Open Writing

Anyone who is familiar with this column will know that I have a wary relationship with the medical profession. The details don’t matter here; just suffice it to say that for me, less is better. Having said that, after a rocky start since I moved to Florida, I have settled into a comfortable relationship with a primary physician I like and trust, and who respects my preferences.

Accordingly, she doesn’t badger me with urgings to get: a colonoscopy, a stress test, an ultrasound of my jugular vein, or any of the array of preventive procedures that get more prolific every year. I get my blood work done every six months like a good boy, take my pills, and get regular exercise, and that seems to work for me, and for her.

But like any American citizen my age, things have started to grow on my skin. So recently, like it or not, dermatology has come into my life. A surgeon friend of mine said that if he had his time over again, he would become a dermatologist. As he put it, no emergencies, no weekends, and a range of conditions that never get completely cured.

Though I haven’t actually sunbathed for years, too many hours at the wheel of my sailboat without adequate protection have now come home to roost. Even if that were not the case, I am told by the profession that one good sunburn, anytime in your life, is enough to cast the die, and I had a couple of beauties when I was with the military in Italy.

My skin is stereotypically Scandinavian, my eyes are blue, and as a kid my hair was white- blond, so I’m a prime candidate for skin cancer. The warning signs first appeared in my late sixties, in the form of blemishes on my face, which had been free of even teenage pimples up to that time. The blemishes were diagnosed as pre-cancerous keratosese by my first dermatologist.

He was a likable guy who proceeded to scare me to death with colored pictures of people with advanced cases of skin cancer. Suffice it to say that you would not want to be seen in public with faces like that. He prescribed a mild form of topical chemotherapy, which produced a reaction not unlike the pictures I had seen, but then quickly subsided.

A year later the blobs were back, and I was back in the doctor’s office. He seemed neither surprised nor disappointed by the set-back, and I have come to realize his response is the norm in this discipline. The second go round took the form of freezing my skin with liquid nitrogen, which is damned cold, and produces instant frostbite.

That treatment seemed to be just as effective as the chemo, but without the temporary disfigurement; just small blisters that quickly dried up and crumbled away, which was fine by me. Subsequent “frostbite” treatments, approximately twice a year, have created a patchwork of light and dark skin patches where the scar tissue has remained pale in comparison with the normal skin.

I tell myself that at my age it doesn’t matter much, and perhaps even adds a bit of character!

Having moved away from my original provider, my next encounter was with a practitioner in Connecticut. Doctor 2 is a mild mannered, scholarly type, who manages to find the time to teach a class at Yale University. Initially I thought this would be my entrée into all the latest science, but in fact, his liquid nitrogen can is just like everyone else’s, except that he calls it “medicine.”

His condition management techniques were just like his predecessor’s, except that Doctor 2, placed more faith in unctions and ointments than did Doctor the first. I never found any of them the least bit effective, but they were free, doled out from his box of samples left by visiting drug salespersons.

One such sample had some kind of photosensitive property that turned it from clear to lemon yellow a few hours after application. Any place my head or fingers had touched, bloomed with the color. The color was actually quite attractive, but two years later is still present on towels and pillowcases.

Now that I don’t spend the summers in Connecticut, I have opened diplomatic relations with Doctor 3. Quite different from his predecessors, he is young, lean and sporty. Since I’m none of those things, we might have a problem. On my first visit, he conformed to the now standard protocol and administered the frostbite treatment.

Then his flinty eyes settle on the bridge of my nose. What he saw there sent him reaching for his biopsy tools, and he relieved me of a good-sized bit of my conk. A week later I learned that the sample was squamous tissue, which is cancerous, and would have to be removed. My date with the scalpel is next week, so more later.

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