In memory of Vishwas (Vic) A. Narurkar, MD

Vic (right) with life partner, Mike, and their best friend, Mavis (portrait reproduced with permission from artist Jenny Condon)

by W. Philip Werschler, MD, FAAD, FAACS

Dr. Werschler is Aesthetic Dermatology Editor-In-Chief of the Journal of Clinical and Aesthetic Dermatology and is Assistant Clinical Professor of Medicine/Dermatology University of Washington School of Medicine in Seattle, Washington.

J Clin Aesthet Dermatol. 2019;12(2):E60–62 epub only

I first met Vic Narurkar when we were both young and eager dermatologists. In the early 1990s, we were asked to speak at a small local meeting somewhere in California wine country­—of course, Vic on lasers and myself on injectables. There wasn’t really much to talk about since the field of aesthetic dermatology hadn’t really started yet. What we didn’t know is that we knew very little about aesthetics, especially compared with today; however, we did know just a little bit more than everyone else in attendance. That makes you an expert by some definitions, or at least in those pre-internet days.

We enjoyed meeting each other and promised afterward that we would stay in touch and look for ways to work together again. Neither of us could have realized in that moment how our lives would become intertwined over the next quarter century. Fate and karma work in mysterious ways.

Vic and I were both interested in furthering the knowledge base of dermatologists, especially in the use energy devices and injectables, as we both felt the field was poised for explosive growth. They say hindsight (or the retrospectoscope, if you prefer) is always 20/20, and I think that’s generally true. I know it was true at that time in dermatology as the specialty was still rooted in medical/surgical care and research. The nascent field of aesthetic dermatology (and aesthetic medicine) was in its infancy. Vic and I were firmly committed to the advancement of the specialty, and saw this as an opportunity for us to contribute to the field’s advancement through research, clinical trials, podium time, and publications—to help bring dermatologic expertise to aesthetics. We also strongly believed that in order for the specialty to keep a seat at the aesthetic table with our plastic surgery colleagues, we needed to reinforce the evidence-based paradigm, especially compared to the experiential and anecdotal observations that had historically defined much of dermatology.

Vic and I put together a roadshow of sorts— “Update on Cosmetic Dermatology.”  We lectured at all types of dermatology meetings, large and small. We tried to stay abreast of changes in the subspecialty of cosmetic and aesthetic dermatology, and to distill the information into small presentable bites to our colleagues. This was when when the vast majority of dermatologists were not in cosmetic practice, or at least not according to the current concept of aesthetic dermatology.

Long-time industry and personal friend, Michele Franklin, recalled the very first Cosmetic Boot Camp meeting where “there was a power outage and blackout at the hotel, and Vic commented that being in the dark allowed you to see the (laser) light.”

Michele especially remembered a particular dinner when visiting Vic and his life partner, Mike, in San Francisco: “They took me to a restaurant where we were all on a bed together—no table and chairs—just a great big bed. We ate and laughed and ate and laughed until my stomach actually hurt.” 

Some of the best things, when spending time with Vic, Michele added, was “the laughing, singing, dancing and happiness. Their joint birthday party last year with Evelyn ‘Champagne’ King performing is one of my happiest memories ever.”

As the years passed, Vic continued along this path. He was proud to be a dermatologist—not a surgical or  cosmetic or “insert adjective of your choice” dermatologist—just dermatologist. He was a great believer and supporter of the specialty, unified and inclusive. Vic was an Ivy League graduate and completed medical school and residency at Stanford. Meeting him, you would never know this fact. In all the years I never heard him trade on the breath of his accomplishments or his educational pedigree. He believed, heart and soul, in the meritocracy of medicine and dermatology, where anyone could advance based on his or her abilities, efforts, and dedication. He lived his life earning his way to the pinnacle of the profession.

Patti Pao, entrepreneur, corporate executive, and special friend of Vic and Mike, shared a particularly poignant story of how, upon first meeting her in 2006, Vic was “a bit suspicious of me.”  According to Patti, she and Vic seemed to have a special bond or connection, but Vic wasn’t quite sure just how.

