Where it all began: redheaded, in Hawaii, without hat or sunscreen

Where it all began: redheaded in Hawaii, without hat or sunscreen

Skin offerings to the sun god, as I call my adventures with skin cancer, began early  for me.

I was born in the sixties (before the invention of sunscreen) I grew up in Hawaii, and I had red hair—the “trifecta of doom,” as the first of my many dermatologists called it. I remember Mom, tanned and brunette, smelling of coconut oil in her crocheted bikini, slathering PABA from the health food store on my peeling nose and shoulders as I ran around in nothing but a pair of homemade bottoms. When my grandmother visited, she always fussed about it and bought hats for  me: ruffled, fisherman style, straw, or baseball hats.

I hated them all. They made my head hot, and interfered with my vision. I was a busy kid, interested in everything and always moving: running, climbing, digging in the sand, riding, surfing, snorkeling.

And getting sunburned.

My first inkling something wasn’t right was when, as a young married with small kids, we’d moved to Indiana to go to college. I was paler than I’d ever been after months indoors, milky-white with freckles like nutmeg on buttermilk—except for some persistent red spots on my shoulders and back. We had no health insurance at the time, so I went to the town’s low-income clinic.

“These are AKs,” the doctor said. “Actinic keratosis. Pre-cancers. I don’t believe in all those unnecessary biopsies. We’ll just freeze them off.” And the man, maned in crazy white hair like an eighty-year-old Einstein, pulled out a container of liquid nitrogen, dipped a Q-tip in the stuff, and went to town. I quickly became familiar with the hiss and sizzle of skin melting under a cold so intense it felt searing.

I was twenty-six.

I returned to that doctor the whole seven years we were in the Midwest, not realizing that his non-biopsy, “just burn it again if it’s not gone the first time” wasn’t typical dermatological care–but he never charged me more than fifty dollars for the office visit.

After we returned to Hawaii, I stayed out of the sun as best I could, but it was too late. The real damage began emerging in my thirties. I joked that the price of living in paradise was annual skin offerings to the sun god as I experienced new unpleasantness: the removal of a basal cancer on my chest that left a gapped scar, like I’d dated a drug dealer who liked a little knife play. Another near my hairline, pulling one eyebrow up and hurting like hell. But the doozy was the surgery to deal with thirty summers of a sunburned nose.

I had no idea what a nightmare of pain and psychological stress I was embarking on the  morning I had Moh’s surgery on my nose. It was a long, endless day of having layers of tissue cut off the top of my shocked proboscis to be analyzed for cancer. Between bouts, medicated with nothing but novocaine, I stared out the window of the clinic with several other shell-shocked patients, all much older than me.

The window was a perfect square, bisected by the angled plane of the next roof. There was nothing beyond it but the ruthless blue sky and its exacting ball of fire whose price I hadn’t known I’d have to pay. Somehow, though, the minimalist shapes and the deep blue color soothed me. That memory is etched deeper than any other from the day.

I used to have a cute bobbin of a nose. It now had a dip where it had had a bulge, and the gory sight made me want to vomit when the nurse let me have a look. “I just have to stop now. I can’t take any more off,” the haughty, impatient surgeon said, and proceeded to cut an inch or so of tissue off from next to my ear and sew it onto the cancer site.

I was still hopeful and trusting back then. I lay on the table with tears trickling out of my eyes, trying not to be a baby as the man stitched a soft, fuzzy cheek skin circle to the top of my mutilated nose. The kind nurse dabbed my streaming tears with a cotton ball on a stick so they wouldn’t get into the surgery area.

I didn’t know I was used to being attractive until I was someone people wouldn’t make eye contact with, wouldn’t look at with a smile. The experience of being ugly was a shock, and added to the trauma of the skin graft’s failure as the hopeful little circle of cheek flesh dried up, turned black, and fell off, leaving more scars.

I’d taken a few weeks off from work, but had to return to my junior high counseling job, where the kids were dying to know what had happened. I looked like I’d lost a fight with a garbage disposal.

“Wear hats and sunscreen, kids,” I said, over-hearty with bravado. “I’m a cautionary tale. Listen to your mamas.” Whenever I saw a redheaded kid, I wanted to cry for the tender pearly pink whiteness and sweet freckles that would brutally cost them later.

Time went on and so did the indignities. I submitted to scorching, cutting, freezing, acid black goo from a health food store, and caustic creams from head to toe. One day my doctor, a kind little Japanese woman who always laughed at my nervous jokes and had a hands like a butterfly, found something new.

