HBO’s The Night Of is many things: part whodunit, part fine-toothed character study, part prison drama. But it is also a star vehicle for eczema. By now it is well-established that John Stone, the schlubby lawyer played by John Turturro, suffers from a debilitating skin condition on his feet. He wears sandals everywhere in order to air out his rash. He totes around a chopstick for easy scratching.
His skin disorder gets so much screentime that it arguably deserves its own place in the credits—so we recruited a dermatologist to assess the accuracy of the show’s eczema portrayal and help us puzzle through its role in the drama. (Kudos to the great minds at Vulture who clearly had similar thoughts while this piece was in the works.) Dr. Katherine White, who is based in Massachusetts, has watched all available episodes of The Night Of, including screeners of a few that haven’t aired yet. A few very mild eczema-related spoilers for upcoming episodes of The Night Of within.
Laura Bennett: So you’ve been watching The Night Of.
Dr. Katherine White: I’m enjoying it so much. And it’s really interesting how integral the quote-unquote eczema is, whatever they’re calling it, the skin disorder.
Why do you say “quote-unquote”? Are you not convinced it’s eczema?
Well, it doesn’t matter what the exact diagnosis is. In my opinion, they get all the details of the frustration and the despair that patients feel about having skin conditions—they get it really right.
Eczema is so integral to John Stone’s character. As soon as he meets Nasir, Nasir notices his scaly feet. And he uses the chopstick on the subway and the lady moves away in disgust. He has to repeatedly assure people that it’s not a contagious condition.
So that’s something your patients struggle with, too?
Oh definitely. I’ve had patients turned away from public swimming pools. There’s just a lot of disgust that people experience when they see skin conditions.
In John Stone’s case, the fact that he wears sandals with suit pants is probably not helping him blend in.
Eczema almost defines John. Almost everyone John runs into, even the security guard at the courthouse, the first thing they ask him is: “How are the feet?” instead of “How are you?”
There’s also a scene with one of his dermatologists when the close-up of his feet looks just like the corpse on the tray. Like dead feet.
Have you ever seen a movie or show in which a skin condition features so prominently?
Oooh. Elephant Man? [Which was allegedly] neurofibromatosis type I. There was a British mystery series with a famous actor who had psoriasis…
The Dennis Potter one? [Googles.] The Singing Detective.
Yes. I wasn’t a dermatologist when I saw that.
That wasn’t what made you want to be a dermatologist?
Ha! No, I don’t think so. But it was a good depiction of psoriasis.
Is there really such a thing as an eczema support group, like the one John Stone joins?
Well, certainly support groups for people with psoriasis exist. And the reason I said “quote-unquote eczema” earlier is that there are elements, as a dermatologist, where I’m like, “Hmmm, does he actually have psoriasis? Or is it eczema?” It’s not important obviously. It’s a skin disorder that’s disabling him and causing him all these problems. There are support groups for people with chronic skin disorders. Most notably the National Psoriasis Foundation, which is more of an online community.
I like that as a dermatologist you can’t turn off the voice in your head that’s like, “But IS IT eczema? Looks like psoriasis.”
Oh god, I know. But it doesn’t matter. It’s a literary device. My theory is that how his skin is doing is sort of a barometer for how he’s doing.
In one [upcoming] episode, out of complete and utter desperation, he goes to Chinatown. He turns to alternative medicine. Which was very interesting to me. When I was a resident in New York, we had a fair number of patients who would go to Chinatown, who would walk up those rickety stairs and get some medicine. I remember we had someone bring in a cream that they got there that was helpful to them, and we had it tested and it was basically a very strong topical steroid. What you could get in Western medicine. It just wasn’t labeled.
What do you think of the performances of all the dermatologists in this show?
Ha, I call the one alternative medicine guy “the sassy dermatologist.” Most of us dermatologists don’t talk to our patients like that.
But I interpreted the testy interactions between the dermatologists and John Stone as a reflection of their mutual frustration that they can’t get him better. … There’s this sense of trying to work together but being frustrated together.
The treatments they are proposing are definitely the kinds of treatments that dermatologists do suggest.
Even Crisco and Saran Wrap?
Yep! Or Aquafor.
The idea behind that is what’s called “occlusion.” Saran Wrap helps the moisturizer, or topical steroid, absorb better. The little bit of extra heat and the tiny bit of pressure from that saran wrap can help. Especially in treating very thick-skinned areas like the feet.
As for bathing your feet in Clorox bleach: Every time I talk to my patients about that, they look at me like I’m crazy. But it can really help! People who have lots of breaks in their skin are often colonized with bacteria that act as a kind of nonspecific activator of the immune response.
What would you say is the most significant artistic license this show takes, dermatologically speaking?
I guess I’d say, would someone really have Saran Wrap on their feet, walking around? It would be rather slippery. But it doesn’t matter. The imagery of it is powerful.
The thing that bothered me most about the Saran Wrap is that he still wore open-toed sandals with it. Seems like you gotta choose one or the other.
That is very true.
Also, we have an editor at Slate who has eczema and complained that the over-the-counter cortisone would never really work.
It’s true. Stone would need high-strength topical steroids that are many, many times stronger.
One of the show’s creators recently dropped the tantalizing detail that eczema “becomes even more important” in the last episode. Any ideas what that could mean?
Wow, I don’t know! That’s so interesting. If my theory is correct that the eczema is the marker of how John’s doing as a character, I hope his skin is clear in the final episode. Because if it gets worse I’d be worried that it’s not good news for our defendant. Stress can trigger eczema.
Is this a show that you would recommend to patients? Or would it be too traumatic?
I actually had a patient ask about the show! He has a chronic skin condition. He asked me, “Does the lawyer really have eczema?” He was curious. I think it really resonated with him.