As usual, nothing with my brother is usual. Earlier in the month, he had gone to the dermatologist, who is the father of one for the best friends of my son. He had a "blue mole" high on his forehead, which had changed size and a bit in color (actually smaller and blacker). I got notice from the nurse practitioner from the nursing home that it had come back benign, but with a foreign substance, maybe from a tatoo. My brother has never had a tatoo.
Last Wednesday night, my husband and I took my brother out for coffee. He mentioned that the doctor had called and spoken to him for about 10 minutes and wanted to know if had ever had a wound or hurt himself at the location. Everything sounded a little wierd, so I called back the doctor on Friday.
I was a bit worried that I wouldn't be able to speak with him, but he answered the phone directly, saying that his staff had already left for the day but that he saw my name and decided to answer.
It turns out he asked either the nursing home or the person from the agency that I still pay to help me take care of my brother to let me know that I was supposed to call him. As I mentioned, if I hadn't spoken with my brother, I would have never known to call.
He told me that my brother's mole was hard to diagnose. At first he thought it very well could be malignant, but it came back with a negative from pathology. Never the less, this doctor turns out to have a speciality in melanoma, and meets with a bunch of doctors regularly to discuss cases. Apparently he sent my brother's data all around to get some additional observations, including a well known specialist at Sloan-Kettering.
Nobody thought it was malignant, but they all thought he either had gotten a tatoo or somehow some kind of foriegn substance had entered his skin. Of course you can't get a straight story out of my brother. In fact, he told the doctor that he had had this mole his whole life, which he hasn't. I told the doctor that in no way had he gotten a tatoo, but that it was possible he could have gotten some kind of trauma and never told anyone. Even my brother said it was too bad my parents were no longer alive to give some kind of medical history on the mole.
I asked the doctor why had just hadn't taken out the whole mole. He said he had thought about it, but that it was deep and he didn't want to do more work on my brother than he needed. Then he started thinking about doing another biopsy. At first I thought this was a good idea, but then I asked about whether the fact the mole had been there for at least 10 years, that it couldn't be growing that fast, had anything to do with anything. Then he stopped himself and said, it came back benign, and that's what we should assume until something else happens. Meanwhile, we will probably never know what the foreign substance is or my brother got it.
I hope we made the right decision. It is really difficult to take responsibility for life and death medical issues, especially when you don't have all the information you need to make a good decision.
