Under the Texan Sun
Writer-at-large Jim Atkinson on protecting yourself against skin cancer, checking suspicious-looking moles, and how he researches health topics.
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texasmonthly.com: How do you decide on the topic for your “Minister of Health” column each month?
Jim Atkinson: I usually try to satisfy two requirements—timeliness and regional topicality—and go from there. Hence, I wrote about flu in January, allergies in May (one allergy season in Texas), and now skin cancer just as it’s starting to get hot down here. I’m not always able to find something seasonal, and many intriguing subjects are, by definition, not just regional. For example, in September, I’ll probably write about presbyopia—middle-aged far sightedness that requires reading glasses. But that’s how I try to edit ideas as things occur to me or come over the transom.
texasmonthly.com: Is it hard fitting all your advice onto one page? Why or why not?
JA: Yes. Please write my editors and demand more space! Actually, the way I’ve come to look at it, any hack can write 2,500 words about skin cancer; it takes an artist to say something interesting, new, and understandable in less than 1,000.
texasmonthly.com: Do you follow all the advice you post in your columns?
JA: My crow’s-feet will tell you that I spend too much time in the sun, but for the most part, yes, I do. In fact, frequently, an idea for a column will come from some tip I’ve picked up from a doctor or some journal I’ve read that I’ve first adopted myself.
texasmonthly.com: How do you do research for your columns?
JA: I generally know a bit to quite a lot about a subject before I even start researching. So the next step is to run down available literature—Medline, which is actually a searchable database for doctors, is always a good start, as it’s thorough and current. Then I begin running down experts through a network of sources I’ve developed—medical schools in the state, the department of health, and so forth. From there, it kind of snowballs. The experts lead me to other research papers and books and, if the story calls for it, patients or survivors of the disease in question.
texasmonthly.com: In the column, you mention that Texas “ranks among the top three states” in incidences of skin cancer. Why is that?
JA: Two things: One, we have really intense sun down here almost year-round, and two, we have a tradition of staying out in it, whether as working ranchers or as playing boaters at the lake. Texans consider the bright sunshine a natural resource and don’t appreciate being told that they can’t avail themselves of it when and how they want to.
texasmonthly.com: You said that people should swear by their sunscreen. What did people do before there was sunscreen?
JA: Other than people who had to work in it, “getting out in the sun” is a post–World War II phenomenon that grew out of affluence and the swimming pools, sailboats, and beach houses it made possible. Most people didn’t need something like sunscreen. And even when it appeared in the sixties and seventies, it didn’t really catch on because having a good tan was considered cosmetically desirable.
texasmonthly.com: Why do you think so many people disregard warnings about prolonged exposure to the sun?
JA: They like their tans. Also, until very recently, sunscreens were really icky, unpleasant substances to apply and wear around. They made you look and feel greasy, and if they got in your eyes, it caused severe stinging.
texasmonthly.com: What about people whose jobs require long hours in the sun—what should they do?
JA: Aside from using sunscreen, most experts I talked to said to cover up with clothing—hats, long-sleeved T-shirts, long pants.
texasmonthly.com: You said that “melanomas have been known to show up where the sun don’t shine.” How do they get there then?
JA: There are a few forms of the disease that are purely genetic in origin and apparently don’t need sunlight to develop. There is a kind of melanoma that will occur on the soles of your feet and even one that grows at the back of the eye. But they are rare.
texasmonthly.com: Are there any other tidbits of advice about sun and skin care that you left out?
JA: Two things. First, melanoma and other skin cancers are actually pretty obvious, if you’re looking at all. They do not look or behave normally. They get bigger when they shouldn’t and they don’t heal. So when you see something obviously suspicious, don’t go into denial—a huge problem with skin cancer—go to the doctor. Second, if you’re a sun worshipper like me, there’s a way to be outside and near the sun without actually being in it for all that long. For example, when I jog during the spring and summer months, I do so early in the morning, when the atmosphere gives me a little better protection, and even then, I run the shadiest route possible. When I go to a friend’s house for a pool party or something, I try to stay in the shade as much as possible.
For more information on skin cancer, check out the following resources.
American Cancer Society (www.cancer.org)
National Cancer Institute (www.cancer.gov)
Skin Cancer Foundation (www.skincancer.org)