A Conversation With Torello Lotti, MD, MD (Hon)

Q. Which patient had the most effect on your work and why?

A. There is one patient who I will never forget. He was a handsome young man in his 20s and a model at one of the major fashion companies in Italy. He used to come and see me at my office because of some acne that was almost invisible. He would tell me that the acne gave him bad feelings, he felt completely out of the circle of his job (fashion), and he lost self-esteem because of his condition. I understood that his problem was body dysmorphic disorder (dysmorphophobia). His acne could be treated easily and there really was little to see. He became increasingly obsessed due to his disorder, and I started to take care of him in cooperation with a psychiatrist and psychologist, meeting with him 3 times a week to give him all of what was possible in terms of mental and cutaneous help. One day he came to me with a picture he had drawn and told me, “I need to become like this man.” His drawing was more like a cartoon than a human being. I said, “You know this is not real skin, but we will do our best to achieve that, and we will also work on your psychological aspects.” Three days later, I was informed that he had committed suicide. This is a very sad story. We should never forget how important our commitment is to our patients, and we must sometimes accept failing even when we try our best.

Q. What is the best piece of advice you have received and from whom?

A. At the beginning of high school, I wanted to be a diplomatic figure. So, I went to the university to sign up for the school of international politics and affairs. The line was long and on the parallel line there was one of my friends from high school who was trying to get into the school of medicine. Because my line was stopped, I followed him, and we started speaking about our life and dreams for the future. Suddenly, I arrived in front of the office of the school of medicine, and they asked me, “Where is your form for enrolling in the school of medicine?” When I replied that I did not fill it out, they gave me the form. I really did not want to become a medical doctor, I wanted to become an expert in foreign affairs but for unknown reasons, I filled out the form and entered the school of medicine. When I came back home, my father and mother said, “So, we will have a diplomat in our family.” And I replied, “What if I enroll in the school of medicine?” My mother looked at me and said, “Whatever thing you will do, you will be the first one in your field and you will be our beloved child.” I was almost crying and told them, “Well, I have just enrolled in the school of medicine” and my mother said, “Oh, so you received my advice in advance. You will be a good doctor.” This is the best advice I have been given in my life.

Q. Are an understanding and appreciation of the humanities important in dermatology and why?

A. Doctors have always been included in the category of philosophers and, in some cases, being a doctor is like being a member of the clergy. A doctor is more than somebody who takes care of your blood pressure, or your blood glucose levels. A doctor is more than someone who diagnoses what is going on with your eczematous skin and what is the future of a mole on your skin. The doctor is committed to giving you the best chance at life and ensuring the best quality of life according to your health, both physical and psychological. To do this, we must be well introduced to the humanities, such as languages, philosophy, history, literature, art, and so on.

Q. Who was your hero/mentor and why?

A. My mentor was Emiliano Panconesi, who was a professor and chair of dermatology at the University of Florence. He was a founding member of the European Academy of Dermatology and Venereology (EADV) and its first president. In fact, in 1989, we organized the first EADV Congress in Florence, Italy. He was not only a man of science, but he was also a writer and a painter. Thanks to him, I became the chief editor of the Journal of the European Academy of Dermatology and Venereology and found enough energy to become a full professor of dermatology when I was still quite young. I must thank Professor Emiliano Panconesi for inspiring me.

Q. What part of your work gives you the most pleasure?

A. What gives me the most pleasure is the transfer of knowledge to the next generations. Each dermatologist, after a long career, understands that few things are written in books and even fewer issues are clearly discussed in scientific papers. In my opinion, the most important part of my work, and the work of any academician, is to transfer all of what we know to others, to the next generations, our pupils, and the scientific community in general. This is like sowing a single seed that will, for sure, bring the growth of many trees, which will generate delicious fruit.