A Return to Healing

A few years ago, at the conclusion of an office visit with Dr. Saputo, he mentioned that he was writing a book about health care reform. At that time, I was making a 45-minute drive to see Dr. Saputo because I couldn't get the medical help that I needed closer to home.

Dr. Saputo embodies the ideal medical practitioner of the 21st century. He uses cutting-edge laboratory tests to diagnose illness. He combines conventional medicine with adjunct alternative or integrative therapies. He goes to the source of many illnesses by looking at the patient's digestive system. Conventional doctors rarely consider nutrition and digestion to be a part of good health.

Dr. Saputo makes himself accessible to his patients. He prefers that they call him "Len." He encourages patients to email him with questions--between office visits--and he responds right away, as long as the question requires a straightforward answer.

I read extensively about medical issues. I typically arm myself with a list of concerns to show my doctors. My aim to be a part of my own care puts off some doctors. Dr. Saputo welcomes questions, and he takes them seriously. He is open-minded enough to consider my thoughts. Yet, he is a strong sounding board who doesn't let me hijack my treatment with my own fears or misinformation.

This review is not of Dr. Len Saputo's medical practice, but of his book: A Return to Healing: Radical Health Care Reform and the Future of Medicine. When he mentioned he was writing this book on medical reform, I thought to myself, Good luck with that. Only an optimistic, energetic person would tackle this subject. When he said that his goal was to provide a solution to the medical care crisis, I asked what his bottom line solution would ultimately be. He said something like, "People must take it upon themselves to demand change."

2008 Full of Promise

I apologize to the throngs of loyal readers who can't get enough of my blog. I promised at the end of 2007 that I was making a big comeback. My comeback got delayed, but I'm back for the remaining one loyal throng.

I'm changing my habits...well, a couple of them. Not because it's a new year, but because this year is almost one-sixth over. Can you believe that?

I think that time zooms by quickly for us boomers. If I'm going to finish my second book this year, I'd better use some discipline. My commitment to myself is to have the basic text down by my June birthday. I will find an agent before the book is finished.

Psychiatric Drugs and Mass Shootings

How many more innocent people will be shot and killed by someone gone mad on psychiatric drugs? When hearing that a shooter--like the 19-year-old male who murdered eight people in a Nebraska Mall--has been under psychiatric care, please read between the lines.

Anyone on psych drugs--anti-depressants, tranquilizers, anti-psychotics, or anti-seizure drugs--must be consistently monitored. The effectiveness of these drugs is always hit and miss. And stopping any of these drugs abruptly can create the worst possible scenario.

Kathy Freston's Transformational Meditation: Healing

After trying several relaxation and healing tapes/CD's, I have found one that I value so much, I want to shout it to the world. If you "are in pain, have been diagnosed with a disease, or have general malaise," this CD is for you.

I first saw Kathy Freston on Oprah, discussing her book on relationships called The One. After the show I purchased the book because I thought it would help me shed baggage that prevents me from attracting the right person. Unfortunately for me, the book is designed for someone who is already in a relationship. The premise of the book is that what you put into the universe, you will attract back. I have put this book aside and will do the exercises in it at some point in my future.

But Freston impressed me so much that I looked for other writings by her. Lo and behold, I found her transformational meditation CD's and I purchased two: One on relationships and the other one on healing.

Rest in Peace, Tammy Faye

Tammy Faye Messner died Friday morning. I did not see her last appearance on Larry King Live, but I read summaries of her interview, and I read her last post of a couple days ago on her page TammyFaye.com.

I normally think it's in bad taste to pronounce someone's impending death, as I did in my last blog. I thought more than twice before saying what I said. After reading her last letter to her supporters and fans, I thought, If anyone can come back from near death, it would be Tammy Faye.

She kept her sense of humor until the end. She also knew that she was headed toward the arms of God. I commend Tammy for her strength and guts and faith. My good friend Janice died in 1986. Memory of her courage and faith has stayed with me all these years. And I think of her whenever I find myself hospitalized.

People die as they live, and those who go with courage, set examples for those of us they leave behind. My father also had unwavering faith, and he died how he lived, on his own terms. People who leave us on their own terms give us a gift. They somehow comfort us, instead of the other way around. And they give us an idea how we might go forward when it's our turn.

This is really about Tammy Faye, an imperfect person who got the most important things right. She didn't give up. She fought. She laughed. She believed. She did things her way (and her interpretation of God's way). She pulled herself up after several "failures."

