Wednesday, July 25, 2012

Boy, Is My Face Red

Typical Doctor's Car
    
     If you look closely at my face, you might notice it is red.  Not a little embarrassed pink, as if I had broken wind in church, but an angry, splotchy scarlet, as if I had a facial with sulfuric acid.   I bragged about what little time I’ve spent with doctors during my lifetime.  Now that I’m old, they are getting even.
     I had a little spot on my cheek, a sort of mole.  It was benign, just a small brown spot that I lived with all my life.  One day, I cut it while shaving and it refused to heal.  I decided perhaps I should “get it looked at.”
     “I don’t believe I’ve seen you before,” the doctor said.
     “No sir, I have never spent a lot of time in a doctor’s office.   If I’m going to buy a Mercedes, I want to drive it myself.”  “No, Sir” would have been just fine, Jim.  Why keep talking? You’re gonna tick him off.
     “Take off your shirt and let me have a good look.  That thing on your cheek is a Squamous Cell Carcinoma.  I’m going to have to dig it out with a scalpel.  Let me see what else is going on with you.”  He inspected me front and back and told me to lie down on his exam table.  “I counted twenty-eight actinic keratoses lesions on the left side of your forehead.  No sense counting any more.  No sense trying to freeze them off, either.  We’ll treat you with 5% Fluorouracil.”
     I was astounded.  I came in here with a little spot on my face and now I have a Squamous, several lesions, and a whole bunch of little keratoses.   The actinic kind.  I’m sure that’s the worst kind.
     “Level with me, Doc.  How long do you think I have?”  I knew enough about medicine to know what carcinoma meant.
     “Well, I’ll get that Squamous Cell Carcinoma out of there today and the other treatments will take a month, maybe two.  You will not be a pretty sight during treatment.”
     “Hell, I’ve never made my living being pretty.  Heh, heh…   Why should I worry about it now?”   Jim, Jim, Jim.  Just shut up.
     The Fluorouracil 5% Topical Cream treatment consists of applying a face cream twice each day.   First I thoroughly wash with facial soap and blot dry, then wait ten minutes.  The instructions insist that rubber gloves be worn for protection and the hands thoroughly washed after handling the cream.  That should have been my first clue---they’re worried about casual contact with my hands and I’m smearing that stuff on my face.
     I read the directions several times.  “When Fluorouracil 5% Topical Cream is applied to a lesion, a response occurs with the following sequence:  erythema usually followed by vesiculation, desquamation, erosion, and reepithelialization.”  That’s good to know.
     I am in my ninth day of treatment now and you can see how well it is working.  I expect you will read about me in the paper.  They’ll say, “When the medical examiner looked at the body, he said, ‘It is a mystery.  He didn’t leave a note, but it’s the worst case of dermacide I ever saw.’ ”
Typical Patient's Car--unretouched photo
Small Disclaimer:  I do not have a grudge against doctors.  Far from it.  Some of my best friends are doctors, and one is a favorite nephew. I admire them.  Most spent years in school, mortagaged their future to the hilt, and postponed their lives until they completed the necessary education.  Now the government is changing the rules faster that the medical industry can react.  To have any future at all, a young doctor has to take aim at a moving target and hope for the best.  I hope they all get big Mercedes' to drive on their day off.  If they ever get a day off.    JPMC
                                                                                    
    

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