Publish Novellas 2 November 2022
EPISODE 6 – Exams
The dermatological tag team begins examining a full roster of patients as they look not only for tattoos but other serious health conditions.
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With Dr. Alison McCarthy in denial of her eating disorder, she and Dr. Beverly Jordan focus on other patients. Beverly feels that she needs to become more of a friend to Alison. She can’t monitor her every meal, but they should be able to share lunch together.
Contrary to the belief of new patients, the dermatology office does more than seek tattoos to enforce evictions. The doctors have concern for the health and wellbeing of each patient. A thorough exam includes a search for moles, rashes, sexually transmitted infections, tattoos, and troubling signs of significant weight deviation.
Susan Barlow arrives for her exam. She is concealing no new tattoos but her fair skin has many freckles and moles requiring scrutiny. Susan also presents a rash on her right arm that looks like eczema. Alison prescribes an ointment.
Tamika Johnson is within the twenty percent of African Americans within Agassi. She moved in two years ago without tattoos. Now she has two small ones on her chest and one on her arm. Beverly must address it before the patient leaves.
“Turn around facing the wall, and raise your panties a little so I can see the progress of your stretch marks. Have you been applying the prescription?”
“Yes, but I’m not satisfied with the results.”
“I can see definite improvement. The goal is to blur them a little, not completely remove them.
“Over all, your skin appears to be in good health. There is no evidence of skin cancer. However, you have some tattoos that were not on your record a year ago. You must realize that this is a tattoo-free community?”
“I thought there was a prohibition against visible tattoos,” Tamika says in her defense.
“The only difference between having one on your forehead and one on your buttocks is that the one on your derrière will go unnoticed until your annual exam. Either is a violation.”
“So are you going to kick me out of Agassi?” Tamika asks with an air of defiance.
“You can remain, as long as you keep them concealed during removal treatment,” Beverly calmly advises.
“What kind of treatment removes tattoos?”
“The one I recommend in your case is laser removal. With three to six treatments per area, you can see fading reach better than ninety percent.”
“Is it painful?” Tamika asks.
“There is discomfort for a few minutes, much like there was when the needles injected ink beneath your skin. Some patients have them apply pigment to the light areas of cellulite for a more even appearance. It’s far less painful and expensive than skin grafts. If you decline treatment, I must report you.”
“Okay, okay. We can remove them. It seems like a double standard though. I could get tattooing to blend cellulite, but not as ornamental decoration,” Tamika says with disappointment.
“I’ll snap a quick photo of the areas in order to compare results over time. You need to schedule another appointment with the receptionist for your first treatment.”
A beautiful patient by the name of Sally Summers arrives with an unusual request. She uses concealing makeup to mask vitiligo. Her neck, chest, and hands have lost all pigmentation. Her arms are variegated and she has large light splotches on her hips. So Sally seeks approval to cover the light spots with tattoos.
“I have seen some really pretty floral designs. Using monochromatic shades of my natural skin color, can I cover my light skin with tattoos?” Sally inquires.
“May I ask why you feel the need to cover your skin?” asks Dr. Beverly Jordan.
“I would like to marry. The attention I draw now is not favorable. But men look at my spots and think disease. They wonder if children will look like Dalmatians. I prefer men to look at me and see a beautiful person.”
“You’re a beautiful person with an enviable figure. Vitiligo is not a contagious disease. But with or without tattoos, your children may inherit it,” Beverly reasons.
“True, but I cannot even reach a conversation to the depth we are having because men shun me. Everyone in town knows how things are advancing between you and Michael. If you had my condition, our roles might be reversed.”
“Tattoos will not cure your vitiligo. For stable areas, camouflage micro-pigmentation, or micro-blading is acceptable in Agassi. A comparison of your records reveals that your vitiligo is spreading. Eventually, your entire body may be the lighter tint.
“That’s some pretty extensive inking, which often becomes an insatiable slippery slope. More traditional cosmetic treatment is to accelerate lightening in order to even out your skin tone,” Beverly recommends.
“I just don’t think albinism will have the same effect as beautiful flower tattoos.”
“Actually, porcelain skin tone is all the rave right now. This is your life. So I will not elevate depigmentation over tattooing. But the ink in this town will ostracize you. If you decide to go that route, you’d have a better outcome in a community that accepts body art.”
