Dr. Erin Warshaw: Dermatologist & Professor

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This week, we had the opportunity to interview Dr. Erin Warshaw, a dermatologist, professor, allergen expert and (spoiler alert!) my mom. Dr. Warshaw is a woman of many talents and has served as Chief of Dermatology at the V.A. Medical Center, Professor of Dermatology at the University of Minnesota, and most recently opened up her dream clinic in Minneapolis, a cold case unit for previously unsolvable skin allergies. Can you tell I’m proud?! She is full of insight on creating a career out of a passion for science, leading a team, and pursuing meaning-based work. And if that isn’t enough--she also shares some truly earth-shattering skin care advice. Read on!

Let’s start with the basics. What is your official title?
My official job title, well I wear several different hats, so my job title at the University is Professor of Dermatology, my title and role at the V.A. Medical Center is Staff Physician, and my title at Park Nicollet is Co-Director of the Park Nicollet Contact Dermatitis Clinic.

Could you explain what contact dermatitis is?
Sure, so when most people think of allergy, they think of a life threatening type of allergy, probably like allergy to peanuts or a bee sting, but that’s actually only one type of allergy. That’s what’s called Type One allergy or Immediate Type hypersensitivity. Contact dermatitis is what’s called Type Four hypersensitivity, or Delayed Type allergy, and it’s the type of allergy that results in a rash, just like what many people get when they come in contact with poison ivy. Another common allergen is nickel, so people who are allergic to nickel might get a rash on their earlobes from reaction to nickel in their earrings, or around their belly button from nickel in their belt.

A contact dermatitis reaction can take up to five days to develop after the initial exposure and lasts around three weeks before your body’s immune system goes through its normal allergic cycle and shuts it down. It’s very itchy, so patients can be pretty miserable and irritable; they usually haven’t been able to sleep and have basically been living with poison ivy, not knowing what the allergy is until they come to our clinic.

So my understanding is that you and your clinic are kind of the last stop for allergens that people haven’t been able to figure out elsewhere, and you use patch-testing to determine those allergies. Is that right? Could you talk a little bit about patch testing?
So there is a pre-packaged kit of 35 allergens called the True Test, and that is what most dermatologists and allergists use. It contains the most common allergens that we see, like nickel, other metals like cobalt and gold, fragrances, preservatives, steroids like the antibiotic medications niacin and bacitracin—those all are on the True Test. Many times, patients will have had the True Test done by their general dermatologist or allergist and then if it doesn’t make sense or the rash doesn’t get better, they’re sent to us for specialized testing.

Did you always want to be a doctor? What lead you to medicine, and dermatology specifically?
I did not always want to be a doctor. I loved the book A Wrinkle in Time by Madeleine L’Engle and when I read it as a young girl, I wanted to be a scientist. I wanted to be the mother in that book who had a lab right off of the kitchen. That was, I thought, the most incredible thing.

I loved cell biology, so naturally that kind of leads to medicine. But I got very disenchanted with traditional medicine and kind of the whole pre-med vibe in college and decided that I wasn’t going to be a doctor. Instead, I wanted to study alternative medicine. So I took a year, and part of that year was spent in India where I went to a yoga hospital. I was really excited about it before going, but when I got there it was a little disappointing because it really wasn’t much of a hospital.

I met an American doctor there who was associated with the ashram at the hospital and he really convinced me to go back for medical school. He said if you ever want do anything in alternative medicine, no one will really respect you unless you have that degree. So, my goal in medical school was to go to a third world country afterwards and do international aid work. I did some of that in India, working with a physician who had a sidewalk clinic, and worked at two of Mother Teresa’s centers there. What I realized while doing that work is that a lot of what is needed in the third world isn’t actually individualized medical care, it’s public health. It’s vaccines, it’s clean water, birth control, it’s getting people out of poverty—human rights. And I saw a lot of the frustration of working on the individual level; it felt like putting a bandaid on a bigger problem.

