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Doctor as Inventor and Visionary
"You know," he says, "the years between five and 15 put you at very high risk for the later development of skin cancer. Have you used tanning beds? Do you use a high SPF sunscreen when you go out in the sun?" As you answer, the doctor is also writing down your danger profile for high risk - light hair, fair skin, blue or gray eyes. He's looking for freckles. He treats your dark, iffy freckle with the same care and consideration he applies to problems on the faces of supermodels, celebrities and stars, many are his patients. The doctor is young, with fair skin and reddish brown hair. Drugge graduated from Harvard and New York Medical College. A family man, his wife, Heather, long his assistant in the office, now edits the online text and Internet Dermatology Society's web site. The Drugges are the parents of a baby girl. Outwardly low-key, he's intense about his work and passionate about saving lives. He draws on family and friends for inspiration. "My godfather, a brilliant man, died of melanoma," he says with white-hot intensity. "I spent a lot of time with him, when he was dying." As a boy, growing up in Darien, CT, he couldn't wait to own a sailboat. "I don't know how many lawns I mowed to buy a little boat! I was ten years old and it was a leaky old wooden Sunfish, basically, a surf board with a sail! Of course, I got too much sun," he admits. He turns back to you, his new patient, and says: "Did you know that skin cancer is an epidemic? There's more skin cancer than any other kind of cancer. And, the most deadly type, melanoma, is now affecting one in 75 people, having doubled during the past 10 years. In 1935, it was only in one person out of 1500." "However," he adds dryly, "the number of dermatologists has remained the same." Doctor Drugge is doing many things about this worldwide problem. He is making information available through his Internet Dermatological Association to 1250 doctors in 90 countries. "We are using digital photography to create a virtual dermatology case conference system whereby the patient with difficult problems can be seen by the best dermatologists in the world!" The doctor is an inventor and a scientist, using state-of-the-art technology to, he hopes, put an end to the now rampant scourge of skin cancer. Drugge has invented a diagnostic machine called TIP for Total Immersion Photography. It registers subtle colors and measures body parts, spots, and lesions. The booth is equipped with florescent lights, 56 digital cameras that take a patient's full body picture. The cameras are driven by a software program. The booth has a chart for melanoma comparisons, in living, accurate color. The range of melanoma simulations was created by by famous makeup artist, Glenn Marziali. He creates all of the makeup for the fresh-faced Victoria's Secret models. He brought a subtle touch to the shapes and colorations. This chart is a guide for doctors and most especially, a test for the machine's accuracy. Marziali says, "Using four makeup pencils in colors ranging from light taupe to dark red, I applied various moles over a model's entire body with the exception of the soles of the feet and scalp. I drew some to look normal and others to look troublesome. A medical book was my visual guide. There were all shapes and sizes. The patient was photographed before and after, to show any changes in color, shape or size to test the TIP's ability to show early signs of melanoma." The purpose of the TIP machine is to record a full body image that can show blips, hickeys and bumps that are nearly invisible to the naked eye. If the person is deemed clear of skin cancer, but at risk, he or she can be re-photographed in three to six months. If anything at all is found, be it a colorless skin cancer or a red bump, the scan will be done again much, much sooner. Thus, the new scan can be compared with the "base-line" picture to see just how much the bump has grown horizontally, vertically, or in crenellations. The photos will note subtle changes in (pigmentation) color, and then, measure the enlargements, more colorful skin blips (abnormalities) against what was seen before. "The measurements are kept in a safe, private computer file, stored until the next exam when they are used for comparison." Drugge asks, "What doctor can remember, even with good notes, the exact size color and shape of a mole? The extent of the growth of the spot is measured by comparison via computer program using the original picture. That creates an animation, a movie whereby we can subtract the size of the old spot from the new dimensions to see exactly what is going on!" In the future, TIP will be on cosmetic's counters, picking up early, barely detectable, cancers on faces, necks and upper bodies. Dr. Drugge cites Senator John McCain, a high-risk and high profile skin cancer patient. McCain has had several melanomas removed from his body. "He grew a melanoma on his face in between his three-month office visits to his primary care doctor. If he'd had access to a TIP booth, the earliest signs would have been detected and he could have been treated before anything was visible to the naked eye." The doctor teaches at NYU, giving young dermatologists the ammo they need to fight skin cancer. He started documenting patient's skin cancers using digital imaging in 1993. He was the first dermatologist to use the Internet to exchange patient case reports. This work was discovered by researchers at the Veteran's Administration and is the basis for the current teledermatology system at the VA. An extensive study in conjunction with the Veteran's Administration Health Services Research and Development Center at Duke University has proven that Drugge's method is equivalent to sending the patient to the dermatologists for the accuracy and method of patient management. The results have been published in several journals, including the Journal of the American Association of Dermatology in 1999. His newest invention eliminates the need for a photographer in obtaining digital images of the patient and was presented his Total Immersion Photography system at New York University's Forum on Advances in Dermatology. That forum has been awarded the American Academy of Dermatology's Award of excellence in Dermatological Education. The doctor is a visionary, a man who sees far into the future imagining the greater uses of technology. Like Robert F. Kennedy, he asks "Why not?" Dr. Rhett Drugge wonders why the government can't expand its focus. Beside scanning for criminals in the Superbowl crowd in Tampa, "They could be screening for skin cancers! The algorithms are available!" And the future of TIP, his scanning booths? A patent
is applied for and a manufacturer lined up. "Why not have the
booths in health clubs, Ys and beach areas. A person needs only
go in for a few minutes. The images will be stored safely in a secure
data file, transported to the doctor of choice via the Internet,
and the person will learn if they are at risk!" And why not?
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