Who will be the keeper of the flame?

February 1, 2005

We are all teachers in dermatology whether we are solo private practitioners, group practitioners, academic practitioners, research practitioners or industry practitioners.

Mental image The mental image of Greece that sticks in my mind is the Acropolis - on the mountain, towering above Athens. I looked at it every day from much the same vantage point captured by television stations during breaks in the Olympic games. In the golden age, when Pericles built the Acropolis, tremendous advances were made in mathematics, art, sculpture, architecture, philosophy and drama. The basic concepts of the Hippocratic oath were developed. The ideal facial proportions that we still adhere to today in dermatology were defined. The Socratic method of teaching was conceived and is still used in dermatology grand rounds. It is amazing to think that this golden age - and the civilization that gave it birth - lasted only 20 years. The ravages of continued war with neighboring peoples drained the Greek treasury of funds and depleted Greece of its most important natural resource: its youth.

Even though this tremendous age of rapid knowledge acquisition was short-lived, the information still exists today. Who was the keeper of the flame? The Greeks had a well-developed line of knowledge transfer from the teacher to the pupil. For example, Socrates (the first great thinker) taught Plato (the first great teacher) who taught Aristotle (the first great student) who taught Alexander the Great (the first great leader).

Modern world The knowledge of the now modern world is hard to contain in any one library. Information technology defines our current age as we electronically encode information and send it in seconds to the far reaches of the earth. There is too much knowledge for one person to know it all.

It is for this reason that I have defined my knowledge base as dermatology. But, even dermatology is too vast to fit in one volume. The most recent textbooks, printed in a 10-point font, still are thicker than can be bound in one volume. But, I might add, some of the most valuable information is still not in the textbook. For example, no dermatology textbook tells me how to prescribe for the unruly teenager with acne who keeps playing his Game Boy video game despite my presence in the room. None describes how to prevent physician burnout 20 years after entering solo practice. None explains how to best purchase surgical instruments for optimal efficiency when performing tumescent liposuction. Who is the keeper of the flame in dermatology?

I am the keeper of the flame. You are the keeper of the flame. We are the keepers of the flame. I think there comes a time in every dermatologist's career when the transfer of knowledge begins as the student matures to the point where he or she understands the importance of consulting elders for advice.