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Transcript

The Importance of Patient Stories · The Science of Skin

• 0:05
  SPEAKER_01: Hello and welcome to Skincare Confidential, a podcast supporting the Science of Skin Summit.
• 0:11
  SPEAKER_01: My name is Dr.
• 0:12
  SPEAKER_01: Ted Lane.
• 0:12
  SPEAKER_01: I'm a board-certified dermatologist and your host for today.
• 0:15
  SPEAKER_01: But I am so excited to welcome our guest, who is Dr.
• 0:18
  SPEAKER_01: Lindsay Ackerman, also a board-certified dermatologist.
• 0:22
  SPEAKER_01: She is the president of medical dermatology specialists in Phoenix, right, Lindsay?
• 0:27
  SPEAKER_01: Is it Phoenix?
• 0:28
  SPEAKER_00: In Phoenix, Arizona.
• 0:29
  SPEAKER_01: Okay.
• 0:30
  SPEAKER_01: Chief of uh inpatient dermatology at Banner University Medical Center.
• 0:34
  SPEAKER_01: She is an associate professor of dermatology at the University of Arizona and the president and founder of Skintelligent Productions, which I think is one thing I'd like to start talking about, Lindsay, if that's okay.
• 0:46
  SPEAKER_00: Sure, of course, Ted.
• 0:47
  SPEAKER_00: Thank you so much for having me.
• 0:49
  SPEAKER_00: It's really a privilege and pleasure to be here.
• 0:52
  SPEAKER_01: My pleasure.
• 0:53
  SPEAKER_01: So I was just telling Lindsay that I binge watched all these episodes of her production.
• 0:58
  SPEAKER_01: It's called Skin Telligent.
• 1:00
  SPEAKER_01: And it is, listen, if you're a dermatologist out there, or if you are a resident in dermatology or interested in the dermatologic field, I highly recommend that you watch these episodes on YouTube.
• 1:12
  SPEAKER_01: They're so easily watched.
• 1:14
  SPEAKER_01: They're they're consumable.
• 1:15
  SPEAKER_01: They're what, seven or eight minutes?
• 1:17
  SPEAKER_01: Is that right?
• 1:17
  SPEAKER_01: Or is that how fast I watch them?
• 1:19
  SPEAKER_00: Somewhere between, yeah, eight and eleven minutes, I think, each.
• 1:22
  SPEAKER_00: And there are eight of them in season one.
• 1:25
  SPEAKER_01: Okay.
• 1:26
  SPEAKER_01: So, and and Lindsay highlights uh an inpatient case that she uh she sees.
• 1:32
  SPEAKER_01: She's she's uh a medical dermatologist specialist and she's chief of inpatient dermatology.
• 1:37
  SPEAKER_01: And so she gets to see some really incredible cases, Lindsay.
• 1:41
  SPEAKER_01: I mean, HTLV1 brought me right back to medical school and then residency.
• 1:46
  SPEAKER_01: And you're like seeing that not on the daily, but it's pretty incredible.
• 1:52
  SPEAKER_00: Well, again, thank you so much, Ted, for having me.
• 1:55
  SPEAKER_00: I I can't um in a concise version tell you how meaningful this entire experience has been to me, but suffice it to say, it is true.
• 2:03
  SPEAKER_00: This project has really been the passion project of my career.
• 2:07
  SPEAKER_00: And I think if I were to distill it down to something simplistic, it's really just about bringing to the narrative where we really are as a specialty in the overall house of medicine, where we ought to be positioned.
• 2:22
  SPEAKER_00: I think that we have um a lot to gain about giving visibility to those diseases that are either more rare and stigmatized and difficult to live with, or those that actually change life trajectories or are life-saving.
• 2:34
  SPEAKER_00: So we've occupied a lot of airwaves with things that are really important in anti-aging and in the cosmeceutical world and even in um pimple popping for that matter, uh, things that are important for patients to learn about.
• 2:47
  SPEAKER_00: Uh, but I think that we shouldn't be doing that necessarily in the absence of giving visibility to the other parts of medicine that are involved in dermatology, namely how skin can tell an incredible story about what otherwise may be going on inside the body.
