People have a hard time doing what is best for them. I would even say people have a hard time refraining from self-defeating or self-destructive behavior. I am not exempt from these human tendencies. I have always had a love/hate relationship with the sun. Despite the sensitivity of my skin to the sun, I logged many hours of sun time without adequate sun protection. I loved the feeling of hot sun on my skin and equally loved having a tan. When I first started seeing a dermatologist for “pre-cancers”, she told me I should be more careful i.e., use sunscreen and long sleeves and hats and stay out of the sun at midday. When I would return periodically to have my pre-cancers frozen I would assure her I was being more careful. She would gently point out my tan lines and tell me not careful enough. Sorry to report, dear readers, that this went on for enough years to add up to more than a decade. Then one of my little pre-cancers crossed over to the dark side and became a squamous cell carcinoma. As luck would have it, this lesion was prominently located on my cheek. I am grateful that it is no threat to my life or well-being. However, the process of having it removed and the long healing time of a one inch incision on my cheek have definitely gotten my attention. Ironically, it is true that over the years I became more and more careful with the sun. Just not careful enough.
This experience has given me much to think about. Any reasonable person, much less a physician who trained as a scientist, would understand that continued sun exposure to pre-cancerous lesions is a game of solar roulette. What psychological explanations are there for this behavior? There is denial: “It won’t happen to me. It will be fine.” Rationalization plays a role: “I am being more careful. The dermatologist’s treatment will keep it under control.” Poor judgment is related to skewed priorities: “I am just running out to the garden for a little while. I don’t have time to put on sunscreen.” How about laziness: “I don’t feel like going to find my sunhat before going out.” I imagine that my readers can submit more explanations. I would be interested to read them.
I have become more humble as a result of all of this. I am subject to the same psychological pitfalls as my patients. Keeping my own behavior in mind helps me to remain empathic in the face of the self-defeating behaviors of others. It is not at all easy to remember long-term consequences when living one’s life in the here-and-now. Wish me luck with the sun. I am determined to do better from here on out.
