A Black Spot

  “You’ve got a black spot,” said my wife when I asked her to scratch my back.

“Black as the tar in the road?” I asked. She confirmed this, but as I quizzed her she realized that a black spot was bad and began retreating. Maybe it was dark brown.

She took a picture with her cell phone. It was half an inch in diameter, dark, and lumpy but not obviously malignant looking. Wives are always discovering things on their husbands which, being men, they ignore. Later the husbands die.

I decided I needed to see an expert. It was Friday, and I didn’t want to spend an anxious weekend, so it had to be today.

My favorite dermatologist in Los Angeles is Pamela Rand. She does not accept insurance, Medicare included, so I use others for routine skin problems. She was on vacation.

I like the doctor I see at the UCLA dermatology clinic in Santa Monica, but the clerk reported no openings until Tuesday. When I pressed, she transferred me to a nurse who, after consulting for several minutes, reported she could move me up to Monday. I would have tried to pull rank as a physician had I been really frightened, but I was only uneasy.

A few dermatologists phoned at random were not helpful. I phoned the main UCLA clinic in Westwood and learned that there were no openings except in distant suburban facilities. Thousand Oaks and Westlake were about forty miles; Porter Ranch seemed closer.

The drive was long, but parking was free. The dermatologist took a quick look and told me it was benign. I sat patiently as she educated me on seborrheic keratoses (age spots) and accepted her handout. Doctors don’t learn that I’m a physician unless they ask. It doesn’t get me better medical care, and some doctors feel uncomfortable having one as a patient. 

 

Why Do I Get So Many?...

Everyone thinks he or she has a weak spot. “My kidneys are weak...” “I have a tendency to strep...” “My resistance is low...” In fact, most recurrent complaints are not your fault.

Colds (or other viral infections such as bronchitis, tonsillitis, flu) are contagious diseases. You catch them from another person. They are not caused by chilly weather, wetness, stress, poor nutrition, or a weak immune system.

Backaches happen because our skeleton is defective. Animals walked on four legs for hundreds of millions of years. Humans stood erect a few million years ago, too soon for evolution to correct matters, so back muscles are too weak for the extra work, and our spine is not built to carry so much weight.

Bladder infections plague young women. Many suspect something is wrong, but this is rarely the case. In young adults, these are caused by germs that normally live around the genitalia. Young men suffer much less often because having a penis gives germs much further to travel to reach the bladder. Men catch up after middle-age when their swelling prostate obstructs urine flow.       

Bruises.  Black-and-blue marks occur after an injury. Rarely, they are the sign of a bleeding disorder, but in young women bruises often appear for no reason at all.

 

Flatulence is usually a sign of good health. Humans digest protein and fat easily, so very little reaches the colon. Carbohydrates are another matter; a person who eats a great deal of grain, vegetables, and fruits delivers plenty of undigested carbohydrate to colonic bacteria that feed on it, producing gas.

Age spots become tiresome if you or your doctor don’t take them seriously. They begin around age forty as small brown spots. A quick freeze with liquid nitrogen makes them vanish with no scarring. If ignored, they never go away. They enlarge; some become thick and wart-like; others appear. Eventually there are too many to treat.

Allergies tend to appear in childhood. Most reactions that adults call allergies are something else. If a medicine makes you ill, that’s probably what doctor’s call “drug intolerance,” not an allergy. This is not splitting hairs. A drug allergy can kill you; drug intolerance is merely annoying. Most stuffy noses are not allergies. Neither are most rashes or upset stomachs.