Letter From the Editor: Embrace Your Story

Raj Chovatiya, MD, PhD, MSCI

I like to think about the year-end holiday season as equal parts fun and chaos. The joy of being together with friends and family, compounded by the inherent stress that comes with squeezing out every last ounce of joy of merriment from the waning year, is a quintessential American experience: Nobody can quite ride that juxtaposition like we do. Of course, this concept was never apparent to me as a child, but now as a parent of 2 young children, the pressure is on. For parents, I think much of this feeling comes from wanting to give our children the best holiday experience possible, which usually takes the form of celebrating our unique traditions. Traditions are so important to us all—no matter what form they take—and this is the one time of year we get the chance to take a tiny break from our fast-paced lives to celebrate the differences that bring us together (yet another beautifully American juxtaposition).

In our house we’re blessed to be a multilingual, multicultural melting pot with a perfect storm of celebrations from around the world. Over the course of several months stretching into the new year (oh the joy of solar and lunar calendars), we get to enjoy many familiar holidays (and some less familiar) from India, Venezuela, China, and the good old USA, with our own spin. Some examples include the following:

• Midautumn festival with fresh mooncakes
• The 9 nights of Navratri, dancing to the beats of garba and raas for days on end
• The 5 days of Diwali, when salty fried snacks and sweet barfi fill every corner of the kitchen
• Thanksgiving, when nothing goes better with roast turkey than biryani, arepas, and char siu
• Christmas, when assembly line construction of hallacas and pan de jamón while singing along to “Mi Burrito Sabanero” doesn’t count as child labor
• New Year’s Eve, when 12 grapes in 1 minute can make all your wishes come true
• Lunar new year, armed with an unending supply of lai see (aka red envelopes) and fireworks

And that’s just a sample of a few months out of our year! I love that I get to pass on old traditions and make new ones with my family based around food, festivals, music, dance, religion, ideology, and just plain togetherness. Our story can’t be explained by any one of these alone, and that is what diversity is all about.

That word, diversity, has been a frequent part of our lexicon in dermatology over the past few years, as we have grappled with how we move our field forward and embrace what brings us together (the physiology and pathology of the skin) while acknowledging the disparities that can make the individual dermatologic experience so distinct and uneven in our country. In medicine, we’ve spent so long trying to identify the singular lens under which all our differences and inequities can be explained (It’s skin color! It’s race! it’s ethnicity! It’s all of them! It’s none of them!), only to realize that there probably isn’t one perfect answer to fully explain concepts like diagnostic inaccuracy, treatment delays, and poorer outcomes. What is clear is that the house of medicine has unfortunately relied too long on using isolated social constructs to support purported intrinsic biological and genetic differences when, as it turns out, we’re not all that dissimilar from one another. We are all human beings, after all.

So how can we better understand many dermatologic disparities when it comes to care, treatment, and outcomes? Well, diversity isn’t just for our holiday traditions; it shapes disease risk and the individual experience. Beyond our cells, proteins, and genes, we are the sum of how we look, where we live, how much money we have, our health care access, and our opportunity for education in a system with variable social, public, economic, and governmental policies and cultural and society values. And our story can’t be told with just one of these elements.

While we have our work cut out for us, keep the faith. You’ve heard great stories in Dermatology Times all year about individuals trying to explore and address these concepts as they relate to the broad spectrum of dermatologic diseases. And you’ll continue to read even more in the coming year, when words will hopefully lead to more action and more change. We’re evolving dermatology in real time, and 2025 looks bright.

From the holidays, to dermatology, and beyond:

Embrace your traditions,

Embrace your diversity,

And embrace your story.

Here’s to 2025!

Raj Chovatiya, MD, PhD, MSCI, is a clinical associate professor of medicine at Rosalind Franklin University Chicago Medical School in Illinois and founder and director of the Center for Medical Dermatology and Immunology Research.