On Being Insatiable

Pity New England Patriots fans. The Super Bowl is over, and they have another win in the books, but they can’t relax and enjoy their 6th championship. If next year rolls around without another victory­, they’re going to be disappointed. Meanwhile, Cleveland Browns fans can be happy that they won a game this season, ecstatic that they were nearly 0.500 and not the cellar dweller of their division. Next year, however, they’ll also want more. 

Humans are never satisfied.  We look at where we are and think only about where we want to be. Rarely do we reflect on how much worse off circumstances were only a short time ago and appreciate the here and now. Imagine how happy previous generations would be if you offered them modern homes, indoor plumbing, unlimited food and clean water, smartphones, cars, 3 times their current life expectancy, and an incredibly fulfilling occupation helping end the suffering of people with skin disease. But, there is a catch. They would have to work with an electronic medical record (EMR), and some of their patients would be dissatisfied. Would they have complained about having to use an EMR, or would they have appreciated the lot in life you were offering them?

 Not that many years ago, the best psoriasis treatments we had were Goeckerman therapy, methotrexate, and acitretin. Back then, the idea that we could clear psoriasis seemed impossible. Our ability to manage psoriasis now is vastly improved. But are we satisfied? Patients think it sure would be nice to be able to achieve skin clearance without having to take shots. In this issue, Brooke Rothstein, MD, and David Rosmarin, MD, tell us about one possible future oral treatment options for psoriasis that may help patients achieve that goal, beginning on page 22. We also spoke with Joslyn Kirby, MD, on the future of rosacea treatments using combination therapies, beginning on page 38. And our cover subject, Robert Brodell, MD, has some thoughts on how we can apply what we’re learning about the immunocompromised district to future treatments in skin disorders, starting on page 35. 

The innate human drive to improve keeps us constantly striving for more. And although there is no way for any of us to ever accomplish enough to be truly satisfied, just knowing that fact can help keep things in perspective and make life more enjoyable.