The Sun

Here Comes the Sun

The Beatles

Here Comes the Sun, The Skin, The Burn

“Our records indicate that you are due for a visit to our Dermatology Department…..” That’s what my notice said.

Yep, that’s probably true. I go back regularly only to be cut and pasted in yet another spot or two – or three – somewhere on my body. I can’t remember exactly when these visits began, but I do remember the circumstances.

I had gone to my regular family practitioner for my regular, annual physical. As with many other things, the visit had taken some prompting from my wife. I was not sick. I didn’t have any obvious ‘things’ going on. However, it was time. And in the meantime, she had some concerns about a couple of spots she saw on my back. I had to use a mirror to try to see what she was talking about, but I knew that it was time for my checkup. I made the appointment, saw our family GP. That check-up ended up with a follow-up first visit to Dermatology.

The appointment was with Doctor Barbara Oldham. As we had never met, she asked why I had come to see her. I had been referred to her, so I suspect she knew.  But I explained. It was probably a story she’d heard many times over the years.  She was preparing to give me a thorough going over. Before starting the physical exam, though, Dr. Oldham gave me an oral exam, a personal history of my relationship with the sun.

She looked at me. Not my skin, exactly. Just me, my face. Then she started asking questions.

“Tell me,” she began, “do you have any Celtic in your background?”

This was well before the day of Ancestry.com and individual DNA testing. But my name is Donlin, and as my mother used to say, “You have the map of Ireland on your face.” Our family names run along Donlin-Dugan-Madigan-Fitzgerald lines. My great grandparents had come over “on the boat”. Aunt Maggie Dugan’s big old coat, the one she wore on that boat, had been in in our attic for 100 years or more. “Yes,” I answered. “I’m pretty much all Irish – Celtic Irish.”

She gave my face another quick once-over. “I see,” was all she said.

She went on to explain that that meant that I was in a higher risk group as people with an Irish ancestry tended to be at a higher risk for skin cancers. She mentioned Australia, full of all those Irish folks sent there a few generations back, having some of the highest rates of skin cancer in the world. That was a very positive way to start this exam.

“Did you grow up here? In the Northwest?”

“No, I didn’t.” I replied. I added that I’d grown up in the Northeast. Her reaction was somewhat nondescript. I wasn’t sure if she knew much about that region of the country, climate-wise. We most often had bitter cold and snowy winters with hot, humid, sunny summers.

“I see.  So – when you were a child, did you ever have any sunburns?” was her next question.

“Yes. I did.”

“Ok. Did you burn more than once?”

“Yes, I did.”

“How many times did you have sunburns when you were growing up, do you think?”

“Well…Every year,” I said honestly and with a straight face. “Usually a couple times or so a summer,” I added. In my mind, I was saying that it was just what we did; it helped to establish a base tan. After the redness went away, we built on the foundation. I didn’t say that out loud, though.

“I see.” I saw a slight grimace. In poker, that’d be called a ‘tell.’ Not much of a poker face, I thought.

“Did you ever blister from these burns?” It may have seemed the logical next question from her perspective, but it seemed redundant to me.

“Sure did.”

She seemed to be waiting for more. After a brief pause, she pursued the question I assumed was answered already. “How often did you blister?”

“How often? Well, about every time I burned, I guess.”

“No sunscreen?”

Apparently, she hadn’t done the math on the number of years since I’d been a child. I explained, “Back in the day, we didn’t have any sunscreen really. We did have baby oil and some suntan lotion. I never used baby oil, but I did use the lotion to help turn the red to tan. Bronze Tan, as I remember.”

The slight grimace was more pronounced.

“OK, so where did you usually get those burns?”

“Oh….at the pool. It was a big outdoor community pool. Also at the lake; we usually went to a lake for a family vacation at least one week over the summer. I guess also at home – when I mowed the lawn without a shirt on…. Then when I lived on an island in Palau, but there it felt like I tanned up more than I ever did at home. I did burn there, too, but less so.”

There was another slight grimacy look, and a bit of confusion, maybe. “Actually, what I meant was where on your body did you usually burn? But – what’s Palau?”

