The Horse Trainer and the Dermatologist.

My gray mare calming signals included squinty eyes, a dry mouth, and a weird chicken-like movement with my neck and head. Every now and then one of my naked feet would kick out. Breathing? Not noticeably.

If there is a medical visit I like even less than a mammogram, it’s going to the dermatologist. I know that women of a certain age who talk about their doctor visits and odd ailments are the worst company. Just stop reading here, because I have a growth acquired from my last visit and I feel like dissecting it and maybe cauterizing it when I’m done.

I was late coming to dermatology. Acne was not my worst problem in high school. As years passed, I avoided cosmetic conversations. I had horses and an occupation that involved being noisy and dirty. I defied facials and manicures. Between being a goldsmith, riding outside daily, and living in a dry climate, well, I had to let something go.  Suffice it to say I could file a hoof with my bare hands.

Ignorance catches up eventually, about too much sun and the medical specialty that is much more than beauty tips. My first visit was for a “flaky thing” beside my eyebrow.  I heard the term “Pre-Cancerous” for the first time and out came the liquid nitrogen canister, giving me the worst ice-cream headache ever, followed with a serious scolding about sunscreen. It felt a midlife version of Scared Straight.

I told him, I wore sunscreen. Like butter on toast. “How many hours a day are you outside?” he asked. Not impressed with my job, he figured being a horse trainer was like being at the beach all day and scolded me about not wearing a hat.

Does he have any idea how often I rant about helmets, the best hat ever made? But it’s true, I struggle with other hats. In some parts of the horse world, the hat you wear is like a membership card to another culture, a riding discipline, or a fan club. None of which I belong to but after a lifetime of snarling at the affectation of hat wearing, I gave in. Especially after a particularly itchy “flaky thing” was frozen off the top of my skull. I still struggle with the politics of hat wearing.

My doctor was a polite man, rabbit-like but in the best Disney way. He wears a headlight with a magnifier on it and he uses all the big words about skin. Do you sometimes do an ordinary thing but in hindsight, the experience feels surreal? In the same way that you have a cell phone, but Star Trek was science fiction at one point? Only dermatology can feel like a lifestyle indictment if you aren’t careful.

The visit starts with the usual open back medical gown pulled around as I sit on the special chair. Looking down, it appears I’m wearing a straight skirt which would be weird enough, but my feet don’t touch the ground, so things are contradictory already. The doctor and his assistant come in, he adjusts the headlight/magnifier and leaning in close, starts calling out impossibly complicated words to his assistant at the computer. He checks my scalp in that way chimps do in the jungle. He scrutinizes scar on my nose, my forehead wrinkles, my jowls, calling out imperfection after imperfection. This is the easy part.

“Please stand up.” It’s his job to scrutinize every inch of skin; my arms, my back, the skin that used to flow seductively to my cleavage that now looks like an animal print, burned seasonally for too many years. With a subtle balance of shy curiosity and slight discomfort, he calls out scars and imperfections, peering in and around my underwear.

There’s that moment when you know you have some semblance of sanity, or at least inevitability, that comes with being a woman of a certain age. To have every inch of my body mercilessly judged with a headlight and magnifier would have killed me when I was a teenager. Obsessing about my “ugly body” was a full-time dysfunction then. I was normal, in other words.

“You can sit again.” Scrutinizing my thighs, the dent where that mare landed her hoof leaving me with tingly nerve damage, my spider veins creeping in all directions, the dry spot on the outside of my calf that my boots rub. Whose legs are these, attached but unrecognizable?

“It looks like a podiatrist got hold of your foot.” Smiling at me, almost in a Prince Charming/glass slipper position. I tell him four screws, a fencing staple, and a lever. He takes a minute to translate my language to his as he checks between my toes. I’d been greasing up my heels for the last two weeks, so that could have been worse.

Finally, seeing his soft hands holding mine, maybe the most sobering moment. He studies, finger by finger, as if checking that I’ve washed them well. I feel small, almost apologetic. There are no current bruises on the back of my hand, but he mentions an elongated s-shaped scar. “Fencing wire,” I reply. He examines the pinky joint that’s frozen and numb. The new black fingernail, a slight curve to that newly-numb joint on the opposite ring finger. “Caught in a fence panel,” I report. He tells me that bump on the middle finger is a recurring cyst in a joint. It leaks clear gel, I know what that means from my amateur vet status. Then the thick ridges on my thumbnails. He finishes, more big words for his assistant, and it’s over.

I feel a bit more chipper after this ordeal. I had been testy after getting a stack of fan mail from Medicare this last month. Being taken on a road trip over the uneven terrain of my scars and numb areas has a different effect on me now that horses and farm life have dismissed any vanity I might have had. Good riddance.

