Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
“Someday, I suspect I will recount this time of fear with mixed emotions. Sadly, there are people who have died and more to come, and this time will also lead us to reassess our way of life and make changes for the better. I work from home, juggling the management of patients by telemedicine with homeschooling my daughters, still working to find meaning and direction to do the right thing.
With movie theaters all shuttered right now, and likely to struggle after this crisis, I hope the simple pleasure of watching these pictures in the theater can still be my escapist comfort. I yearn to go to the movies, and for me, streaming on Netflix can’t match that theater experience. Still, I find purpose and meaning in reminding myself that we are characters in this movie, and just as in Hitchcock’s thriller, the deeper meaning is in how we as people respond to extreme circumstances.”
Jules Lipoff is a dermatologist.
He shares his story and discusses his KevinMD article, “Alfred Hitchcock, COVID-19, and the MacGuffin.”
Did you enjoy today’s episode?
Please click here to leave a review for The Podcast by KevinMD. Subscribe on your favorite podcast app to get notified when a new episode comes out!
Do you know someone who might enjoy this episode? Share this episode to anyone who wants to hear health care stories filled with information, insight, and inspiration.
Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Jules Lipoff. He’s a dermatologist, and he wrote the KevinMD article “Alfred Hitchcock, COVID-19, and the MacGuffin.” Jules, welcome to the show.
Jules Lipoff: Thanks for having me, Kevin. Great to be here.
Kevin Pho: So we’ll get into the article in a little bit, but first off, tell me a little about who you are, your story, and your journey to where you are today.
Jules Lipoff: Yeah. Well, I’m an academic dermatologist and assistant professor at the University of Pennsylvania in Philly. I grew up in Kansas City, and now I’ve gone through medical school and trained, and now I’m about eight-some years into being an attending. I practice general medical dermatology, but I specialize in outreach to underserved populations. I have an HIV dermatology clinic. I have a clinic that specializes in LGBT populations, transgender and non-binary populations in particular, working through global health and expanding care through telemedicine.
A lot of interesting research. And I also love to write, and creatively, I’ve done screenwriting consultation for TV and all sorts of things, and that’s what even led me to the article that we’re going to talk about today.
Real physician voices, twice a week
Free, and one click to unsubscribe.
Kevin Pho: Fantastic. And how has the pandemic affected you and your practice?
Jules Lipoff: At first, we basically completely shut down, and we converted our in-person visits almost entirely to telemedicine. And actually, since I had a research interest and have done work in telemedicine, I’m actually the chair of the teledermatology task force for the American Academy of Dermatology. It presented a really cool opportunity, as a silver lining to all this horribleness, to see how we can finally get past some of these policy barriers and see how we can enact telemedicine and get access to people.
Kevin Pho: And from a dermatology standpoint, what are some skin manifestations of COVID-19?
Jules Lipoff: So I’m actually also a part of a COVID-19 task force for the American Academy of Dermatology, and we have this international registry. People can go online, medical professionals can go online, and submit cases. There’s been a lot of talk about, quote-unquote, “COVID toes,” or perniosis, chilblains on the toes and hands, which may be associated usually with milder cases and maybe even after acute infection. But we’re seeing a whole host, a spectrum, from morbilliform eruptions to, even in severe cases, retiform purpura. It’s definitely interesting, and we think, as we can often see, that the skin can give great insight into systemic illness.
Kevin Pho: And I’m a primary care doctor. I practice in southern New Hampshire. So COVID toes, what exactly do they look like, and what should I be looking out for in the exam room in my primary care clinic?
Jules Lipoff: Well, if you’re seeing non-blanching, purplish lesions on the hands and feet. It’s hard to define. I don’t want to be too specific, because not everyone speaks the same language. But it’s really just that we see it idiopathically, perhaps just related to cold, or in people with autoimmune disease. So we’re starting to see more cases of this, and what’s confusing is that we don’t even have testing on all the people who have had it, and then some people who have had testing have been negative but possibly have a contact. So we’re still trying to figure it out, but there are just far too many cases to be a coincidence.
Kevin Pho: So let’s get into your KevinMD article. You’re a dermatologist and a screenwriter, and I think that’s a wonderful combination. You wrote the article “Alfred Hitchcock, COVID-19, and the MacGuffin.” Can you walk my audience through that article for those who haven’t read it and the story of why you decided to write it?
Jules Lipoff: I think I really love to look at the intersection between entertainment and medicine. I’ve actually written several articles on that theme for Vox. I wrote an article about the skin disease greyscale on Game of Thrones, and even published in German dermatology on that. I’ve written about the real etiology of what could cause the myths of zombies, werewolves, and vampires. I wrote an article about what diseases the Avengers could really have. So I’m always looking at things through a different lens.
And when I was sitting around and absorbing what was happening all around us in the weeks after COVID-19 finally seemed real, I started thinking, “Well, this is just like the movies I like to watch, these science fiction dystopias that I usually love.” But it’s a little easier to enjoy it when you’re an audience and less so when you’re in it. And then I started thinking, “Huh, well, what if I start trying to analyze it and find meaning in it, as if I was watching this as a movie?”