• 2:59
  SPEAKER_00: So I set out to just build that product and um we're a few years into it.
• 3:04
  SPEAKER_00: And yes, it was very rewarding to be able to put our season one of Skin Telligent with Dr.
• 3:08
  SPEAKER_00: Lindsay Ackerman fully on YouTube now to put to put that on display.
• 3:15
  SPEAKER_01: I'm such a fan, Lindsay, and I um am so excited about what you're doing because I completely agree with you.
• 3:22
  SPEAKER_01: You know, I think we highlight the glitz and the glamour of our specialty because it's relatively easy to do that, um, especially on social media where we have dermatologists who are playing very important roles in making sure that good information is disseminated regarding skincare and you know some aspects of medical dermatology as well.
• 3:44
  SPEAKER_01: But I think what your show does is really highlight the medical, the the important medical aspect of our specialty to to take care of patients who are truly sick uh and come in with with rare diseases.
• 4:00
  SPEAKER_01: And I think in a couple of episodes, you really note how it's it's a uh it's a patient who requires multiple specialties.
• 4:09
  SPEAKER_01: So there's a coordination of care.
• 4:11
  SPEAKER_01: And I really liked how a lot of them times they turn to you as the dermatologist to help them understand what's going on because they have little bits and pieces, but you're able to take a 10,000-foot cohesive view of the patient.
• 4:26
  SPEAKER_01: In particular, I'm thinking about the protein C, the acquired protein C deficiency patient who had the perperfulminans, and you were able to come in and say, oh, this is what's going on.
• 4:36
  SPEAKER_01: And it changed the trajectory of that patient's care tremendously.
• 4:39
  SPEAKER_01: I mean, you probably saved his life, let's be honest.
• 4:42
  SPEAKER_01: So, you know, people think of dermatologists, and and you know, uh everybody remembers the Seinfeld episode, right?
• 4:48
  SPEAKER_01: Skin cancer, right?
• 4:50
  SPEAKER_01: And so yes, and that's important.
• 4:53
  SPEAKER_01: But beyond the inflammatory skin disease that we treat as well, there are these more rare but so serious conditions, and and you really highlight that.
• 5:05
  SPEAKER_01: So I just I think that you're doing an amazing job.
• 5:08
  SPEAKER_01: And I just wanted to thank you as well for placing a spotlight on that aspect of what we do.
• 5:13
  SPEAKER_00: Thank you so much, Ted.
• 5:14
  SPEAKER_00: And I'm really glad that you sort of introduced even those up-and-coming next generation healthcare providers, our resident doctors.
• 5:21
  SPEAKER_00: You know, my one of my aims is really to make this work compelling, to put out there in full form really what this is, what this really means, not just to the patients who overwhelmingly uh, you know, clearly need our subspecialty expertise.
• 5:38
  SPEAKER_00: They do.
• 5:39
  SPEAKER_00: The other specialists in the hospital, as you mentioned, need our expertise.
• 5:43
  SPEAKER_00: But there's this immense amount of fulfillment that we can have in our daily work, even though I don't see HTLV one on the daily, as you say.
• 5:52
  SPEAKER_00: But to be involved in these critical moments where the skill set we're provided in residency allows us to walk in the room and literally say, I think you have leukemia by skin findings alone, or you have streptococcal sepsis and I need phoresis and IV antibiotics, you know, those sorts of moments are indescribable, really.
• 6:14
  SPEAKER_00: And yet they're at our disposal.
• 6:17
  SPEAKER_00: If if this work becomes a compelling form of work for the up-and-coming next generation, we will have more dermatologists, I think, participating, choosing to participate in this type of work, which I think will be good for the whole healthcare system at large.
• 6:30
  SPEAKER_01: I think you point to a bigger issue in our specialty, which is so many of our peers are turning towards cosmetics and certainly no judgment on my part at all.
• 6:41
  SPEAKER_01: Um, I I do, I perform cosmetics and and I it's a part of my practice, but I've never been And I don't want to cut you off, but I do want to emphasize as well, I don't disparage one iota of our specialty.
• 6:54
  SPEAKER_00: I do it all as well.
