was warned when I moved to the Colorado high desert
(western side of the Rockies) that the dry air and
penetrating sun would be bad for my skin. It was my
mortgage banker, in fact, who said "find a good
dermatologist." He wasn't speaking from any particular
awareness of my skin problems — it's just true that high
desert climate is hard on skin, especially pale Nordic
skin. But this was before I knew I had psoriasis. I knew
about my vitiligo and the irksome allergy-related rashes
that would come and go.
built a house in Grand Junction with my first wife.
After fifteen years of college she was finally a
credentialed professional with two college degrees. We
had been married for seventeen years, during which time
we lived in Eureka and Alameda, California, Denver,
Colorado, and Washington, D.C. In that same decade and a
half I grew from lowly sailor, through college student,
to hi‑tech professional, then an executive, and now my
own business. Stress? You bet. Lots of it. But I loved
new house in Grand Junction, Colorado, was also my place
of business. I'd manufactured a beautiful office for
myself with glorious views of the desert that had, in
prehistoric times, been an inland sea. I took pride in
my manicured lawn. Played volleyball with the neighbor
kids. Learned how to in-line skate; bought a hot tub and
soaked with glorious indifference under the star-filled
desert sky. I had a mountain bike and took afternoons
off to go on long rides along paths flanking miles of
skin seemed oblivious for a season or two. Nothing new.
The pigment-less blotches got sunburned and the rashes
waxed and waned. I was somewhat careful not to get
overexposed, and that seemed to be all that was
required. But then the dandruff set in.
Dandruff wasn't news to me, either. Switch shampoos.
Rinse well. Don't scratch. All the usual remedies. But
this was tough dandruff. Couldn't shake it. My barber
was the first person to mention psoriasis. I thought,
"Okay. So it may be psoria-whatever. I'll get
over it." I did sort of get over it, or I should say
more serious crises diminished its importance.
marriage collapsed. I sold the house in Grand Junction
and moved away.
dandruff and I moved to Kentucky to start a new life in
the Blue Grass. Goodbye high desert, new house and hot
tub. Hello condo on a golf course, a.k.a. Twentieth
Century Southern living.
I'll probably never
know what triggered the severe psoriasis, whether it was the
sudden climate change, from arid to humid, or the trauma of
such a drastic life change. I've often thought it was the
failed marriage, that God was punishing me for divorcing the
woman I had pledged my life to. Or perhaps he was punishing
me for marrying another woman, less than a year later.
My second marriage lasted
four years, during which psoriasis became an all-too-blatant
fact of life. It would be convenient to blame the onset of
the severe psoriasis on wife number two — too convenient.
I'll talk more about what I "blame" my psoriasis on, later.
For now, let's leave it at this: The women in my life may or
may not be catalyzing influences on my psoriasis, but even
if they are, there's more to it than that.
Ed's Postscript (11/29/2007): Though I pooh-pooh the
concept of stress as a trigger for psoriasis later in the
book, now — nearly two
decades after these events transpired — with a much more
sympathetic view of stress as a psoriasis trigger, it makes
perfect sense to me that this late-Eighties, early-Nineties
period was the start of my flaking life. I'd never been as
stressed as I was in these years. Abandoning a career in
favor of self-employment,
plus uprooting and moving
1200 miles, plus experiencing the fast erosion of a
nearly-twenty-year marriage ... my life before all of this
had been becalmed in comparison.
there was a boringly Plebeian reason why it took me so long
to seek professional medical counsel about my worsening skin
— I had virtually no health insurance. I remember very
vaguely grappling with the issue of no health insurance
shortly after moving and launching my own consulting
business. I did have a couple of retainers I'd negotiated
before I left the East Coast and this plus a modest nest
egg enabled me to explore a few options. I ultimately
settled on a health insurance package that was, at the time,
issued for short durations to "hunters." As I said, my
memory of all this is vague, but I believe the package was
designed largely to cover medical expenses that might be
incurred by uninsured hunters who have "accidents" during
"the season." There was a lot of hunting seasons in
Colorado at that time, so the insurance was available year
around, but it had to be purchased repeatedly for these
"short durations." If I recall correctly, it covered major
medical and that was about it. Effectively this meant
running around to consult specialists about things like skin
issues was problematic.
much has changed. Uncounted tens of thousands of Americans
with psoriasis in 2007 have little or no recourse to
effective treatment because of lack of insurance. Even if
they manage an educated diagnosis from a public health
doctor, even if they are given some supply of "trial
samples" of psoriasis drugs (usually topicals) the long term
commitments required for effective psoriasis therapy are
beyond reach. The most effective therapies for severe,
recalcitrant psoriasis — systemic biologic therapies
administered routinely and perhaps for a lifetime, or
clinically supervised light treatments — are completely out
of reach for many of the uninsured in the U.S.
believe if the statistics were known the number of people
suffering from psoriasis who have
not been diagnosed or
received appropriate treatments for psoriasis would be
staggering, especially if we include people with mild to
moderate levels of the disease. While some of this shortfall
in health care can be attributed to an assortment of
non-insurance-related factors, the problem of the uninsured
plays a significant role — just as it does for many other
health problems in the United States today.
is why I refuse to dismiss the pursuit of alternatives to
professional medical treatment for psoriasis. There are far
more people than any of us have counted who simply don't
have access to conventional health care for psoriasis. If one in twenty
of those people find relief in a diet, or dietary
supplement, or non-prescription palliative, I cheer for
them. In my mind, to advocate only methods of therapy that
some people simply cannot obtain is not only narrow-minded,
it is immoral. Put another way, as a society we can afford
to treat alternative medicine with enmity only if and
when all of us can afford conventional state-of-the-art
period of time covered in this chapter was from September,
1988 through August, 1994. The barber who suggested my
"dandruff" might be psoriasis did so in late 1989 or early
1990; I moved from Colorado to Kentucky in the Fall of 1990,
remarried in the Spring of 1991 and separated from my second
wife in September of 1994.