Spotlight on: Robert Gniadecki, MD

Dr Gniadecki is a professor of dermatology at the University of Alberta in Edmonton, Canada. He received his medical degree from Warsaw Medical School in Poland in 1991 and 3 years later obtained his PhD from the Faculty of Health Sciences at Copenhagen University in Denmark. In 2001, he earned a specialty in dermatology from the Danish National Board of Health, and in 2010 he was appointed as a full clinical professor at the department of dermatology at Bispebjerg Hospital in Copenhagen. In 2015, he began his current position as director of the division of dermatology at the University of Alberta, where he also leads the Multidisciplinary Cutaneous Lymphoma Clinic. His main clinical interests are cutaneous lymphomas, psoriasis and autoimmune skin diseases, and surgery of skin cancer.

Q. WHAT PART OF YOUR WORK GIVES YOU THE MOST PLEASURE?

A. I am fortunate to be a physician-scientist and both aspects of my work, clinics, and research are sources of pleasure. There is nothing comparable to the thrill of an original discovery, but every scientist also knows that research work is full of disappointments and frustrations. On those disastrous days when nothing works in the lab, papers get rejected, and grant applications turned down, I can still go to my clinic and feel great practicing dermatology with confidence and competence.

Q. WHO IN THE FIELD HAS INFLUENCED YOU?

A. I was extremely lucky to meet a number of great people who helped me become who I am by encouragement, practical help, or support. Dr Stefania Jablonska, who was a professor of dermatology in Warsaw during my years as a medical student, was one of them. The 1980s in Poland were dark years for medicine: lack of funding, horrible conditions in the teaching hospitals, and a general collapse of the public health care reflecting the bankruptcy, decline, and fall of the political system of that time. But the dermatology clinic in Warsaw was an exception. Dr Jablonska was a world-renowned dermatologist and scientist, and her research was outstanding. I remember her introductory lecture to the students when she said: “Well, dermatology is just modern immunology applied in the clinics.” I was impressed, dazzled, and hypnotized, and that was the moment I decided to become a dermatologist.

Q. WHAT IS THE BEST ADVICE YOU HAVE RECEIVED?

A. To profit from good advice takes more wisdom and courage than to give it, so I am afraid that like most people I largely learned from my own mistakes. One remark, however, quoted from Machiavelli by my good friend and great dermatologist, Dr Gregor Jemec, got stuck in my memory and I often recall it in the times of adversity: “Where the willingness is great, the difficulties cannot be great.”

Q. ARE AN UNDERSTANDING OF THE HUMANITIES IMPORTANT IN DERMATOLOGY?

A. Skin disease has fascinated artists, poets, and philosophers throughout the centuries. Think, for example, of leprosy, which was considered to be God’s punishment for sins. This old prejudice is still echoed in social ostracism that patients with psoriasis or vitiligo experience even today. On the other side of the coin, skin imperfections may also be an important aspect of individuality. Just as an example, The National Portrait Gallery in London exhibits at least 4 portraits of Oliver Cromwell and in 2 of those pictures, we see mild rosacea and a not a very flattering dermal nevus over his right medial eyebrow. The mighty Lord Protector could easily ask the painter to produce a more pleasing image of his face, but for some reason he chose to accept (or perhaps even encouraged) the realistic likeness. These are interesting questions to consider, especially by anyone who practices cosmetic dermatology.

Q. WHAT IS THE GREATEST POLITICAL DANGER IN THE FIELD OF DERMATOLOGY?

A. Leaders in our field mention cannibalism of medical dermatology by cosmetics, loss of “serious” diseases to other specialties, and an image of dermatology as a luxury specialty dealing increasingly with trivia. I think that at the root of all these problems is the language of dermatology. Unlike most other medical specialties who speak the language of function (eg, liver failure, heart insufficiency, respiratory distress…), we never talk about skin failure or the functional consequences of skin diseases. I am afraid that with a possible exception of some university centers, the dermatologists lost natural ties to other medical specialties and the price to pay will be marginalization of our specialty.

Dr Barankin is a dermatologist in Toronto, Ontario, Canada. He is author-editor of 7 books in dermatology and is widely published in the dermatology and humanities literature.