My week of visiting doctors continues. While yesterday I had my blood drawn, tinkle collected, heartrate confirmed and chest irradiated – all of which was done to confirm that I have cancer after having been diagnosed with same six years ago – today I dealt with more superficial matters – my skin. Indeed, it was time for my semi-annual visit to see my friendly dermatologist. Although I apparently have long been prone to the formation of dysplastic nevi, which are unusual-looking atypical moles (question: Aren’t all moles atypical? Isn’t that definitional?), the need for dermatological visits has only increased with my cancer diagnosis because, for reasons I do not even partially understand, having CLL can also enhance one’s chance of getting skin cancer. I actually would have thought the opposite were true – having cancer does not really motivate me to spend more time in the sun so I would have thought this was a net plus. Alas, no. Similarly, I also have an increased risk of colon cancer due somehow to my leukemia. This one I could see – the CLL has done a number on my heretofore indestructible stomach so a lessening of high-fiber foods was inevitable. I guess I will discuss it with the gastroenterologist – his turn in the rotation is coming soon.
Of course, as a cancer sufferer, most of the time I spend doctoring is at the oncologist. Interestingly, however, a visit to the dermatologist is about as far afield from a visit to an oncologist as one can imagine. For starters, there is the office itself. My dermatologist’s office is decorated in spirit-raising pastels with skylights ushering in rays of golden sunshine (which, of course, is bad for your skin – there’s a reason dermatologists generally do better than other specialties). The whole environment is welcoming and cheerful. The staff are young and acne-free and even the sign-in system uses LED displays and modern technology. An oncologist’s office is a whole different animal. There is nothing welcoming about it (even if the receptionists are quite pleasant). The walls are painted (mostly – there is definitely some touch-up work needed) with drab gray. It’s not uplifting, but it does seem to appropriately capture the mood of those in attendance. There are no windows or other means of natural light. It’s a cave of cancer.
Then there is the waiting area. In the dermatologist’s office, the waiting area is replete with comfortable chairs and a table overflowing with feel-good, mindless reading material the likes of which include People, Teen People, Us Weekly and Golf Digest. All of these are months outdated, but dermatologist or not it is still a doctor’s office. In my oncologist’s office, there are few chairs, straight-backed and uncomfortable, again befitting the mood of those there. And then there is the magazine selection. At my last visit, the three magazines atop the tiny table of periodicals were HemOnc Today, Focus on Classical Hematology and Living With Cancer. One can’t make this stuff up.
Of course, not everything is more pleasing at the dermatologist’s facility. A dermatological examination is not for those who have any body image issues. Not only is one forced to don one of those robes –these tie in the front, although some tie in the back; can’t they standardize this and at least eliminate one area of consternation? – but the patient must reveal every square millimeter of skin. As if that were not enough to make one hyper self-conscious, the doctor takes a magnifying glass to really get a sense of one’s shortcomings. And although one can start with the underwear on, more often than not there is a growth of some manner or other in a “private region” that one considers whether the humiliation of revealing it is worse than the risk of it being cancerous. (Since I already have cancer, sometimes I am willing to risk it.)
As if all of this was not demoralizing enough, the dermatologist invariably has in tow an assistant whose assignment it is to write down all of the findings that the doctor’s microscope reveals. I feel for this assistant: It must be akin to driving by a horrible car wreck. You know she doesn’t want to look, but some of the moles, freckles and other protuberances must peek her curiosity just as the opening of the Ark in Raiders of the Lost Ark did to those unsuspecting Nazis. If she does look, she would probably similarly melt.
In contrast, there is very little disrobing involved with an oncology appointment. I typically have to unbuckle my pants just so that the doctor can check my groin lymph nodes – uncomfortable to be certain but no skin is exposed. It’s just unfortunate that lymph nodes are located in embarrassing areas.
Another distinction is that a dermatologist’s examination room looks like pretty much all other non-oncologist examination rooms. There are various scalpels and gauzes and ointments galore. At the oncologist’s office, there is an un-zeroed scale and a whole mess of papers. Other than feeling up my “lymphs” there is not much done other than kibitzing. The oncologist examination room is more like a graduate assistant’s cubby than actual medical facility. Finally, on the way out of the dermatologist’s office, one notes another difference. There are products for sale. Skin creams, exfoliants and their bizarro counterparts – hair growth salves – and pimple-eradicating liniments. As I said, these doctors know business. There is, however, nothing similar in the hemonc’s office. What could they even sell? Platelets? Bone marrow? If anyone does know an oncologist that sells bone marrow, please let me know. I am in the market for some.