Skin Deep

“Beauty is in the eye of the beholder.” ~ Margaret Wolfe Hungerford

“Beauty is only skin deep, but ugly goes clear to the bone.” ~ Mark Edward Rowen

“Love between the ugly is the most beautiful love of all.” ~ Todd Rundgren

* * * *

I went to see a dermatologist for the first time in my life last week. I’m a guy, and guys think about their skin about as often as they think about making a souffle. I was in high school the first time I ever had any appreciation for skin. Even then, it wasn’t my skin that I appreciated. That skin belonged my girlfriend, and what I appreciated most was that she let me touch it.

Women have silken skin, mostly because they think about it all the time and go through great pains to enhance their skin. In 2018, worldwide sales of skin care and other beauty products was in excess of $300 billion. There’s a simple reason for this. Life, if you live long enough, will make you old. But no one wants to look old.

Depending on the study you look at, genetics plays a huge factor in whether or not you have great skin. Or maybe it doesn’t. But it does play a huge part in determining what color your skin is.

I’m not going to elaborate on skin color. I know as much about being non-white as I do about rocket surgery, which is clearly nothing at all. My Muses might have something to say about it someday, but they never submit any of their ideas to me for pre-approval.

* * * *

Possible Little Known Fact About Skin: Your skin is the largest organ of your body, and is the major component of the integumentary system. This system plays multiple roles in maintaining homeostasis.

All body systems work in an interconnected manner to control the internal conditions essential to the function of the body. Your skin is your body’s first line of defense against infection, temperature change, and other challenges to internal balance and equilibrium. 

There’s a reason for that. Your skin is primarily an external organ. Because it’s on the outside of your body, it’s exposed to a plethora of natural and unnatural environmental conditions.

Sun. Wind. Cold. Heat. Biting insects. Bears. Bullets. Paper cuts.

If not for your skin, you probably wouldn’t survive any of them.

* * * *

This is all really cool and stuff, dude. But aren’t you going to tell us why you went to see a dermatologist? I mean, it kind of seemed like that’s where you were headed with this, weren’t you?

Um, yeah. I probably was. So, thanks for getting me back on track.

Right around Christmas, I developed a crusty patch of skin in my right eyebrow. Just about the time I was on vacation from being retired and came down with the Mexico City flu, it started itching. I’m a nurse, so I have an impressive array of ointments for just about everything. I put a dab of this on it, then a dollop of that. And a strange thing happened. The itch didn’t go away. It got worse.

That’s when I became convinced that I had skin cancer.

* * * *

Nurses have a vast array of superpowers, not the least of which is the ability to put up with an endless supply of bullshit from doctors and patients simultaneously. Nurses are poised to assume the worst about almost anything. So when something goes wrong with our bodies we tend to think we’re going to got dead.

Granted, we’re not always correct with our diagnosis of imminent death, but doctors aren’t always correct either when they tell you there’s nothing seriously wrong with you, so there’s that.

I think this penchant for assuming the worst thing has something to do with nursing school. Being a nursing student makes you almost totally paranoid. Not everyone is designed to be a nurse, so a good portion of nursing school seems to be designed to cull out those individuals. When everyone really is out to get you, it’s not paranoia. It’s just good thinking.

Before you become a nurse you might have a vague idea about some of the things that can go wrong with your body and kill you to death. However, by the time you graduate and become a nurse, you have an extensive knowledge of not only deadly infectious diseases, but a few hundred other killer conditions and fatal processes that you didn’t even know existed. And one of the things we learn is almost every killer disease or ailment starts out looking or feeling like something totally harmless and innocuous.

Nurses are trained to be compassionate and caring. We tend to identify closely with whatever our patients are experiencing. Almost everyone I went to school with was convinced they had whatever their patients had. When I was going through my OB/GYN rotation, I was pretty sure I was pregnant.

* * * *

I actually told that to one of my instructors. Not my OB/GYN instructor. That was Sister Mary Hitler, and we weren’t that close. It might have been Kathy Ohman. She once told me that I intimidated the hell out of her, so I felt very comfortable around her. She told me her theory about the caring, compassionate nature of nursing students. And then she said this:

“Almost every one of my students has believed they’ve come down with whatever illness their patient has. But you don’t strike me as being an overly caring guy. Don’t get me wrong, I think you’re one of the best students I’ve ever had, but you don’t fall into the same category as most of young girls that become nurses.”