Many people loved her. You can't do better. I will remember Tammy's courage always. She has joined that rare club with my father and my friend Janice, those who have shown me how to navigate illness and death.

Thank you, Tammy Faye. I know you're with Jesus, and I know you're at peace.

Tammy Faye: Too Ill for Television

Yesterday I flipped the remote to check out Larry King Live. The guest was Hulk Hogan, but Larry had just taped an interview with Tammy Faye Messner, which I believe will air today. He showed an excerpt from the interview.

Let me say first that I'm no stranger to ill or injured people. I spent time with my mom when she was in ICU and when she was dying. I spent time as a patient in ICU after sustaining, what they called, serious disfiguring injuries. (I look fine now, but my family was unable to recognize me at that time.) I also volunteered at the trauma center at Eden Hospital in my town. I can hold the hand of sick or injured individuals, and if I feel squeamish, I can pull myself together for someone who is suffering. I'm no lightweight when it comes to health matters.

Back to Larry King Live and Tammy Faye. I was in utter shock to see Tammy Faye. At 65 pounds, she is literally skin and bone. She is dying of cancer, and she is too ill for television. I've always enjoyed Larry King, but I believe his show is exploiting someone who is too ill to realize that she no longer resembles herself.

What is the purpose of airing a show with someone so ill? I hate to say this, but Tammy Faye's image is frightening to me. Years ago when I'd been banged up in a bus accident, I did not allow reporters in my room. I did not wish to share my deepest suffering with the local media. I was afraid to let my 10-year-old son visit me, as my image might upset him. My son and I both survived, but in retrospect, my appearance wasn't as frightening as Tammy Faye's. My situation was full of hope as I improved each day. This is a hard pronouncement, but Tammy Faye is, in fact, withering away, and now she is withering before the cameras. And for what purpose?

I was once critical of Tammy Faye and the whole Jim Bakker and PTL scandal. And what woman in America wouldn't like to get hold of Tammy Faye's makeup and give her a makeover? She has always had a pretty face--with too much mascara and misplaced eyebrows.

Although Tammy Faye has battled cancer several times in recent years, she has remained steadfast in her faith in God. And during the worst of times she kept her sense of humor and her positive attitude. Surprisingly, she became someone I deeply admire. She is one strong woman.

Maybe Tammy Faye approached Larry and asked to make a public appearance. Maybe she wanted to thank the public for supporting her through trying times. Maybe after several appearances on the show, Larry and his staff's interests are honest but misguided. I hate to think this interview is for ratings.

STILL, SOMEONE SHOULD HAVE STOPPED THIS INTERVIEW FROM BEING VIDEOTAPED.

I wrote to the show, and asked them not to air the interview. That's all I can do. I debated about writing this blog, as I'm calling attention to the show. Curiosity sometimes draws us to look at misery. For instance, it is sometimes human nature to slow down to see traffic accidents. But if you read this blog today, I suggest bypassing the show. I will not be watching.

I'd be curious to hear from anyone on this subject, especially from someone who has lost a family member to cancer or from someone who has had cancer. Do I seem insensitive to Tammy Faye? I hope not. I would like to protect her and help her keep her death (dying) private.

Edit: July 19, 2007 @7:44 p.m.You can post prayers and good wishes to Tammy at: Tammy's Page.

Squamous Part Trois

In previous blogs I described my challenge of having a squamous cell carcinoma, a type of skin cancer. I also described my experience, having Mohs Surgery, the most effective procedure (statistically) to remove all cancer cells. My procedure was on June 19, 2007. I will post photos of my healing scar at about three months post-surgery.

Yesterday I got my bill from Dr. Ting, my dermatologist and surgeon. Holy guacamole! Who would think it so costly to have a few cells removed from a cheek? I have a large deductible on my medical insurance. As cancers go, my experience hasn't been bad, but. . . .

Last night Dr. Ting phoned me. When I noticed his number on my caller I.D., as the phone rang. . . .well, I'm familiar with the drill by now. I have another squamous cell carcinoma on my opposite cheek this time, underneath my eye.

My original purpose for seeing Dr. Ting was to have unsightly--albeit small--precancerous bumps removed. My desire was to beautify myself.

So far, every time I leave Dr. Ting's office, I look beat up and patched up. I've been waiting for my last procedure to heal, along with the tiny wounds I have from removed skin tags, warts and moles, that Dr. Ting likes to call "barnacles of wisdom." And now I need another cut that requires a surgical flap to cover the small crater that is created by the excision of the cancer cells.