So, I didn’t really know what I wanted to do and I definitely never thought about dermatology. But I knew that I didn’t want to be in the operating room, and I didn’t really like emergency situations, and I also realized I liked being an expert. Dermatology had a combination where you could do surgery in an outpatient setting, but it also had a lot of specialized facets to it.

How does alternative medicine and what you learned during that year factor into your practice now?
It doesn’t really play a role in what I do currently, and I feel kind of funny about that in some way, but I actually use a lot of it for myself and using those practices makes me more grounded and better for my patients.

What type of training was needed for your job?
Four years of college, then four years of medical school, one year of internship, and three years of dermatology residency, so twelve years total. Dermatology residency requires a total of four years but that first year is what’s called an internship and it’s kind of like general medicine, so you work at a hospital and admit patients with congestive heart failure, diabetic coma, all different kinds of things so you get the basics.

Then it’s three years of speciality training just in dermatology. Then there’s some specialties that require a fellowship after that, for example if you want to specialize in surgery, you can do a surgery fellowship which is usually one or two years, same for children’s dermatology, pediatric dermatology. And if you want to become a dermatopathologist, so someone who is not only in the clinic seeing patients, but also creating the pathology slides of biopsy specimens, that usually takes one or two additional years.

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You also have a master’s degree in public health. What inspired you to do that?
I had finished residency and I was working at the V.A. and every year we interview applicants for the residency program and I just loved hearing so much about the different things all of the applicants were doing, taking a year off studying something or another. A couple of them had gotten a masters in public health which I thought that would be really cool to do, and we were working on a study and I realized I really didn’t know how to design a study.

I didn’t know anything about statistics really, how to do a double blind study, what randomization was about, so I was really motivated to go back [to school] because it was directly applicable to doing clinical trials. I actually loved doing that, it took four, maybe five years to complete because I did it part time. But all of the classes were exactly what I was doing in the clinic in clinical trials so it was really cool, I loved that.

How were able to do that part time as a practicing physician?
I applied for a career development award through the VA and that protected my time to take the classes, I still had to run clinic but I wasn’t there everyday, I was half-time in clinic, half-time in classes.

You were in school when we (my brother Gregg and I) were born. What was that like?
The key was having that protected time, because I could do most of the studying I needed during the day and not have it affect my time after work. And a huge factor was that Grams, my mother, your grandmother, helped along with Grampers to take care of you guys everyday, and that was a tremendous help. You don’t really ever remember me studying, do you Madeline?

No.
Yeah, I was really able to get most of it done during the day and then after you would go to sleep sometimes I would work a little bit after that.

You’ve worked at the V.A. for many years. How is working at a government hospital different from a private practice or private hospital?
Working at the VA, there’s definitely bureaucracy and it’s a different patient population. There’s no children, it’s historically been mostly men but now we see women too. Something I love about working at the VA is that when i see a patient and think a medical treatment is appropriate, the VA will pretty much cover it and we can get almost whatever medicine we want, except for cosmetic things obviously. That is a huge difference compared to the private practice world where there is so much money involved with the choice of treatment and the co-payments and conflict of interest, which I believe is a huge problem.

For example, at the VA, I never have to think about how much I’m going to receive if I do a biopsy on a patient, I just do what is needed for that patient. Whereas in private practice, even if physicians don’t really want to talk about it, I think there is conflict of interest when the higher number of procedures they do, the more money they make. And there is always a temptation, I think, for a little abuse there; so I love the freedom I have at the VA to just do what’s right for the patient. But the bureaucracy of it can get old.

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As a professor, a big part of your job is also mentorship. What role has mentorship played in your career so far?
I think mentoring others has been a huge part of what has made medicine fun for me because it’s fun to show your enthusiasm to other people and really discuss it. Like right now, we have three research fellows that work with us for a year--they have fresh eyes to look at clinical problems and they actually come up with really good questions and help us look at things differently.