“You have to come in for this one,” she said gently.

“Oh, for goodness sake. You’re always so cautious. I wish you’d just zap it like my first doctor used to.” I really missed my wacky old doc with his canister of liquid nitrogen. Those were the good ol’ days.

“No. We have to talk in person.”

I went in, and she told me I had melanoma.

The Big M.

This killer looks like nothing much, just an odd little mole, but it can break off and migrate throughout the body like few other cancers. It’s mobile, spreading like a rhizome. I’d been living with this fear so long that I burst into tears in a potent combination of terror and relief.

I’d leveled up to the big boss in Skin Cancer Wars, Version 10.0.

“It’s small, still. I think I can get it all and you won’t have to have more treatment,” she said. “I hope. We’ll know after we examine all the margins of what we remove.”

“Get it off me. Get if off me now, or I’ll go home and have my husband cut it off,” I said, dead serious. My woodworker husband was a real craftsman, and his skills included drills, box cutters and soldering irons. I’d trust him to cut this shit off me with an exacto knife in a heartbeat, no anesthesia needed. My overactive mind imagined the cancer as a poisonous plant, sending down fragile, toxic, breakable roots to try to take up residence in me. I wanted it weeded out, NOW.

“I’ll move some stuff around and get you in tomorrow morning,” my doctor said, and I almost kissed her in gratitude. I had to go back to work, though, and I cried the whole way in the car, asking God for the courage not to be a total basket case. He did show up a bit, getting me through that day and the next. My doctor with her butterfly hands shot up my back with novocaine, took out a chunk of meat the size of a baby’s fist, and stitched me up efficiently.

I needed no further treatment, and I call it the scar on my back my “saber wound.” It doesn’t bother me like the dented, corrugated remains of my nose does. I won that round.

But life is long, and so is the reach of the sun. I’ve taken to having every three month checkups at a different doctor, one who owns his own Photodynamic Light Therapy machine, a deadly combination of chemicals and laser light that zaps the skin preventatively. Not a pleasant process, I assure you, but better than many alternatives.

Still, in spite of vigilant and periodic frying, I had to have another surgery on my face, removing a basal next to my nose, just yesterday.

This surgeon, kind and bluff with a loud voice, cut out a piece of my upper lip the size of a dime, pulled my cheek over it, and sewed the cheek skin to the corner of my nose.

“Hid that cut right in the fold next to your nose,” he boomed proudly, holding up a mirror so I could see the hideousness. I looked properly Bride of Frankenstein: swollen as if I’d gone a few rounds in the ring, decorated with a blasphemous black row of stitches that echoed the curve of my nostril. The real bummer was that this wasn’t even plastic surgery to make me look better. It was cancer surgery, and made me look worse.

“Awesome,” I mumbled through puffy, numb lips. “That was about as fun as my last root canal, and I expected much worse.”

He laughed. They all do. It’s how I get them to like me. “But you have to get that eyelid done next. And I’m sending you to Oahu for that. I can’t be responsible for wrecking a pretty girl’s looks.”

A pretty girl. I used to be one, once upon a time, when I was too young to appreciate what that meant. And now, I’ve got a lesion on the tender wet edge of my eyelid, where my tears collect, and I get to look forward to that further adventure.

Driving myself home, loopy from novocaine, a pressure bandage cocking my sunglasses up at a weird angle, I counted my blessings.

  • I have health insurance, in spite of being self-employed and having this as a pre-existing condition. (Thank you, Obama!)
  • So far, I haven’t had “real cancer” and had to do chemo and radiation.
  • I figured out how to manage my fear and anxiety during the procedures using self-hypnosis recordings. That made me so relaxed this time that the doctor thought I was falling asleep during the procedure, when I used to get so anxious I had to resort to medication.
  • Maybe, when I go to Oahu to get my lower eyelid cut off, I can go to Bishop Museum and see the exhibits and do some book research.

I wish I had some nugget of wisdom from my adventures with skin cancer. I have nothing to offer but my own story of struggling on in the fight. I’m not going to let it get me down. I’ve still got a sense of humor. I’m grateful, happy and productive. I’m learning to manage myself and have courage, something I’ve always admired in others.

Yeah, sometimes I cry, but those tears, loaded with hormones and cortisol, carry off the bad stuff and help heal. Maybe, if you looked at my tears, you’d see cancer cells in them—cancer cells that aren’t in my body any more.

It’s a hopeful thing to imagine, and imagining helps heal too—and I’m extra good at imagining.

What has helped you recover from the stuff life has thrown at you?

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