Facing It

Some time back, I told you about the Mohs method for dealing with certain skin cancers, which I once had performed, very successfully, on my right hand.  But more recently I had to cope with another such malignancy in a much more prominent area.

Not to beat about the bush, we are talking about the very tip of my nose. I have never been famous for anxiety about my personal appearance – but still, the tip of one’s nose would hardly be anybody’s first choice for the infliction of a probably permanent scar.

My dermatologist, who was to perform the surgery, did want to use the Mohs technique, which offers the best chance of removing all the “squamous cells.” But this would involve an incision and stitches, and I was naturally concerned about how disfiguring this might turn out to be.

However, I was able to choose an alternative method, called EDC (Electro Desiccation Curettage) which doesn’t involve so much digging, and – while not quite as thorough as Mohs, was considered acceptable in my case.

Before continuing this story, there are two earlier episodes in my life which I must relate. When I was six, I had chickenpox, an ailment which causes pimples, which turn into scabs. My mother warned me not to pick the scabs, and I was able to avoid picking all of them, except the very last one, which was just above the bridge of my nose, right between my eyebrows. However, it was so itchy that I “cheated,” and managed to remove it by not actually picking it, but by rubbing it against the rough surface of a brick wall. When my mother saw the result, she was horrified, and told me I would always have a mark there. 

And alas, she was right. I did have a slight pockmark in that very central spot, and I remember feeling very sensitive about it as a teen, although as the years passed, my eyebrows tended to come more together, and make it somewhat less noticeable.

But meanwhile, something even more ghastly had happened, once again, right in the middle of my face. When I was ten years old, my two upper front teeth were so badly damaged in a street-game accident that eventually they both had to be extracted. From then on, I could never overcome the unhappy consciousness that my two most prominent teeth were false.

So, I already had two “defacements,” both very centrally located. And, sure enough, the EDC surgery has now given me a third one – a very visible pockmark, as plain as the nose on my face.

Looking on the bright side, these losses of face are at least all nicely symmetrical, and will make me easily identifiable in any morgue. I can also compare these minor blemishes with the dreadful effects of actual Smallpox, which is so often fatal that, ironically, in places where it’s prevalent, those who survive with only a pock-marked face are considered fortunate, especially since they’re then immune. (I learned much about this from a recent book called Sometimes Brilliant, by Dr. Lawrence Brilliant, whom I know, and who’s probably a distant relative. Among his other claims to fame, he was a leader in the highly successful campaign to eradicate Smallpox in India.)

But we are reminded of the persistence of such plagues, going back at least to the time of Shakespeare, when, in Romeo and Juliet, Mercutio, Romeo’s best friend, who belongs to neither of the feuding families, cries out, as he is dying, “A pox on both your houses!”

[Incidentally, if, you too had chickenpox as a child, there are several things you should know: (1) You are more likely than other people to develop the very unpleasant affliction called Shingles. (2) You can now get vaccinated against Shingles. (3) The early vaccines weren’t very effective. A much better one is now available, which you can and should get, even if you had one several years ago. End of Public Service Announcement.]

But why should the face be of such importance anyway, especially as we get older?  It’s good to remember that the word “Vanity” has two meanings – concern about one’s appearance – and futility, or worthlessness. To wrap this up, then, here’s a comforting little ditty I learned long ago:

At beauty I am not a star –

Others are fairer by far –

But my looks, I don’t mind them,

‘Cause I am behind them –

It’s the people in front get the jar.