• 6:55
  SPEAKER_00: And I believe in the value of all of the scope of what dermatology has to offer.
• 6:59
  SPEAKER_00: That is that is a holistic uh belief that I have.
• 7:03
  SPEAKER_01: Absolutely.
• 7:03
  SPEAKER_01: And and and, you know, the our peers that are performing cosmetic services as their entire practices are filling a uh a need for our patients and they're doing in a correct way and more importantly in a very safe fashion as well, um, as we are the experts in the skin, hair, and nails.
• 7:19
  SPEAKER_01: But I I do wonder, though, are we losing our focus a little bit as a specialty?
• 7:24
  SPEAKER_01: You know, we're taught and and trained in residency to really treat these six, sick patients, and we come out and and we start losing that ability because of all the different, you know, things that are pulling at us and and the different aspects of our practice.
• 7:40
  SPEAKER_01: So I think that you make a very good point there, which is look, there's there's a real need here, and we need doctors who to go into dermatology to want to treat these very sick patients that present at the hospital.
• 7:53
  SPEAKER_01: And and um one thing else is uh it struck me how often you were called in on a Friday afternoon or Friday night.
• 8:02
  SPEAKER_00: It does seem peculiarly uh yeah, common that that does happen.
• 8:06
  SPEAKER_00: But you're absolutely right.
• 8:07
  SPEAKER_00: You know, when I think about the three real pillars of my mission, it's to give the public a real understanding that maybe they really should be taking their skin findings a little more seriously.
• 8:17
  SPEAKER_00: Maybe this whatever rash that's persisted for, you know, a year, two years, three years might be something of actual significance.
• 8:25
  SPEAKER_00: You know, the second pillar is really to, again, change the position of where dermatology is in the House of Medicine and maybe even to make inroads to change the opinions of those that make the rules we have to play by, namely the payers and the legislators who really have, I think, an incredibly limited idea about what dermatology is or the role we play in changing lives.
• 8:48
  SPEAKER_00: And then lastly, again, this up and coming generation, if we can compel them to see the value, I do hope that that trajectory of more and more dermatologists choosing fields that would otherwise not take care of portions of dermatology that would not take care of maybe our sicker patients, to find the work rewarding enough to say, I want to do this, so that the next 15 years of my career looks like a different trajectory than what the first 15 years of my career look like from a scope and where patient, where uh physicians are practicing in dermatologist.
• 9:18
  SPEAKER_01: It struck me too, Lindsay, how fulfilling it is for you to see these patients.
• 9:23
  SPEAKER_01: I mean, they're they are very difficult patients.
• 9:25
  SPEAKER_01: You it really makes you stretch.
• 9:27
  SPEAKER_01: And I remember in one of the episodes you talk about sometimes I have to reach back 20 years in my memory to think about a patient.
• 9:33
  SPEAKER_01: Uh and so, you know, you as you say, you know, when you walk in the room in a hospital, you know the patient's sick.
• 9:39
  SPEAKER_01: You've gotten some, you've received some information from the referring doctor.
• 9:42
  SPEAKER_01: Um, but otherwise you're really kind of going in blind a little bit, and you are relying on your experience and your knowledge to to help a very sick patient, which, which I think in many cases, for for a lot of us, that's that's a little bit um, I don't know, I think I would be a little scared, quite honestly, if I'm being completely vulnerable.
• 10:03
  SPEAKER_01: I would be scared to walk in, not having lots of experience in the hospital anymore, to go see somebody in the ICU.
• 10:12
  SPEAKER_00: I can totally appreciate that.
• 10:13
  SPEAKER_00: I still get nervous.
• 10:15
  SPEAKER_00: You know, I still have that, oh my gosh, am I going to be able to figure this out here?
• 10:20
  SPEAKER_00: Uh and I would absolutely uh be in the same position you were.
• 10:24
  SPEAKER_00: Had I not been doing this every day since I actually finished my residency in 2007, I don't know that I would be comfortable even engaging in this particular type of practice, which is why I specifically mention that when I look at where I want to leave this profession, when it's all said and done for me, I mean, 15, 20 years from now, when it's over, the door closes gently behind me for the last time.
