Your Botox Or Your Life!

Did you know that, in Boston, it takes on average just 13 days to get in to see the dermatologist for Botox injections, but to get a worrisome mole examined, you'll wait - gasp - NINE WEEKS??

A study by a UC-San Francisco dermatology professor found that in the US, it takes a patient an average of about 26 days to have an appointment with a dermatologist to examine a possibly cancerous mole, yet only eight days for an appointment for Botox injections.

Now, the way I'm thinking, spending up to nine weeks worrying about your mole is going to give you big-time forehead lines, so you could always make the Botox appointment, just to get in. Then, if you're like me and prefer to let your eyebrows roam free, you can feign squeamishness at the sight of the needle (maybe you won't have to feign!) and "change your mind" at the last minute. On your way out the door, you can say, "As long as I'm here, doctor, I've got this mole that really needs to be checked...."

This tactic will work only once -- at least with that doctor -- but it's worth a try. Of course, you could always just think of your possibly cancerous mole as a beauty mark and keep it as long as possible.

The researcher didn't know why Botox patients got preference but speculated that it was because of the higher relative payments for Botox. It's a huge profit center for clinics. My dermatologist told me she's had patients come in for thousands of dollars worth of Botox and other cosmetic treatments in just one session, yet I know from personal experience that the mole screening is just the cost of an office visit, with other payment going to the lab.

And I was surprised when they didn't just say, "Come in tomorrow," when I said I had a suspicious mole. Melanoma is serious business; an acquaintance of mine died of it a couple of years ago, and it's possible to get it at a very young age. I have that pale-pale skin that's highly susceptible, and the small, rough patch was on a part of my body that had suffered a severe sunburn during those carefree (read "stupid") college days. But the receptionist wanted to set up the appointment for about five weeks later. "Wow, is there any way I can get in sooner?" I asked. "We do have a nurse practitioner on staff," she replied, "and she's available this Friday. Would you like to come in then?"

That's what I chose to do, and I did end up seeing the doctor briefly; she came in and also checked out the mole. It did turn out to be cancer, but not melanoma. Basal cell carcinoma doesn't metastasize into surrounding tissue, so it wouldn't have killed me, but it did need to be removed before it got bigger to keep it from disfiguring my gorgeous bod.

There's one other reason why it might take longer for a medical exam. Many dermatologists' offices set aside certain days of the week for cosmetic procedures, because so much of their business is for Botox and the like, so all other appointments are made for the days that are left. A dermatologist will always advise that, once a year, you make a routine appointment to have every square inch of your glorious body checked for suspicious moles.

That sounds like a good idea. As for Botox, if you're in Beverly Hills, you can call 911 and a team of dermatologists will rush over in an ambulance to administer it.

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As long as we're on the subject of cancer, there's a story I just read in the Wall Street Journal that needs to be mentioned here, if only because it illustrates so well my beliefs that "life doesn't happen on a timetable" and that one's numerical age means next to nothing.

Chef Grant Achatz, whose restaurant Alinea was named the best in the country in 2005 by Gourmet magazine, has recently been given a devastating diagnosis: stage 4 cancer of the tongue. With his cancer so far advanced, he's been told by three doctors that the only way he can possibly survive is to have part of his tongue cut out. Imagine being one of the world's most celebrated and creative chefs and having to anticipate life without the ability to taste.

Achatz is 33 years old.

"Well," you may say, after the initial shock, "he's probably spent years smoking!" Achatz, who's described as "skinny and boyish," says he's never had a cigarette in his mouth in his life. Knowing the damage smoking can do to the sense of taste, you believe him.

Not surprisingly, Achatz has been looking for alternative treatments that might let him keep his tongue along with his life. He'll soon begin an intensive combination of chemotherapy and radiation treatments; these may dull his sense of taste slightly as they destroy cancer cells, but not ruin them permanently. His doctor says the sense of taste will slowly return after treatment.

Achatz could end up losing his tongue after all, and, of course, he could die. When I look in the obituaries, I see people of all ages there. This is why I think concepts such as "middle age" are essentially pointless. A twenty-year-old who laughs at "middle-aged" people may be middle-aged himself, and just not know it.

Those who know Achatz are confident that with his talent, he'll go on with or without his tongue. So much of what he does comes from his deep well of visual artistry and conceptual genius. "You could take out his tongue and eyes," says Nick Kokonas, his partner in Alinea. "I can't imagine that he wouldn't be able to overcome any limitations."

May good health come to Grant Achatz. And remember, whatever decade you're in, taste life while you can.