Damn Spot

I didn't like the looks of a spot on my forearm, so I photographed it and sent it to my dermatologist. He indeed said he would like to take a look at that, and I should get an appointment. I did. A month and a half out. Well, I'm used to that with Kaiser. I like them a lot but if you want to see a dermatologist or a gynecologist you might be waiting a while. You might have to wait if--as my friend Noah put it--you have a vagina, or skin.

I have both. Neither is in original condition.

I'm assuming my spot is not all that dire or they would have found a way to slide me in earlier. And I'm not particularly worried about it. It's suspicious, but I have this idea, true or no, that no one dies of forearm cancer. Dying of forearm cancer would be weird. Not as weird as that sports photographer who wanted to get the cool inside shot at the dog track and got his head lopped off by the mechanical bunny--that was really weird. Or the fellow buried alive after standing on a stepladder to administer an abruptly effective enema to an elephant. Also weird.

But as long as I have an appointment anyway, I'm going to give him a tour of the neighborhood. He's never been enthusiastic. Maybe he feels short of time. He never wants to see anything but the dot I came in with, and that just bugs me. There's at least half of me I can't even see. I'm only in there every couple years. Why can't he get a bright light and have a look around? It couldn't take that long. I'm only 5'3". I don't care if he has to hold a dainty hankie to his nose, as long as he does it.

Even if I could see it all, I wouldn't necessarily know what I'm looking at. When I met Dave, I discovered he had a set of the most baroque and alarming moles on his back, any one of which looked poised to take him down, but he never did anything about them, and they're still there, only forty years older. What do I know?

I also plan to point out my tick bite. You know, the tick bite I got in March. Still there. That sucker has stamina. I suspect maybe the little bastard left some spare mouth parts in there, and I hope-to-shout he never gets his mouth properly assembled again. Or perhaps the lump is some kind of egg sac, and one night when I least expect it, it's going to rupture and aliens are going to pour out of it like Huns over the steppes of Asia. It does have a sinister Vesuvius look about it. I had a nurse friend look at it, and she wasn't impressed. Well, she's a midwife, actually, but that's the same thing, and she's had to wrap her head around, and in some cases jam her arm all the way up, way worse things than this.

I guess if the good dermatologist is that pressed for time, I can get Dave to flip me over and circle anything suspicious with a Sharpie before I go in. But I don't want to. Three minutes in, he won't be able to stop himself from connecting the dots. This I know.

Losing Face: Layer One.

Before

The dermatologist has been breezily freezing off spots on my face for years. There's not a lot of chit-chat. He gives me a glance, blasts my spots, asks me if there's anything else I want him to look at. There's about half of me that I've never even seen, and I thought he might have volunteered to have a look, but the fact that he asks makes me feel like there's something sort of unseemly about it. So I say I guess not. Then he hands me a brochure about actinic keratoses and packs me off for another year. This summer he looked at my nose and said, breezily, "well, let's put some cream on that this year," and waved a photo of some violently pink people at me. "You might look a little sunburned for a while," he explained, "and then you'll have skin like a baby's bottom." Which can be good or bad, depending.

"I don't care how I look," I told him. "Is this spot precancerous or something?"

"Okay," he said, breezily. All righty then. Cream it is. Do I need to stay out of the sun?

"If you want," he said. "Whatever. My nurse can give you the details." And he's off.

One week

She said if I have a wedding to attend or something I could put this off until October, and I did, so I do. In the intervening months, my friend Vicki, who is doing the same basic treatment, clues me in, and I spend some time on the internet. Where I find out that the treatment, ideally, is supposed to turn your face into a flaming, pulpy, oozing mass of fried nerve endings and reduce you to hammering your fingers to distract yourself from the pain before it starts working. Various victims have posted progress photos on the web. Not much happens for the first few days and then spots light up here and there, mass together, and erupt. Helpless villagers flee. After a few weeks it is hard to distinguish between the eruptions and the marks left by attempts at self-strangulation. In the final photos the patients can be seen licking out the inside of the Oxycontin bottle. 40% can't bring themselves to continue to that therapeutic level. Sleeping is impossible, because of the screaming. The cream is called Efudex, or F.U. for short. Oh boy!

