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 Feature Article "Seasons in the Sun..." I'm sometimes surprised and amazed at how well my kids remember to do things that I never did when I was a kid, and yet somehow I managed to survive childhood with only minor injuries. I re- member in 8th grade when our car was side swiped by a hit and run driver, turning the car directly into a telephone pole. This was 1975 when men were men, and nobody wore seat belts. I can still see the windshield zooming in toward me as we hit the pole and I even remember bouncing off it We were only going about 20 MPH, so I just got a bump on the head. My mom wasn't so lucky - she was spitting teeth and had her jaw wired shut for 6 weeks. After this, mom became a believer in seat belts, but didn't start wearing a seat belt religiously until I started driving myself, in large part because of the annoying beeping alarm thing that went off whenever you didn't have it on. So that's what I've become for my children...an annoying beeping a1ann thing. An effective raining tool, apparently. "Put on your sunscreen." "Wear your seat belt unless you want to be a projectile!" "Bike helmets - keep your brains where they belong!" This works great for my kids because I see them all the time. I reinforce the training frequently. But, this doesn't seem to work as well for my patients. I don't get to chide them frequently enough. I am amazed at how often people will come in to see me with a SlU1burn. "Ah, Mrs. Smith, the glow of your ultra- violet radiation-induced DNA damage is quite striking today." But people who get sunburn are taught by negative reinforcement to be more careful the next time. Studies have borne this out. It worked for seat belt use with my mom, but not for me -my reinforcement wasn't negative enough initially. But for people with milder sun block who get minimal negative reinforcement from the sunburn pain, it does provide few opportunity to talk about SlU1 protection and skin cancer, wrinkles solar keratoses, poikiloderma of Civatte, melasma, freckles and other It is even more dishearten me to hear a patient say "can I tan while I take and antibiotic for my acne?" If a parent is in the room, I always have to bite my tongue to keep from saying "if you don't let your daughter smoke because it causes cancer and wrinkles, then why would you let her tan?" Why indeed. Choosing their battles, I suppose. My oldest is only 11, so I don't have to deal with the "tanning vs. tongue piercing" dilemma. But it is another Opportunity counsel. Sometimes you have to teach by example. When I first moved to Iowa, my neighbors must have thought I was a real basket case. "95 degrees in August and he's out there cutting grass with a big jungle hat, army fatigues with the collar up, long sleeves, work gloves on and long pants." They used to think I was a few cards short of a full deck, but they don't anymore. At least not since I stopped caring the M-16... I like doing surgery as much as the next guy, but preventing a skin cancer is better than cutting one off. Counsel your patients frequently. Be that annoying alarm thing. More importantly, practice what you preach.
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