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Thursday, April 17, 2014

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More than skin deep

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It wasn’t my usual reason to be in a downtown Toronto hospital. This time, it was because I was an out-patient in a dermatology surgical clinic at Women’s College Hospital. The experience taught me a few very important lessons.

It reminded me how lucky I am to have a universal, publicly funded health-care system to which all patients have access to without any real impediment. Although I was just shy of 70 years old, I was among younger people in the waiting room. It was clear from the various bandages I saw that most people were having surgical procedures on their faces or necks, which can be done safely and effectively on an out-patient basis.

Signing in was smooth and effortless. The referral had been made by my dermatologist, with the confirmation coming within an hour of his faxing the request. Although it was a few months hence, I was not worried, as I knew the lesion in the crease of my nose was very slow-growing. My being a doctor had nothing to do with the appointment being made for me, and I was happy in that knowledge, as I respect the intrinsic equity of access to the system.

After I showed my health card, I waited until the nurse came to me, explained the procedure and prepared everything for the doctor. He, too, explained the procedure and performed the first part of it. After waiting to demonstrate that the “margins” of the tissue were clear, he told me that he had to establish that everything was clear, which was eventually achieved. He then showed me how he had to “fill” the space made by the surgical removal and did a finely planned and executed “plastic” repair.

It took a few days, some modest pain and a black eye before things began to recover, and a week later he removed the sutures and told me everything was “fine.”

In addition to my relief, and delight with the health-care system, I saw, by the number of people that had been waiting for similar procedures, the relationship between sun exposure and the risk of developing skin lesions that might require invasive treatments.

I grew up literally on the beach in Brighton Beach, N.Y., made famous by Neil Simon’s play Brighton Beach Memoirs. At that time, little was known about the dangers of excessive sun exposure, and the summer ritual of sunburn to suntan was practised by all of my contemporaries, even to the point of using oils and reflectors that would increase the impact of the sun’s rays. Little did we know or appreciate how we would suffer during our mature years from the negative effects of this prolonged sun exposure, which range from cosmetically unattractive lesions to more serious ones, some of which can be lethal.

We know better now, and it is therefore incumbent on us who know the risks to let our peers know what kind of care they should take in the sun. And most importantly, we should impress on our children and grandchildren that the transitory attractiveness of a suntan can play havoc with one’s skin in the long run, with damage ranging from increased wrinkling and premature aging to malignant skin lesions.

My experience in the clinic was more than skin deep – it went right to the core of our wonderful health-care system – and it reminded me of the steps that all of us should take to maintain and ensure good skin health.

 

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