Wednesday, October 21, 2026
Dermatology and Diary
The dermatologist turned out to be something of a non-event. I ventured deep into the labyrinthine hallways of the Royal Free Hospital, in search of Clinic 8, where a young woman photographed the suspicious rough patch on my lip. She got close-ups and even mashed the camera against the skin -- which, when it's your lip, is rather awkward -- to get photos of the first layer of cells. And then I was sent on my way. A doctor will review the photos and decide on a diagnosis or send me back for further tests or a biopsy if warranted. Apparently this is standard operating procedure for dermatological issues under the NHS.
I was somewhat disappointed that I never saw a doctor and didn't have the chance to ask about other rough spots or treatments for my keratoses. Apparently I need to make a separate appointment for every spot. And forget screening -- in the states it can take forever to get in to see a dermatologist, but as I recall once you do, they'll look you over from head to toe and make sure nothing funny is going on. There's none of that here.
Anway, that was that, and then I was out on the street with the rest of the day to kill. I went to a nearby Starbucks, where I sat out on the pavement beneath an awning and read. It was a gloomy morning, drizzly and damp, and people passed to and fro in front of my table, with South End Green across the street.
This area appears to be a sort of hub for bus service, as several buses pulled up while I was there, including one bound for Canada Water, in the southeastern part of the city. I can't quite imagine how that bus goes all the way down there but I'm tempted to take it one of these days to find out.
Anyway, from there I walked home and spent the afternoon reading on the couch with Bailey.
She got wildly excited about a squirrel in the avocado tree outside. I let her out the back door so she could bark at it from the patio.
I'm about halfway through Thomas Mallon's diaries. Reading this book is a peculiar experience because so far I've personally known two people he's mentioned! One was just an acquaintance I met through a professional group, but the other is a friend from New York who I actually went out with several times soon after I moved to the city. We're still friends on Facebook. I'll have to ask him how he feels about turning up in a published diary. Mallon calls him "old-fashioned" and said he's the kind of guy who, at a diner, would order pie and coffee. I have no idea what that's supposed to mean. I would order pie and coffee myself.
Other interesting observations from Mallon:
On the Iran Contra hearings (July 7, 1987): "Interesting as today was, these hearings -- the whole scandal -- is missing something. What's really needed is someone like Martha Mitchell. A lot of laws may have been broken here, but there's too much dignity to the scandal: idealogical zealotry can't compete with venality, power madness, hysteria & sheer stupidity -- all of which made Watergate so exciting."
On meeting author David Leavitt at a party (April 24, 1987): "There are no bones in Leavitt's hand. It's like shaking a chicken patty."
On Russian poet Yevgeny Yevtushenko (May 11, 1987): "A reading I did not go to. I decided to give the Rod McKuen of Occupied Kabul a miss. I saw him about 15 years ago at the Felt Forum, when I was a starry-eyed détentist." (I interviewed Yevtushenko for my college newspaper, apparently while he was on the same speaking tour -- my article came out just weeks before Mallon wrote this. I wish I'd thought to call him "the Rod McKuen of Occupied Kabul.")
On politicians and their retrograde responses to the AIDS crisis (June 2, 1987): "Cuomo wants to put in jail people who pass the virus on to others; Koch wants to test all tourists coming into the city."
And on being nervous about a romantic partner taking an HIV test (Sept. 27, 1987): "There's no way it could have passed between him and me, in either direction, unless everything they say is completely wrong." (This resonated with me because I often endured these exact same thoughts in the era of HIV and AIDS -- replaying every careful encounter in my mind, mindful of the fact that the doctors were still figuring out exactly what passed on the virus and what didn't. It was a terrifying time to be a gay man.)


Possibly the risk of melanoma or other skin cancers is quite low in British persons given the cooler wetter climate, but for people from other countries there should be a place where the entire body can be checked at a single appointment. In my city we have clinics run by several companies, one within walking distance of my home is called Dermadocs and when you make an appointment you can ask for a specific are or a full body scan where they go over every inch except the genitals unless you ask for that area to also be scanned. I believe it is quite pricey if you don't have insurance.
ReplyDelete*specific area*
ReplyDeleteBut a lot of British people vacation in sunny climes or have lived in places like India or Australia, so I would think the risk of melanoma is actually fairly high. That Dermadocs scan sounds worth it. Maybe I should do that. (I'm sure we have something comparable here.)
DeleteI confess I didn't think of those who vacation in warmer places.
