Just a Little Brown Dot

This little brown dot about 1/8 inch across was the focus of my semi-annual visit to see Dr. Peck, one of my trusted skin doctors. It was the dark irregular portion that sent up a red flag.

The drill at these visits is I’m always seen by his student-du-jour at first and then Dr. Peck comes along afterwards to check on the student’s findings. Some of them are shy and almost apologetic about the fact that they have to look at every bit of your body. But today’s student Meredith was confident and reassuring at the same time. After a thorough exam, she had determined the little brown dot to be the only suspicious thing on my entire body.

I found myself already thinking that an excision on my right inner thigh would not be nearly as bad as the last one on the inside of my left knee.

Dr. Peck is quite cautious when it comes to even taking a biopsy. He agreed with Meredith, but after looking at the little brown dot through his dermatascope thought there was a good chance it simply represented an aging mole that was not all aging at the same rate. He asked me to come back in 3 months or if I noticed any change in it. Fortunately it’s in a place I can easily observe.

Even as late as several years ago, I would have blanched at the idea of having a melanoma and opted to have it removed even if there was the slightest chance it was malignant. But after so many such surgeries that did turn out to be benign and even after the 4 melanomas I had removed, I would rather not rush into what might be unnecessary surgery.

Dr. Peck knows EVERYTHING that is going on in the world of melanoma. He thinks big and thinks in the future. He would love to see a screen on the wall where he could project an image of what he was seeing as he looked through his little scope so the patient could understand what he was doing better.

He said the latest finding is that melanoma is always associated with a change in DNA. If there could be a topical gel that would mark such DNA change, the guesswork in diagnosis might be eliminated. I jokingly said, “Maybe that’s how you can make your mark before you retire.” He replied, “I’ve already made mine. Maybe Meredith can do it.” As the N.I.H. researcher who discovered Accutane, he has already made a significant contribution to the field of medicine.

He and Meredith were somewhat concerned about the many pre-cancerous spots on my face. Instead of continuing to freeze them, they prescribed Retin-A, which I will now have to use several times a week forever. The unexpected pleasant side-effect of this medication is that it removes wrinkles.

My skin will no doubt continue to be a challenge, but it’s doctors like Gary Peck who give me the confidence that I’m really doing just fine.