And I started thinking about some of the classic movies that we all felt like: It felt like a thriller, it felt like a dystopia, it felt like a horror, a family disease drama, all these genres that we know. And then I started saying, “Well, what is the plot about? Who are the heroes? Where are the turns? What do we care about?” And I started realizing that it’s not really about COVID-19 at all. That’s kind of the standard, that’s what we’ll talk about, but it’s really about the relationships. It’s about how we work together, it’s about how we don’t work together, it’s about distrust, it’s about misinformation, it’s about all of these things.
But that’s not at all specific to this disease. That’s just the inciting incident that sparked our conversation and this whole craziness. And I think it is useful to get some perspective, so we don’t just get so narrow-minded and we can actually start to appreciate what’s going right and how we can learn from this, even when things are going wrong.
Kevin Pho: And for those who aren’t familiar with the term MacGuffin, what exactly is that, and how does that relate to what you’re talking about with the pandemic?
Jules Lipoff: Yeah, so MacGuffin is a term that Alfred Hitchcock used to talk about a plot device. He’s been quoted on a talk show. I don’t know if he necessarily invented it, but basically, he describes it as something that we as the audience are led, you know, the characters seem to care about this. This movie North by Northwest, which I repeatedly refer to, is a good example: The characters are chasing after this microfilm that has these secrets that the government and the agents are after. And well, we never actually find out what those secrets are, and maybe if they came up with something, it would have been unsatisfying.
But it’s what sets the plot in motion. It’s what makes the characters act in the way that they do. They have to chase it, they have to fight over it, but we don’t necessarily care what it is. We care that they’re fighting or that they’re struggling or that they’re going to achieve something.
Kevin Pho: So you wrote your article in May, and we are now talking in the last week of July. What do you anticipate the next act to be?
Jules Lipoff: I mean, maybe it’s changing from a feature film into a new series or a multi-season TV drama, right? I mean, it’s unfortunate, because it felt like we had the first season, and now we’re moving on. I anticipate that in the next couple of months, the climax of this season or film is now the presidential election and the preparations heading into the fall, with the drama of getting back into school.
And so we’re just going to have to see how that all comes to a head, as we’re all anticipating what’s going to happen when we have people go to school, when the election is driving up, what is the rhetoric, what is the economy. And I think after that act closes, we’re going to see what the next chapter is, which will probably coincide with winter and, hopefully, a new administration.
Kevin Pho: Now, one of the things that we talked about earlier was that intersection between creativity and medicine. Why is that association so important?
Jules Lipoff: A lot of people who are in medicine, you and I, I’m sure we’ve all gotten told, “Oh, you must be really smart,” or, “That must be so hard, to be in medicine.” But I mean, you’re an entrepreneur or a creative person. You know that to achieve anything truly great, you have to absorb a lot of rejection and failure. And in medicine, that’s not really well tolerated. It’s all about getting it right. And our paths are pretty secure. Like, if you get into med school, then you get into a residency, you can kind of coast. I’m not saying it’s easy, but it’s very risk-averse.
And I think when you consider creativity and creative careers, there’s a lot to learn from that about how to grow and accept rejection and failure and trying things out, that is really advantageous to personal growth. And I think there are a lot of physicians who get kind of stuck and get burned out because there’s just no motivation. They’re just trying to get the next thing, to get the big house, to get the big car, or whatever. And they lose sight of the fact that you need to enjoy the struggle of growing to really have a fulfilling career.
Kevin Pho: Wonderful. I think what you said was so true. One of the things I always talk to physicians who are burned out about is that they need a passion, either another one within medicine or a passion outside of medicine. And what you do with creativity and screenwriting, I think that’s a perfect match for what you do clinically.
So we’re talking to Jules Lipoff. He’s a dermatologist, and he wrote the KevinMD article “Alfred Hitchcock, COVID-19, and the MacGuffin.” Jules, what is your take-home message that you want to share with the KevinMD audience?
Jules Lipoff: I would say that what holds up a lot of creative minds, and even academic minds, is self-filtering and saying, “It’s too hard, I can’t do it.” And I mean, this article was just one of my whims. One morning, I just wrote it out, and I didn’t know if it would be of any interest to anyone, but it was something that I found meaningful. But I didn’t filter it. I decided I wanted to share it with the world. And I think a lot of people have real worth to share, but they’re too scared of rejection.
And I would ask people to not be afraid and take the leap of faith and find trusted friends in the world and put it out there. Keep writing, keep being creative, and put stuff out in the world, and it can only help you. You can never know which piece or which things are going to really resonate with people. I’m sure on KevinMD, you never know which ones are going to truly go viral and which ones are going to be barely looked at. But you have to just put out volume. Not only will something finally hit, but you will be learning how to write better and how to produce better the more that you do.
Kevin Pho: Wise words. Jules, thank you so much for your time and insight, and thank you for being on the show.
Jules Lipoff: Thank you for having me again.
Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes
