Derm and Dermer

Should it put the lotion on its skin, now that it's nearly forty?

By Zach Hively

I’m nearing forty.

Reaching this age teaches a man a lot of things, among them that forty is not nearly as old as I always thought it was.

I came by this delusion honestly. You see, my parents, when they were nearly forty, were significantly older than I am now.

I can also think of one middle-school teacher in particular who skewed my perceptions. He had the visual texture of a neglected Red Wing boot. I thought he had simply been worn down by very many years of life and sunshine. Now, having also been worn down by almost forty years of my own, I realize he had something extra: excessive exposure to middle schoolers. For putting up with the likes of us for nearly two decades, he looked great.

Even though I’m not as old as other nearly-forty-year-olds, I still need to take certain precautions into consideration. Like continuing to limit my exposure to middle schoolers. Like learning what exactly a 401(k) is. Like partaking in routine health exams recommended for Men of a Certain Age, Whether or Not We Agree with That Age.

It’s in my interest not to die young even if, on paper, I’m getting older.
I’m beginning with what appears to be the least invasive of these routine health exams, which is a skin cancer screening.

I took great skin care precautions in many of my earlier years. For instance, I wore a baseball cap—the same baseball cap, mind you—for about four presidential terms, back when we youths curved the bills of our caps and wore it over our faces. This fashion provided an amount of shade and shielded me, at some distance, from an obvious lack of coolness.

​I also wore a shirt in outdoor public spaces for most of my adolescence and young manhood, due to such debilitating body image issues as acne, lack of muscles, and middle schoolers being really mean at the pool, even to college graduates.
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All for naught.

If you listen to skin health experts, you learn that you are at heightened risk for skin cancer if, like me, you have left the house at any point. Your odds worsen if you went out in daylight hours. You might slough off your epidermis every month or so, but the UV radiation? That sticks like glitter, and it gets everywhere.

That’s how you get spots like this one on my arm. I thought it was yet another weird zit. But then it didn’t pop and it never went away. For two years. Nothing to worry about at thirty-seven, I figured. But now, as close to forty as I’ve ever been, this spot inspired me to figure out whether or not I have insurance, and what, if anything, it covers.

Then I had to call and make an appointment with a dermatologist who, at least in that moment, accepted my insurance. That’s right: the don’t-make-me-use-the-phone generation is entering its big four-ohs. In case you wanted to feel old too.

The maximum allowed amount of direct sunlight in any given lifetime.

The dermatologist’s office scheduled my critical preventative care appointment several months out.

Fortunately, this placed my appointment in that small window when health insurance companies were reluctant to deny any coverage at all, especially for handsome white men.

I arrived on time, which is late, to fill out my emergency contact info. You’d be surprised how often recommended routine care goes sideways. Unless you’re American. In which case, you’re surprised to learn that there is such a thing as recommended routine care.

Then they put me in a room with a doorway in full view of the lobby and told me to strip to my underwear.
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So I’m in there, down to my skivvies, for two trained medical professionals to inspect at their leisure. They make casual chit-chat to put me at ease and make a conversation in my underwear feel more normal. Their idea of casual chit-chat, it turns out, is asking me what they’re looking at today.

I balk.

I don’t know. That’s why I’m HERE.

In this room, our expected medical knowledge directly correlates to the layers of clothing we are wearing. The only resource I have in my pocket (which is over there on a chair at the moment) is the internet. It has convinced me that I am a walking squamous cell carcinoma because I forgot to wear my cap that one time.

So they whip out what sure looks like a black light flashlight. This makes me nervous. I don’t know what that black light will reveal on my skin. Remember, I was once a middle schooler. There is no telling what stains might show up. Also, isn’t UV light what caused me to need this checkup in the first place?

I now have some tangible literature, in case the internet goes away.

But the trained medical professionals don’t seem concerned. They flash that radiation stick over every inch of my skin outside of my undies, and as a sign of their advanced education, they do not make a single hurtful comment about my physique. They aren’t concerned with any of my many spots, despite every one of them sure looking irregular to me after I stare at them too long.

I point out the not-a-zit on my arm, which the trained medical professionals seem to have overlooked. They freeze it off to shut me up and make me confident that I am getting my insurance money’s worth.

They recommend I come back once a year for the rest of my life, just to be safe. They even rebook my next appointment for one year later, down to the minute. I appreciate their faith that I, who will be nearing forty-one at that point, will still be kicking.