“I instantly bonded with Mike, and we would spend time together while Vic was working, having fun admiring his skill at the podium,” Patti said.

“Eventually we figured it out: We were the same person, only separated at birth” Patti added with a smile.

“He was my soulmate who, along with Mike, became family, and we began to enjoy our lives together in a way that I can’t describe, only treasure forever,” said Patti, adding “his loss has been devastating to me and I can’t even begin to understand how Mike feels.”

As Vic’s reputation and influence grew worldwide, he began to mentor colleagues both formally and informally. He wasn’t concerned with who you knew, or where you trained, or any of those other definitions of future greatness. Quite the opposite, Vic saw all dermatologists as being created equal. Once you completed residency and passed your boards, you were a member of the club, and he would always there for you. It was the same with dermatology residents and fellows: there was always time to answer that last question, give that piece of advice, or offer that constructive criticism. Vic was a gentleman.

As aesthetic dermatology exploded in popularity in the early 2000s, Vic became aware of nondermatologists posing as such, along with a few dermatologists pretending to be plastic surgeons. This was disturbing to him on a personal level, as well as a professional level. Initially, Vic responded by starting a meeting called “For the Core: By the Core.”  This was one of the first core aesthetic specialty meetings to be held in the United States. Vic subsequently focused his efforts on the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS) and was elected President. His efforts and commitment to promoting core aesthetic training contributed to the explosive growth in the society, and he later helped integrate ASCDAS into ASDS, again believing that all dermatologists were created equal and it was better to stand united. After ASCDAS, Vic joined colleagues Ken Beer and Mary Lupo to establish Cosmetic Boot Camp, continuing the legacy of core aesthetic training. Vic promoted #noposers. This was his way of monitoring the promotional activities of aesthetic practitioners who were, perhaps, less than completely transparent in their training, board certification, and/or experience. Vic was strongly committed to the work ethic of  “earning your stripes.”

Bob Rhatigan, an industry executive who knew Vic for nearly two decades was always impressed with “Vic’s honesty, integrity, gentle mannerisms, and open mindedness, along with his firm convictions on solid scientific evidence.” He added that if you wanted Vic to support your products, you needed to have the data to support your claims, or else you were in trouble. Bob’s best memories, however, were of “Vic bringing his best friend, Mavis [a long-haired dachshund], to meetings, where friends would take turns holding her,” while Vic would lecture, adding, “I have a special respect for those who are kind to animals, and Vic and Mavis were inseparable.”

During the surging popularity of dermal fillers, there were a number of classification systems being used to describe products and their actions. None of these were systematic or consistent with each other. The unmet need of a rational evidence-based classification system of dermal fillers was obvious. In conversation one day, Vic and I decided to do something about it. While watching a beautiful sunset one evening in Coeur d’Alene, Idaho, we noticed that some of the decorative flowers were real and some were artificial. From a short distance they looked alike. Vic jokingly said to me, “Just like fillers, some grow (collagen) and others just occupy the space, but they look the same.” Shortly thereafter, our classification system for dermal fillers was published, using the terms collagen stimulating or stimulatory and replacement or space occupying. We followed with an injection technique poster that was distributed to dermatologists for many years and served as an educational guideline for training. Vic had told me, many years ago, for something as simple as a poster you could hang in your office, he was especially proud to have helped provide clarity and wished he could do the same for lasers and energy devices. Vic was the consummate teacher.

Vic practiced for the past 20 years in downtown San Francisco with Kathy Fields. According to Kathy, he was known in the office as “VN.”

“His practice was a magical playland of curiosity, ingenuity, and genius…he skipped between rooms, made superhero call outs, and deeply bonded with his adoring patients and staff—and always tried to do the right thing,”  Kathy said.

Recalling his commitment to teaching and training, Kathy fondly remembered, “He opened our door to mentees from all over the world…He was our white-coat caped crusader with his infectious smile…a joyous cosmetic wizard! We miss him dearly.” 