Instead, this gratitude for the job my skin has done, holding me together through this wild life. I’ll trade a few stiff joints for the lessons learned. Scars are forgiven for the light they have let inside. It’s been a rough week on our little planet and maybe the best “revenge” is to not be taken over by numbness but to be sensitized by what may not be felt directly. Humbled by my good fortune, and holding a space for healing with each breath, I’m sending every good wish to those feeling sadness and loss.

Anna Blake at Infinity Farm
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Anna Blake

62 thoughts on “The Horse Trainer and the Dermatologist.”

  1. Oh, Anna, you are a dermatologist neophyte! From my decades with horses, I get multiply zapped with the nitrogen gun at least twice a year(although I have never had the top-of-the-head experience, thank you, Lord). I became a believer when a little scab on my nose proved to be basal cell carcinoma, which is at least the Very Best Kind — no radiation, no chemo, just a serial biopsy otherwise known as a MOHS procedure. Except that the hole left behind required a reconstruction and 6 weeks of looking as if someone’s little finger was super-glued to my face. So — sunscreen and hats hats hats! Sessions with the nitro gun are the best alternative. 😀

  2. Boy oh boy, can I relate to all of this. I do regret all the baking I did in Colorado as a kid with my body completely devoid of sunscreen. In fact, sometimes even baby oil was added to the mix. Now the thinness of my skin and the constant bruising from even the gentlest bumps have me resembling someone two decades older than I am. Sigh………

  3. My mother used to quote from the standards for judging terriers in shows:
    ‘Honorable scars from fair wear and tear shall not be counted against’

    That about sums things up, I’ve been collecting those honorable scars since I was a child, now nearly 67, still trimming my horse’s feet, fencing, repairing the horse shelters, etc. etc. etc. They are the story of my life.

  4. Amen sister! Although I board my horse and don’t have the scars from farming incidents, I am a contemporary who can relate to your visit to the dermatologist–a vivid description of my own experience.

    Recently an acquaintance of a similar age asked would’t I like to have my youth back. “NO!” was my unequivocal response. I am grateful for every single year!

  5. Oh my, can I relate! The calming signals of THIS gray mare also include a few involuntary jokes. Which only adds to the awkwardness. Hope your skin is ok, scars and all.

  6. Have had melanoma as well as colon cancer and will see a dermatologist twice a year for the rest of my life, and grateful for it. No more short sleeves. I’m okay with having the dermatologist scrutinize every part of me, but it’s a little weird having the notetaker and his trainee there as well. Like having my first child in a teaching hospital. Who else is in the delivery room? Is that the mailman? The janitor?

  7. It’s amazing to identify our bodies as vehicles that have carried us for many years through bad and good events. What’s pitiful is that it takes so long for our brains to start catching up. It’s too long before our heads start becoming as intimate as our bodies, and that becomes an entirely new trip. I enjoy your blogs, and particularly your poetry. Keep writing!

  8. Oh boy – does this make me feel at home! Yes, twice a year dermatology appts. Have had the MOHS procedure for “bump” next to my nose – many zaps with the freezing zapper – left kidney removed 18 years ago – now getting a needle biopsy for a nodule in my lung! PLUS!!
    But like all of you – not done here yet – still here. And I can empathize with Lisa regarding the crowd in the dermatologists exam room – modesty just does not exist anymore.

  9. I’m glad that you were okay. I was afraid you were going to tell us of some horror that was the beginning of the end. Just the way you probably felt about your doctor. I give you what a friend gave me years ago. The beginning of the end and the end of the beginning are only as close as you make them. What’s in between every day is what counts. Make it count.

  10. I don’t think we get to our age without some wear and tear. But we horse woman may see the ER a bit more than others. I grew up in the pre-sunblock era. Before horses, we spent our summers camping on the river. Baby oil was our sun protection. I’ve had melinoma and basel cell carcinoma and of course now see the dermatologist every 6 months. Sun block has become my moistureizer and I am shopping for sun protecting long sleeve shirts this year. I am also now breaking bones. Thankfully I heal well and enjoy physical therapy, because I want to take care of my horses and ride. In that order. I have a pair of buckskin mares of a certain age coming to stay with me on Monday or Tuesday. Can’t wait. My barn has been empty for a little over a year since my old gelding and mini lost their battles with old age and laminitis. I do not feel a need to pamper my body to have a good looking corpse. That ship sailed a long time ago. But I do hope to be able to continue to live to the fullest I am able. No regrets. And especially to do my best to give all my 4 footed friends the best care I can. Party on my friends.