DeleteVarious bits of my fair-skinned husband have been excised/photographed/ examined for years and years. Once you're in the NHS system things continue, albeit sometimes at a snail's pace.
ReplyDeleteI had some keratoses frozen off (at my insistence) several years ago, and a potential basal cell carcinoma removed from my forehead, so you'd think they'd have me on their radar -- but apparently not.
Delete"There's none of that here..." Ehm, when I had a small benign skin cancer patch on my back, the NHS consultant dermatologist checked out my entire body. Perhaps she was just worshipping my manly physique - like a Grecian athlete.
ReplyDeleteI had a basal cell carcinoma removed from my forehead about ten years ago, but I don't think anyone gave me a more comprehensive look and as far as I recall no one has done so since. But I think NHS care does vary regionally. It's been my experience that the NHS isn't great at screening for potential illness -- they're better at reacting to illness once it appears.
DeleteAfter I had the large melanoma excised from my leg I was given a full body check at my first follow up appointment.
ReplyDeleteI now have another lesion that is starting to concern me but I haven't yet made an appointment to get it checked. Must do that soon.
Yes, must! I'm sure having melanoma necessitates follow-up exams.
DeleteI remember very thorough screenings with my American dermatologists. Not here. Even with private insurance. And it’s so difficult to get an appointment. I’m glad you at least made some progress.
ReplyDeleteYears ago I had to insist that I see a dermatologist to have some keratoses frozen off. Otherwise everyone seems content to let them be. Or they give this ridiculous ointment that you have to apply multiple times a day for MONTHS. Crazy!
DeleteYou are right about dermatologists in the USA. It is very hard to get into a practice, but once you do, it is good. I remember the first time I saw one, it took me months to see them. But now that I am a patient, I can get in rather quickly.
ReplyDeleteI'm sure once they know you and you have a record of treatment they're more accessible.
DeleteThe idea of someone pressing a camera to my lips would make me crazy!
ReplyDeleteDo you smile for the camera, or no??? 🤔
Ha! No smiling possible! Probably more like a grimace.
DeleteI occasionally shake hands with a man who has "chicken patty" hands! It is very unnerving every time I do. I always fear that I squeezed too hard and injured him in some way.
ReplyDeleteI think I've mentioned this before in a past comment but it was unnerving even for those of us who weren't gay in the AIDs world of the 80's. I still remember a family friend with AIDS who came home to die and visited with our family one afternoon. After he left, my mom threw the glass he had drank from away and I remember asking her about it. She told me that he had a disease and doctors weren't sure how it spread. I spent several days wondering if I was going to get AIDs because I had been breathing the same air and perhaps it spread like the flu or colds did. The family friend died in May of 1988 of AIDs.
I do remember that story. No doubt it was a scary time for everyone -- I don't mean to minimize that sort of experience!
DeleteI need to find a sidewalk to read on today.
ReplyDeleteIt's a nice break outside, with people around!
DeleteIt was terrifying all round before the cause and transmission of AIDS was understood. People simply didn't know what was safe, whether being in the same room, sharing dishes, etc, was safe or not. Much worse for the gay community because that was where we were seeing all the illness.
ReplyDeleteYes, everyone was alarmed. I think of it primarily through my lens as a gay man, of course.
DeleteThe only thing that can be done for the pesky keratoses is to freeze them or cut them off! So I've been told, they are not caused by sunbathing, but they are hereditary! My back is covered with the ugly things!
ReplyDeleteOh, I thought they were caused by sun exposure! Though I'm sure there's also a hereditary component. My dad had tons of them.
DeleteThat strikes me as convoluted way to do dermatology. It takes no time at all to do a head to toe check. And making you come back for each thing? Five or six visits compared to one? I'm in and out in 30 minutes when I go. Last time had two things removed and about 10 spots frozen.
ReplyDeleteOur best friend is gay and we were quite worried about him during that time but he escaped being infected though many of his friends died.
I'm hoping when I see the actual doctor I'll be able to ask for treatment for (or at least advice about) a few more spots. The woman with the camera was a lab technician but not a doctor.
Delete(Assuming I see a doctor and they don't just tell me it's benign and to live with it.)
DeleteThat diary sounds like an interesting read especially since you can relate to so much of it and even know some of the people mentioned.
ReplyDeleteI don't think I've ever seen the actual doctor at either dermatologist office I've gone to. It's always the PA who takes a look at everything.
