Dr Sauder is past chairman of the department of dermatology at the Johns Hopkins School of Medicine in Baltimore, MD. He is also past chief of dermatology at University of Toronto in Ontario, Canada, and past head of dermatology at Princeton University Medical Center in Princeton, NJ. Dr Sauder has held senior positions with biotechnology companies and has assisted in the development of numerous novel biologics. Currently, he practices general dermatology in Toronto and consults for several biotech companies.
Dr Sauder was instrumental in developing the field of cutaneous cytokine biology by identifying the role of certain immune system molecules, interleukins, and cytokines in inflammatory skin diseases and tumors. He has authored more than 200 peer-reviewed publications and is the recipient of numerous national and international awards.
Q. What part of your work gives you the most pleasure?
A. Working with young and talented colleagues, including my son, and treating diseases where our interventions result in a major improvement in patients’ quality of life.
Q. Who had the greatest influence on your career?
A. I have had many outstanding mentors from deans to chairmen of medicine. Perhaps the two who made the greatest impact on my career were Dr Don Rosenthal from McMaster, who taught me a love for learning and excellence in clinical dermatology, as well as Dr Steve Katz at the National Institutes of Health, who taught me critical research thinking and contributed greatly to my scientific discovery.
Q. Are an understanding and appreciation of the humanities important in dermatology and why?
A. As our profession is driven more and more by technologic advances, including most recently artificial intelligence, it becomes essential to combine these technical skills with a humanistic approach. Grounding in humanities can imbue not only critical thinking but also empathy. Through exposure to literature, philosophy, culture, and history, dermatologists can become much better rounded as individuals, which in turn contributes to clinical excellence.
Q. Which patient had the most effect on your work and why?
A. I learn every day from patients. From some patients, I learn lessons in gratitude, for example, how my septuagenarians approach each day with a zest for living. From some patients (luckily, few in number) I learn the antitheses of gratitude. There are patients who cannot be satisfied no matter what is offered. From these patients, we learn tolerance.
Perhaps the most memorable patient I had was a patient with pemphigus who I saw when I first became chief at the University of Toronto. He had extensive pemphigus vulgaris (in the days prior to rituximab). This patient was treated with intravenous immune globulin, mycophenolate mofetil, systemic steroids, and then plasmapheresis and pulsed cyclophosphamide. At this point he approached me and asked: “Will I die soon?” Perhaps it was the overconfidence of my earlier years, but I stated: “Not only will you not die—you will be golfing by the summer.”
This turned out to be an accurate forecast. Years later, I was camp doctor at a summer camp when a young counselor came up to me. He recounted his father’s history with me and stated how my words had made a major impact on his father. I am a little more cautious now as I have gained respect for what we say and how our words can have a major impact on patient’s lives.
Q. What is the greatest political danger in the field of dermatology?
A. There has been an astonishing expansion of our molecular understanding of the pathogenesis of skin disease, which has led to major advances in medical, surgical, and cosmetic dermatology over the past few decades. Immune modulatory drugs and biologics have revolutionized how we treat dermatologic diseases. At the same time, advances in lasers, fillers, and toxins have led to incredible achievements in facial rejuvenation and body shaping. Our greatest political danger is that we may be regarded as purveyors of technology and not viewed as an integral part of the health care team.
