Fortuna Imperatrix Mundi (Fortune empress of the world): Reflections of an immigrant dermatologist.

Immigration has been considered a common human behavior, but it is usually the result of severe conditions that force people to leave their countries. For specialized physicians who have invested years of study, training, hard work, and money to establish a successful career, the decision to leave behind everything to start over is as difficult as for the rest of the people. Adapting to a new country requires a good deal of patience, persistence, and resilience to reinvent oneself, exploring and developing new areas, plus using knowledge and experiences previously acquired. This paper reflects the anxieties, fears, and hopes of a dermatologist driven by the dynamics of a migratory process. The reflections are framed with verses of the goddess Fortune, extracted from a medieval Codex, as a way to compare how Fortune's whims can change circumstances to keep us moving upward and downward during our lives.