• 10:45
  SPEAKER_00: I feel this very strong belief that I had a duty recognizing how important the work is, to put that on display and hope to compel the next generation of dermatologists to follow in suit and find a way to make this work in their career before it's too late, before they go another 10 or 15 years without having done it.
• 11:07
  SPEAKER_00: Um, and and on the other end of that, you know, anxiety-provoking, oh my goodness, I'm hearing walking into the hospital from the intensivist, everything that's gone on for the for the past three weeks.
• 11:19
  SPEAKER_00: And I'm wondering if I'm going to be able to help.
• 11:22
  SPEAKER_00: And then I have to say, so many times, I'm driving out of the hospital, and I sort of feel like, you know, it's the final four, and there was a buzzer beater from half court, and the shot is made, and you know, the the basketball player that shoots it jumps in the air and, you know, throws their hand in the air.
• 11:40
  SPEAKER_00: They did it.
• 11:41
  SPEAKER_00: They got it.
• 11:42
  SPEAKER_00: And there's this incredible feeling of having been able to walk in and save someone's life.
• 11:48
  SPEAKER_00: I mean, there's just not something you can really put words to easily in that equation, but it's immeasurable.
• 11:56
  SPEAKER_01: I saw the emotional aspect of it for you as well.
• 12:00
  SPEAKER_01: I think there was one of the episodes where at the end you you were you you started crying and and it was, it had obviously taken a toll on you emotionally to take care of this patient.
• 12:10
  SPEAKER_01: Although you'd done an amazing job, the patient is doing well.
• 12:13
  SPEAKER_01: But you could just tell from that interview um that it had taken an emotional toll.
• 12:20
  SPEAKER_01: That you that, you know, you were really worried about this patient.
• 12:22
  SPEAKER_01: And it obviously thought about her uh and and really just wanted to make sure you're doing the right thing.
• 12:31
  SPEAKER_01: And and you, I think there was a bit of a release there, is is how I saw it.
• 12:35
  SPEAKER_01: Uh and so I can just imagine, yeah, yeah.
• 12:38
  SPEAKER_01: And I can imagine how that feels taking care of the sickest patients on a day-to-day basis.
• 12:43
  SPEAKER_00: Yeah, and and not all of them make it.
• 12:45
  SPEAKER_00: And not all of the times that I'm involved am I able to efficiently necessarily distill down the entire uh hospitalization to a single diagnosis that we can treat.
• 12:56
  SPEAKER_00: And so, with that, the significant highs that come in this work, to be transparent, Ted, you're right.
• 13:02
  SPEAKER_00: There is an emotional exhaustion at times.
• 13:04
  SPEAKER_00: There is um a sense of sadness when you can't meet the needs of a patient and they decline.
• 13:12
  SPEAKER_00: But I don't, I don't think the answer is turning my back on the vulnerable.
• 13:16
  SPEAKER_00: You know, I don't think that the right answer is to say, well, I'm just not going to do that because it's hard.
• 13:21
  SPEAKER_00: On the contrary, you know, I have a skill set that's as great as any, you know, as anyone in that hospital facility to come into that room and potentially offer a solution.
• 13:32
  SPEAKER_00: And frankly, I feel incredibly privileged to have been someone that matched in dermatology so many years ago and been given that skill set.
• 13:40
  SPEAKER_00: And so it's sort of for me this, this um, you know, with great privilege comes great responsibility piece that uh I feel a duty to serve in ways that are most needed.
• 13:52
  SPEAKER_01: I love that.
• 13:53
  SPEAKER_01: Did you do you have a fellowship now, Lindsay?
• 13:56
  SPEAKER_01: A complex medical derm fellowship or we don't have a fellowship.
• 13:59
  SPEAKER_00: I did it, I did a complex medical dermatology fellowship at Tulane, where I had trained in dermatology with Aaron Bow.
• 14:05
  SPEAKER_00: Um, oh my gosh, shout out to Erin Bow, who, you know, has embraced me from day one and I'm in debt, indebted to her forever.
• 14:12
  SPEAKER_00: Uh wonderful woman.
• 14:14
  SPEAKER_00: We do not have a complex medical dermatology fellowship, but we actually train the dermatology residents in inpatient hospital dermatology and complex medical dermatology, both in our outpatient office and then in the hospital setting.