I feel a bit foolish. There's a good chance that the application of nitrogen--which is far less invasive and far less expensive--could freeze the cancer cells off my face completely. My face would look a whole lot better, and my finances wouldn't take such a hit.

What if doing nothing is all I need to do? Would these cancers really spread? I've opened Pandora's box and can't seem to close it.

Dr. Ting says that if it were his daughter or sister with skin cancer, he would recommend Mohs Surgery. I believe him but can't help notice that with nine Mohs Surgeries, he's making over $20K in one day, and I feel stuck without a choice.

To be fair to Dr. Ting, I'm leery of doctors in general. I wouldn't have him as my doctor if he hadn't demonstrated skill, patience and kindness for me as his patient. But what if we discover a third cancer? We haven't even begun to work on my neck and back. Dr. Ting tells me that Mohs Surgery would not be necessary on areas other than my face. He could simply make a cut.

He has suggested a chemical peel to me many times as a preventative measure. The cost: $500. Not a moneymaker for him. I am researching the side effects of the chemical peel, and when my face has healed, I will probably take that step. At that time I will describe the procedure and post before and after photos.

To be continued. . . .

The Word on Sunscreen

My goal for this blog entry was to give basic advice on using sunscreen:

1. How does sunscreen work?
2. What ingredients do I look for?
3. What are some recommended brands of sunscreen?

There are some differences of opinion on this topic, so I’ll give very basic information.

Sunscreen protects the skin from ultraviolet light, which can cause sunburn. Ultraviolet (UV) light can produce long-term damage, such as premature skin aging and skin cancer.

The ingredients to look for in sunscreens are titanium oxide or zinc oxide, which reflect the UV light. Avobenzone and oxybenzone (sometimes called “helioplex”) absorb the UV light.

The American Academy of Dermatology recommends using a sunscreen with a minimum SPF (Sun Protection Factor) of 15. After finding cancer cells and precancerous cells on my face---see The Word is Squamous and Squamous Part Deux---my dermatologist wants me to wear SPF50. SPF indicates the time a person can be exposed to sunlight before getting sunburn with a sunscreen applied relative to the time they can be exposed without sunscreen. Say what?

For instance, someone who would burn after 12 minutes in the sun would expect to burn after 2 hours (120 minutes) if protected by a sunscreen with an SPF of 10. However, the effectiveness of sunscreen depends upon how often you apply it, what type of activity you’re engaged in, and what type of skin you have.

If that doesn’t confuse you, here’s another school of thought. Research has shown (one bit of research) that a population known to have worn sunscreen actually had more incidents of skin cancer than the average population. It is suggested that some of the ingredients in sunscreen can cause cancer.

Others believe that while sunscreen blocks UV rays, it also prevents the skin from absorbing vitamin D—which is vital in the body’s utilization of calcium.

The pro-sunscreen group, which includes dermatologists and the Skin Cancer Foundation, suggests that everyone wear sunscreen beginning at the age of six months. Use of sunscreen is recommended for all races, including African-Americans. Use of sunscreen is also recommended on overcast and cloudy days.

I wonder why so many people get skin cancer nowadays. Is it because we live longer? I also wonder if thousands of people have skin cancer and live their lives without knowing it. Maybe the cancer only spreads once it’s cut or aggravated in some way. Obviously, some skin cancers spread vigorously, dangerously and fatally. But I wonder about the tiny ones, like the squamous cell carcinoma that I had removed. What would have happened if I’d done nothing? It was teensy, but I had it removed anyway. I still wonder....

I played in the sun as a kid. I got a pretty good suntan maybe two or three summers of my young adult life, when I still had time to lie in the sun. One summer, while getting ready for my 20th high school reunion, I had at least 10 visits to a tanning bed. I think that using the tanning bed caused my skin cancer.

Http://www.skincancer.org says that all sunscreens should have the Skin Cancer Foundation Seal of Approval. Here’s a list of effective sunscreens, approved by the Skin Cancer Foundation.

I tend to be sensitive to cremes. I had to remove the first sunscreen that I tried (Coppertone Water Babies), because the scent bothered me. I now see that this brand contains none of the required ingredients that block UV rays. Yet, the front of the bottle says, "No. 1 Pediatrician Recommend Brand." I now use unscented Neutrogena Healthy Defense Daily Mosturizer SPF 45 with helioplex. My dermatologist says this is a good one. Yet, today I read the active ingredients and there is no titanium oxide or zinc oxide.

