The Joy of (Still) Loving What You Do

Dr. Grimes received a DF research grant early in her career for her work, “Immunologic Aberrations In Vitiligo.” We had an opportunity to ask her how the Dermatology Foundation has shaped her career and the specialty.

The Difference Between a Good, and a Great Physician

DF: Good morning, Dr. Grimes, it’s so nice to meet you. Let’s start with how you first became connected with the Dermatology Foundation.

Dr. Grimes: I’m so honored to share my Dermatology Foundation experience because they played such an integral role in helping me launch my academic career.

Many, many, many years ago (!!), I started my dermatology career with Dr. John Kenney as one of his residents. I worked with him for four years and then moved across the country from Washington to Los Angeles to work with Dr. Paul Kelly. I had no funding and many great ideas, and I was so excited to take my science to the unique special level that I just knew was so key. So with support from Dr. Kelly and others, I applied for a grant from the Dermatology Foundation. And the rest is history.

DF: Why was that grant so important to you?

Dr. Grimes: My favorite quote, and we’ll come back to this, is from Sir William Osler: “The good physician treats the disease. The great physician treats the patient with the disease.” During those first four years of doing clinical work for Dr. Kenney, I had the luxury of spending hours and hours with patients getting insights into their needs, and it allowed me to develop my hypothesis regarding what was happening in the disease of vitiligo.

Patients tell you what’s happening, you simply have to sit back and listen. So, we hypothesized, albeit it was controversial, that Vitiligo was an autoimmune disease. And the grant that I received from the Dermatology Foundation gave me the early funding to do basic science research in support of that hypothesis.

The Dermatology Foundation has done that for so many young investigators in supporting their seminal -their early – work. And when I asked myself the question, how would I define it for me? I would define the Dermatology Foundation as just the best parent in the world.

DF: No one has defined it like that before!

Dr. Grimes: Well, let’s tease out what parents do—they nurture, and they support, and they provide, and when I look at the Dermatology Foundation, that’s what they do. They are a parent in that they see something special in the individuals whose early work they support, and they gamble a little bit, but hopefully, they can look back on the careers of the myriad of people whose work they have supported, and say, “oh my God look at my baby!”

DF: So the Dermatology Foundation gave you the time to listen to patients, grow, and realize that instinct you had was true. And now 40 years later, it’s not a hypothesis anymore.

Dr. Grimes: Exactly. I was truly in the trenches in the 80s—we were making our own phototherapy units. Can you imagine that? So, as I said, I’ve seen it all.

DF: How did this career find you? Did you always want to be a dermatologist?

Dr. Grimes: I came from a family of science-driven people. My father’s father wanted him to go to medical school, but instead, he majored in animal husbandry and became the community veterinarian, the unofficial veterinarian. I have an older brother who was a physician, another brother who’s a dentist.

When I was in medical school, dermatology was one of my rotations that I really enjoyed. And I ultimately got into a dermatology program, and I have never looked back. It was probably the best decision that I could have ever made.

And the very passion that I felt in getting into a residency, in starting my career in research, you know, it’s exciting for me to say that I have not lost that passion. I have not lost that desire to be that great physician that Sir William Osler spoke about, who takes a deep dive at all levels in doing the best job that you possibly can for patients. I think for me the luxury in what I do every day in being a very creative thinker is to be able to incorporate science and research into patient care.

DF: You’re echoing a passion and gratitude for your career, from residency until now that I’ve heard from other dermatologists in other interviews and it’s inspiring.

Dr. Grimes: My patients will ask me “Why do you do this?” and my response is I do it because I love it so much. The day these emotions abate, I won’t do it. But I think I’ll always do it at some level.

DF: What do you think has been the most significant impact that the Dermatology Foundation has made in dermatology over the last 60 years?

Dr. Grimes: The Dermatology Foundation has launched the careers of so many brilliant scientists, moving science forward, and allowing the work of so many investigators to create new paradigm shifts that have facilitated better treatment outcomes.

I think the end point of everything we do in the house of dermatology translates to how we care for our patients every day. And the Dermatology Foundation has been the parent supporting their children who have been very effective in moving the science of dermatology and patient care forward.

DF: Where do you personally hope to see dermatology advance in the next 60 years?

Dr. Grimes: That’s such a great question. I look to the next 60 years as a time for a deeper dive into precision medicine. With AI, we’ll have the capacity to tease out the unique genetics of diseases, to look at biomarkers so we will be able to customize treatments for individuals.

Certainly, when you look at diseases now we’ll have new drugs that come to the marketplace and there will be patients who are responders and some who’ll be non-responders. And the question that I ask is why? What’s the difference? But I think the future will have paradigms that allow us to answer these questions to be able to customize treatments.

DF: What impact do you hope that the Dermatology Foundation might have in the next 60 years?

Dr. Grimes: One unique area would be to look at the impact of AI. As scientists and clinicians, we will have to figure out how to incorporate it into our scientific models. It’s a unique opportunity for the Dermatology Foundation to be ahead of the game in that arena.

We can’t bury our heads in the sand. It’s coming and it’s going to stay. And we have to all step back, look at the good, the bad, the ugly, and decide how we will incorporate the good into our own unique areas and moreover how we will deal with the bad to protect our patients.

DF: Yes. Exactly. Thank you so much for your time. Is there anything else that you would like to add?

Dr. Grimes: I would just like to again take the opportunity to thank the Dermatology Foundation for all that they do. I’d like to thank the founders for having a vision. As clinicians and researchers, we all stand on their shoulders to bring on the next generation of scientists and clinicians who have a true passion to make a difference in the house of dermatology and the house of medicine.

DF: I would like to take this opportunity to thank you for all that you’ve done and given and for every patient that you have listened to. I’m glad the house of dermatology has you.

Dr. Grimes: Well, you’re making me emotional. I didn’t know what I was going to say but you just have to let it come from your heart.

DF: That’s exactly what you did, and I appreciate it so much.

Dr. Grimes: Thank you.