folks have been threatened, uh, you know, that if they tell anyone something bad will happen to them or something bad will happen to someone they care about, you know.
• 16:16
  SPEAKER_01: And so I think that the most important thing is to show our patients who are affected by this problem that they're safe and that everything will be on their terms and that that we're prepared to meet them where they are and provide the resources that they want and that they and that our medical environments are a safe place for them to come.
• 16:40
  SPEAKER_01: And so I think that the most important thing is that.
• 16:43
  SPEAKER_01: And sometimes it's just being sensitive to that person and saying, you know, are you hungry?
• 16:47
  SPEAKER_01: You know, um, or can I get you a drink?
• 16:49
  SPEAKER_01: Or are you comfortable?
• 16:51
  SPEAKER_01: Are you cold?
• 16:51
  SPEAKER_01: And some things, you know, just very small cues that allow the person to know that they're seen and that this is a safe environment.
• 16:59
  SPEAKER_01: And I think we learn a lot as physicians from our nurses in this regard.
• 17:03
  SPEAKER_01: I think nurses are really great at making patients feel comfortable.
• 17:07
  SPEAKER_01: And sometimes I find that that things are shared with the nurses that might not even be shared yet, you know, with the doctor.
• 17:13
  SPEAKER_01: You know, so I think that that's something I've learned a lot from our nurses.
• 17:17
  SPEAKER_01: And then in addition to that, when the disclosure comes, if a person shares something with that, for us to be ready with our resources.
• 17:24
  SPEAKER_01: Like, for example, right?
• 17:26
  SPEAKER_01: So, for example, one of my mentors, Ambassador Mark Lagon, who was the former ambassador at large for human trafficking, he's all the he's also the founder of Polaris, which was the first really national NGO that that uh responded to this problem.
• 17:40
  SPEAKER_01: And they had this 900 number.
• 17:42
  SPEAKER_01: I think it's still, you know, a resource.
• 17:44
  SPEAKER_01: But he found that it wasn't so much the patients and and the victims and the survivors of trafficking the trafficking that were calling the number.
• 17:50
  SPEAKER_01: It was ER nurses that were calling for advice, you know, so that they could be prepared.
• 17:56
  SPEAKER_01: And so, you know, I always try to emphasize that we should know our resources, but we should recognize that providing someone with a phone number is usually not what sort of gets them to safety.
• 18:06
  SPEAKER_01: That, you know, we we need to have something that, again, people like Dr.
• 18:10
  SPEAKER_01: Jovich have have taught me are the resources of a warm handoff.
• 18:14
  SPEAKER_01: Like, so for example, I had to really educate myself in my healthcare system.
• 18:19
  SPEAKER_01: Who were the point people that a person would call?
• 18:23
  SPEAKER_01: So, for example, if there was a social worker, you know, either in my hospital or say for private practitioners in the community, there might be a survivor organization.
• 18:32
  SPEAKER_01: Like there's a great one in Massachusetts called My Life, My Choice.
• 18:36
  SPEAKER_01: And I think the survivor advocates, you know, people that have survived this situation that are now advocates running nonprofit organizations, they are, you know, so priceless in terms of their ability to guide our um our response.
• 18:49
  SPEAKER_01: And so actually calling up these organizations and knowing them and saying, you know, I have a friend, let's say, for example, my friend is named Kimberly, who's a social worker or a person at nonprofit, and I'm gonna give you her phone number.
• 19:02
  SPEAKER_01: And let's say that this is a person that I work with regularly.
• 19:05
  SPEAKER_01: So that that patient that I might share that information with knows that this is a person who's known, known to me.
• 19:12
  SPEAKER_01: And that person has a name and this is this person's direct phone number.
• 19:16
  SPEAKER_01: You know, so that would be called a warm handoff, for example.
• 19:19
  SPEAKER_01: Okay.
• 19:19
  SPEAKER_00: Yeah, I I've always wondered how this would work.
• 19:21
  SPEAKER_00: You know, if we could call the national trafficking, uh, human trafficking hotline, but having someone local for a person who is unfortunately being trafficked to quickly contact and maybe they could come and rescue or save is that makes a lot of sense.
• 19:35
  SPEAKER_00: Actually, I don't know why I didn't think about that.
• 19:37
  SPEAKER_00: So thank you for it.
• 19:38
  SPEAKER_01: No, of course.
• 19:38
  SPEAKER_01: I mean, hey, Ted, I can tell you that there are a lot of things that I had never thought about in my life until, you know, we as doctors, we learn things when we're suddenly faced with a patient in front of us and we think to ourselves, oh, how am I gonna help this person?
• 19:51
  SPEAKER_01: And then we go learn.
• 19:53
  SPEAKER_01: Then we go learn, you know, and so I think that's it for for all of us.
• 19:57
  SPEAKER_01: And one thing that you that you mentioned, for example, is the American Academy of Dermatology.
• 20:01
  SPEAKER_01: Um, I want to really shout out to them and the American Society for Laser Surgery and Medicine, who, you know, I work with, I've worked with them and also their leadership, my dear friend Um Dr.