• 14:25
  SPEAKER_01: That's wonderful.
• 14:26
  SPEAKER_01: So the residents can rotate with you and really see what you do.
• 14:28
  SPEAKER_01: And and maybe, hopefully, they they get a little, you know, a light bulb goes off for them and they can really walk into, after they finish residency, walk into or walk through in your footsteps and go into a complex medical derm situation.
• 14:43
  SPEAKER_00: Absolutely.
• 14:43
  SPEAKER_00: I want them to have several of those experiences in their rotation with us where they walk out of the hospital and say, man, that was pretty awesome.
• 14:50
  SPEAKER_00: They relied on me.
• 14:51
  SPEAKER_00: And, you know, also I will just say there's this window for us in dermatology because there are not a lot of us in this space.
• 14:59
  SPEAKER_00: And so you sort of almost get perceived like you hung the moon just by walking in the door.
• 15:04
  SPEAKER_00: You know, they're like, oh my gosh, a dermatologist is here.
• 15:07
  SPEAKER_00: Wow.
• 15:07
  SPEAKER_00: And I was like, well, I've been doing this for 17 years.
• 15:09
  SPEAKER_00: I mean, uh, you know, but they they have this sort of understanding that we would just not show up for some reason.
• 15:16
  SPEAKER_00: And when we do, you know, there's a lot of respect.
• 15:19
  SPEAKER_00: There's a lot of delegation of, you know, uh, please let me know your thoughts.
• 15:23
  SPEAKER_00: What what what do you want us to do?
• 15:25
  SPEAKER_00: Um, which gives us some autonomy and authority in the space, which feels pretty good.
• 15:30
  SPEAKER_01: Lindsay, you you have published your your episodes on YouTube and they're amazing, as I said.
• 15:35
  SPEAKER_01: But didn't you do something also with L'Oreal?
• 15:38
  SPEAKER_01: Was it a separate um series with L'Oreal?
• 15:40
  SPEAKER_01: Okay.
• 15:41
  SPEAKER_01: Thank you so much.
• 15:42
  SPEAKER_00: Yeah, no, we did.
• 15:43
  SPEAKER_00: Yeah.
• 15:43
  SPEAKER_00: So that's called Demystifying Dermatology with Dr.
• 15:46
  SPEAKER_00: Lindsay Ackerman.
• 15:47
  SPEAKER_00: And that is a more medical peer-to-peer uh educational um endeavor with L'Oreal Dermatological Beauty dot us.
• 15:55
  SPEAKER_00: And that is actually going to, I believe, be posted either the latter part of this year or early next year.
• 16:01
  SPEAKER_00: If you are one of the members, I think they have over 200,000 subscribers worldwide.
• 16:07
  SPEAKER_00: Um, and it's, you know, they have a lot of direct peer-to-peer education in the cosmeceutical, you know, sun protective realms.
• 16:14
  SPEAKER_00: But they asked me to really just distill down some common, some more rare dermatologic diagnoses and how to assess patients.
• 16:21
  SPEAKER_00: So um, again, all of this, I really need to step aside and just say thank you to my patients who gave me the privilege of like telling their stories, those that were incredibly vulnerable in the hospital setting and those that were outpatient cases that we used in the demystifying dermatology uh webcast, that still were willing to tell their stories despite having had pretty significant disease burdens, whether that was psoriasis or vitiliga, what we consider primary skin disease.
• 16:46
  SPEAKER_00: Um it's amazing that when patients are given this opportunity to share their story, understanding that they're going to help someone else, it's really uh it's quite incredible.
• 17:02
  SPEAKER_00: In fact, this entire endeavor with Skin Telligent, I had actually contemplated for a few years before I ever stepped foot and decided I was just going to do this.
• 17:10
  SPEAKER_00: And the entire hesitation I had over those first few years in thinking about it came simply from not wanting to make a vulnerable patient in a hospital setting in any way feel more vulnerable.
• 17:22
  SPEAKER_00: You know, oh, great.
• 17:23
  SPEAKER_00: And and by the way, would you like me to fly my filmmaker in and have a camera and lights and a microphone on you?