  11. “Scars are forgiven for the light they have let inside.” What a tender thought for today. Thank you, Anna. Be well.

  12. Good read. I must be of a certain age or a farmer because I can relate. This made me laugh and then feel tender. You are so funny and there’s is nothing I enjoy so much as a sense of humor.

  13. The skin cancer pamphlets always seem to point out the big scary looking things as relevant meanwhile those innocent flaky things are actually relevant. I had one on my chest, went in, they biopsied it, it was a melanoma of the mildest variety, went back, they cut it out and sutured me up, they called me back in just as it had healed, they hadn’t gotten it all, back in, longer scar, more sutures. And now one boob sits up higher than the other. Lovely. They could at least raise up the other one, right?!!! Combine all that with the vertical scar from sternum to navel for my pancreas surgery and I am a bit hacked up on the front side (which I always felt was my best side haha). Lucky to have gotten this far and learning what really matters and what doesn’t. (Don’t slip on the ice!!! ) Thanks for your human and humane voice Anna and for creating this humane community.

  14. Hi Anne,

    Been there and glad I only had to have part of one nostril taken away and repaired with skin from inside my ear. Not pretty. Spent a lot of time outdoors all my life and now have to cover up, wear a hat and have sunblock on all the time. Your story about your dislike of wearing hats, well I can relate and that’s something that I too had to get used to wearing. But I met a woman who had squamous cell cancer on both sides of her nostrils. She had to have proper plastic surgery for her repair. Skin cancer awareness is an important part of your story. Thanks for writing a funny and serious account of your skin cancer story.

    • Glad you’re okay, Catherine. Like so many things, we are figuring it out. Kids wear hats now and sunscreen. I hope fewer of us have to learn later as time goes on. thanks for commenting.

  15. Thank you, Anna ! You write so compellingly that my mouth got dry just imagining the ordeal of the exam. Too real ! But good on you for taking care of yourself in this way. I wear straw hat myself- convinced it settles my mind for working with my horses.

  16. I had the semi-annual exam a couple of weeks ago. I can relate to all you said. That my dermatologist is one of the nicest guys on the planet, makes it a bit easier. He should teach “bedside manner” to med students! This time I had the liquid nitrogen treatment only on my forehead at the hairline. He reminded me that it would sting – as though I might have forgotten. I did a white knuckle squeeze on the arms of the chair and soft “eeek” as he finished. I am friends with MOHS surgeries. My first was a basal cell on my cheek – face, that is. 🙂 The incision looked like a large 5 without the cap at the top – or maybe an upside down question mark. I had the stitches out the day before leaving for a trip to New Zealand. Since I couldn’t see the result without a mirror, I pretty much forgot about it. To the public, I’m sure I looked like I had been in a sword fight. A good thing about getting older is that it, and two more that followed, fit nicely in the wrinkles! But if they didn’t (or don’t), who cares, which is another perk for getting older.
    I enjoyed your blog, as usual, Anna. They make long sleeved UV Protection shirts that work well. As much as you are outside, one of those would be a good idea to wear with your HAT!! By the way, you are gray and a mare but DEFINITELY not OLD!!

    • I do wear those shirts, they are thin and dry fast, too. Perfect for standing in riding arenas! Now I do everything, just like you. Thanks, Jean. Hope you are having a sweet spring down there.

  17. A few weeks ago I ended up with a cat scratch completely across my face, an accident by cat in our confined quarters, and there was a brief moment when I thought about hiding while it healed. Then reality kicked in, and I devised a fictional story about what happened…..And had fun with that.
    More seriously though, I caution about using sunscreens. Full of toxic chemicals most of them, plus nano particles that get into every organ. No, I cover instead. Learned it a little late, so have damage, but I won’t use sunscreens ever again. Just wait another decade, and all the now young children will be getting treatment for sunscreen use.

  18. Ahhh the vagaries of middle to old age. After my induction into the Medicare club I saw a dermatologist for the first time. He looked impossibly young. My husband sees him quite regularly for basal cell carcinomas acquired when he was a young boy and sunburns were part of summer. We call him Toby Maguire. My skin has shown an alarming tendency to sag downwards. It’s great when you lay on your back and stick your legs up in the air….nice and smooth! But stand up and the illusion is gone. No carcinomas or precancerous bits for me yet. I specialize in seborrheic kertosis, those lovely brown or black spots.

    • Rather than laying down with my legs in the air – I stand in front of the mirror & raise my arms up high – surprisingly, there is less sag!!! I blame it on my shrinking height – from 5-5 1/2 down now to 5-3!! But then – with clothing – who can tell!

