“YOU NEED TO LISTEN TO
WHAT’S BOTHERING
YOUR PATIEN TS A ND HOW
IT MAKES THEM FEEL”a junior doctor. I had a young girl come in
with horrible psoriasis – the skin gets itchy,
cracks and bleeds. As a GP registrar, there
was really nothing I could offer her, which
inspired me to read up on various skin
conditions. Now I know the mind-blowing
results that dermatology can offer.
“I now specialise in cutaneous lymphoma
[cancers of white blood cells that primarily
involve the skin]. It occurs in about four
people per million, so it’s very rare.
“I work privately, and come to Melbourne
to work at the Peter MacCallum Cancer
Centre. Patients often present with
what they think is eczema. When
people hear lymphoma they think
they’re going to die. But if people
have a very low grade of the disease
they have the same overall survival
rate as the age-match population, so
my job is to educate and, in more
serious cases, manage quality of life.
“When I started dermatology
I thought skin couldn’t involve that
much. Then we got four massive
textbooks and I thought: ‘There is no
possible way that a: there is that
much to k now and b: I’m ever going
to know it!’ You have to accept that
for a while your life will be
completely unbalanced and
everyone around you has to live with
it. By the end of exams last year, my
poor boyfriend remembers me in the
same old turtleneck and Ugg boots
every day. We never went out. Now
I’m getting my life back.
“It’s an exciting time for dermatology
and being able to provide effective
management plans for people with nasty
skin diseases. It’s not just skin, the
psychological impact skin diseases has on
patients should not be underestimated,
both from a cosmetic point of view and
a symptom point of view.
“Those with severe psoriasis can become
very socially isolated because people think
they are infectious. They are often under the
misapprehension that nothing can be done
and don’t ask for help. It is so fulfilling to
see the change in their demeanour once
they are treated. People shouldn’t feel they
just have to live with their skin disorder.
“Empathy is not something you can
teach, you learn it along the way. You need
to listen to what’s bothering your patients
and how it makes them feel.
“People continue to want more from
their skin and therefore more from their
dermatologist. The anti-ageing push needs
to be managed responsibly. There’s nothing
wrong with ageing gracefully, but
dermatologists can suggest how to slow
that process down. There is nothing worse
for your skin than smoking and excessive
sun exposure – that’s obvious. I don’t use
soaps and recommend moisturising
sunscreens and creams with alpha-hydroxy
acids in them.
“I love the fact there is never a dull
moment at work – you are constantly
learning from patients, journals and
professional development programs that
keep you up to date with new research.”DR MICHELLE RODRIGUES
is a consultant dermatologist in
Melbourne at St Vincent’s Hospital
and the Royal Children’s Hospital.
“I was attracted to the diversity of
dermatology and saw incredible mentors
along the way who seemed very happy with
their choice. It is one of the few specialities
where you can see both children and
adults, can treat skin cancer, use lasers, and
often see patients for many years and
develop a relationship with them.
“This disease is visible, unlike high
cholesterol or kidney problems. With skin,
everyone knows, so it affects life, work
and relationships. Treatment can change
a person’s whole life.
“The major shift in the past 10 years has
been the patient demographic. Starting
out, the patients were mainly Caucasian,
with skin cancer issues and so on. Now
people from Pakistan, Asia and Africa
are coming in and challenging the
dermatologist to understand the nuances of
other kinds of skin.“My particular area of interest is in
pigment and skin of colour, which I saw as
an area of real need as a young graduate.
My own parents are of Indian descent –
half Indian and half Portuguese.
“There are a lot of myths about ethnic
skin. People with skin of colour can still
get skin cancer. It is also harder to detect,
so it can get diagnosed much later. I have
studied with experts in pigment disorder
and skin of colour overseas.
“Someone in my own family had vitiligo,
a condition in which the immune system
attacks the skin’s own
pigments causing the skin to
become white in that area.
They were told nothing could
be done. When I shared this
news overseas, practitioners
said: ‘Are you serious?’ People
of colour with skin disorders
or pigmentation no longer
have to walk away
disheartened. Or worse ... in
some cultural groups, a child
could be completely ostracised
for having a treatable and
noninfectious condition. We
have effective treatments
including medicated creams
and ointments, laser and light
therapy, and a new technique
called non-cultured epidermal
cell grafting.
“When there is a leap
forward like this, I’ve seen
everything from tears of joy to complete
dismay: ‘How can this be, I’ve been told for
the past 25 years this is impossible.’
“Of course, dermatology can involve
general maintenance, too. Everyone knows
that sun protection is very important. Now
medical evidence shows prescribed topical
vitamin A-derived creams can even out
pigmentation and fine lines, and increase
luminosity. Inner peace and a simple
skincare routine – oil-free, fragrance-free
cleanser, moisturiser and sunscreen daily –
can do wonders. Regular dermatologist visits
ensure everything is in good order.
“A dermatologist has to be a people person.
There are the difficult conversations about
melanomas (at least one a week), cancers and
end of life. But it can also be very lighthearted
when people are overjoyed with a result.
Today, as a doctor, my spirituality gives
me a sense of inner peace. It’s important
because the work is intense. As with any
profession, if there’s passion behind what
you’re doing, it naturally gives you all the
momentum you need.” ■From left: Dr
Rudd, Dr Newland
and Dr Rodrigues.128 – MAY 2015
vogue HEALTH
PHOTOGRAPH: JUSTIN RIDLER CLOTHING: DR RUDD WEARS A SCANLAN THEODORE TOP AND SKIRT DR NEWLAND WEARS A BOSS SHIRT AND SPORTMAX SKIRT DR RODRIGUES WEARS A WILLOW SHIRT AND CARLA ZAMPATTI SKIRT DETAILS LAST PAGES SHOT ON LOCATION AT THE SKIN & CANCER FOUNDATION, MELBOURNE