Indian Journal of Dermatology
: 2012  |  Volume : 57  |  Issue : 4  |  Page : 333--334

Under My Skin

Arijit Coondoo 
 Department of Dermatology, KPC Medical College and Hospitals, Kolkata, India

Correspondence Address:
Arijit Coondoo
Department of Dermatology, KPC Medical College and Hospitals, Kolkata

How to cite this article:
Coondoo A. Under My Skin.Indian J Dermatol 2012;57:333-334

How to cite this URL:
Coondoo A. Under My Skin. Indian J Dermatol [serial online] 2012 [cited 2021 Jun 12 ];57:333-334
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Full Text

[AUTHOR:1]Author: Dr. Alan Rockoff, M.D.

Publisher: Mill City Press Inc, 212, 3 rd Avenue, Suite 290, Minneapolis, MN 55401, USA.

Year: 2011

Price: US $15

Paperback: Pages 204


Dermatology as a specialty has traversed a long distance since the early days when it was considered not only a subspecialty but also a distant cousin of Medicine. Till the eighth decade of the 20 th century it seemed to have no right to be placed on the same pedestal as its more prestigious cousins, pediatrics, cardiology and neurology. With the gradual entrance of dermatosurgery and cosmetology and with increasing importance being given to the relationship clinical dermatology has with other specialties, the tide has turned and more than three decades down the line dermatology has entered the hallowed portals of the leading professional fields in the medical world.

Dr. Alan Rockoff, M.D., became "a dermatologist by accident" at a time when dermatology was considered to be "tangential to internal medicine." Thirty two years on, he looks back with characteristic wit and compassion at a profession that has provided him with a lot of insight into the vagaries of human behavior. His book "Under My Skin" has the subtitle "A dermatologist looks at his profession and his patients," and is divided into two sections "Practice" and "Patients" though there is a distinct but unavoidable overlap between the two.

The first section titled "Practice" deals with his profession. Starting from the very first moments of his practice, the initial tottering, the relationship with other doctors and the finer skills needed to build up a good practice, he moves on to the rapidly changing face of modern-day practice where the Internet and modern gadgets dominate over humans, where history-taking and other mundane matters are delegated to medical assistants and counseling is offered by other personnel. Dr. Rockoff recognizes the pulls and pressures of modern-day commercialism, consumerism, bureaucracy and medico-legal issues but rightly rues the fact that the ultimate victim of this change in the pattern of practice is the basic one-to-one human relationship between the doctor and his patient.

It is this relationship he explores in the second section. The variety of patients he has encountered during his sojourn in the practicing world of dermatology presents an interesting mix. The first narrative about Letitia's brave fight to rehabilitate Stacey and the latter's miraculous recovery is captivating and sets the tone for the later chapters. Each of these chapters, written with dollops of humor, reveals Dr. Rockoff's not so inconsiderable observational powers and deep insight into the patients' psyche. In his "Remarks to the Medical Youth Forum" appended at the end of the book, he rightly comments "Though technology advances and systems change, people don't."

Dr. Alan Rockoff started his practice in Boston in 1979, the same year that this reviewer in Kolkata (or Calcutta as it was then known) started his sojourn in the fascinating world of dermatology as a young postgraduate. The two practicing fields were set thousands of miles apart in two completely different milieus. Yet one finds a lot of similarity in the experiences regarding the patients and their relatives, doctors and their gadgets, the high and low points of practice, and the distinct change in the attitude of our colleagues in other specialties toward us. It is obvious that the experiences of any dermatologist shall be the same anywhere in this globe, and one can empathize with the attitude of Dr. Rockoff toward his patients and vice versa, whatever be one's geographical location.

The essays are written in a style that is laid-back at times, racy at others, but extremely witty all the way. He looks at his patients with sympathy, at his colleagues with respect and at his profession with a lot of candor. His deep insight into the world of dermatology is reflected in almost all the pages of the book, yet he avoids the trap of sermonizing to his readers.

In his preface, Dr. Rockoff writes "Somehow, becoming a dermatologist still feels like an accident. A pleasant one." Among all the tales of joy and sorrow, of success and disappointment there is one common thread - Dr. Rockoff has immensely enjoyed the experience of his sometimes smooth, sometimes roller-coaster ride in the practice of dermatology during all of 32 years. With this background in mind, one wishes that the book could have a more pleasant and interesting title other than the rather creepy "Under My Skin".

Overall, the book is a must-read not only for all dermatologists, young and old but also for laymen who may be surprised at the detailed, analytical and sympathetic manner in which a dermatologist beholds them.