  19. I love the notion of forgiving scars because of the light they let in! About 15 years ago my legs started keeping track of every bump or scrape, even long after they have healed. I know it’s 15 years because of one prominent discoloration on my shin from a scrape acquired playing on a playground with my grandson when he was 3, and he’s now 18. After a lifetime of “hating” my legs, I routinely thank them for carrying me so far, so well, and so long (seems so odd to me now to hate a part of my body, like it chose to make me ugly or unloveable!). I am so drawn to you and this community you have created because we still have so much to talk about!!

  20. As a public service announcement…🙂 Young Living Essential Oils makes a chemical free, nano free sunscreen. Thanks for all your posts. I am now motivated to find my tube of it and actually use it. Having to go to a dermatologist for procedures eats up a lot of barn time. Enjoy the day! 🐎 TAZ

  21. Oh Anna, I have been feeling particularly downtrodden on my aging body and life in general these days. Ended up in the ER the other night because I was having chest pain and almost fainted. Nothing wrong with my heart and lungs, just lingering symptoms of a ongoing virus. I was grateful and feeling like a fool all at the same time for going to the ER. Hitting my 60’s has been a little rough. So reading your blog made me feel like I am part of a group of women who bear the scars, stretchmarks, broken bones, skin tags, barnacles of menopause, dry heels, permanent dirt under fingernails, rolls of flab succumbing to gravity, etc. with as much dignity as we can muster. Being a horsewoman keeps my spirits high and beaming with pride that defies the horror I feel with what is going on in this world. I count my many blessings for where we live and what I have in my life. So thank you once again for sharing your experiences with us. I feel fortunate to be in this group.

  22. Dear Pam,

    You are so articulate at expressing the comfort I feel at joining a group of (at least some) “elders” who are going through many similar experiences. It may sound odd, or foolish, but since reading Anna’s books and getting to know a little about the others out there, I have been able to actually consider letting my hair resume its natural color (gray of course!). It helps that I’m just about to retire from my day job that requires looking “presentable”…now I’ll be able to simply be “present”. Being with horses is the life-changing event that has allowed me to make this transition. Thank you for sharing and helping us all connect.

  23. OMG but this made me laugh! To see the humor in our frailty is a blessing and to “get” the strength under it all. For we are strong and resilient and though perhaps held together with things other than bones and muscles we persevere and live on. I recently had to get 2 blood transfusions because my hemoglobin was at 5. Apparently this is low! My husband had had his shoulder replaced and I was doing all the horse chores and was pretty sure I was going to have a heart attack and he would find me out amongst the herd dead as a doornail, so I went to the Doctor. Turns out I have a tendency towards anemia, and bruise easily so I have to be aware of that. A few days ago I went to the arena to get something and though my husband had said “it’s icy”, I looked and saw water, walked in and wiped out. Luckily I usually leave stuff out so was able to wiggle, slide to some poles I’d left on the ground, manage to lever myself up and use a cone as a sort of cane to make it out (who knows how long it would have been before he noticed I wasn’t in the house) and now I have a bruise the size of a dinner plate on my upper leg BUT I didn’t break anything. Even when you aren’t coming off a horse you “tuck and roll”.
    I so appreciate being old and active!

    • Anyone notice that whenever you go to the drs – EVERYONE asks have you fallen recently? Maybe this doesnt start until you get to 80! The thing is – coming right out & SAYING no I havent – makes me feel like I’m jinxing myself. Then its “do you feel safe at home”? I feel the urge to snicker – considering that its me, dog & cat – hopefully we all 3 are safe at home!
      No horses anymore (sorry to say) but Suzy Q (dog) & I walk thru the field & up along the woods every morning & night. So glad I have my little 4 acres and the wildlife that lives near it. I live on a secondary road but its treated like a racetrack, it seems. So walking on the road is not an option. Going up by the woods & thru the field so much better. Do need to cut more trails thru the brush tho this year.

  24. Find a new dermatologist. I’ve been seeing dermatologists for 60 years for a variety of skin diseases. Dermatologist vary; some are human and humane. Though she keeps her little nitrogen gun handy, my current one is sweet, explains techno jargon, and is very discreet when examining all my skin.

  25. Morning Anna, I just now had a chance to read your piece and was filled with both laughter and a sense of solidarity. Then, as always, I read the comments and felt as though each one was written by a blood relation. It is comforting to have the insanity of my equine passion rationalized by my religion “Sisters of the Holy Horse”. We all have seemingly followed a path of passion verses glamour, and I believe, we’re better for it. Actinic keratosis be damned!

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