They have questions that come up and I can say, “Do you want to write a paper on that? Let’s look at the literature and synthesize it because I bet other people probably have the same question” or “Let’s write a protocol and see if we can get funding to answer that question.” So I love that part in the clinic--the nitty gritty--and it’s really, really fun to see those mentees now in their careers, whether it’s private practice or academics, to see where they go. It’s really cool, it makes me really proud of them.

What’s been a part of this job that you didn’t expect?
I did not expect the level of, sort of, personnel management that is required. You go to medical school thinking you’re just going to take care of patients, but there’s a lot more to running a clinic or a research unit and working with other people, motivating a team, keeping communication open, and at the same time maintaining a professional distance, to the job, which I think is actually really hard for women in workplaces.

I think women leaders are more often seen as a confidant. Like people will come to me and talk about personal problems whereas I think if I was a man, they wouldn’t do that. Sometimes you have to step back and say I am the Chief or the Director of this clinic and maintain some professionalism, and I think that balance is really hard. I didn’t expect that the personnel management bit would be such a big part of my career.

On a different note, What is your biggest advice for taking care of your skin?
(Laughs) My biggest piece of advice is to wear sunscreen. And START young! So many of the common skin problems are just related to UV damage. So basically sunscreen, minimal soap, and a basic moisturizer, ideally one with SPF in it so you don’t even have to think about putting it on. You don’t need a major cleansing routine with toners and exfoliants and multi- step processes, you want your natural skin oils to do some moisturizing and just use a gentle soap.

Ok finally, if you weren’t a dermatologist, what else would you be doing?
Well if you had asked me that when I was in college I would have said a yoga instructor or something in holistic health. If you asked me now, I might be a biostatistician. That’s someone who does the mathematical analysis of data, runs statistical tests to see if there are differences and models epidemiological data, I think that’s pretty cool.

I’m surprised you didn’t say being Bug (our dog’s) personal assistant!
Well that’s my side thing.

Okay, but what do you do? Please write your answer as if you’re explaining to your ten-year-old self.

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Thanks so much, Dr. Mom! This was so special for me, and I feel so lucky to share it with our readers. If there’s anything I know, it’s that moms rock and sunscreen is IMPORTANT, and this interview strongly affirms the both. For more from the world’s coolest dermatologist, stay tuned next week for Dr. Warshaw’s super science How-To.  



How To: Listen To Yourself

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Last week, we had the pleasure of speaking with Jennifer Meng, founder of LA-based jewelry line Ready-Made. This week, she’s back to share with us her top tips on listening to yourself, even if goes against what everyone around you is promoting. Read on for her helpful advice!

1. Notice the early signs
You know that feeling of looking at your to-do list, only to scroll down to your monster task, the one you’ve been avoiding for a while, that has made it through to a third re-write of your to-do list because you’re avoiding it so much? Well, that might be one way your gut is talking to you. Jennifer says, “When you find yourself procrastinating a lot, like when I was applying to law school, when [I had] to write a personal essay, I really couldn’t write it. I felt like I was being really dishonest. That’s a major indicator that something’s up.” So, before judging yourself for not checking something off your list, take a moment to think about why you’re dreading it.

2. Take the time you need.
It’s so easy these days to feel like everyone around you is finding success immediately, even the kids that never helped out in class projects. Meanwhile, you’re in line at Chipotle deciding whether you can afford the guac. It’s at those moments when you feel you must double down and turn your ten-year plan into a five month one that Jennifer suggests otherwise: “People say ‘Hurry up and develop your career,’ but that’s so not true. You have plenty of time. It’s ok to wait a year or two years to figure out what you want. If you really feel uncertain, what’s wrong with waiting? That’s something you have to give yourself permission to do.”

3. Prepare as best you can for people’s reactions.
Once you’ve made the tough but honest choice that your gut was suggesting this whole time, you have to tell people about it. Jennifer explains that “It’s really hard. When I told everyone that I was going to start a jewelry business, no one took me seriously. My parents were very upset. They were like, “What’s wrong with being a lawyer?” It might be hard, and reactions might not be as gentle as you’d hope, but keep your eye on the long-term outcome.

