Beauty School: A Journey Into the Heart of Truth and Beauty.

November 29, 2020

Beauty School: A Journey Into the Heart of Truth and Beauty.

May 29, 2023

She was one of my best friends in my dermatology residency, the period of a physician’s education spanning three years after completing medical school followed by a one-year internship. Wickedly smart and unabashedly quirky, Dr. L had graduated from Princeton and earned an MD-Phd degree from one of the most prestigious medical schools in the United States, Johns Hopkins University.

Her scientific mind was genius, her clinical skills were superb, and her attention to detail unparalleled.

We were a comical duo in ways, an unknowing odd couple gallivanting around the high-end boutiques, shops, and restaurants of Los Angeles in the late 90’s amidst the starlets and hunks of Hollywood who had rightfully earned their place at the Ivy while we had snuck in the backdoor through the Ivy League and academic pedigree. “It’s like we are the Shakespearean fool on this stage of stars,” I would chuckle in my head.

We were not actors or stars at all and I for one did not feel beautiful in that town. But it was ok – we were doctors and we were stomping out disease and suffering. We wielded a two-edged sword, warriors in the battle against bad diseases on the one hand, while also training to be purveyors and creators of beauty on the other hand.

Ironically, we were now frolicking among the most beautiful and handsome that the world had known – perhaps had ever seen! I was constantly awestruck by the perfect, lean, muscular masculine physiques with chiseled jaws, the kind with the crease in the chin that must have been bestowed by Adonis himself. And women blessed by Aphrodite with the softest of lips, apple-shaped rosy cheeks, and a feminine mystique that makes men lose their minds. They say Helen of Troy had a smile that launched a thousand ships. I could only imagine what kind of bellicose grandeur of nuclear chain reactors these beautiful people would incite.

At times, I felt my time in training was akin to a secret apprenticeship where I would learn all the secrets of beauty. Like the wizards in training at Hogwarts, we were medical wizards in training, learning how to use our magic wand — the injectable syringe. We learned from the master wizards, many of whom had innovated these techniques from the start. The names of our teachers formed an all-star roster. I was among the beautiful, studying the beautiful, creating the beautiful, and learning from the best. This was the culmination of twenty-seven years of life. I felt I had arrived.

And then like a bomb, “isn’t it funny that you went to Yale and I went to Princeton and we are essentially in Beauty School?” Dr. L had once said to me. It wasn’t really a question but a statement of irony. I chuckled but could feel a shadow that I knew normally quietly lurked in the background now begin to rise with some new-found virility that would tower over me and force me to question my existence to its very core over and over again for decades to come.

He was always there but would pop up every now and again with an intimidating ferocity just when my defenses were down and the time was right. The mind would question and repeatedly ponder some of life’s biggest questions. Am I too superficial? It isn’t just me, right? Isn’t everyone like this? Is it wrong? Isn’t this what I was learning to do? To help understand and create beauty?

The path kept unfolding and I found myself diving deeper and deeper into the ocean of dermatology and its beauty secrets. I was not just skilled in cosmetics, but I was in the top 5-10% in my exams every year. I was learning to treat the most complex medical diseases and we had the strongest skin cancer treatment training of almost any comparable program at that time. I felt I was on track. There is a balancing act that has to be achieved between the science and the beauty and I was on the path.

I made a conscious effort to learn all that I could. I would learn everything: all the stuff of Medicine and the art of cosmetic beauty. And I would do it all with maximum scientific rigor. To that end, after 3 years of digesting Modern Medicine’s treasure trove of medical and aesthetic dermatology and training with the best that Los Angeles had to offer, I decided to take my obsession with beauty to the next level. I dedicated an extra year of apprenticeship with the Kings and Queens of Cosmetic Dermatology, my fellowship professors in San Diego. I devoted my time exclusively to training in laser, cosmetic, and surgical dermatology devoting hours poring over basic science research, laser physics, the science of cosmetic procedures, and playfully obsessing with fat and liposuction in that nerdy scientific way that I loved.

If I was to be the Shakespearean fool on the stage of beauty, then I would be the best one – one that would claim the rightful wisdom of that role. I believe our imperative as physicians, scientists, and scholars is to research and innovate advancements in techniques, study and evaluate data on outcomes and side effects, and research optimal treatment protocols and parameters. That was the science I could help create and foster and then, I would be legitimate I thought.

I subsequently practiced dermatology for years delivering the best and most compassionate care I could. As physicians, we are called to our profession, treating every individual with dignity despite race, nationality, language, gender, orientation, age, or any other mental or physical attribute, condition, or disease. I saw all comers ranging from the Hollywood elite to the impoverished with an agnostic eye to income level. I was committed to treating the most fulminant rash to the most superficial of wrinkles with all my heart and skill passed on to me from my teachers.

I loved the science. I loved the data. I loved studying. I loved learning. Through the coming years, I practiced dermatology in Los Angeles and New York City, constantly plucking new facts, advancing my treatment techniques, and cherishing new experiences with dear patients as if they were apples of knowledge and friendship on a tree of endless bounty. I even had the opportunity to teach rising dermatology stars and direct the Dermatology Resident Clinic at the Dermatology Department of Columbia University.

But something always felt askew and every now and again that shadow would pop up. I knew our treatments were amazing and worked like a charm, giving great joy to our patients. But there were limitations, downsides, and costs and perhaps most importantly, I realized we see plenty of people in the world who are objectively “beautiful” who just are not all that happy. The relief provided by cosmetic treatments and beautiful things was only temporary at best and it was always incomplete. The shadow was always there asking me to question what I as a physician was doing and what we as humanity are looking for in our quest for beauty.

As time went on, I felt as though I was turning and spinning faster and faster in a stormy sea of beauty. There were ups and there were downs and ups and downs, ups, downs, and more ups and downs — until the spinning forcefully ejected me, sending me hurling into a nosedive that metaphorically smacked me in the face and forced me to finally ponder: So Dr. Iyer, what is this all about? After doing countless syringe injections, laser treatments, and fat sucking procedures, I was left asking, “What is this thing called beauty, really?” And what are we all really chasing? I knew I needed to stare the shadow down once and for all. Perhaps, this was the true wisdom of beauty.

The process of inquiry into the nature of beauty seemingly was the story of my life. Years after reveling in the glamour, party, and celebration of the fast life under the Hollywood sign and in the city that never sleeps, it seemed to me that it wasn’t my medical training that was the Beauty School after all. Rather, it is life – a series of unfolding experiences and lessons when analyzed as a whole, retrospectively, reveal the world itself to be a beauty school – a place to find and enjoy beautiful things but more importantly, to find Absolute Beauty itself and one’s relationship to it.

Shilesh Iyer MD is a New York City-based physician dedicated to promoting the most accurate information and knowledge about health and wellbeing. As a cosmetic dermatologist, he is a perpetual explorer and student of Beauty as seen through the lens of science, philosophy, and humanity's wisdom.

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