“So, what category do you think I fall into then?” I decided to ask.

“Oh, that’s easy.” she replied. “You’re just crazy.”

* * * *

Skin cancer is one of the most common types of cancer, and it’s most commonly caused by overexposure to ultraviolet light. Our sun produces three different types of UV rays. Coincidentally, there are three types of skin cancer.

I’ve never been one of those people who laid in the sun trying to get the perfect tan. For one thing, I don’t turn a luscious golden brown in the sun. I burn, baby, burn, and look like unto a boiled lobster. Only worse.

See? I told you

However, I have become person who wanders around a golf course looking for a little white ball in the bright light of day. I don’t always use sunscreen, but I always wear a hat when I golf.

Altitude and proximity to the equator increase the intensity of the UV rays. The Chula Vista Resort and Spa is 5000 feet above sea level, and about 1400 miles north of the equator.

I don’t know how that compares to wherever it is that you might be, but I can tell you this: the sun here is very intense no matter what season it is.

* * * *

I made an appointment at the Dermika Centro Dermatologico Ajijic with Dra. Tania Sánchez Tenorio. I almost wished there was a lots of stuff wrong with my skin so I would have to see her more than once. She’s a tall, skinny, young supermodel that just happens to be a doctor. 

But she doesn’t wear a bikini at the office, which is a shame because she has great skin

Dra. Tania listened to my assessment of my problem, then did her own examination.

“You actually have two lesions by your right eye, but they’re not cancerous, they’re precancerous. I can burn them off with liquid nitrogen. The entire procedure will take five minutes and will cost one thousand pesos.”

* * * *

Contrary to popular belief, the healthcare system in Mexico is very good. The doctors here are excellent, and most of them actually listen to their patients. But probably the best part about it is it’s actually affordable.

Getting those two lesions burned off my eyebrow cost me fifty bucks.

Dra. Tania told me to always use a sunscreen with an SPF rating of at least 50 when I golf, so I’ll be adding that to my pre-golf routine. Before I left her office, I asked her what the best treatment for spider bites was.

The previous morning, our roommate, Todd, woke up with what appeared to be two nasty insect bites near his right eye.

She wasn’t at all annoyed that I was hitting her up for free information, and agreed that the treatment I had already suggested to Todd was the best course of action. And then she said this: “But if he doesn’t get better in a couple of days, have him make an appointment with me. Sometimes it’s not a bug bite. It could be Shingles.”

* * * *

Shingles is a viral infection caused by the varicella-zoster virus — the same virus that causes chickenpox. The hallmark symptom of Shingles is an extremely painful rash.

I didn’t think Todd had Shingles. The eruptions on his face looked similar to spider bites that Lea and I have both experienced since moving here. And they looked like that for two days. But on the third day, Todd’s face kind of exploded. So, yeah. He really did have Shingles, and my already high level of esteem for the beautiful Dra. Tania climbed even higher. Which I didn’t think was even possible.

Todd looked like unto Charles Laughton in The Hunchback of Notre Dame

On the rare occasions that he left the house last week, people couldn’t help but stare at him. I tried to reassure them when they asked me, “¿Que pasó con Señor Tadeo?”

I told them, “Creo que tiene lepra.”

* * * *

Leprosy, or Hansen’s Disease, is an infectious disease caused by a slow-growing bacteria called Mycobacterium leprae. Leprosy results in disfiguring skin sores and severe nerve damage, usually in the arms and legs. Eventually, it kills you to death. Leprosy has been around since ancient times, and was once the most terrifying disease in the world.

There’s a reason for that, too. Leprosy was once thought to be very incredibly highly contagious. It turns out that it isn’t, but no one knew that way back in ancient times. As a result, lepers were expelled from their communities and sent to live out the rest of their lives in leper colonies, like, the island of Molokai in Hawaii.

Possible Interesting Sidenote From My Nursing Career: one of my patients at the Minnesota State Hospital was on an obscure medication called Orap (pimozide). When I looked it up to learn more about it, one of its indications for use was the treatment of leprosy.

It’s weird the things you remember sometimes…

* * * *

In closing, love the skin you’re in. Unless you were Michael Jackson, there’s nothing you can do to change its appearance. The older you get, the more fragile your skin becomes, so be good to yourself. Use a good sunscreen if you’re going to be in the sun for an extended period of time. And drink a lots of water. Your skin will love you for that.

And watch out for paper cuts…