Job satisfaction: the passionate dermatologist, the chair, and the metal hook

As a teenager I had terrible skin.  It was just average-bad until I was nineteen, at which point it went absolutely Vesuvian, requiring Accutane to tame it.  Each pill came in a nearly impregnable (hah) blister pack which required multiple steps to open: first, slide open the box and see the outline of a hydrocephalic fetus; second, remove a serrated paper tab with the silhouette of a pregnant woman and the red ban-symbol through it, and finally pop the liquid-filled gel pill through a rather tough plastic laminated foil surface.  (The packaging shown at right is nowhere near as extreme.) I would later give the paper tabs with the "no pregnancy" symbol to friends and co-workers to encourage contraception.  But I digress.

Rewind slightly: at sixteen I was taken to a dermatologist.  I went with my mother, who always tried very hard to get me to take care of my skin.  I can't count the number of doctors who looked at my face, looked again, mumbled uncomfortably, then handed me a bar of Purpose soap and gently indicated that I might try using it.  I didn't, of course - the only thing I was willing to do was take the erythromycin that would stain my teeth.  I went through a couple of dermatologists over the years.  But I digress.

So, the dermatologist: somewhere in the northern woods of Fulton County, a rather long drive from my parents' house in Marietta.  Picture me hurtling across the suburbs in a gray 1979 Ford Mustang: one time I recall taking a corner through a freshly red light, tires squealing as I accelerated through second gear, laying on the horn to make sure the other people didn't act too soon on their green light and get in my way.  But I digress: obviously I'm stalling.

The dermatologist was a woman in her mid-to-late thirties, average height, and sensible black hair.  Her skin had obviously been ravaged by acne.  She did the usual first visit: yes, here's your bar of Purpose soap, your prescription for Retin-A, your bottle of pills, whatever.  Then she put me in a reclining dentists' chair, fixed the spotlight on my face, and proceeded to squeeze out each and every one of my blackheads through use of a metal implement.  It hurt like hell: she pressed with that damn thing really hard, all across my nose, forehead and cheekbones.  Push down, scrape across, wipe on a tissue, repeat.  No small talk, no lectures, just intense concentration.

This took at least forty-five minutes, and at least a half hour on each of my subsequent visits.  Each time my face would eventually stop producing the goods and she'd reluctantly let me go.  This was back in the days of full insurance, no copays, and no referrals, when you could go to a specialist all you wanted, for anything you felt like doing.  I have no idea what this woman charged, and it probably wasn't cheap, but she was doing the whole thing herself: no receptionist, no assistants.  Just her versus the zits.

The last time I went she came out to the waiting room to get me.  I stood up and said hello to her, and she never looked me in the eyes: she mumbled hello as she started scanning my face.  I sat through that last agonizing session as she pushed, scraped, and wiped my throbbing face.  Yes, I stopped going because it was a long way from home, because it was painful, and because it didn't stop the pimples that actually bothered me, but mostly I stopped going because that woman creeped me out.

She obviously loved her job, but she loved it way too much: she was a sebum junky, a zit juice vampire, a woman on a mission of vengeance against the acne that had obviously scarred her for life.  To this day, when people talk about being "passionate" about their job I think of her.