I knew that was what she’d meant, but I wanted to see how this would play out.

“Palau? Oh, it is a group of tiny islands in the western Pacific pretty close to the Equator. I was a Peace Corps Volunteer. It was spectacularly beautiful! And the ocean water was so warm that we’d have to get out to cool off in the sun.”

Then I went on to answer her previous question again. “As for where on my body? I got burns on my back, of course. And then my shoulders. And my nose. My mother worried most about my nose; seemed like it started to peel almost as soon as the sun came out in the spring and all through the summer. She made me put lotion on my nose all summer long. Then there were my arms, ears, lips – oh, and my knees and the tops of my feet. No shoes.”

Poor Doctor Oldham was all but shuddering. I’m not sure just when or how it came up in the conversation, but I did also mention that I’d been a lifeguard at the same outdoor pool I’d swum in as a kid.

“You were a lifeguard, too? Did you wear a shirt? Cover up? Use sunscreen?”

“Yes, I was. No shirt. No hat. Maybe some early sunscreen. But a tan was a priority.”

By the time the interview was over, I could see the doctor just wanted to bless me, order a coffin, and send me on my way. But she continued with the actual skin exam. Not surprisingly, she found something. More than one something. She took biopsies to send off the lab. The rest is history.

In the coming days, I learned that there are several kinds of skin cancers. Basal cell carcinoma is the nost common in places on skin which get a lot of sun. For me, that was just about everywhere. The good part, though, is that it’s very slow growing and the least risky kind of skin cancer to get. It’s also fairly easy to deal with. Basically, the doctor cuts or scrapes it away. That was what the doctor found that first time around. Since it was on my back and out of sight, the spots just got skimmed off. Scars? What scars? Can’t see a thing.

And with that, my annual dermatology visits began. There were times when what the doctor found was squamous cell cancers. And once, at least, one of the buggers was a melanoma. That’s the one we really want to avoid. It can be spread and can become very nasty.

As I got older, I experienced a sunburn or two over the years which I had not been prepared for. The top of my head, once well protected by a thick coat of dark hair, had become … exposed. The first time I realized that was after a day outdoors. Not a particularly hot nor sunny day, just a day outdoors. It wasn’t until I stepped into a shower at the end of the day, and felt the warm water hitting my head, that I realized how burned my scalp had gotten. It hurt like hell! Hats became a priority.

I haven’t seen Dr. Oldham in years, but I now have a list of new docs whom I do see. I wish that it had been possible to label each of my scars. They’re all over my body; some of pretty obvious and easy to see like the long zipper-looking one on my left arm. Others are all but invisible.

There is one in particular which no one ever notices – my nose. It’s new! I have had it for a couple years now. What ordinarily would have been a simple Mohs procedure morphed into a multi-layer skin removal. In the end, with so much bad skin sliced away, my nose was reconstructed with good skin from my upper chest area. The nose looks great, but I do have to pull chest hairs out of it every so often.

Over the years, we have had “the talk” with each of our kids. They are all half Celtic Irish, but susceptible to sun issues in differing degrees. Each responds differently to the sun. Sean, our oldest son, has the naturally darkest complexion.  He gets that from his Hawaiian mom. He merely thinks ‘sun’, and he tans almost instantly. Our daughter Noe is a bit fairer but loves to be tan. Fortunately, she stopped visiting tanning salons. Now, sprays do the trick for her. Shea is our youngest and most fair. His brother and sister tease him about coming from “old eggs.” He, like me, has dark hair and fairer skin, and he burns.

These days, I wear hats in the sun. I have a selection of baseball caps that will do for almost any occasion. Long sleeve t-shorts and umbrellas also help. And of course, sunscreen. Real SPF-loaded sunscreen. I didn’t mention earlier, but I absolutely hate putting anything other than after shave on my skin. If I were a woman, I would not be able to wear makeup. As a result, I slather up on sunscreen when going out in the sun, and I take a shower as soon as I get home.

So, “Our records indicate that you are due for a visit to our Dermatology Department…..”

Slice and dice. Cut and paste. Send to the lab to test.

Here we go again.