• 17:29
  SPEAKER_00: And ultimately, I just decided it was sort of one of those, if not me, who, if not now when.
• 17:35
  SPEAKER_00: And it was actually COVID.
• 17:36
  SPEAKER_00: It was 2021.
• 17:38
  SPEAKER_00: And I said, I'm gonna just give this a shot.
• 17:41
  SPEAKER_00: So I approached the first patient.
• 17:44
  SPEAKER_00: And the response, I mean, I think I was shaking and probably, you know, in my voice, it was probably evident.
• 17:49
  SPEAKER_00: I was fairly nervous.
• 17:50
  SPEAKER_00: You know, I took care of the patient in the hospital, I let them know what was going on, what I thought we were going to do.
• 17:55
  SPEAKER_00: I left the room, and then I went back and said, you know, I I I want to ask you something, but I really want you to know that there's there's this your answer can be whatever you want for you, whatever you feel is best.
• 18:07
  SPEAKER_00: I'm still going to take care of you exactly the same way.
• 18:10
  SPEAKER_00: And I said, you know, I I am actually putting together a production and telling stories about how skin is an incredible window into hidden internal pathology.
• 18:18
  SPEAKER_00: Um, would you ever be interested in telling your story?
• 18:20
  SPEAKER_00: My idea is to give patients information that would ultimately potentially help them and maybe even encourage other doctors to know more about this disease.
• 18:28
  SPEAKER_00: And the first patient was a slam dunk.
• 18:31
  SPEAKER_00: Oh my gosh, you mean like I could help someone else with this, like or help another doctor know what this is?
• 18:36
  SPEAKER_00: Definitely.
• 18:37
  SPEAKER_00: I'm happy to do it.
• 18:38
  SPEAKER_00: And the next patient said something that was very similar.
• 18:40
  SPEAKER_00: And the next patient that said something that was very similar.
• 18:42
  SPEAKER_00: Now here we are, it's 2021.
• 18:44
  SPEAKER_00: We're in the middle of a pandemic.
• 18:46
  SPEAKER_00: There could not be a greater political schism.
• 18:48
  SPEAKER_00: You know, some people want to wear masks, some people don't want to wear masks.
• 18:50
  SPEAKER_00: We have a morgue outside our hospital in a big truck.
• 18:53
  SPEAKER_00: I mean, it was a bad time.
• 18:56
  SPEAKER_00: And yet here's this glimpse into humanity spoken by someone who's incredibly vulnerable in a hospital, sick, that just says, Oh, well, if if my experience can help someone else, I'm happy to do it.
• 19:10
  SPEAKER_00: And it was this eye-opening moment for me where my entire hesitation was wiped away.
• 19:17
  SPEAKER_00: And I realized not only was this something that they were open to, they wanted to do it.
• 19:23
  SPEAKER_00: And so with both Skintelligent and the demystifying dermatology, it's been the same theme.
• 19:29
  SPEAKER_00: I think we have people uh in our presence all the time that are really good people that really believe in humanity.
• 19:36
  SPEAKER_00: They believe in letting their experience not be the last one, but rather how this can maybe change what the future looks like for others.
• 19:44
  SPEAKER_00: And that to me is something beautiful to put on display itself.
• 19:47
  SPEAKER_01: I have to tell you, as I was watching the episodes, I I felt exactly the same way.
• 19:53
  SPEAKER_01: And I think anybody who takes care of patients would and watches Skin Telligent would really it is so unbelievably giving of your patients to tell their story.
• 20:05
  SPEAKER_01: Especially for the ones where, you know, it's an ulcerating disease or they're in a ton of pain.
• 20:11
  SPEAKER_01: I mean, you had one poor woman who had just become blind because of vasculitis.
• 20:16
  SPEAKER_01: And you know, they are really in in terrible straits.
• 20:20
  SPEAKER_01: And and for them to allow their story to be told such that the rest of us get to benefit from that in terms of our education.
• 20:30
  SPEAKER_01: And also in terms of um understanding humanity and and understanding, and as you say in the series, you know, we treat the patient, we don't treat the disease.
• 20:38
  SPEAKER_01: And I think you do an amazing job of that in the series.