4. But don’t forget you’re in charge of the narrative
Jennifer goes on to give encouraging advice. As difficult as it might be, you have some control over how you communicate your choice, so exert your power through tactful thought. Jennifer says, “A lot of the work is on you. When you tell people about these big moves you’re going to make, how are you going to tell people? And that really sucks, because why should [you] even be considering how [you] talk to people about these transitions? But if you start the conversation with ‘I’ve put thought into this. I know this is how I feel, and I’m going to go with it, I just need you to support me,’ people will back off a little bit, even if they’re strongly opposed to it.” In other words, now that you’ve heard and followed your gut, stand up for it!


Thank you so much for sharing your wisdom, Jennifer! Readers, after you’ve taken the time to check in with yourself, come back next week for an interview with a doctor who runs her own practice.

Jennifer Meng: Founder of Ready-Made

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Today’s interview centers on Jennifer Meng, a woman whose willingness to follow her calling is a wonderful call to action. She’s the founder of Ready-Made, a delightful jewelry brand that sets a new standard within the jewelry industry besides being incredibly wearable. From her love of storytelling, to the legal field, to running Ready-Made, Jennifer has learned to live by her own code. So keep reading to learn from her so that you can too! 

Let’s jump in! What is your official job title?
When I talk to other people I say I’m a Founder, but I think my role is really a Brand Builder and a Creative Director.

Can you tell me the story of your career so far?
It’s been a very interesting path and it has a lot to do with how I grew up. I’ve always been very interested in art, writing, and story-telling. I collected objects and was a very imaginative kid. But I didn’t have the guidance to turn that creativity into something productive, into a career. I majored in Art History and English and when I graduated and started looking for my first job, I was like, “Ok, I have to be serious here. I have to find something that I can transfer my writing skills to, but be taken seriously for it.” And I thought, “The legal field.”

I ended up in a corporate law firm [in Taipei, Taiwan] for two years. I grew up in Taipei, that’s why I went back when I graduated from Wellesley. Work there was really different from that creative freedom of expression. I really enjoyed the rigidity and that corporate seriousness, that ambitiousness that comes from being in a competitive environment. I was very dedicated—I took the LSAT and got into law school. But during this arduous process of applications I realized, “You know, I don’t think I wanna do this.” The information you work with in the legal field was so different than the storytelling I had aspired to for all of my life.

It was during this time that I met Jeff [her partner] at a high school reunion. He’s a designer and was thinking of starting his own business (and he did—check out Inventery!). By observing him, I saw that you can actually take your creative vision and transform it into something commercial. That was the guidance I always wanted all my life, and I finally figured out that combining my love of art and storytelling with the structure from the legal field was very suitable to building a brand and a business. That’s how I arrived at Ready-Made.

What pushed you to give up law, a more stable career, to start your own brand, a career that has more ups and down?
When I was at the law firm it was very extreme hours. When I had that little extra time, I’d write a story, or I’d paint. I [also] realized that with all the time I was committing to working with clients and writing in a very structured way, I was losing [my] creativity. I wasn’t writing stories the way I used to. It scared me because my parents and my bosses were telling me, “Work really hard now, and enjoy life later,” but I feel like for creativity, it doesn’t work that way. If you wait too long—you lose that drive. I didn’t want to make that mistake.

What is something you do to foster your creativity so you don’t lose it?
After I started this brand I realized that when you’re in the business of creativity, you only use a small percentage of your creative potential because most of your time is spent on making sure your business is stable first so that you can continue to harness your inspiration. I think being in this industry is enough to allow you to be creative. I’m always talking to a lot of content creators, photographers, make-up artists, seeing how they’re inspired and hearing their stories.

Did you take out a loan, use savings, or fundraise to start Ready-Made?
It was all savings. After the law firm, I was able to use money earned from that to start a vintage jewelry brand, and with that [money] I was able to start Ready-Made.

