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Written on the Skin

The dermatological consequences of a misspent youth

A year after I first noticed the odd spot on my leg, I finally made it to a skin clinic. Although my father had died five years earlier, shortly after being diagnosed with metastatic melanoma, I had been typically slow to action. Whether a sniffle, a fever, a pain, a sprain, a Phillips-­head-shaped hole in a foot caused by a power drill falling from the top of a ladder, I tend to give the body time to heal itself before rushing to the doctor. It’s an attitude driven by a mix of stoicism, martyrdom, laziness, an aversion to spending money and, at times, the kind of quiet stupidity that leads to epitaphs like “Here lies Paul – at least he didn’t cause a fuss.”


After being greeted by a receptionist with the leathery skin of a Greek shipping heiress who’s heavy-handed with Reef oil, I took the only available seat in a busy waiting area. Almost everyone around me had that quintessential white Australian appearance, which allows you, with a high degree of accuracy, to identify compatriots when travelling overseas. Their elongated vowels eventually confirm your suspicions, but it’s the mottled pinkish skin, weathered hands, Argyle-­patterned neck creases and, of course, crow’s-feet, remnants from a lifetime of squinting, that give them away. 


Before long I was stripped down to my best pair of underpants and lying on a paper sheet atop an examination bed. If my dermatologist, Dr W, was impressed with my physique she didn’t say. In any case, she was not there to appreciate the art, as evidenced by the way she was inspecting the sun’s brushstrokes upon my canvas, close enough that I could feel her breath. She centred her magnifier on blemishes on my back, my arms, my inner thighs. She even peered into the spaces between my toes, explored behind my ears, fossicked through my hair. 


I’m not sure anyone had ever looked at me so thoroughly, and I had to resist squirming. Since then, I’ve returned to Dr W’s rooms enough times to become as unselfconscious as a naturist with an all-over tan as we chat about our respective kids and her most recent European holidays I’ve helped pay for. 


“So,” I asked her, during that first consult, “that spot on my leg – should I be worried?”

“No,” she replied. “Looks like a basal cell carcinoma and at this stage it’s easily dealt with. But you do have what looks like a melanoma on your back. I’ll do a biopsy in a moment, and we’ll send it away to confirm.”


Half an hour later, the spot on my leg having been shaved off with a curette, and a section of the potential melanoma removed, I was on my way with a “Don’t worry, it looks like we got it early.” Don’t worry, I thought, before calling my partner. “Well, there’s good news and possible bad news,” I began. “Firstly, that spot on my leg? Not a melanoma.”


Passing me in reception was a man in his seventies. He had patches of flaking skin on his pinkish face and, over both temples, circular skin grafts, as glassy as rice paper. I wondered if every time he looked in the mirror he wished his ancestors had stayed behind in the United Kingdom or Ireland, countries where the sun isn’t as determined to kill you. I began to wish the same of my parents, who’d both emigrated from Ireland in 1969. Despite their best interests I was firming in my belief that they may have made a mistake.


This won’t be news to Indigenous Australians, but people like me don’t belong in this country.

A couple of weeks later, Dr W excised the entirety, and then some, of what did indeed turn out to be a melanoma. Stage 1. (Nothing to worry about, relatively speaking, though later I did at least entertain the notion when I saw the concern in my daughters’ eyes the day the biopsy results came through.) Lying there on my stomach, elbows out, turned head resting on my hands, I inadvertently adopted the pose of Max Dupain’s mahogany­-skinned, ocean-slick sunbaker. Eye level with the cold metallic trolley holding various instruments, I watched as Dr W placed a fat-white chunk of my flesh into a specimen jar. 


The melanoma and the basal cell carcinoma, she told me as she began to stitch me up, were likely a result of sun damage sustained decades earlier in my youth. The sins of the past, so to speak.


Over the past 25 years I’ve been careful, even hyper-aware, of the sun’s position in the sky and the way its warm touch on my skin can so quickly turn malevolent. I’ve become aware, too, of Australia’s dubious honour of being the skin cancer capital of the world, not least due to the level of ultraviolet radiation, which in summer is 15 per cent higher than it is in Europe. Any Australian who has holidayed in northern climes would surely have noted a difference. Consequently, I wear hats and long sleeves, I lather myself in sunscreen, and whenever possible I retreat to the shadows like a vampire who has forgotten to adjust his watch to daylight-saving time. 


