Scrutinising beauty and skin ailments

Laurence Toutous Trellu of the Geneva University Hospitals has a fine aesthetic sense. | Photo: Guillaume Megevand

Dressed in a suit and sat by the Jet d’eau fountain, Laurence Toutous Trellu (58) looks out over Lake Geneva. “This colour is very hypnotic, it’s so pure. I enjoy looking for beauty”. Toutous Trellu’s visual quest for the sublime is not new, and she is sensitive to the nuances, the textures and the play of light. Her attentive gaze into the visible has gradually led her to a singular territory of medicine: the skin. It is a living surface where the marks of time and the body’s fragile balances become engrained. Her eyes are absorbed by the landscape, and she seems soothed. The lake, where she bathes all year round, offers her a rare moment of calm, and it’s a welcome digression, given how her responsibilities have accumulated over the years, between consultations, research and teaching.

Toutous Trellu’s childhood was also characterised by time spent reinvigorating herself with the blue waters. Back then it was the Atlantic Ocean and the shores of Brittany. As a teenager, she was fascinated by the idea of deciphering human beings “through their beauties and defects”, and she began to consider anthropology and ethnography. In the end, she chose medicine, because it combines the confrontation with this human complexity with the concrete aspect of care.

She then left Brittany and dived into the effervescence of Paris. It offered her both medical training and an international outlook. “I’ve always been very attracted to the global level, where I can see humans more generally. Paris was a very good start in the great variety of humankind, our colours, our origins, our professions”.

In Paris, with her eyes focussed through a microscope, Toutous Trellu began to admire samples of human tissue, microbes, and other “little critters”. She chose to specialise in dermatology, a very visual field centred on skin diseases. But beauty and colour are sometimes difficult to come by in the often hard medical environment. “I did my practical training during the 1990s, in the middle of the AIDS years. It was an electroshock”, she says, sighing. “You had to jump into action, right away, in order to treat sick people”.

Their visible marks and lesions made her understand how much dermatology can reveal the disease. The signs of infection and its complications are there to be seen on the skin. This is what drew her naturally towards infectious dermatology. After Paris, she was offered a position at the Geneva University Hospitals (HUG) in the HIV-AIDS unit, then in the dermatology and venereology department.

Beyond the boundaries of care

Looking up from the lake, Toutous Trellu glances at her watch, gets up and makes for her bicycle. It’s time to go back to the hospital after this well-deserved break. On the way, the calm of the water is quickly replaced by the commotion of cars and passers-by. She greatly admires the internationality of Geneva, reflected by the audible mix of foreign languages. “I like to meet other people. I also like to travel. I’m a little restless”, she says, smiling and walking with her bike. She goes on to talk about her travels to Cameroon, Mozambique and Eswatini, where she leads partnerships with Doctors without Borders, and more recently to Côte d’Ivoire as part of a collaboration with the WHO.

In these countries, it was necessary to conduct diagnoses, tests and treatments, often with little means. She has led collaborations with local doctors and prevention missions against sexually transmitted infections. “It’s very energising for everyone. We learn from colleagues, and patients are extremely happy to see these collaborations”.

It wasn’t the jumpstart of the AIDS years alone; the injustice of differing care levels among countries and the imbalances of access has also contributed to her long-standing desire to fight for change. For sure, her determination for this cause has never waned, but she also carries with her now a word of caution against portraying the ‘saviour doctor’ who would jump off the plane without any further thought. In that sense, she does not forget that “every place has its history and its habits”.

These reflections have been developed thanks to her interdisciplinary teamwork, including in a research project dedicated to ‘endless’ infectious diseases. She has also studied alongside historians to look at care provided during the colonial era.

Searching differently

Toutous Trellu also describes how this intellectual wealth, gained through working with others, has allowed her to face up to the brutality of her profession. She is confronted with not only deep wounds but also the distress that accompanies them. Hardening off in this way has already led her to fancy “discarding everything and becoming a florist” just so as to be surrounded by colours and beauty. This idea has always become entangled with her passion for her work and the need to crack open human mysteries.

Toutous Trellu now co-directs Archimed, a project to digitise 20th-century medical archives, which combines aesthetics and medicine. With specialists in digital humanities and history, she is reviving collections of human tissues. These medical reports, brain samples and other tissues – long since static – are now being deployed to provide new answers to the scientific questions that remain unanswered. Among them is one about the impact of pharmaceuticals: are tissues from the pre- and post-penicillin ages different? And can we train AIs to classify these samples according to their pathology? “It’s like a herbarium with dried flowers, but here we scan biopsies and patient records”, she says happily.

Once her bike is locked in front of the hospital, she walks through the front door of the HUG Julliard building, where the hurried steps of the caregivers in white coats cut away from the serenity of the lakeside. Here, the constant beeps of the machines and the ever-present patients and doctors create an incessant hubbub. From the vast expanses of Lake Geneva, she enters a small room filled with folders and computer screens, and on the desk she juggles three phones and confronts the pile of documents waiting for her. “There are constantly letters to sign”, she says. Soon, she will have to visit hospitalised patients in the dermatology unit she runs. The vigorous routine does not frighten her; to the contrary, it fuels her determination and passion.

On a shelf behind her is the photo of a ballerina. The elegant figure adds lightness to the room and is likely a reminder that beauty is never very far away. Indeed, Toutous Trellu seems to possess an ability to find beauty everywhere, and not just on the blue depths of the lake: “Here, it is the patients who teach us”, she says, smiling. “I see people who, despite their suffering, read beautiful books while waiting for their care”. She’s also an amateur oboist, further demonstrating how aesthetics permeates her busy life: “There are the actual notes, the ones written on the score, which we play, almost mechanically. Then, there are nuances, piano, pianissimo, mezzoforte. That is what brings harmony and emotion to our daily lives”.