Physician's profile: A journey from patient to physician

March 1, 2008

Dermatologist John David Carey, M.D., did the interview for this profile while multitasking. He was washing dishes and keeping an eye (via baby monitor) on his son, Andr?, as the baby slept peacefully in another room.

Dermatologist John David Carey, M.D., did the interview for this profile while multitasking. He was washing dishes and keeping an eye (via baby monitor) on his son, André, as the baby slept peacefully in another room.

It was Dr. Carey's day to be an at-home dad - one on one with his son - while wife Elizabeth Romero, M.D., a psychiatrist, worked her one day a week at the Veterans Affairs Medical Center.

He says he'll keep working four days a week at his Albuquerque private dermatology practice until André starts school. The day spent alone with his son keeps him connected to his wife and son, and spotlights the importance of family.

"It is a sign of maternal respect," Dr. Carey says. "I am one of those guys who married up, if you will."

The fact that he is a doctor has not given this dermatologist a sense of entitlement that patients should come to him and respect him.

Rather, the degree has had the opposite effect. Dr. Carey feels grateful for his patients' trust. He says he has a responsibility to care for them in a way that is very different from one experience he had as a patient in a dermatologist's office.

At age 24, and a medical school student aiming to be an orthopedic surgeon, Dr. Carey was told by a dermatology resident that the mole on his back was melanoma.

The bad news was worse because of his lack of knowledge.

"Most medical schools do not teach much about skin disease, and, frankly, I did not know that much about melanoma and how dangerous it could be," he says.

Dr. Carey's dermatologist-in-training was mechanical in his delivery of the news and said, basically, that it was melanoma and he would have to cut a substantial excisional specimen out of Dr. Carey's back.

Dr. Carey says the dermatologist's response to his only question - "How will I know if it has spread?" - was a simple, "If you get flu-like symptoms, you'll know."

"When you tell somebody they have cancer, there are certain nuances and certain interpersonal, human ways of conveying that information. This interaction did not have any of that," he says. "Thankfully, it was a very shallow cancer. My prognosis was about 95 percent survival, which is pretty darn good, but nobody told me that.

"I am 10 years out, as of right now, and the likelihood of my dying is vanishingly small."