Spotlight on: Amy E. Gilliam, MD
In dermatology, we are fortunate to have many insightful practitioners and great teachers and mentors. Some are bright stars in our special universe–others unsung heroes. All of these colleagues have much to share, from wisdom to humor to insights into dermatology and life. This column allows us to gain insight from these practitioners and learn more about them.
Amy E. Gilliam, MD, is a pediatric dermatologist practicing in Palo Alto and San Carlos, CA, at the Palo Alto Medical Foundation. She trained in pediatrics, dermatology, and pediatric dermatology at the University of California, San Francisco (UCSF). Dr Gilliam attended medical school at the University of California, San Diego (UCSD) and studied as an undergraduate at Stanford University.
She is originally from Dallas, TX, and was inspired to become a dermatologist by her mentors at UCSF and UCSD as well as by her mother, Anita C. Gilliam, MD, PhD, who was a respected dermatopathologist and scientist, and by her father, James N. Gilliam, MD, who was also a highly revered academic dermatologist and researcher.
Dr Gilliam served on the dermatology faculty at UCSF from 2005 to 2008 and continues to volunteer as an attending teaching physician in the pediatric dermatology clinic there. Her clinical and past research interests include pediatric morphea and autoimmune disease as well as laser and medical treatment of birthmarks and hemangiomas.
Q. What part of your work gives you the most pleasure?
A. The most rewarding aspect of my work is when I am able to make a diagnosis that has been elusive to others or myself (ie, that “Aha!” moment) or when I am successful in initiating therapy or a skin regimen for a child that “finally works.” I see a large population of infants and young children with atopic dermatitis, which can greatly affect quality of life for the patient and family when severe. I am often the last in a long line of physicians/providers who have treated these children, and when my advice to the family finally results in significant improvement for the child, it is such a triumph. The families express their gratitude, and it is incredibly rewarding to see the child much more comfortable and happy.
Q. What is your greatest regret?
A. I do not have one regret in particular, but I do regret ever being impatient or frustrated with a patient or patient’s parent. For those situations in which patients are extremely late for an appointment, require extra time and explanation, or have a long list of questions/concerns, I try to be understanding and patient, but sometimes the frustration wins out. In this type of moment, the best advice to myself is to try to conjure up the parent in me and identify with the family’s overwhelming concern for their child. Although I do not express this frustration openly, I regret even feeling it, as I know that everyone involved has the same goal in mind—that is, what is in the best interest for the child/my patient.
Q. Who was your hero/mentor and why?
A. I am grateful to a number of mentors throughout my training, but my greatest hero is/was my mother, Anita C. Gilliam who passed away from cancer in November 2015. She was a role model to me not only professionally but also in my personal life. She was highly respected as a researcher and clinician in dermatology throughout her career, and she carried herself with professionalism, humility, and grace. I relied on her expertise and recommendations for diagnosis and treatment of many of my patients; and even more importantly, her advice to me with respect to raising my family and other personal issues was always insightful and wise. I very much miss her but am comforted by the thought of her when I am confronted with a difficult decision. I often think to myself, “What would she say to me?” which helps guide me through life every day.
Q. Which patient had the most effect on your work and why?
A. One of my most challenging patients was a very young girl whom I diagnosed with disabling and very extensive morphea at the age of 3. The disease progressed over months to affect almost her entire body. This patient had a profound impact on me, as it was heartbreaking to watch her disease progress despite every treatment I recommended. I met with her family very often and went to great lengths to attempt to stop the progression of her disease through consultation with multiple experts in the field, both in person and electronically. Throughout the time I cared for her, I developed a very close bond with her and her family. They eventually moved out of the United States. This experience taught me humility and at the same time touched me emotionally, as I cannot imagine having this experience as a parent—that is, watching your child become encased in her skin, despite all efforts. It was a situation in which we were faced with the fact that we had no control, which, of course, is very disconcerting and humbling.
Q. What is the best piece of advice you have received and from whom?
A. I always have appreciated my mother’s comment: “Done is better than perfect.” I find that many individuals, especially MDs and other highly trained professionals, get bogged down in details that often “paralyze” them or inhibit them from embarking on and completing projects or tasks. I think the most effective individuals are comfortable with imperfection to a certain degree because the intent to achieve perfection results in spinning the wheels. They never get anywhere or complete the task at hand as there is fear that the final product will not be perfect.
Dr Barankin is a dermatologist in Toronto, Ontario, Canada. He is author-editor of 7 books in dermatology and is widely published in the dermatology and humanities literature.
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