Heading Home


At first glance, Nathan Roberts presents a collection of contradictions.

He’s a hardworking medical student with a dream of being a small-town doctor, and he’s a patient with an unusual disorder.

Roberts with Dean Edward Abraham

Roberts with Dean Edward Abraham

He’s a young man who is unable to sweat, yet he’s very active and physically fit. He works out in the gym regularly. As a college student at Virginia Tech, he learned the salsa, the meringue and several other dances. He loves playing basketball, even while accepting that he has limits that others don’t.

“I overheat easily and cool down slowly,” Roberts says. “After two or three games, I have to take a break.”

He has endured lifelong dental problems and overcame an eating disorder, and he now eats “anything and everything,” he says. “I’m kind of a foodie—I love trying new and different foods.”

He created these contrasts through his determination in dealing with two genetic disorders: eczema, which affects his skin, and x-linked hypohidrotic ectodermal dysplasia (XLHED), a rare disorder characterized by a reduced ability to sweat, missing teeth and fine, sparse hair.

He’s quick to acknowledge the help he has received in facing his health challenges and in creating the full life he has built for himself.

“For as long as I can remember there have been doctors in my life, from the NIH (National Institutes of Health) physicians who diagnosed me with XLHED to the Wake Forest physicians who are now teaching me,” says Roberts, a fourth-year medical student about to become a doctor himself. “They have all helped me to overcome emotional and physical difficulties and have cared about me.”

‘A Quiet, Friendly Atmosphere’

Roberts grew up in Marion, a town of about 6,000 people in southwestern Virginia. It’s best known for “the Lincoln Theatre, Hungry Mother State Park and the alleged birthplace of Mountain Dew,” he says.

“Growing up in southwest Virginia was a tremendously influential factor in my life,” he says. “The quiet, friendly atmosphere that characterizes small-town Appalachia is something that I don’t believe I could ever permanently leave.”

He says Marion helped teach him about the role that doctors play in rural communities, which often have few primary care providers. The few providers in place may be the only point of access to health care for many residents.

“Caring for patients as a family physician becomes more challenging when those patients live 45 minutes away from the doctor’s office and, as a result, they’re less inclined to routinely go for checkups,” Roberts says.

His early life guaranteed that his exposure to doctors would go far beyond what most people experience.

Dealing with Disorders

As a boy, Roberts would miss school sometimes because of dry and cracked skin caused by eczema. He tried countless lotions, medicines and home remedies before a dermatologist at Wake Forest Baptist Medical Center helped him—then a fifth-grader—get his eczema under control.

When in class, his schools always placed him in an air-conditioned room because of his health concerns.

XLHED so affected the development of his teeth that his parents worried about him choking if he ate regular food.

“I spent the first 10 years of my life eating nothing but baby food or food that was puréed,” he says.

By the time Roberts was 10, a speech-language pathologist determined that, while there was no longer any physical reason for him not to eat regular food, he had developed an aversion to eating regular food. Determined to eat as others do, Roberts credits his family’s support for helping him learn to eat adult foods.

“It marked a huge change in my self-esteem and confidence,” he says.

Despite his inability to sweat, Roberts played a number of youth recreation sports, including his favorite, basketball. He also eagerly sought out creative outlets, from reading copious amounts of fiction in high school to learning the guitar, which he enjoys playing regularly. Sports became more demanding in high school and limited his participation.

Roberts and his guitar

“Academics became an outlet for me,” he says. He excelled in the classroom, and he went on to earn degrees in biological sciences and biochemistry from Virginia Tech in 2012. He says he chose the school in part because of its proximity to his home, and he considered Wake Forest School of Medicine for the same reason.

‘The Best Place for Me’

“I knew when I was here for my interview that this was the best place for me and that I belonged here,” Roberts says of Wake Forest’s medical school.

A few weeks after accepting the school’s admission offer, he received a call: He had received the Patricia H. Vann Scholarship, a full-tuition award given with a preference toward students from southwest Virginia and northwest Tennessee. Stunned by the news, he immediately called his mother.

“She took a few moments to process it,” he says, “and then she started to cry.”

He calls the Vann Scholarship support “humbling” and says its impact “means so much not only to me, but to all of the members of my family as well.”

He’s making plans for the scholarship and his training to mean something for the people of his native region, which he says has given him so much through family, friends, education and opportunity. He plans to pursue a residency in internal medicine, with most of his top choices for residencies being in North Carolina or Virginia, and follow his plan to practice in southwest Virginia.

‘My Disorder Helps Define Me’

Roberts says he understands just how the difficulties he has faced has shaped who he is.

“My genetic disorder is one of many things that helps to define me,” he says. “It definitely has played a big role in shaping me into the person I am today.”