• 20:11
  SPEAKER_01: Paul Friedman, who's a dermatologist, in private practice in Houston, Texas.
• 20:16
  SPEAKER_01: He and I kind of found each other doing this work because he is also in private practice.
• 20:20
  SPEAKER_01: He was working with his local survivor organizations.
• 20:22
  SPEAKER_01: And he, when he was president of the American Society of Laser Medicine and Surgery, he found me when I was chairing the task force for the American Academy of Dermatology.
• 20:29
  SPEAKER_01: And we kind of found each other and we both appointed each other to our to our task forces and we said, okay, we have to work together.
• 20:37
  SPEAKER_01: And so we kind of made complementary resources.
• 20:40
  SPEAKER_01: So if you look at like the website of the American Academy of Dermatology or the American Society of Laser Surgery and Medicine, there's resources for the American Society of Laser Surgery and Medicine, it's a little bit more specific for like laser expert physicians, for example.
• 20:52
  SPEAKER_01: The American Academy of Dermatology, a little bit more general.
• 20:55
  SPEAKER_01: And so anyone can go on the AAD toolkit for trafficking and you know, as you did, and look at the videos and look at the resources.
• 21:04
  SPEAKER_01: In the American Academy of Dermatology, we also made an app, and it's called STEAR, S S T E A R.
• 21:12
  SPEAKER_01: And that spells Skin Signs of Trafficking, Education, Advocacy, and Resources.
• 21:17
  SPEAKER_01: And so this is a free app, S-S-T-E-A-R, that we made in collaboration with, you know, with the American Academy of Dermatology, and it has all the resources on the website on it.
• 21:30
  SPEAKER_01: And it also has a searchable database by city.
• 21:33
  SPEAKER_01: So, for example, if you put in that you're in Boston, I will come up as a contact of a physician that can help a patient with their dermatology services like laser treatments and things like that.
• 21:44
  SPEAKER_01: But then there are other things that come up, like the Boston University Legal Aid Center, where, you know, the the um the survivors may need legal aid, you know, a lawyer that can help them understand what their rights are.
• 21:57
  SPEAKER_01: It also has a nonprofit organization, My Life.
• 22:00
  SPEAKER_01: My choice.
• 22:01
  SPEAKER_01: So we also have these resources for Houston.
• 22:04
  SPEAKER_01: You know, you need to let me know if there's anything we're missing for Austin that we need to add.
• 22:08
  SPEAKER_01: But, you know, so, and and I'm so thrilled that we have so many of our colleagues, so many doctors in the dermatology community, over a hundred that Paul Friedman, my dear friend in the American Society of Blazer Surgery and Medicine, helped to mobilize.
• 22:22
  SPEAKER_01: So he and I worked together and we got all these volunteers.
• 22:25
  SPEAKER_01: And so I'm I'm happy to report that there are many people in the dermatology community, like our friend Dr.
• 22:31
  SPEAKER_01: Elias, for example, who are doing this great work in their communities.
• 22:35
  SPEAKER_01: And now we have a way of finding them through this app.
• 22:38
  SPEAKER_00: Love it.
• 22:39
  SPEAKER_00: S-S-T-E-A-R is the app.
• 22:42
  SPEAKER_00: Listen, we'll link in the show notes to many of your publications.
• 22:45
  SPEAKER_00: We'll link to the toolbox uh to the toolkit for the AAD as well, so that patients can easily find patients.
• 22:52
  SPEAKER_00: Sorry, so that people listening can easily find uh use these resources and build a community for themselves and they're in their own locations of people that they can refer to.
• 23:05
  SPEAKER_00: Um, so that if we do ever come in contact with a patient who we think may be traffic, there's opportunities to help, and we have the resources at our fingertips as well.
• 23:14
  SPEAKER_00: I I can't think of a of a more serious subject than this.
• 23:18
  SPEAKER_00: Shadi, I was, you know, I try as like you, we travel quite a bit.
• 23:22
  SPEAKER_00: And, you know, we're used to seeing it in airports, the signs, you know, if you this is a safe place, if you uh, you know, weren't are worried about human trafficking or if you are being human trafficked.
• 23:31
  SPEAKER_00: But recently I actually saw one on the plane as well, uh, in the bathroom of a plane.
• 23:35
  SPEAKER_00: And so we know that flight attendants now, for example, are getting the training.
• 23:39
  SPEAKER_00: Uh, and so certainly if flight attendants are getting trained, physicians need to be trained as well.
• 23:45
  SPEAKER_00: Um, we see so many people.
• 23:47
  SPEAKER_00: And I think this is just one step in helping people get, first of all, understand the resources that are out there, and hopefully we can um provide the impetus for people to actually take advantage of those resources and be ready should someone present in your office that needs help.
• 24:02
  SPEAKER_00: Shodi, listen, we have a little bit more time.
• 24:04
  SPEAKER_00: And you, as I mentioned, you are a person of many interests.
• 24:08
  SPEAKER_00: And one of the other places that we met was at an aesthetic conference in Paris where you were leading a session on longevity.
• 24:15
  SPEAKER_00: And so, and it was a brilliant talk that you gave because you're you were you brought in your work in public health to longevity.
