Dr Robert Klitzman, an associate professor of clinical psychiatry at Columbia University Medical Center said "How you look is something patients confront and try to control, but they often have to do so on their own.

In his book, "When Doctors Become Patients", the seventy-five doctors interviewed describe how they became aware of the importance of appearance and self-esteem only after they themselves became seriously ill. "Repeatedly, they told me that they were astonished at how changes to their physical appearance disturbed them far more than they had ever expected," he said "As one doctor with cancer told me: 'when you lose your hair, you suddenly become a totally different person. You don't recognize yourself. When I look in the mirror, I don't see myself. It's a different me: a cancer patient.'"

Dr. Klitzman said that many seriously ill patients try to hide the physical changes because of what they represent: Illness and loss of dignity and humanity. He believes that appearance can have far-reaching effects on patients and that physicians need to be trained to deal with such issues. "Aesthetic assaults on patients can contribute to depression and anxiety that could in turn hamper patients in treating and caring for themselves"

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