The Neutrogena brand has no seal from the Skin Cancer Foundation, but it has a seal from the American Cancer Society, and it says, "The American Cancer Society (ASC) and Neutrogena, working together to help prvent skin cancer, support the use of sunscreen. The ACS does not endorse any specific product. Neutrogena pays a royalty to the ACS for the use of its logo."

Maybe this is Neutrogena's explanation for not using titanian oxide or zinc oxide, as the Skin Cancer Foundation is a separate entity from The American Cancer Society. Hmmmm. Maybe I'd better find yet another sunscreen that is unscented, with all of the recommended ingredients.

This is what I choose to do with this information: I keep a hat and some sunscreen in my car at all times. I will avoid getting a sunburn at all costs. I’d rather protect my face with a hat, but I will use the sunscreen in moderation. If I go for a walk, I’ll probably just wear a hat. If I’m spending time at the beach or on the golf course, I’ll put sunscreen all over, and mine will be SPF45 or 50.

Your Drug May Be Your Problem

It seems like everybody’s taking Prozac, Zoloft or some other antidepressant. Well, maybe not. But we all know somebody who is. At least one of the Columbine shooters was on antidepressants (Eric Harris was on Luvox). These drugs may help some people but they make other people crazy. Taking a mind altering drug is like playing Russian Roulette.* Here's an article that lists the many killings done by individuals on antidepressants.

Drugs and Mass Shootings

You may assume that these killers all had serious problems before they took these drugs. But all too often a patient who is given a drug to cope with mild depression has a bad reaction to the drug. This reaction may occur over time in a patient that is not monitored adequately by a doctor. And no one recognizes the problem until it's too late.

Drugs to alter our moods are common today. The drug companies are making a bundle of money while we are their guinea pigs. Many consumers have a naive sense of security, believing that we’re protected by the FDA. I urge anyone who takes a mood altering drug, or loves someone who takes a mood altering drug, to read Your Drug May Be Your Problem: How And Why To Stop Taking Psychiatric Medications by Peter Breggin, M.D. and David Cohen, Ph.D.

How does anyone know how drugs affect the brain? The idea that Prozac corrects a chemical imbalance is purely a guess. However, it is a proven fact that Prozac causes a disruption of the normal firing of brain cells. No one who knows the research can dispute this. Drugs like Prozac, Ritalin, or Xanax destroy the brain’s capacity to function properly on its own.

How long does this disruption last? No one has the answer to this question because there is no long-term research done. All research to approve a drug is conducted over short time periods.

Your Drug May Be Your Problem describes adverse effects of various psychiatric drugs, including antidepressants, stimulants, benzodiazepines (tranquilizers), mood stabilizers, neuroleptics, and others. If you are taking a mood altering medication, please read about the side effects of your particular drug. Often the patient believes (or is led to believe) that their “chemical balance” has gotten worse, when it is the drug that is causing the problem.

Aren’t we protected by the FDA? The FDA relies on data that the drug companies have assembled, organized, pruned and interpreted. Using only this data, the FDA makes its risk/benefit analysis. The FDA almost always ends up making compromises in order to accommodate industry. This process is called negotiating with the drug companies. It is kept entirely secret from doctors and consumers alike. The risk/benefit ratios are never determined by the patient.

Here is Peter Breggin, discussing antidepressants on The O'Reilly Factor:

Peter Breggin on You Tube

Breggin and Cohen have written a solution-oriented book. They describe some of the side effects of withdrawing from these drugs. They suggest guidelines to help therapists offer patients a more balanced view of using drugs, and, finally, they give sound psychological principles to help patients learn to feel better so that a drug may be used as a last resort.

*Sorry if this is P.I. The phrase illustrates a point.

Death by HMO

Today is the nationwide release of Michael Moore’s documentary Sicko. Maybe I’m a dreamer, but I hope this movie is the catalyst for the long-needed change in our medical system. No matter how much attention Sicko garners, it’s still up to all of us collectively to stand up and be counted, and refuse to tolerate conditions as they are. In a “civilized” country such as ours, the medical care is often far from civilized. In a country (the USA) that prides itself in technological advancement, our medical care really isn’t “care” at all.

If you’ve never been exposed to medical negligence or indifference, you are vulnerable to betrayal. Caring doctors and nurses are out there, but we can’t assume the professionals know best without us asking many questions and doing our own research. People often question their auto mechanic more than they question their doctors.