I put on my first application of cream. Twice a day for fourteen days, my doctor says. I know from my research that most people go three or even four weeks. I stare nervously at my face. We have started something here, and only great pain will resolve it. It is like finding yourself pregnant with a really ugly baby.

By day five, when most people begin to see spots and blotchiness, I look normal. I feel normal. Not until three days later do I begin to see the dawn of disfigurement. By day fourteen, when  I am supposed to quit, I don't look good, but nothing has erupted, nothing is oozing, nothing is crusting over, and--even according to my instructions--I have not reached the level of "therapeutic effect." I'm not even uncomfortable, just a little chapped. The doctor doesn't take calls. He's got a nurse for that. I call her.

"Yeah, you should probably keep going," she says, "but let me message the doctor. I'll get back to you."

Two weeks

She gets back to me. Nope: fourteen days it is. I should quit. He'll see me in six months.

"Are you sure?" I say. "I  mean, I've gone to all this trouble, and I'm willing to keep going. Am I supposed to lose all this time in? What if he tells me next time I have to start over? I'd have to murder him, and that wouldn't be good for either of us."

"I'm sure," she says. "It's right here in black and white." Well then. Can't argue with those colors.

So there it is. My dermatologist wants me to march right up to the edge of cancer with spears and cauldrons of boiling oil, and then stop short of the fortress and go booga booga booga. If my actinic keratoses are as easily startled as I am, it just might work.

To be continued.

True Colors

A local woman is suing a tanning salon for allowing her naked body to be seen by passersby on the sidewalk. In its defense, the salon points out that there is a teeny little sign in the room indicating she might want to lower the blinds. The woman stated that she naturally assumed, when she walked into the room and began to take off her clothes, that the large plate-glass window to the sidewalk was one-way glass. One would think she would have been tipped off by the bleachers set up street-side and the popcorn concession. Also the area set aside for the biology class field trip, where they hoped to observe the leatherization process.

These should have been red flags for the tanner, but we are dealing with someone who is willing to pay thirteen bucks a session to get a nice even start to the cancer season.

Lots of time and money is spent to remodel skin tones in this country. Michael Jackson may have spent the most, when he came down with a particularly virulent form of mythical impetigo and had no recourse but to try to get the patches to coalesce. He and the tanners have in common an urge to acquire an even skin tone, whatever the cost, as long as it isn't the original even skin tone.

I suppose I could do it too, but I don't like to part with cash for items not related to food and alcohol. If I did want an even skin tone, it would be difficult to choose which of the dozens of colors already in evidence on my body to go with. As it is, the best I can do is take an average.

Some of the spots need looking at. I developed an odd bump on my arm that stuck around long enough for me to make an appointment with my dermatologist. He was two months out, of course, and the bump had finally disappeared by the time the appointment rolled around, but I kept it anyway, because I believe it cheers up my dermatologist to stare at my skin. Then he gets out his freeze spray and kills portions of it more or less at random. I always try to get him to remove the mole on my eyebrow but he won't do it, even when I tell him it's getting bigger. The first time I said that, he put dots around it with a Sharpie and took a Polaroid of it so as to be able to get a baseline measurement of my veracity. He did not remove the ink, or remind me to, and I went around the rest of the day with bright punctuation around my mole in case anyone missed it. Dermatologists get a huge kick out of themselves. This last time I reported it had gotten so large that you could see the movement of the elbows of the alien life-form it contained, but he still put it down as a cosmetic procedure, not covered by insurance. My mole was so delighted by this that it petitioned the city for basic infrastructure and drew up plans for expansion. My dermatologist is correct; I have had this mole all my life, but I know it didn't used to cast a shadow.

Other things change too. In the last ten years various segments of my body have decided, all on their own, to change color and texture, and you've got to admire that kind of initiative. In fact, I'm festooned with dots and lesions. I've got perfect camouflage for hiding naked in a vat of Skittles, should the need arise. I know they make pots of face spackle in any shade I might desire, but I don't plan to invest in any. My plan is to just stick with what I've got and then sue people for staring.