My first contact with the private dermatology clinic was in the middle of August 2026 when I emailed some initial queries to them.
There was no mention of a lab on the website and I wanted to clarify their arrangements for the analysis of biopsy samples. It turned out they had a contract for this service with a large local hospital, which seemed fine to me. A dermatologist's opinion was obviously a valuable first step, but the full diagnosis needed to come after lab analysis and only a pathologist could give me that.
My appointment with the third dermatologist was made for three weeks later. For the first time since being referred to the NHS by the fourth GP back in June, I actually knew where I stood. Waiting for a specific date felt so much easier than waiting for ever and evermore.
I kept myself busy on You Tube and sailed in all weathers in various parts of the world. And if the sea was too calm I always had my bookmarked 'RNLI Roughest Launches' to enjoy.
But one morning I gave myself the rare treat of an outing for coffee. It was a perfect day for it. Clouds the colour of night filled the sky and the rain was heavy but not torrential. The bots had warned me that clouds offered no protection from UV light so the factor 50 was liberally applied. My waterproof jacket had a good hood. I was almost set to go.
I picked up my flat cap and shoved it in my pocket. I'd never seen myself as a flat cap sort of bloke. I doubt I ever will. But as the lesions went from strength to strength they became more and more disgusting to look at. I'd therefore headed to Amazon and bought that cap to conceal my disfigurement when indoors (my wide-brimmed sun hat took care of this outdoors).
The larger lesion, with its rough black crust, was particularly vomit-inducing. It actually looked as though it was thrusting its way towards daylight from inside my head, which I suppose it was. On closer examination, the healthy skin on my scalp was being peeled aside as this monster relentlessly forced its way through. In medical terminology, this is described as an 'eruption'. I thought they'd got that one right because the lesion had now assumed the conical shape of a small volcano.
Standing like a flesh-coloured watchtower closer to the crown of my head, the smaller lesion had now also become painful when touched. On its own, it would have been a thoroughly disgusting sight. Dwarfed by its revolting counterpart, it paled into relative but malevolent insignificance.
I enjoyed my coastal drive in the pouring rain. The scenery is beautiful. This is a part of the world where bin lorries pull over so the crew can get out their phones and take photos of dolphins. On a clear day you can see the Mull of Kintyre and Ailsa Craig in Scotland, no distance away.
There are also some picturesque harbours. My journey took me past one where I once saw a favourite You Tube yacht moored for the night. But on this trip I was heading for a café overlooking a lovely little harbour made famous as one of the locations for filming Game of Thrones.
The rain was heavier when I parked the car. I shoved my cap in my pocket, pulled up my hood and headed for the café. A delicious latte and sourdough toast awaited me and I wanted to get out of the rain. Once safely indoors I pulled off my soaking wet jacket and went to place my order.
As I approached the counter the girl behind it looked up and immediately took a sharp step backwards, wide-eyed in horror.
In my haste to place my order, I'd forgotten to put on my cap.
I was equally horrified. But sadly the damage was done. I felt acutely self-conscious and ashamed of my grotesque appearance. I nervously fumbled to cover my scalp as quickly as possible and noticed the poor girl's hands shaking as I placed my order. I felt awful.
The little harbour and its fascinating selection of boats was a joy to behold in any weather. I could gaze at it for hours. A couple of times I'd even seen a horse swimming in it. But on that day all I wanted to do was get in the car and go back home.
In the second week in September my son and I met the third dermatologist.
He seemed like a very nice chap and had a particular interest in skin cancers (the patients who attended the clinic did so for many reasons other than suspected cancer).
I had self-referred to the clinic and therefore needed to give him the relevant history. It seemed best to go right back to 2022. I did this and then offered to bring him up to date with three photos I'd brought with me on my phone. In preparation for this appointment I'd cropped out the distraction of my son's lovely young daughter and his equally adorable dog from two of the photos. I didn't like doing that but the originals were untouched and safely stored away.
The first photo had been taken shortly before Christmas 2025, when both lesions were mere scratches on my skin. The scratches were slightly more obvious in the second photo, taken in May 2026. But when the third photo was taken after the referral to Dermatology less than two months later, the transformation in both lesions was obvious. The fourth comparison was the shocking state of my scalp three months later on the day of my appointment.
The third dermatologist asked me me to move closer to the light above the nearby couch so he could check things out. An examination of the lesions with his expert eye didn't take long. At one point I flinched when he gently touched the larger one. And then we sat down again.
It was time for a diagnosis. I wasn't surprised when he confirmed the larger lesion was squamous cell carcinoma. He thought the smaller one was either Bowen's Disease or early stage squamous cell carcinoma. Both required treatment. The larger one needed excision with biopsy. It'd be cut out in one go and the whole lot would go to the lab for analysis. The smaller one was thought suitable for curettage. This was a simpler procedure in which it would be scraped out of my scalp bit by bit and the shavings sent off to the lab.
The only other comment he made related to the fact that I flinched on examination. He told me: "When this happens we worry about it." I appreciated his candour.
The fourth GP had more or less said the same thing. When I received my copy of his letter to her, I saw he described the larger lesion as 'exquisitely tender'. Another intriguing medical term that until that point I would have thought referred to a perfectly cooked piece of ham.
