Shoot-from-the-hip A friend of mine named Sallie called the other day to tell me one of those "this you won't believe" stories. Sallie had just returned from a dermatologist. Of course, first she had to visit her primary care physician (which took nearly two hours) so she could get a referral. When she saw the dermatologist, he examined a spot on her arm that was dark in the middle and peeling on the edges. He diagnosed this as dermatofibroma - a fairly common skin growth that's not dangerous. No treatment is necessary unless it's unsightly or painful, and fortunately neither was the case with Sallie. So she decided to take the doctor's advice and just keep an eye on it and call him if it caused any problems. When that was taken care of the doctor gave her a quick general examination, looking for possible skin cancer spots and so on. While doing this he pointed to a larger-than-average freckle on her face and said, "That's new." Sallie said, "No, I've had that freckle all my life." Dermatologist: "I'm pretty sure it's new." Sallie: "I'm pretty sure it's not." The dermatologist replied, "Well, it's changing." Taken aback, here's what Sallie didn't say: "I met you 10 minutes ago and you're insisting that my lifelong freckle is new!? And it's changing!?" That one gets a prominent spot in the Shoot-From-the-Hip Diagnosis Hall of Fame. And the doc's business card got a prominent spot in the circular file. | 