One family’s fight to reform the medical system is documented in an excellent, but gut-wrenching book, Death by HMO: The Jennifer Gigliello Story. This book is written by Dorothy Cancilla, a bright and feisty woman, who learned the hard way how callous and incompetent some medical providers can be. Cancilla’s book documents her daughter Jennifer’s eight years of painful illness that eventually led to a premature and avoidable death. Jennifer (below) died four days before her 30th birthday.



I’m amazed at how much information and detail is compiled into this 132-page book. The reader gets an education on the human body, and the tragic errors made by doctors at every turn become very clear.

I can’t imagine helplessly watching my daughter suffer, as Cancilla was forced to do. She and the rest of the family tried everything they could to support Jennifer and help her make the right decisions. Their biggest mistake was daring to think that doctors and Kaiser Hospital had Jennifer’s best interest at heart.

Jennifer’s problems began with frequent abdominal pain and vomiting. While doctors debated about the cause of her suffering, she trusted her doctor who literally butchered her (let’s tell it like it was) by removing her pancreas, instead of her gallbladder. Jennifer, who was somebody’s mother, wife, daughter and sister, tried to live a normal life around many hospital stays and surgeries. Cancilla portrays her youngest daughter as heroic. Anyone reading this book will fall in love with Jennifer, but what pulls at my heart is Cancilla’s loss—a mother’s loss—that never goes away. She honors her daughter and husband by writing this book.

Death by HMO documents medical negligence and indifference but also shows how truly callous some businesses can be for the almighty dollar. In Jennifer’s case the greed of the HMO set off a chain of events that affected her life––and her death—which in turn devastated her family. While viewing Jennifer in her casket, her father Lou Cancilla had a heart attack and died. Dorothy Cancilla and her family lived through a horror show, barely hanging on, in a daze, wondering which family member might be next as they survived two funerals.

To add more insult to much injury, Kaiser Hospital (and members of it) promised to release the facts of the cause of Jennifer’s death, only to hide the autopsy until the courts intervened.

I love Dorothy Cancilla. What a mom she is, and one tough cookie. She did not disappear in her grief, but joined the family in suing Kaiser; and then she later wrote this book. Although the family was triumphant in winning a lawsuit against Kaiser, I’m disappointed that the law limited their financial compensation—received by Jennifer’s husband and son—to a whopping $125,000. Of course, no money really compensates for suffering and loss of life. But at least the judgment in the case allows the author to legally and openly state that Kaiser was at fault.

People need to know what can happen to any of us once we put ourselves in someone else’s hands. We must advocate for ourselves and our loved ones. We cannot assume that the doctor is always right. We have to keep in mind that the only body we have has to last us a lifetime. We are the ones who are affected by wrong decisions. Ultimately we must consider the medical professionals as part of our team. They are expert consultants and sometimes gifted surgeons. But even the most dedicated doctors are imperfect, not God-like. Even decent medical people may be cajoled into betraying their patients by the HMO who pays their salary.

Death by HMO will surprise and dismay you. But you will be inspired by the courage of Dorothy Cancilla and her family. This story has all the elements for a great movie.

Squamous Part Deux

On Tuesday June 18, Dr. Ting removed the tiny carcinoma from my left cheek. The procedure only required one pass--to remove cancerous tissue to be examined under the microscope. When Dr. Ting returned from the lab, he asked me if I wanted to see the incision ("excision" is more precise). I normally prefer to be involved in my own care as much as possible, but I didn't have the heart to see the results.

A soft paper cloth draped over my face caused me the most discomfort. The purpose of the cloth was to keep the wound sterile. Feeling smothered is a personal quirk of mine, but it was no big deal, and no pain whatsoever was involved otherwise.

Stitching the wound required more time than anything else, partly because the skin needed further cutting to compensate for the gap made by the vacant hole. Dr. Ting made some sketches of potential cuts he could make as part of Mohs procedure that I previously described.

Here are Dr. Ting's sketches:


Holy guacamole, Batman! Can't you just spackle the hole, instead of making it bigger?

I'm usually a control freak about my medical care. But since my dismay about getting my face cut made it difficult for me to picture minimal scarring, I asked Dr. Ting to do what he thought best. Mohs procedure is a bit bizarre. The idea of making a relatively big incision in order to keep scarring to a minimum is hard to grasp. You can judge for yourself whether you think it works or not by viewing the photos below.

