How I Was Inspired By…My Patients and Mentors

Newport Beach dermatologist (and cover star!) Zena H. Gabriel, on the people who shaped her counterintuitive medical philosophy

zena-gabriel-md-dermatologistBiggest success story?

A woman came to me who had lung cancer that had metastasized to her brain. She’d had full chest and brain radiation, which cured her cancer. But it weakened her immune system and caused her to develop skin cancer on her chest. She was in remission, but she felt ugly. I removed the skin cancer and helped her hair grow back. When she got her five-years-clear result, we had a celebration. It was emotional for us. She was even approached by Northwestern Memorial Hospital in Chicago to be its poster child for surviving cancer. She’s going to be on billboards! She’s not only beautiful on the outside, but she just exudes beauty, love, compassion, and strength.

What sparked your interest in dermatology?

I did clinical research trials at UCLA Medical Center. There was one patient, a young woman with lupus. She had scars on her face and had lost hair in clumps, so she wore a wig and heavy makeup. She was on dialysis and was really sick, but the thing that was actually depressing her was her appearance. Something clicked for me, and I realized how much appearances can impact the way we feel about ourselves.

Does that affect how you see yourself?

Since I’ve had my kids, who are 9 and 6, I’ve learned I don’t have to be perfect. Women are so hard on themselves. We get our nails done, our hair, our eyelashes, Botox, we have to stay thin, we have a celebrity obsession. And we lose sight of ourselves. So for the past few years I’ve really focused on accepting myself and helping my patients accept themselves.

How do you balance that with your profession?

If someone comes in wanting to fix something on their face, I always try to steer them toward doing less. If I just do what they want, not only is that perhaps not ethical but it probably isn’t what’s going to make them look their best. If I can persuade them they only need a little done and can still look natural, they’ll trust my aesthetic and feel better about themselves.

Ever refer patients to a psychologist?

There have been a few cases. I saw a woman in her 60s with skin cancer on her hand. I did the surgery, and she was fine. But she kept calling and coming in every day to ask if the wound was OK. Just really excessive. So finally I said, “Hey, this is not about your hand. What’s up?” She was going through a rough time, moving out of her home of 25 years, having marriage issues, stressed. I called her primary doctor and let him know about her anxiety so she could get help. In med school, the dean told us, “I can teach you differential diagnoses, but I can’t teach you to give a damn.” I really try to give a damn.

Any other advice you remember?

When I worked in the trauma ward, there was a physician who said, “Don’t just do something, stand there.” What he meant was, stop, think, and then act. Another piece of advice I received from many people was to always treat the patient first, then the disease.

Can you elaborate?

A man came in with erythrodermic psoriasis, which leaves the body red and scaly. It’s one of the few dermatological diseases requiring hospitalization. He didn’t have insurance. He didn’t speak English, but I know Spanish. I sent him to LA County-USC. I knew a nurse there from my residency, so I told her to meet him and take him to the clinic. He came to me every month after that for maintenance, and I saw him for free on my lunch break. He’d come to me in tears, he’d bring me gifts for my kids to thank me. My dad was an immigrant from Greece, and I imagined him walking in somewhere and being ignored. I couldn’t do that. I had an obligation to help him.

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