George Herbert Walker Bush, our 41st President, passed away last night. This commentary is a personal reflection on a “pen pal” experience in 1986 that still makes me smile.
“When you see something, say something” has an alternative meaning to a dermatologist.
Skin lesions are observed on photographs, television, and in the movies. Whether it is Bill Clinton’s rosacea, Richard Gere’s Becker’s nevus, or Mikhail Gorbachev’s port wine stain, I have to consciously ignore these conditions to concentrate on why I am watching them in the first place.
On February 13th, 1986, the cover of the Sunday New York Times Magazine section displayed a full-face photograph of then Vice President George H.W. Bush. His sun damage was striking – undoubtedly a consequence of summers at Walker’s Point in Kennebunkport, his service in the Pacific Theater near Chichi-Jima, and in the Texas oilfield sun. I was most concerned that a freckle (solar lentigo) on his right temple could have been an early melanoma (lentigo maligna). I was less worried about a red lesion on his nose, thinking that was more likely due to pressure from his glasses rather than a pre-cancerous lesion (actinic keratosis).
It is one thing to express concern to a stranger when noticing a suspicious lesion in person – but from a photograph? Initially, I was not going to mention anything because I assumed the Vice President had superlative medical care. But then I felt guilty – what if I subsequently learned that he had melanoma and I was reticent? I decided to write to Mr. Bush, recommending that he have a complete skin examination, with no expectation that my letter would even be read – at least my guilt would be alleviated.
Mr. Bush was found to have a basal cell carcinoma on his left cheek, which was excised on May 15th, as detailed in Lawrence K. Altman’s column, “The Doctor’s World” (Basal Cell Carcinoma: Most Benign Malignancy, New York Times, May 20, 1986).
Check out the rest of the story here.