The biggest problem in dealing with skin cancer has been the inconvenience of the surgery and the $2000-deductible I have on my medical insurance policy. Once I removed my bandage a few days later, I looked like Frankenstein's distant, distant cousin.

Day 6 before my office visit:


I suffered no discomfort, getting the stitches removed. I had opted not to take antibiotics for this procedure. And when I found out that the topical antibiotic ointment was $48 a tube, I did not buy the prescription. I kept the wound very clean and used the topical ointment that Dr. Ting gave me.

Day 6 after the removal of my stitches:


In two weeks I return to Dr. Ting to get more moles and precancerous bumps off my skin that are typical to baby boomers who worshipped the sun when we were young, especially here in California.

If anyone reading this gets skin cancer, I'd try not to worry. A melanoma is more likely to cause problems than a squamous cell carcinoma or a basal cell carcinoma. Early detection of all of these is the key. It is definitely time to wear a hat when I go for a hike, play a game of golf, or work in the yard.

Dr. Ting swears by sunscreen with an SPF rating of 50 or higher. He also recommends that I get a chemical peel to remove other recancerous marks on my face. I will research both these topics and post what I decide here on this blog.

The Word Is "Squamous"

Two days before my 59th birthday, my telephone rings at 8 a.m. When I see my dermatologist's caller I.D., I assume his staff is contacting me. I've recently had session two of moles and other weird thingies removed from my face, mostly for cosmetic reasons. I don't want my grandchildren to see an old witch when they look at my face.

After session one, everything was benign. I haven't thought twice about the lab work from session two until I hear my doctor's voice on the line. He says that one tiny bump on my face has come back positive. "Remember that one bump that I thought looked suspicious?" he asks. I remember. He says I need to come in and have it cut out. No big deal.

What could be difficult? Nothing really, except that he will excise some skin, freeze it, and send it to the lab. We will then wait for the lab results before sewing me up or before cutting deeper. If he cuts more, he will freeze more cells and send them to the lab, and the procedure will repeat until there is no sign of cancer.

He asks me to look up "Mohs surgery" on the Internet. Hmmmm. I've been looking forward to this year's birthday. I'm not sure how to feel now. Once I Google "Mohs," it becomes difficult to be optimistic. I read that the physician makes an oblong incision, plenty long to get all the cancer cells. Nothing significant on someone's forehead or arm, but my tiny lump is on my cheek, near the smile crease that goes from my nose to my mouth.

I call the doctor back and talk to his staff. "I need to know what kind of cancer this is," I say. "The doctor told me to look up "Mohs surgery. He did not say what kind of cancer it is." The nurse says: "Squamous cell carcinoma." "Isn't this worse than basal cell carcinoma?" I ask, trying my best to pump her for info that will give me some peace of mind. She seems noncommital.

I find out that both basal cell and squamous cell carcinomas are usually 100 percent curable if treated right away. Squamous cells may metasticize more quickly, but basal cells go deeper and may be more disfiguring. In my case I'm more concerned about potential disfigurement--I think. I request the name of a plastic surgeon.

When Dr. Ting calls me with some surgeons' names, I ask to schedule an extra appointment to discuss my options, face to face. Is surgery a must? I don't want to be disfigured. I love Dr. Ting. He fits me in two days from now. I've decided that once I do everything possible to insure success, I will put this topic out of my mind. I'm feeling more in control as I pursue more information.

Meanwhile, I find infinite sources on the Internet indicating that the Mohs procedure provides the highest assurance of complete cancer removal but preserves a maximal amount of normal tissue.



I go to my consultation two days later. Dr. Ting draws an incision on my face as plan A. He will do Mohs procedure on eight different people on my big day, and I'm second in line. I like the order. He can warm up on number one, but still be fresh during my turn.

Below is the squamous cell carcinoma on my left cheek. What you see started as a tiny thing before it was cut and sent to the lab a few weeks ago. Note: I cropped away my face like they do in the medical journals--to display these silly cancer cells.



Dr. Ting erases the ink and draws plan B, in case there are lots of cancer cells. He tells me that the plastic surgeons will charge $6,000 to stitch the hole closed. This fee is obscene. Why would one human overcharge another human to do an hour's work when this procesure is not optional?

Dr. Ting looks like an Asian Doogie Howser. He credits his consistent use of sun screen for his youthful appearance. (He reminds me to put on my SPF50 before I step outside.) He has performed Mohs technique many times; he is confident that the scar will not be a problem for me. I believe him. I decide to count on him. June 19th. I will say so long to "squamie" and update this topic.