How was that? Putting so much on the line can be scary.
Putting all that money in? It was very scary. But I think I’m very lucky because I have Jeff, and he does the exact same thing, so we’re able to split rent and help each other out with personal expenses, especially when we were first starting out. That’s the realistic side of things—having someone who can help with bills when you’re feeling low, and vice versa. Having that partnership definitely helped.

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Something that makes Ready-Made so special is your approach to jewelry. You use sustainable materials, it’s affordable, but it’s really good quality. How do you explain this unique stance within the jewelry world?
Dealing with vintage jewelry taught me a lot about the disparity in quality and different metals. It also made me realize that the vocabulary around jewelry is very confusing: gold-plated, gold-filled, vermeil. Does it tarnish? Silver oxidizes, but if you polish it then it becomes bright again… It’s very confusing. And the market is so saturated. There’s fast jewelry, high-end, and more middle. There’s also more hand crafted and artisanal, like Etsy.

But no one really talks about the materials that transparently. I didn’t want to spend all this money on fine jewelry, but I wanted something that was worth my money. That’s why I started taking applications from the medical field and the industrial field to make jewelry that truly is affordable but is skin-friendly and really can survive the everyday –water, sweat, accidental tugs and bangs, and all. Although the metals and ceramics I use are definitely harder to work with, it’s not a super complicated procedure, but no one’s been very hard-set on using it for a jewelry brand.

What do you think makes a good creative director in relation to your manufacturers?
Number one is definitely communication. And number two is consistency. If you’re always doing something the same way and your priorities are the same across the board, people will take you seriously and they will make sure that everyone goes through with them. The third is being empathetic, because things do go wrong. It happens. Something I hear a lot about overseas manufacturing is “I was lied to,” or “They took my money and I didn’t get a great product!” It does happen, but it’s not because someone is out there to get you. Sometimes it’s timing, there are also a lot of environmental, political factors involved with factories overseas, so it’s about being empathetic and knowing that everyone’s end goal is to actually create a good product.

How do you come up with designs?
For me, it’s what I want to wear. I don’t like to think that much when I roll out of bed, I just wanna throw on some jewelry. I admit I’m not a mood board person. In line with my childhood, I’m focused on storytelling—I focus more on the mood, I don’t really focus on the visual. For jewelry, it’s always “how do I wanna feel about these shapes?”

Do you have help at Ready-Made or are you a one-woman show?
I’m a one woman show. Jeff helps with the digitals [digital rendering of Jennifer’s designs], and I help his brand with the copywriting. But it’s easy to be a one-person show in e-commerce these days with the number of available tools. I have a developer for the website and I have seasonal interns that come in and help a lot, but in terms of leading the branding, the design, even the packaging design, the manufacturing, and creating the assets, it’s just me.

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Can you walk me through the process from having the idea to shipping it out?
First, a feeling or mood or shape comes to mind, and I have to draw it out to communicate with the manufacturer. I’ll hand sketch and Jeff will transform it into a 3D file that we’ll then send to the factory. A lot of manufacturers can work off a 2D picture, but I really want complete control over my product, so we send a 3D file, and they’re able to turn it into a mold and make it directly.

After the back and forth with the manufacturer (sending over checklists, how-to’s, things to be careful of), we put the order in. Depending on how much we’re producing, a few products or an entire collection, I might fly to the factory to make sure the process goes smoothly. If I stay in LA, production takes about one month. [That’s also around when] we start planning the photography and the branding behind that product or collection. Once we get the product, we do a final quality check and report any deficiencies or defects to the manufacturer so that they know next time. We photograph and measure it, upload it onto the website with dimensions and descriptions, and launch. It takes about four months from the beginning to the delivery, if there are no delays.

How do customers find you?
I run targeted advertisements and those have been successful with brand awareness. A lot of my customers also find Ready-Made through Instagram. I work with a lot of influencers, specifically those under 10k [ten thousand] followers. I find it to be more personal and I get to know them better. They’re at that ideal number of followers where they’re authentic, confident, and professional and have a lot of activity on their posts. In short, people trust them. Since I’m putting a lot of spending into ads, I have to balance that out and spend less on influencers and instead build long term relationships with them. So far, it’s been working because customers come when influencers post.  