Yeah, it's rare to read a book that I feel so personally connected to, even though I've never met this particular author.
DeleteOne appointment to take a picture of your lip seems odd. You could have emailed them a picture from home if pictures are part of the process.
ReplyDeleteThis whole picture requirement seems ridiculous. It is a thing!
Instead of fixing my heat pump, a plumber sent someone out to take a picture of the heat pump and I was charged $200 for a service call. I did tell them I could have sent them a picture at no charge. They removed the charge and sent another plumber out to do the repair.
Creating billable charges are common in many aspects of life. It is disconcerting.
Thank goodness AIDS is no longer a threat. Medical science is a miracle.
Good for you for pushing back on that service charge! That's crazy. I think the camera they use at the hospital is especially high-res and can photograph on a cellular level -- not like an iPhone.
DeleteHope you get your answer soon and that the thing on your lip is nothing to worry about!
ReplyDeleteOur statutory health insurance provides an app for its members and we use it to take pictures at home of suspicious spots, someone looks at them and contacts us within 24 hrs with their findings and what we should do next.
Oh, that's a cool idea. If we have that I've never been made aware of it, but it seems like a process we should adopt!
DeleteWe are told here that we need to get an all-over body check at the dermatologist every year. Which of course makes sense in Florida.
ReplyDeleteI doubt that anyone who was not around during the AIDS crisis has any idea what that was like and even those of us who were and were not gay males could not truly grasp the fear and tragedy of it all. And on top of all the deaths, it gave prejudiced people yet more excuses for hate speech. I think though, that if there was one good thing that came of all of it, it was that the gay community came together in ways that they never had before. Wasn't PRIDE born of that?
Pride events existed before AIDS -- the first Pride parade in NYC occurred right after Stonewall, in 1970 -- but there's no question that the AIDS crisis galvanized the gay community. We learned how to fight for what we needed and push the authorities in ways we never had before. We were no longer running scared from paddywagons. All the various factions of LGBTQ learned to work together, too -- which is a lesson we have sadly moved away from in the modern era.
DeleteDespite having public health sysyems here (NZ) and Greece - visiting a skin clinic is best done in the private health sector and we are encouraged (in both places) to get annual all over checks. Once registered wr get annual reminders. In Greece my US trained skin specialist (dermatologist) charged about Euro45 for all over check. It would almost be worth an annual holiday in Greece (from UK ) to go see her - two birds with one stone... more sun-induced skin damage and go see the dr.😅
ReplyDelete"Don't mind my sunburn, Doc, I'm on vacation!"
Delete@ Tigger's Mum, You don't use a high SPF sunscreen?
DeleteI had great service from my dermatologist although the office keeps wanting me to come back. Since nothing was found last time (fairly recently) I've been ignoring them. Interesting observations from the book. I remember all the inservice presentations and assemblies we had about HIV/AIDS in the '80s.
ReplyDeleteIt's probably wise to go back once a year, especially if you have a history of sun exposure. I'm sure there was a lot of concern about AIDS in schools.
DeleteI love the last photo of Bailey! The camera against the lip sounds really weird.
ReplyDeleteIt WAS really weird. I kept thinking, "I hope she sterilizes this thing between patients!"
DeleteThis is why I love modern history, it explains what I have lived through. Did you read the diaries of Exileonpainstreet dot com when he blogged?
ReplyDeleteI did not! Are they still online? I should look them up!
DeleteHis diaries are still online.
DeleteI'm laughing at the description of Yevtushenko and the chicken patty hand.
ReplyDeleteLove,
Janie
I thought those were pretty funny moments, too.
DeleteBasal cell carcinoma inside my ear, a rather odd place for my latest skin issue. Due to be removed November 6th. Skin cancer treatment is a high priority by our public system, usually within 30 days of diagnosis.
ReplyDelete30/09, skin cancer doctor noticed a suspicious spot in my ear, hospital appointment available on 5/10 with biopsy sample taken. 12/10 stich removed and results given, BCC. Removal 6/11. I dread seeing my skin cancer GP. But after having three melanomas removed that she discovered, I worship her knowledge.
Well, Australia is notorious for skin cancer -- something about the ozone layer, I think? -- so I'm not surprised they take it seriously there. Glad you got this latest episode handled so quickly!
DeleteI was in Zambia during this period of time (1987-1988) & people were afraid that AIDS was spread by mosquitos and/or drinking water. It was a sad and scary time.
ReplyDelete