Freeze 'em, Cut 'em, Stab 'em

Lesson of the week: incredibly pale people + Queensland sun = skin cancer.

When I first arrived in Chinchilla, I felt like I'd probably just doubled the town's ethnic population. The people in this town are, as is in most of Australia, mostly white, and mostly of Northern European extraction. Throw in an economy based on farming, building, and occupations that generally require people to work under the sun, and you've a recipe for funny things growing on people's skin. Australia has the highest rate of skin cancer in the world, and the rate in Queensland is double the Australian average. With stats like that, GPs here end up spending quite a bit of their time looking at people's skin.

In the last few days, I got a chance to check out weird-looking moles and bumps on people's skin: weepy ones, dry and crusty ones, fleshy ones, angry looking ones, ones that have been there for thirty years, ones that just sprouted in the last couple of months, etc. Often the patient points out the ones they are concerned about, then the GP has me look at them first under magnification. I would peer through the dermascope, but have only the vaguest idea of what I'm looking at. The GP then comes over, does the same on all of them, and delivers his judgment. "This one's fine, this one's not good, and this one's ok, but keep an eye on it." Then it's time for the execution of the guilty parties: light offenders - mostly superficial sun spots - get the freeze job; the more serious ones - established skin cancers or very likely ones - get cut out; and suspiscious-looking ones on the face get biopsies with a hole punch. The freezing is done with squirts of liquid nitrogen. With the excision, the wound is sometimes followed by some fancy skip flap repairs or grafts with amazingly good cosmetic results. When GPs have these kinds of skills, who needs to go to the dermatologist?