The Invisible Cancer

By the time I completed biochemotherapy treatments for Stage IIIc melanoma, I had the unmistakable look of the stereotypical cancer patient. I’d lost enough weight to look skeletal, had no eyebrows or eyelashes and only a little fuzz left on my head, and my skin was red and crusty. The melanoma clinic oncologist who saw me for a checkup ten days or so after the last round even told me “you certainly don’t look as good as you say you feel”, which, although true, nevertheless irked me more than a bit.

But oftentimes Stage III and IV melanoma patients undergoing immunotherapy don’t look “sick” like most people think cancer patients are supposed to look. They may feel lousy and even be in a lot of pain, but to casual acquaintances and co-workers they look “just fine”. So the relative invisibility of advanced melanoma and its treatment seems to sometimes engender a certain degree of denial that a Stage III or IV melanoma patient has a “real” life-threatening cancer.

I surely don’t want any of my melahomies to look like I did during treatment. But maybe we’d strike a blow for melanoma awareness if we all made a pact to shave our heads (or hide our hair under fake bald caps) and wear jet-black stocking caps or head scarves while undergoing immunotherapy treatments like interferon or ipi? A few black patches in the sea of pink at the infusion center couldn’t hurt the cause now, could it?

I’ll sign off with a song to those who still think our “invisible cancer” ain’t the real deal and say insipid things like “thank heavens it’s just skin cancer”, to the tune of U2’s “Invisible”…



It's like our gloom’s just hid in cloak
I didn't even want the heart you broke
It's yours to keep
You just might need one

I finally found my real bane
I won't be free when you see me again
No, my mole C’s my stalker one

I'm more than you know
I'm more than you see here
More than you let me be
I'm more than you know
A body with loud mole
You don't see me but you will
I am not invisible

That's right
I'll be in the invisible world

I don't dream, not as such
I don't even think about mel that much
Unless I start to think at all

All those dosin’ days
And your frozen gaze
They melt away your face like snow

I'm more than you know
I'm more than you see here
I'm more than you let me be
I'm more than you know
A body with loud mole
You don't see me but you will
I am not invisible
I am here

There is no them
There is no them
There's only us
There's only us
There is no them
There is no them
There's only us
There's only us
There is no them
There is no them
There's only you
And there's only me
There is no them

Winter Fun in the Sun

Whenever I find myself at Denver International Airport during spring break ski time, I always get a grin out of seeing deplaning ski bunnies in fur coats and snow boots who are about to discover when they leave the terminal that it’s sixty-something and sunny out there. You see, one of the many things folks who dwell on the left and right coasts don’t know about Colorado is that we enjoy lots of sunny and mild winter days. Here at Casa De Rich, elevation 7200 feet, today it’s bluebird skies and an afternoon in the 50’s, and that’s not at all unusual for late February. And it could also snow a foot tomorrow, who knows. So Coloradans tend to spend a lot of time outdoors during the winter, not just sliding down the slopes or standing in long lines outside the local recreational pot shop, but also enjoying non-alpine sports like hiking, biking and even golfing. And we’ve learned, sometimes the hard way, that year-round sunscreening is a must with the high UV indices we encounter at altitude.

So if you come to Colorado this winter and don’t want to look like my ‘idol’ Kim here, please pack some sunscreen in your bag and leave that tacky fur coat at home, okay?

The trails are calling me, so until next time I’ll sign off with the Hotel Melanoma rendition of “Here Comes The Sun” from The Beatles…

Here comes the sun, doo doo doo doo
Here comes the fun, and I say
It's alright

Little darling
It's been a long, outdoorsy winter
Little darling
It feels like years that it's been clear

Here comes the sun
Here comes the fun, and I say
It's alright

Little darling
The fries returning to the faces
Little darling
It seems like years since sunscreen’s smeared

Here comes the sun
Here comes the fun, and I say
It's alright

Sun, sun, sun, here it comes
Fun, fun, fun, here it comes
Sun, sun, sun, here it comes
Fun, fun, fun, here it comes
Sun, sun, sun, here it comes

Little darling
I see the high is slowly melting
Little darling
It seems like years since I’ve been clear

Here comes the sun, here comes the fun and I say,
It's alright
It’s alright

Dermatology's The Prodigy

According to a recent New York Times article, dermatology is one of the highest paying medical specialties. The reason for that is that a dermatologist can perform a lot of relatively quick and easy “procedures” in a day, e.g. a simple biopsy of a suspicious mole, and bill a handsome sum for each one of them. Since my oncologist kicked me halfway to the curb a year or so ago, I’ve had first-hand experience with the billing prowess of a dermatology clinic. Some very minor outpatient surgery last month to take a second whack at a squamous cell carcinoma will cost me a rather astounding hospital “facilities charge”. I can hardly wait to receive the doc’s bill for the “procedure” itself, which was actually performed by a resident with a modicum of supervision from his faculty mentor. And I’m sure the pathologist won’t come cheap either.