One of Vic’s most respected colleagues in the laser/energy space was Vic Ross. Affectionately known as the “laser Vic 1 and laser Vic 2 (unknown who was which)”, Vic Ross recalled, “Vic Narurkar would stand firm on principle even when it meant taking shots. He was strong willed and rightfully believed that money should not be a guiding principle for any organization.”

On a more humorous note, Vic Ross remembered a particular meeting aboard a cruise boat, stating, “Vic became incredibly seasick but still wanted to keep conversation going regarding an energy device design in spite of his obvious distress. I was impressed, especially as a former Naval officer, in his resilience.” 

Most recently, Vic and I discussed the emerging role of regenerative aesthetics and how transformative they would become. Vic saw a future in which aesthetic treatments would become mainly autologous. He was looking forward to contributing to the science of this newly emerging field and to participating in the clinical trials. Vic was a visionary.

Perhaps Vic’s most important qualities, according to his friends, were his kindness, his wonderful sense of humor, his contagious smile, and his charm. He was a fabulous and sophisticated entertainer who loved a bit of suspense and drama. Vic was gay, and was in a long-term committed relationship with Mike, a wonderful man with whom he was deeply in love. Together, Vic and Mike were quite the couple, and were always sought out by others as tablemates at specialty and industry dinners. If you were fortunate enough to be seated at their table, you were guaranteed a great experience not easily forgotten.

It was at one of these dinners, in San Francisco many years ago, in which we were co-hosting a multi-specialty core meeting that, for my wife, Pam, and me, a truly memorable event occurred. Months earlier, Vic and I had agreed to divide the responsibilities for the meeting into the scientific and the social. Vic suggested that since he was a local, he would choose the venue and the menu while I would take care of the scientific agenda. I really didn’t have much of a say in the matter, so I agreed. What I didn’t know is that Vic really wanted to plan a fantastic dinner party for about 100 of his colleagues. Let’s just say it was “over the top!” As I was presenting a toast thanking our hosts and Vic for their hard work and generosity, I naturally asked Vic and Mike to stand for “cheers.” I thanked them for planning such a wonderful event, and, as I returned to the table, I will never forget what happened next. Vic leaned over to me and, with a sincere smile and a look of gratitude, whispered, “Thank you! Do you realize that’s the first time at a medical dinner that anyone has publicly acknowledged Mike and that we are here together as a couple?”

Of course, I didn’t. Why would I? Vic and Mike were dear friends of Pam and me, and we had always thought of them as they were— together. I’ve thought of that night many times and how a simple public acknowledgment like that could mean so much to someone.

Vic had East Asian (Indian) heritage and ethnicity, he was strikingly handsome with brown skin. We never talked much about this because it didn’t matter to us. However, it mattered a great deal to Vic when he overheard, observed, or perceived bias of any type, including racial. I have observed him openly and politely face it with grace and charm, not anger.  In his way, he would educate. Vic was proud of who he was as a person.

Vic was funny—he had a wonderful sense of humor. Once, many years ago, when we were returning from a consulting visit in Europe, he and I were seated in the first class section of the airplane. Somewhere over the mid-Atlantic, there was a medical emergency and the flight attendant announced that if there were any medical personnel on board to please identify themselves. Vic and I looked at each other and softly said, “Let’s see if there’s anyone else on board.”

After a second plea by the attendant, we raised our hands like two schoolboys. Simultaneously, we identified ourselves as dermatologists. The flight attendant then announced, while barely holding in a burst of laughter, that “fortunately, there are two dermatologists in first class.” 

We sprang into action, asking the distressed passenger if he had any medical problems? After learning about his kidney stones, we quickly determined we could proceed to the USA, instead of turning back to Europe. Vic was standing in front of the flight deck speaking to the pilot, when the pilot announced that he wished every flight had a dermatologist on board, to which the entire group of passengers broke into sustained applause. Only Vic could orchestrate such an ending. We enjoyed traveling the world together.