• 20:41
  SPEAKER_01: Um, and and kudos to you again for that.
• 20:45
  SPEAKER_01: But it is um it it really kind of makes you realize how these patients understand that doctors are human as well, and and we need to learn, we make mistakes, but we also try and improve ourselves all the time.
• 20:59
  SPEAKER_01: But we can't do that without the help of our patients.
• 21:01
  SPEAKER_01: And I think that's what they were trying to do, honestly, is is they were trying to make sure that other people watching this got better because of their experience.
• 21:10
  SPEAKER_01: And I I would was so appreciative of the patients in that series as well.
• 21:14
  SPEAKER_01: I think, you know, for them to share that experience, as you said, such a vulnerable experience was incredible.
• 21:23
  SPEAKER_01: Um, and and I, for one, learned a ton from that.
• 21:26
  SPEAKER_01: It reminded me of so many of these diseases that I hadn't treated in forever, but it also reminded me of how to be a doctor.
• 21:33
  SPEAKER_01: And uh, so it was incredible.
• 21:35
  SPEAKER_00: Yeah, and there are a lot of great ways to have meaningful relationships with patients.
• 21:39
  SPEAKER_00: Uh, most of them exist within the office.
• 21:41
  SPEAKER_00: You know, one of the unique things about when you end up getting welcomed into someone's home to film sort of, you know, the end product of this, you know, investigative journalism uh skintelligent episode uh is that there is a closeness necessarily that comes of that.
• 21:55
  SPEAKER_00: You meet their family, you meet their children, you see their dog.
• 21:59
  SPEAKER_00: And um It's been like a really cool experience for me to actually get to know these people too, on a level I would never have otherwise gotten to know them.
• 22:07
  SPEAKER_00: So most definitely they are the generous ones.
• 22:12
  SPEAKER_00: I get to be along for the ride.
• 22:14
  SPEAKER_00: I'm so grateful in so many, so many ways.
• 22:18
  SPEAKER_01: It's almost like an old country doctor that gets to go to people's homes and and takes care of them from birth to death, right?
• 22:24
  SPEAKER_00: Yeah.
• 22:24
  SPEAKER_00: Right.
• 22:24
  SPEAKER_00: I mean, again, not on the daily.
• 22:27
  SPEAKER_00: Not on the daily.
• 22:27
  SPEAKER_00: You know, that would be tough to work into this to the schedule.
• 22:30
  SPEAKER_00: But, you know, when you are filming someone's experience and you want to follow up with them outpatient uh in your office and then maybe to see how this is translated to their home.
• 22:37
  SPEAKER_00: For Elisa, the woman who had gone blind from her urticarial vasculitis diagnosis, seeing how she navigated her home.
• 22:43
  SPEAKER_00: I mean, this was a reality.
• 22:45
  SPEAKER_00: She was a young mother of two children who had to figure out how she was going to live in this environment again.
• 22:53
  SPEAKER_00: Um, and she fortunately, you know, we we were able to salvage a bit, a little bit of her sight so she could see her children again in in some, you know, small um visual portion of her field.
• 23:04
  SPEAKER_00: But uh yeah, I mean there's there's like there's kind of this satisfying end point to telling the story to really see how they're getting along.
• 23:13
  SPEAKER_01: Yeah, amazing.
• 23:15
  SPEAKER_01: So Lindsay, as you think about kind of what's next, I know you said season one, so I'm thinking, is there a season two already in production?
• 23:22
  SPEAKER_01: Okay, that's amazing.
• 23:23
  SPEAKER_00: Yeah.
• 23:24
  SPEAKER_00: So season two, we have footage for season two, you know.
• 23:27
  SPEAKER_00: Um the the entire product thus far, Ted, has been executive produced, created, and financed by me.
• 23:34
  SPEAKER_00: So uh sponsorships, uh a big ask at this point.
• 23:37
  SPEAKER_00: So in before I go into full production on season two, I'm I'm currently in the process of seeing if there are stakeholders that would want to have their name on some of these, um, some of the content or on our website.
• 23:47
  SPEAKER_00: And we've had some people show up.
• 23:49
  SPEAKER_00: So that's been pretty good.