Lawyers, on the other hand, are just plain stupid because we generally bill by the hour-- despite the fact that some of our hours are worth a whole lot more to the client than others because sometimes, through years of experience and training, we’re able to quickly and efficiently solve some complex and high-stakes legal problem, and other times we’re stumped and spinning our wheels. Even at the astronomical hourly rates charged by Big Law firms, which routinely send three lawyers to appear at a mundane hearing at which only one will open his mouth in the courtroom, few lawyers can hold a candle to medical specialists when it comes to capturing the full fair market value of performing a specialized “procedure” a dozen times a day. Docs, my hat goes off to you (but only in the shade) for understanding that the time you spend with something like a scalpel in your hands is worth a whole lot more to the patient than your time spent doing a routine office examination, and billing accordingly.

Half-wishing my Mama had kicked me up the side of the head when I first mentioned applying to law school, I’ll sign off with the Hotel Melanoma rendition of Waylon and Willie’s “Mamas,Don’t Let Your Babies Grow Up To Be Cowboys”…



Lawboys ain't easy to love and their bar years get old.
They'd rather bill you a song than diamonds or gold.
Old scarred belt buckles and old faded green ties,
And each fight begins a new way.
If you don't understand him, an' he don't die young,
He'll prob'ly just write away.

Mamas, don't let your babies grow up to be lawboys.
Don't let 'em fix tickets or charge hourly bucks.
Let 'em be doctors and surgeons and such.
Mamas don't let your babies grow up to be lawboys.
'Cuz they'll never stay home and they're always on phone.
Ev’nings with some judge they ‘love’.

Lawboys like smoky old board rooms and clear pharma warnings, Divorce borne yuppies and felons and girls of the night.
Them that don't know him won't like him and them that do,
Sometimes won't know how to take him.
He ain't wrong, he's just different but his pride won't let him,
Do things to make you think he's right.

Mamas, don't let your babies grow up to be lawboys.
Don't let 'em spring drug czars or bail out old drunks.
Let 'em be doctors and surgeons and such.
Mamas don't let your babies grow up to be lawboys.
'Cuz they'll never stay home and they're always on phone.
Ev’nings with some judge they ‘love’.

Cabin Fever Rock

It’s been a very rough winter for so much of the country, including my neck of the woods where it was 15 degrees below zero this morning. Again. I was out shoveling the driveway yesterday morning and my eyelashes were forming ice crystals. So I’d imagine that millions of Americans share my urge to use Punxsutawney Phil for a bit of target practice, even though we know the little critter is not to blame for our long winter of discontent. But there’s just nothing as cold as the indoor tanning industry, which will gladly sell a carcinogen to teenagers. And I believe that someday soon the industry will follow in the footsteps of the tobacco industry and pay the price for its deceptive and misleading claims about the safety and health benefits of its product.

For my ‘friends’ in the indoor tanning industry, here’s the Hotel Melanoma rendition of Foreigner’s “Cold as Ice”…



You're as cold as ice
You're willing to sacrifice our young

You’d rather make the lies
Someday you'll pay the price, I know

I've seen it before, it happens all the time
(Oooh-oooh) You're op’ning the door, you grieve young girls inside
You're digging for gold, you're throwing away
(Aaah-aaah) A fortune in teenlings, but someday you'll pay

You're as cold as ice
You're willing to sacrifice our young

You flaunt bad advice
But someday you'll pay the price, I know

I've seen it before, (oooh-oooh) it happens all the time
(Oooh-oooh) You're posing sun bore, you leave young girls skin-fried
You're digging for gold, (aaah-aaah) you're throwing away
(Aaah-aaah) A fortune in teenlings, but someday you'll pay
(Cold as ice) You know that you are
(Cold-cold, As-as ice) As cold as ice to me
(Cold-cold-cold, As-as-as ice)

(Ooh-ooh-ooh) (Cold as, cold as I-I ice) (You're as cold ice) yes
(Cold as ice) You're as cold as ice, cold as ice, I know
(Cold as ice) (Cold as, cold as ice) Yes I know
(Cold as ice) (Cold as, cold as ice) You're as cold as ice, cold as ice, I know
(Cold as ice) (Cold as, cold as ice) Oh yes I know
(Cold as ice) (Cold as, cold as ice) You're as cold as ice, cold as ice, I know
(Cold as ice) (Cold as, cold as ice) Oh yes I know
(Cold as ice) (Cold as, cold as ice) You're as cold as ice, you're as cold as ice, I know