• 24:25
  SPEAKER_00: And it was incredible.
• 24:27
  SPEAKER_00: So, how in the world did you get interested in longevity, which is such a hot topic right now?
• 24:32
  SPEAKER_01: Thank you so much, Ted.
• 24:34
  SPEAKER_01: It's such a pleasure to work with you.
• 24:35
  SPEAKER_01: And I think that we're so aligned, you know, in our in our view of things.
• 24:39
  SPEAKER_01: And I think that I came to that realm also as a public health person because, you know, I spent so much of my career working on public health initiatives, doing public education around dermatology.
• 24:51
  SPEAKER_01: And I was getting all of these questions.
• 24:53
  SPEAKER_01: And I realized that there was a real need, as I'm sure you have, because you've been dedicated to educating on this topic, that, you know, of separating, let's say, science from snake oil.
• 25:01
  SPEAKER_01: And, you know, there are so many claims, you know, that um longevity, you know, I always laugh, you know, when some of my colleagues at Harvard Medical School started talking about the new science of longevity.
• 25:12
  SPEAKER_01: I said, longevity is the oldest story in creation, you know, the epic of Gilgamesh, the oldest surviving.
• 25:18
  SPEAKER_01: There's a tablet that's three, 3,500 years old in the British Museum, and people are talking about longevity.
• 25:24
  SPEAKER_01: You know, so it's, you know, it's a topic of great interest.
• 25:28
  SPEAKER_01: But now we have to really educate people on where the like scientific outcome measures.
• 25:34
  SPEAKER_01: Like you asked me at the beginning of this conversation about deliverables when we talk about human, right?
• 25:39
  SPEAKER_01: And so I think that you and I are both committed to understanding what the deliverables are, you know, in the longevity space and really making sure that the truth is out there uh, you know, in terms of patient protection and guidance, consumer protection to really help our patients reach their goals.
• 25:59
  SPEAKER_01: And, you know, so I think that that that was it.
• 26:01
  SPEAKER_01: It's it's as an educator who was getting a lot of questions.
• 26:05
  SPEAKER_01: I realized that we needed to, you know, mobilize around this issue.
• 26:09
  SPEAKER_01: And I'm so glad that you you have as well, and that we're now a team sort of educating people.
• 26:14
  SPEAKER_00: Yeah, and we're trying to develop a much larger team around longevity.
• 26:18
  SPEAKER_00: And and we are we're starting a new conference on longevity uh in February in in Arizona.
• 26:24
  SPEAKER_00: And so we'll be talking much more about that with the idea of separating fact from fiction.
• 26:29
  SPEAKER_00: Let's as a community come together and really define skin longevity uh and and allow all these companies who are doing great work individually to work with the dermatology community and and bring the science forward and and make products that will help everybody.
• 26:44
  SPEAKER_00: So um, Shodi, I love that you come at it from the viewpoint of public welfare, essentially, because that's where it should be thought of and not just for the rich and famous.
• 26:56
  SPEAKER_00: Uh, because I think this is a way for us to put, you know, longevity to me is is preventative medicine.
• 27:01
  SPEAKER_00: And it's a way, it's a reframing of preventative medicine which sits squarely in public health.
• 27:05
  SPEAKER_00: So I just thought that was brilliant and I really appreciated what you were doing there on podium and and we are gonna work more together, I can promise you that, because we're gonna we're gonna try and make this something squarely in the middle of dermatology.
• 27:17
  SPEAKER_01: Thank you, my friend.
• 27:18
  SPEAKER_01: I look forward to that.
• 27:20
  SPEAKER_00: Absolutely.
• 27:20
  SPEAKER_00: Well, listen, everybody, as I mentioned, you just heard one of the world's most interesting people, Shadi Karosh, uh, who is a professor, associate professor of dermatology at Harvard Medical School and in the public health as well, uh, School of Public Health as well.
• 27:32
  SPEAKER_00: Um, Shadi, thank you so, so much for spending some time with us.
• 27:36
  SPEAKER_00: I know how busy you are, and I really appreciate it.
• 27:38
  SPEAKER_01: Thank you, Ted.
• 27:40
  SPEAKER_00: Absolutely.
• 27:41
  SPEAKER_00: So listen, uh, if you have any questions about today's episode or if you have thoughts on future episode topics, please send us an email at questions at science of skinsummit.com.
• 27:51
  SPEAKER_00: Otherwise, we found that the growth of this podcast really occurs through word of mouth.
• 27:55
  SPEAKER_00: So if you enjoyed the show today, if you thought it was helpful, please tell your peers, your colleagues.
• 27:59
  SPEAKER_00: Uh also subscribe.
• 28:01
  SPEAKER_00: We have a lot of great information on here.
• 28:03
  SPEAKER_00: It's not just about aesthetics, it's about really interesting topics like human trafficking and longevity and all sorts of great things.
• 28:09
  SPEAKER_00: Uh, my name is Ted Lane, Ward Certified Dermatologist in Austin.
• 28:12
  SPEAKER_00: Dr.
• 28:13
  SPEAKER_00: Karosh was our guest today.
• 28:14
  SPEAKER_00: Thank you so much for listening.