"All music comes from God."

The clinical assistants in my program’s clinic routinely schedule talks and invite outside speakers with various expertise to give the talks. I went to one today, which I think is the most interesting one I’ve been to this semester. The speaker is a specialist in treating Trichotillomania, which I have never heard of before today. This disorder is so rare that I think we actually skip it in our pathology class this semester… ha… but it’s so interesting! It’s basically a “hair pulling disorder.” Patients with Trichotillomania pull out their hair compulsively. They pull out their hair excessively from their head, eyelashes, eyebrows, arms, legs, face, etc. Many of them become bald (or partially bald) because of the extreme hair pulling behavior. The shame and stigma attached to this “secret” disorder also make the patients experience great psychological distress. According to the speaker today, the majority of these patients have never shared this disorder of theirs with anyone, including spouse and best friends.  Physically, becoming bald is the milder consequence of the disorder. The more severe one is this: about 30% (if I remember correctly) of people with Trich actually eat their own hair after pulling them out! And since hair is not easy to digest, they would accumulate in one’s body and eventually become a solid that needs to be taken out of the body through surgery.

I find this talk particularly inspiring not because of the disorder itself, which is interesting. But it inspires me what a great career the speaker has by specializing in something this specific and rare. Probably most people don’t even know that a “hair pulling disorder” exists. In fact, the prevalence of this is about 3%, meaning only about 3% of the general population have this disorder – very rare comparing to depression and anxiety, which are much much more common. With something this rare and specific (pretty much the only characteristic symptom is one keeps pulling one’s own hair), there are a limited number of specialists in the field, so they easily get lots of referrals. The speaker today has a private practice where 90% of her patients are Trich patients. Seeing so many cases with one specific disorder probably makes her become an expert easily. She has written a book from her clinical experience, and the book became one of the few books ever written about this disorder. She also created a website (http://www.stoppulling.com) which probably is the only website out there for Trichotillomania. Another thing is, while there may be biological basis for this compulsive urge to pull one’s own hair excessively, there is currently no medication to treat this disorder, which means ” 冇藥醫 “. On the other hand, Trich is quite treatable with a variety of psychological and behavioral strategies to treat. So this means psychologists are the only professionals that these patients can turn to for help.

So the inspiration I got is that to find a very rare, specific, and not-treatable-by-medicine disorder to specialize in would be quite a career! haha..