What are some things you want people who are starting their own business to know?
Don’t underestimate the power of an accountant, no matter how small your business is at the moment. Accounting is complicated, and while you can do it on your own, you should focus your time on other things, things that you’re good at.

Another thing is to filter the information and advice you receive. Most people won’t take the time to understand your business and goals, and a lot of people can’t differentiate between different kinds of businesses and may offer irrelevant advice. If you take every piece of advice or even spend time thinking about each one, it can get confusing or even depressing, and the most dangerous thing is to lose focus.

Do you get feedback from customers, and if so, do you listen to it?
I get a lot of feedback from customers and I listen to them every time. It’s valuable because I can build better products based on what people say. I get moms who tell me that they like how the chains are indestructible because their small kids pull and tug. Our pieces are very fade-resistant, but one customer told me her ring faded from wearing it to hot yoga every day for a week. Now I know that that combination of heat and sweat, seven days a week, is going to eat away at our coating faster than anticipated and I can make our plating stronger.  

Customer feedback also helps me be a more universal brand in terms of pricing, but also accessibility. When I first launched, I had ring sizes 5 to 8, but I received emails saying that that wasn’t good enough. Now I know that sizing is going to be a priority because I don’t want anyone to feel like they can’t wear my jewelry. We’ll be offering size 4, 9, and 10 in a month.

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As a female, non-Caucasian business-owner, have you encountered any obstacles?
There have been some challenges. A lot of women want to get together and help each other out; I think that’s great. But sometimes we don’t realize that while we’re all women, we might not [see] that our businesses are so different that we can’t really collaborate. When a lot of support is encouraged, you have to be sure you spend time trying to support each other efficiently.

Another obstacle is that since I’m Asian and my products are made in Asia (Taiwan, Hong Kong, and China), there’s that challenge of breaking down the first impression that somehow I’m okay that my products are unethical or low quality. I’ve had to take control of the narrative – great products certainly come out of Asian factories that treat their employees well, I’ve seen it first-hand. A good product all comes down to great art direction and quality control. Like I mentioned previously, no one wants to band together to make a bad product.

What’s your least and most favorite part of your job?
My least is probably social media. It takes a lot of time and you get absorbed. You have to reply to messages and comments, and keep track of influencers’ lives. Your mind has to be so nimble and your responses fast and varied. My favorite part is having control. Full control of a company was never something that appealed to me, but now that I have it, I can see why some people strive for it.

What’s a mistake you made that people should learn from?
Don’t delve too fast into paid services when you’re such a young brand because too many things are changing. Next week you could be focusing on an entirely different message. If you’re paying for services from an established PR firm or advertising agency to market your brand, you will need consistency to get the most out of your retainer. It’s also emotionally challenging because you feel inconsistent and you’re always having to explain your reasoning and ambition. Doubting yourself is the last thing you need!

How do you spend your daily life with Ready-Made?
In the morning I’m answering emails from customers and packing up orders. From twelve until the end of the day, it’s working on the brand, thinking more long term.

What are dates you need to keep an eye out for as a jewelry designer?
As a jewelry designer in e-commerce, Black Friday/Cyber Monday is the holiday. Valentine’s Day is almost irrelevant now, in my opinion. Women buy jewelry for themselves; waiting for that one time of the year now seems unbelievable. I don’t even advertise it as Valentine’s Day—it’s Galentine’s Day, for your girlfriends! I really think it’s great that women have taken control of the jewelry industry in their own way. Jewelry’s an identity, an extension of who we are. I like how things are turning out!

Okay, but what do you do? Please write your answer as if you’re explaining to your ten-year-old self:

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Has this interview awakened a dormant dream in you that you put aside for your “sensible” ones? Then we’re glad you read what she had to say. Even better, come back next week to hear how to follow your gut!

(Photos provided by Jennifer Meng)