“Did you have a lot of sun exposure when you were young?” Dr W asked, seeking to verbalise what was written on my skin. 


“You could say that,” I replied, as the suturing thread tugged at my back. 


I was too embarrassed to go into detail, as if my youthful self should have known better, should have realised the link between sun exposure and skin cancer. Lying there I remembered something I hadn’t thought about for years, those summers of teenage vanity when I unhitched the flyscreen from an upstairs bedroom window in order to lie on the corrugated red-tiled roof of my family home in Wollongong. This was in order to get “a little pink” in the hope pink would turn to brown. Not George Hamilton–brown – that was never going to happen. Nor could I hope to attain the honey brown of the Uncle Tobys ironmen who turned girls’ heads on Coolangatta Beach. No, I just longed for something a level up from my whiter shade of Boo Radley. 


Before actively exposing myself like that I was just active. As a child of the ’70s and ’80s I spent my daylight hours in parks and backyards, in the bush, the pool, the ocean. It’s not just that I was a sporty type, but to be indoors on a sunny Saturday was considered indolent and, as my father put it, “a waste of a beautiful day”. 


School offered little respite. I think now, with something resembling horror, of all those hatless lunchtimes playing cricket on concrete playgrounds as hot as barbecue plates. Of sitting on bitumen in the sun, constructing cairns of flies we’d slapped to death on our arms as we waited for the school bus. Of hours-long swimming carnivals held at Olympic-sized pools with forecourts as desolate as deserts. Some effort was made with sunscreen, reduced at the end of the day to the ghostly remnants of zinc on our noses, but we’d all troop home lobster-red and as wrung out as the twisted wet towels in our bags. 


I’m sure that during these years my parents tried to make me slip–slop–slap, as the 1981 ad encouraged us to do, but I don’t recall being hounded. At least not in the way I hound my daughters before a beach trip or outing today, a routine so exhausting and boring I wonder sometimes if the pleasure of diving into the ocean is worth it.


If I don’t quite remember being pestered to cover up, I do recall many evenings standing in the bathroom as my mother gently lathered me in calamine lotion, an attempt to assuage the tears-inducing pain of my sunburn. The lotion, fairy-floss pink, would dry to a brittle skin, and I’d walk from the bathroom stiff-limbed and full of regret. The following day, at school, unable to hide my sunburn, I’d endure deliberate slaps on the back and shoulders from classmates. These weren’t delivered out of sadism or spite but as a kind of warped solidarity. I’ve been there, these backslaps would say. Hurts, don’t it?


In Year 9 I sat behind a boy and watched him hitch up the short sleeves of his summer shirt in order to peel 50c-sized pieces of skin and gently place them on the edge of his desk, his own version of the Dead Sea scrolls. A year earlier a snowy-haired kid I’d struggled to contain on the rugby league field had spent the weekend surfing and had been admitted to hospital with third-degree burns. 


I wonder what became of him. 


And now another kiln-hot summer reaches its zenith: days when the air and the colour are leached out of the world, and that heavy listlessness sets in. It’s bad enough feeling that the sun is out to get me, waiting for me to spend a little too long in the surf or the park or a beer garden. Worse is that summers no longer feel like isolated annual events to be endured, but harbingers of a dystopian future that even the wearing of sensible wide-brimmed hats won’t ameliorate.


In the meantime I maintain my rolling appointments with Dr W. Every six months since the discovery of that melanoma a few years back she’s given me the lingering once-over and almost every time found basal cell and squamous cell carcinomas to remove. A dirty dozen in total. Mostly on my back, which is now puckered with pink keloid scars like buckshot wounds, but three have been sliced from my face – one on each side of my nose, another down its ridge. Dr W’s skill has at least ensured those scars are hard to see. But they’re there, like my rising sense of being unsuited to this sunburnt country and, increasingly, this heating planet.


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