Beverly adds, “I obviously do not have pictures of the floral tattoo you’re considering. But with some Photoshop editing, I can show you extensive monochrome tattooing to give you an idea of how much is necessary. Keep in mind that over time, pigments may migrate to dark green…. Take a look at this.”
“That’s far more ink than my body should have. I know what you’re telling me is right. Any man I marry will need to accept my true self, not a masked version. If I could have this exact conversation on a date, his attitude may change.”
“The only other advice I might suggest is to embrace your uniqueness. Hold your head up high, without the use of any concealing makeup. Wear zebra or leopard patterns. Perhaps get a custom T-shirt that says something like ‘Beauty is more than skin deep’ or ‘Enjoy marbled fudge.’ Break the ice by putting the conversation front and center.”
“You’re right. The man I end up with must cherish my uniqueness. I’ll never find him if I hide who I am.”
Like a tag team, the two dermatologists assist patients with a variety of conditions. Alison completes an exam with a patient whose BMI has climbed from 29 to 35 in the past year. This is something a medical doctor or nutritionist should address. But here she is with the diminutive dermatologist, Alison.
“Have you spoken with your regular physician about your weight gain over the past year?”
“I haven’t had my annual physical yet,” the patient admits.
“You should get that checked out. There are many causes of rapid weight gain. It could be lack of exercise, high caloric intake, metabolic imbalance, benign tumor growth, or pregnancy in women, to name a few. With rapid weight changes, your skin is also prone to stretch marks.”
“I haven’t been exercising. Binging on chocolate sundaes while watching rom-coms doesn’t help either. You’re pencil thin. I must look like a polar bear by comparison.”
“Did something bad happen in your life?” Dr. McCarthy asks.
“My fiancée left me.”
“I am so sorry to hear that. Are you comfortable with your current weight?”
“At first, I was defensive, feeling that any criticism was body shaming. Then no one said anything as I gained more and more pounds. It’s as if nobody cares if I eat myself to death. Nothing in my closet fits anymore.”
“I care about you and want you to turn this spiral around. Here is a referral to a great counselor. I also recommend you see your personal physician within two weeks.”
Michael Winston arrives for a full body examination. He tells the receptionist that he prefers to see Dr. Alison McCarthy even though Dr. Beverly Jordan has an open room. Beverly catches sight of him from a distance down the hallway as he disappears into an exam room.
Alison and Beverly have been dividing the morning dermatological appointments. It is now a little past noon.
“Did you bring a lunch or do you want to step out together for a bite?” Beverly asks.
“You can go on.” Alison says. “I brought something to munch on.”
“You need to do more than munch on celery and carrot sticks,” Beverly advises sternly. “Let’s go somewhere that has both vegan food for you and an egg salad sandwich for me.”
“Can we do it some other time?”
“We’re going now… even if I have to kidnap you, drive you to my house, and force feed you a head of iceberg lettuce. No, really, I want to talk as friends.”
At a local restaurant, Alison eats half of her salad with a cup of orange juice without criticism. Beverly is concerned with crossing the line into nutritionist.
She asks, “Have you noticed an increase in nutritional counseling in our practice?”
Alison notes, “I have. Just prior to lunch I referred an obese patient.”
“Since we look at everyone’s body on a regular basis, weight issues are more apparent to us,” Beverly says. “What do you think about bringing a registered dietitian into the medical practice?”
“It’s actually a great idea. It would give us a means to followup on referral outcomes. Wait! This isn’t a veiled protraction of your examination on me this morning, is it?”
“This is something that’ll benefit all of our patients. I would hope that when you examine me, you provide referral to a nutritionist if necessary, and I would comply.”
“Okay, it’s settled. We’ll expand our practice to include nutritional counseling by a registered dietitian,” Alison concludes.
“Great!” Beverly affirms. “I really enjoy my work with you and feel it’s beneficial to patients. Today, I helped a one who slays a bikini to take pride in the uniqueness of her vitiligo.”
“Oh, yes. I know you you’re talking about. That’s great. I enjoy having you share the office with me,” Allison acknowledges.
“Now, tell me how your examination of Michael Winston went,” Beverly inquires with curiosity.
“Nothing out of the ordinary. Why?” asks Alison.
“We’ve begun seeing each other without actually seeing each other yet, if you know what I mean.”
“Well, the exam was strictly professional. But I can say that if your relationship progresses, you should not be disappointed.”
“That’s all I need to know right now. I don’t want you scrutinizing him too closely. There’s already enough competition in this town. Let’s head back to the office.”