Looking for a new doctor can be a headache, and scary. Your health care provider will usually give you a long list of approved doctors with very little information on their reputation, ranking or personality. Of course, you can search for a doctor on your own, but it can be a pretty frustrating endeavor. A couple years ago I realized I needed a specialist in dermatology. I have been living in San Diego since 1986 and spent a lot of that time outside or at the beach. I needed someone with discerning eyes to really check my skin, so I could rest easy and prevent further damage.
I went through endless lists of names and landed upon a highly ranked clinic referred to me by a friend in Encinitas. This comprehensive dermatology clinic had a lot of positive reviews; all focused on one particular doctor at the clinic. So I called to make an appointment, and of course, the prize doctor was not taking new patients. They never are. So I accepted an appointment with the “also-ran” doctor “S” and waited for my appointment which was months away.
Finally, the big day arrived. I walked into the clinic, a very stylish office with dim lighting and contemporary furniture. A woman with comically inflated lips greeted me from behind the reception desk. There must be a special employee discount on lips this week, I thought, as all of the women behind the reception desk had the Kardashian duck lips.
After many forms and a significant wait, I was escorted to an examination room and told to disrobe. Soon, I was greeted by a small, fragile-looking blonde woman, deeply pregnant, yet with glossy, almost translucent skin. Alien-like, she smiled without expression and welcomed me to the clinic.
I had my skin check, and, of course, the doctor found something. She sheared off a minor bump just left of my nose for biopsy and then proceeded to run through all the various skin embellishments that I could schedule, and reviewed her amazing prices for Botox and Juvederm. The sales pitch was annoying, but I figured that since it was my first appointment, they were just selling their services. I left feeling good like I was going to get high-quality treatment there.
Because of my many years in the sun, I wasn’t that surprised when I received the call that my biopsy had indicated pre-cancerous cells. She said I should come in again to discuss treatment.
At that next appointment, doctor “S” discussed the results and said that she recommended a deeply invasive procedure called Mohs. Before you go googling it, let me warn you about the photos. Mohs is a skin surgery performed to remove skin cancer. The operation takes several hours. The dermatologist begins by cutting a section of your face open. Let’s say you had a cancerous spot about the size of a pencil tip, like I did. The incision could be as big as three inches, and cuts deep into the epidermis.
The dermatologist then goes layer by layer, cutting out the skin cells. After each cut, you must sit there under the lamp with your face still open, or so I was told, as they test the layer to ensure they removed all the offending cells. They take your cells under the microscope while you wait there, and come back to remove more until they are gone. The procedure can go very deep, and as you can imagine, the scar can be significant.
I left the office feeling very unsure and seriously freaked out, but with an appointment on the calendar to get the surgery. A month passed, and then two. Skin cancer is very slow growing, and apparently, the clinic was in no hurry to get me in.
So I waited and monitored my face very carefully in the mirror each day. I noticed something very curious early on. The “bump” that the doctor had removed was completely gone, and my skin looked healthy underneath. No other symptoms presented themselves. I wanted to trust doctor “S” because I figured she must see something that I couldn’t, underneath. Still, I took to reading more about the procedure on the internet and tried to ignore my growing doubts that there was nothing there.
Less than a month prior to the surgery, I felt I needed to see the doctor just once more.
“I am sorry to bother you,” I said at the appointment, “but I just don’t see anything there. I know you’re the expert, but it seems like a very drastic surgery when there is nothing visible.”
“Let me take a look,” she said.
She turned a bright light on my face and peered closely.
“You know,” she finally said, “I see what you mean. The bump has not returned, but I still recommend the surgery. Cancer cells could still be lurking underneath and just not be presenting as a topical adhesion. Let’s keep the appointment.”
She also mentioned that they were taking appointments for Botox.
I left feeling deflated. I didn’t want the surgery. I had neighbors and friends with facial scars ranging from merely noticeable to horror movie worthy. My dad had had part of his ear reconstructed from a similar surgery. And the spot was on my cheek just next to my nose, a very sensitive and noticeable location. The surgery could forever change the look of my face.
I went home that night and talked to my husband.
“I just feel unsure about it. The doctor recommends the surgery, but I just don’t see anything there.” I said.
In the end, I asked my husband to accompany me to the surgery and sit in the room with me. He agreed, a big commitment since my husband is pretty squeamish of any medical procedures. But we both felt suspicious of the doctors’ true intentions.
The morning of the surgery, my husband and I drove to the clinic. I was very nervous. I checked in and was immediately handed the permission forms, removing any liability of the clinic for surgical complications and a number of other potential mishaps including scarring. We waited.
Finally, we were called into the surgery room. My husband took a chair at the opposite end of the room. A nurse came in and cleaned my face and had me put on a gown and lay on the table. She gave my husband a sideways glance then greeted him. I said, “My husband is going to stay in the room with me if that’s ok?” The nurse said, “Oh, sure,” and left the room. About ten minutes later she returned with the doctor.
Doctor “S” walked in and looked over at my husband and greeted him with a handshake and his name. Obviously, the nurse had mentioned he was there.
Then doctor “S” came over and said, “Let’s take a look at the spot, I want to see if it has resurfaced or what is going on.”
She examined my skin, and the nurse stood by.
“Well,” she said jovially, “it looks like you’re right, I don’t see anything there. At this point, I would recommend we postpone the surgery. It’s a good thing we kept a close watch on it.”
I was elated, and my husband and I left in good spirits, although I wondered to myself if she would have proceeded with the surgery if my husband had not been in the room. And if “we” had not kept such a close watch, “we,” as in “me.”
A few months later I had my regular skin check. Curiously, the spot on my face, the one that I nearly had my face cut open to remove, had never returned. At this appointment, doctor “S” examined me and found a new spot to remove and cut it off. She then went over the pricing sheet for Botox and other treatments that she recommended to me since I have a lot of freckles and wrinkles. I said I would think about it and left.
Later, I received a bill for $250 for the latest biopsy, which came back normal. I paid off that bill and made a new appointment for my twice-yearly examination. Pretty soon I received a call that the appointment needed to be rescheduled. Over the next months, I would receive three more calls that my appointments needed to be rescheduled, always three to six more months in advance. It has been over a year since my last appointment, and two years since the day I was scheduled for surgery. I came to the conclusion that I am never going to get another appointment. I didn’t buy their products, I didn’t get their unnecessary surgery, and bottom line, I wasn’t spending enough money at their clinic.
A few days ago I received a call from their office on Friday. You’ll never guess. They needed to reschedule my October appointment with doctor “S”. My response? Fuck off. I know there were so many other brilliant things I could have said, but that came to my mind first and fierce. Thanks but no thanks. Just a quick word to the wise: Don’t trust a doctor just because of their fancy clinic or heavily over-plumped staff, or even their reviews on the internet. Get a second opinion. Because if you don’t, it may literally scar you for life.