I was leaving a Sanibel restaurant the other day with a white bandage on my face. As I passed a nearby table another gentleman had a similar bandage on his face. He saw me and I saw him.
He said: “Basal or squamous?”
I said: “Basal. And you?”
He said: “Squamous. Mohs or excision?”
I said: “Mohs. And I assume that since it’s on your face you did Mohs as well?”
At that very moment, a couple was entering the restaurant. The male also had a white bandage on his face. He saw that the two of us also had white bandages on our faces and chuckled.
He said: “Harris?”
We almost said in unison: “Yes.”
He said: “I think everyone goes there. The good news is they’re so highly trained that they can spot a no-no on your face a mile away.”
I said: “The three of us are classic examples of Mohs surgery survival. You can tell by our white badges of courage.”
The three of us had some more chuckles and went our separate ways. But we weren’t chuckling initially when we went for our routine dermatological checkups and Doc Harris noticed the tiniest growth on the surface of our faces. At first, we thought we were still experiencing childhood pimples that came and went like the wind.
Our parents would wash our faces with soap and water to melt away those pimples. And indeed, they would go away, until the next one. Never in a million years did our parents grab us by the pimple and whisk us off to dermatologists. I don’t think my parents even knew what a dermatologist was.
But then came those days in the sun when I was in my 20s. It was vital to have a good sun tan. Girls would like the way you looked. A tan evoked success and self-confidence, not a bad thing in those days.
And a healthy tan could even lead to good jobs, promotions and pay raises. A tan meant high self-esteem. And then the years passed. The pimples still came. But they didn’t go away. Soap and water didn’t do the trick.
That’s when we really learned what a dermatologist does. You’re compelled to take all your clothes off and submit to his professional scrutiny. And you learn that your dermatologist knows more about your body than your wife or significant other.
He looks for things that you may not even know you have. But if it’s on your face and you don’t notice it rest assured that Doc Derma will. And that’s when you learn what Mohs surgery is. It’s a surgical technique that removes all the cancer cells under a facial blemish but minimizes scarring afterwards.
Mohs surgery is both invasive as well as cosmetic. The idea is to remove one thin layer of tissue at a time and biopsy it immediately. If the cancer cells are all removed with the very first layer of tissue you get bandaged up with the white badge of courage and can go home.
On the other hand, if the cancer cells are still there with the removal of a layer of tissue you need to hang around and have another layer removed. And another and another – until there’s an all clear.
It’s a little like Russian roulette. How many bullets of tissue can you dodge? When you’re done the famous white facial pressure bandage is applied to cover the wound. And you get to commiserate with other white badge of courage honorees as you come across them in restaurants or other public places.
And the conversation is like prison language. Instead of “what are you in for?” the question is “Basal or squamous?” “First layer or third?” “Too much sun in your twenties?” “Why wasn’t sun screen invented by then?”
And you go your merry way hoping that when you recover the scar is indeed unrecognizable. And you continue that nervous passage from bedroom to bathroom mirror to explore your face fully. You’re hoping that you won’t detect any more signs of potential skin cancer. But you know that if you do the white badge of courage awaits you.