• 23:51
  SPEAKER_01: I wonder if we could do a GoFundMe from dermat the dermatology community, because I think you're benefiting the community so much that it it would be something that I would be interested in in helping out because I think you know you you're really doing such a service to us, um, not only to the patients, but also to our specialty.
• 24:10
  SPEAKER_01: And so it's it's really something that I think dermatologists themselves should help fund this.
• 24:14
  SPEAKER_01: Um, obviously industry would be amazing.
• 24:17
  SPEAKER_01: Um, and this would be such goodwill for industry uh to have their backing and their name behind this this series.
• 24:24
  SPEAKER_01: Uh, but otherwise, you know, maybe maybe it's something that that we can get other derms to help chip in, because it certainly should not all be on your shoulders.
• 24:34
  SPEAKER_00: Well, thank you for that.
• 24:35
  SPEAKER_00: I appreciate that very, very much.
• 24:37
  SPEAKER_00: Uh, we are now a 501c3.
• 24:39
  SPEAKER_00: So um if anyone does want to, and we can talk offline about the GoFundMe, but Skin Telligent Dermatology Undressed is the name of the 501c3.
• 24:48
  SPEAKER_00: And this is our flagship product, the Skintelligent with Dr.
• 24:50
  SPEAKER_00: Lindsay Ackerman uh YouTube series.
• 24:52
  SPEAKER_00: We're also producing some other educational materials that are going to go into the 501c3 to again continue the dialogue, continue the presence of dermatology uh and the scope of what we do and who we served in the public arm aim.
• 25:07
  SPEAKER_01: Do you think that this might be your future?
• 25:09
  SPEAKER_01: Do you think that you would start moving into production and kind of highlighting maybe dermatology but other specialties in this way?
• 25:18
  SPEAKER_00: Yeah, that's a great question.
• 25:20
  SPEAKER_00: Uh nothing's off the table, although my clinical work is what drives me what I wake up every day to go do is to really literally be in a room with a patient and hold their hand and ask about their child as we're talking about whatever the you know issue of the day may be.
• 25:33
  SPEAKER_00: Um I don't, I don't know that I'm ready to give that up at all.
• 25:36
  SPEAKER_00: Uh I think I would need to still have a significant portion of my career be involved in clinical care.
• 25:41
  SPEAKER_00: But interestingly enough, as I kind of think, you know, from 30,000 feet and look down at my life, uh, when I was actually choosing which undergraduate institution to go to, I chose the University of Pennsylvania because they had a wonderful pre-med curriculum and they also had the Annenberg School of Communications, a journalism major, which I had actually contemplated heavily, swayed into medicine quickly, loved everything about my pre-medical curriculum, and just went from there.
• 26:05
  SPEAKER_00: Uh, and it's just so interesting, full circle this many years later, that I have found myself brought back into sort of this medical journalism uh piece, which I hadn't even thought about till recently.
• 26:18
  SPEAKER_01: Well, I just I think it's amazing, Lindsay.
• 26:20
  SPEAKER_01: Thank you so much for joining us.
• 26:22
  SPEAKER_01: This is um Dr.
• 26:23
  SPEAKER_01: Ted Lane with Dr.
• 26:24
  SPEAKER_01: Lindsay Ackerman.
• 26:26
  SPEAKER_01: Uh and remember, Lindsay's show is called Skin Telligent.
• 26:29
  SPEAKER_01: You can see it on YouTube.
• 26:31
  SPEAKER_01: Um please, please, please watch and and tell everybody, uh, in at least in our field, about this amazing show.
• 26:39
  SPEAKER_01: I really think it needs to be disseminated widely.
• 26:41
  SPEAKER_01: I'm certainly going to do my part.
• 26:43
  SPEAKER_01: Uh Lindsay, thank you so much for your time.
• 26:45
  SPEAKER_00: Ted, couldn't be couldn't have been greater.
• 26:48
  SPEAKER_00: Thank you so much to have had me on your program.
• 26:50
  SPEAKER_01: It is my pleasure.
• 26:51
  SPEAKER_01: All right.
• 26:52
  SPEAKER_01: Thanks, everybody.