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Chief Medical Editor Message

It’s More Reasonable Than It Appears

October 2019

Dr Feldman, Chief Medical Editor of The DermatologistBack in 2008, an article in US Airways Magazine caught my eye (as an aside, neither the magazine nor the airline exist anymore. Oh, how times change so quickly!). It was an interview with actor Dennis Farina (sadly, he passed away, too, in 2013), an Italian-American character actor, well recognized from playing roles in law enforcement or in crime on television and cinema. Farina had experience to back up those roles. Before becoming an actor, he was a Chicago policeman for 14 years and continued as a policeman while acting on the side for another four.

In the interview, Farina described what he had to do to be an actor. It wasn’t romantic or exciting. “I learn my lines. I show up on time. I do my job,” he said. He made it sound downright pedestrian.

What struck me most is when his interviewer tried to probe deeper, trying to get Farina to talk more about the craziness behind Hollywood’s glitz and glamour, Farina responded, “There are more reasonable things going on in Hollywood than unreasonable things. The unreasonable stuff makes good copy, but most people are doing what they should.” Oh, how the unreasonable stuff makes good copy! The more unreasonable and outlandish it is, the more likely it is to make the cover of the rags at the grocery store check-out along with their television and internet counterparts.

Farina’s observation sums up a critical point. Outliers are publicized and noticed; the everyday normal is often ignored. A quote (mis)ascribed to Mark Twain says it well too: “If you don’t read the newspaper, you’re uninformed. If you read the newspaper, you’re misinformed.”

Focus making the reasonable a part of your dermatology practice. For example, Dr Wendy Roberts discusses how to ask about hair loss while examining the scalp during a full body exam on page 42. As she notes, it’s easy to build a hair practice when you add in that little extra step. It might even be practical to start adding platelet-rich plasma to your treatment toolkit as well (you can read more about its application in aesthetic dermatology starting on page 44). Some of the onus for incorporating the reasonable can fall on our patients as well. The National Rosacea Society introduced a handy new guide to help patients identify flareups; you can read more about it or find out how to get your own copies on page 38.

Twain also wrote, “the newspapers fetches you the troubles of everybody all over the world, and keeps you downhearted and dismal most all the time.” Yet, there is so much good, so much peaceful, so much normal behavior going on all the time.” Yet, there is so much that we just don’t see or notice, orders of magnitude more than the troubles. If Farina was right that even the things going on in Hollywood are mostly reasonable, we should find our practices and our world a much more reassuring place.