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Open Letter

You had me at "You will get skin cancer. You were born to get skin cancer."

I can't say "You had me at hello" because you never actually said that. When you walked into the exam room, I said "Hi" and you declared, "I'm going to cut you today!" - in a very friendly, cheerful way. I enjoyed your slight accent. I couldn't quite place it, but from your pale complexion I'm guessing somewhere Nordic. I'm also assuming that "I'm going to cut you today" isn't slang for "hello" in your native tongue. If it is, then you did have me at hello, after all.

The cutting went very well. You do a lot of these, so I'll jog your memory: You were excavating the last vestiges of a formerly gigantic mole behind my left ear, because the original biopsy came back pointing just slightly toward abnormal. True, it was slightly disturbing when the nurse placed a steel plate under my arm to ground me in case excessive bleeding required cauterizing the wound, but I'm sure that was a good precaution. Most importantly, the ex-mole was hardly even sore that evening. Thank you.

You are the first skin specialist who has really motivated me. I already get my moles checked (somewhat regularly) by a dermatologist and I wear sunscreen. I was smug about my skin care, especially the sunscreen part. You convinced me this doesn't mean jack, especially the sunscreen part.

Here's how you did that: Like every other skin specialist I've ever seen, you asked me if I use sunscreen. "Yes!" I barked instantly. Then, as always, came the second question: "Do you check your moles?"

This is a question that has always flummoxed me. It's so clearly impossible. As you know - not because you're a specialist, but because anyone would know by glancing at me from the top of Sears Tower - my skin looks like a microscope slide of the pollen count on a very bad ragweed day. And any other simile you care to devise that involves an infinite number of tiny brown dots.

So no, I don't check my own skin. Where would I begin? I would as soon attempt to memorize the varying shades of color on every grain in a ten-pound sack of wild rice or the contours of each cotton ball in a jumbo bag from Costco. Not a single nurse or dermatologist has ever challenged me on this before.

You, however, retorted, "If you can't notice any changes, who will? Your parents? Your sister? You think we will be able to notice, if you can't?"

I think this is when you told me I will definitely get skin cancer, someday. As you pointed out, indicating both our fair skins (well, mine is fair underneath the freckles and moles), "We don't belong here. Chicago is at about the same latitude as the south of France. You come from northern Europe. You aren't supposed to be here. You should be in Canada."

This may have been when you lightly gripped my upper arm and twisted it a bit so we could both see underneath, an area that looks positively albino. "This is what your skin should look like," you said.

I defended myself at this point. When I was a kid, sunburns and suntans were considered a good thing - by everybody, not just idiots, like today. An untanned child was one who didn't get out enough, didn't play enough, wasn't healthy. Staying inside to read books was as bad as staying in to watch TV, because either way, you were staying in when you should have been out.

Sunscreen did not exist, to my knowledge. When we put anything on our skin, it was something designed to purposely increase the effect of the sun's deadly rays. The contrast between the Coppertone girl's light behind with her tanned back and legs was not taken to mean that the girl was in danger of getting fatal melanoma. It meant Coppertone was doing its job - she was getting a good tan.

"Yes well, luckily my brother is a lawyer who specializes in suing parents," you grinned. "I am just kidding."

Then you talked about the various stages of malignant skin cancer. "If we catch it at stage one, you come in, we take it off, no problem," you said. "If it takes longer, if it's stage two, then you flip the coin. Either you go to Las Vegas, or you live happily ever after."

"Some people would live happily ever after in Las Vegas," I noted. "But I wouldn't be one of them."

Stage three - the worst - you see most often in single men. "They go someplace hot, Florida, with their buddies," you said. "Somebody says, 'Hey, you have some dirt on your back.' But it's not dirt. They don't do anything about it. Finally they come in, and three months later they're dead."

A lot of doctors don't like to say "dead" around patients. You do, I can tell. It had the desired effect on me.

But here's the point that made me think most. You got out a pamphlet showing normal moles and various kinds of abnormal moles - the ones where the color varies, or part of the mole is raised and part isn't, or the edges aren't even. Like all of mine. "I don't want you to go by this," you said. "You don't decide which moles are bad, we decide."

You started pointing out various moles on my arm. "I don't like that one. This one is slightly elevated on one side, I don't like that one. That one is uneven, I don't like that. But I can't cut out all of them. I can't make you like Swiss cheese."

Your point was that my role is to look for changes in these infuriating moles, and look for new ones. If they're changing, you said, they'll do it quickly - "before your eyes."

Sunscreen is fine, you said. "But you get 80 percent of your sun exposure by the time you are 18." In other words, I am already toast. "I would rather you didn't wear sunscreen, but you check yourself. I don't care if you use sunscreen."

Now that got my attention. Sunscreen, sunscreen, sunscreen is all you hear anymore, especially this time of year as the papers start running gearing-up-for-summer articles. As if anyone can remember to put on sunscreen precisely 20 minutes before going out, much less re-apply it every two hours, every single day. I generally put it on once right before I go out and forget about it the rest of the day. And even so, I realize, I was imagining it as a sort of force field between me and not just the sun, but skin cancer itself. Maybe, if I had used sunscreen during that 1978 Rolling Stones concert at Soldier Field where I roasted outside all day to save a spot next to the stage, it would have done some good. But I'm well north of 18 now.

So I'm beginning to memorize my blotches. I'm thinking of taking digital photos of the worst areas - certainly my arms - and keeping them on my computer for easy updates and comparison.

"I'll be seeing you again," you smiled as I left.

Yes, and if I can help it, it won't be in Las Vegas.

Thanks again,

Cate Plys

*

It's no skin off my nose - and that's lucky, considering the multitude of stitches. Has your dermatologist gotten under your skin, or failed to do so? Open Letter is open to letters, at cateplys@sbcglobal.net. And catch up here with such Open Letter classics as "Dear People Who Normally Park in the 5300 to 5500 Blocks of S. Shore Drive" and "Dear Person Who Let Their Dog Defecate Near The Southeast Corner Of 58th And Kimbark."



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Posted on April 17, 2007


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