Would my dermatologist give me Accutane if I asked for it?

Maybe. He/she would need to be satisfied that all other possible rx's for your acne (or a few other skin diseases) haven't or won't work. You'll have to show you are emotionally stable, determined not to become pregnant or drink alcohol, and that you're tough enough. It's the most powerful and effective rx for acne that exists. Go ahead and ask.