Vic and Mike traveled extensively throughout the world for both medical meetings and personal experience. Vic’s reputation as a top-level thought leader in aesthetics, combined with his mentoring of fellow dermatologists from around the globe, resulted in standing invitations to visit and lecture. Vic and Mike were especially close to Jose Montes and his partner, Cristôbal.  Jose, an oculoplastic surgeon in San Juan, Puerto Rico, noted, “Vic was living, at the moment, one of his best and happiest times in life. We would bring our families together (Mavis and Chabella) and just have fun and smile and remember how lucky we were.”

Jose also wistfully recounted that he and Vic,
“…would sit next to each other in meetings and pass notes back and forth in an attempt to make each other laugh during discussions.”

Jose also shared Vic’s concerns over non-experts pretending to be something more, and reflected on the value of the #noposers campaign Vic started, stating, “It was for patient safety—that was the most important thing to Vic.”

Another long-time industry friend, Keith Greathouse, worked closely with Vic on product development. However, Keith’s best memory of Vic revolved around a “celebration for the ages” in Napa, California.

“I was contacted by an old friend from China, Kieu Hoang, who had just purchased the Michael Mondavi’s Carneros winery in Napa,” Keith stated. “Kieu was very excited about his new venture and was having a celebration party for his closest friends—including their closest friends. The party was held at the vineyard, catered by Crustacean from Beverly Hills, and had performances by Leona Lewis, Li Bing Bing, and Isabelle Huang Ling. There were over 300 ‘friends and their friends’ in attendance. I will never forget how much Vic and Mike enjoyed the pomp and circumstance, the red carpet, paparazzi, celebrities, Silicon Valley entrepreneurs, and such. They were right at home, and Vic was posting on Facebook as fast as he could. I will never forget the smiles on their faces.”

I had two avocational passions in common with Vic. The first was Porsche 911s. Our pursuits were varied: I could be called a track enthusiast, while Vic was more of a concours-type of guy. Nevertheless, we appreciated the fine art of Stuttgart. The other was animal welfare. We often spoke of our love of animals, and I believe our concerns grew over the years. Wild or domestic, we viewed all life as precious and hoped for the well-being of all animals. Pam and I are the parents of Nevus, a pug mix, and of course Vic and Mike were the proud parents of Mavis, their long-haired dachshund.

The portrait of Mike, Vic, and Mavis, which appears on the title page of this memoriarum, was a gift to Mike and Vic by their dear friends Dennis and Jenny Condon. Jenny, an accomplished artist from China, and her husband Dennis, an industry executive and mentor, were befriended by Vic and Mike, enjoying many special times together over the years enjoying art, food, music, and entertainment. Dennis explained,  “In this (aesthetics) industry, you meet many people from all walks of life, but not very many that you can really call your friends. Vic was one of those rare individuals who didn’t value or judge you by what you could do for him. Instead, he welcomed you for who you were, with value placed on the human being, not the degree or the title or the size of your wallet. Jenny and I cared for Mike and Vic very deeply. His loss is just a gut-wrenching tragedy for not just us but all who knew him.”

Dennis shared, “The portrait was presented to them as a light-hearted surprise one night at a small restaurant in town [San Francisco]. It was our way of saying thank you for who you both are— we appreciate you.”

Reflecting on the sentiment of the images captured by the brush, Dennis added, “I’m so happy Jenny, in that casual moment, preserved their beautiful smiles, their love for Mavis, and the clear affection they had for each other. We will always remember Vic for the great and good man he was. Farewell my friend.”

Vic became my best friend in dermatology over the years and I believe I became his as well. I admired his many attributes, especially his unwavering commitment to scientific inquiry and ethical conduct. We shared a value system that was predicated on always trying to do the right thing. Sounds easy, right?

As Vic used to say with a laugh to Pam and me when we parted in person or over the phone, “To be continued,” and Vic’s legacy in this world will be continued on for many years to come.

There are no goodbyes. Where ever you’ll be, you’ll be in my heart. —Ghandi