In August 1993 the Shelleys described their family vacation in Great Falls, Montana. Back in the office, the Shelleys explained why it is not always true for doctors to think the diagnosis tells the treatment. They wrote, "Most of what we see is a reaction pattern requiring detective sleuthing for the cause that tells the treatment, or the treatment that tells the cause." On August 22, they mentioned that the American Academy of Dermatology was voting on a possible name change to "The American Academy of Dermatology and Dermatologic Surgery"; we all know the outcome of that vote. They also provided library and literature synopses.