Dear Prudence

You Should Get That Looked At

Prudie counsels a dermatologist who is tempted to warn strangers about their suspicious moles—and other advice seekers.

Emily Yoffe, aka Dear Prudence, is on Washingtonpost.com weekly to chat with readers about their romantic, family, financial, and workplace problems. An edited transcript of this week’s chat is below. (Read Prudie’s Slate columns here.)

Emily Yoffe: Good afternoon, everyone. Let’s get to it.

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A mole hill of trouble: I am a dermatologist who specializes in mole removal. A lot of these are cosmetic in nature: “Doc, I’ve had this mole on my nose my whole life and would like it removed.” However, sometimes I do mole removal that is of medical necessity, meaning cancer or precancer. As the weather is growing warmer and women especially wear more sleeveless, strapless, backless clothing, I notice moles on them that are highly questionable. I do notice them on men, too. But women tend to show more epidermis in the summer than men. Yes, I apparently have mole-radar!

On an elevator, I once noticed a mole on a woman’s back that looked very suspicious. Obviously she was not my patient, nor can I perform a lab test at that moment. However, I quietly mentioned that as a dermatologist, I felt she should have it checked by a doctor. Her response was very negative. I felt I was being treated like a pervert or an off-the-street weirdo. So, my question is: When I go out in public, should I shut my mole-dar off? After all, they are not my patients. Or is it the right thing to point out to someone that they may have a dangerous mole and should see a doctor as soon as possible?

Emily Yoffe: You need to develop a thick skin if you’re going to approach strangers and say, “You have an unsightly mole that’s potentially malignant.” You can understand the recipient is likely to find this puzzling and disturbing. However, as long as you don’t hand out your business card along with your recommendation, I think you’re doing a good deed. If, because of the miles of epidermis that’s on display in the warm weather, your mole-dar is constantly going off, it’s worth it to warn people, given how deadly melanoma is. But you have to pick your spots about these spots. You can’t go chasing people down the street. And after you say, “Excuse me” and explain you’re a dermatologist, try to make the news as unalarming as possible. Just explain that to your trained eye, it would be worth it to get that mole checked out by the person’s dermatologist.

Dear Prudence: Husband Out on the Town

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And after you say, “Excuse me”: Shut up. Seriously, we’ve all heard the PSAs, seen Oprah. Do NOT condescend to tell people what to do. Just like doctors can tell people in the street to stop smoking or stop going to McDonalds, you do not approach people and tell them to get their mole examined. MYOB even IF you do know better than everyone else. This is America.

Emily Yoffe: This is not about being the nanny police and giving a lecture to a smoker. This is letting someone who probably has no idea they might have a deadly growth that they need to have it checked out. If a doctor told you on the street to check out the mole on your neck, and your dermatologist said it was cancer, but fortunately it hasn’t metastasized, wouldn’t you always be grateful to the stranger who stepped up?

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Los Angeles: I have had a relationship with my first father for almost 20 years. We reunited when I came of age and the agency that handled my adoption helped us reunite. Slowly, my father introduced me to his family, and, happily, they welcomed me with open arms. But he has never permitted me to meet my half-siblings. He was married to their mother at the time of my birth and when we reunited, but he’s been divorced for many years now.

For a variety of reasons, I would like to meet my half-siblings. Mostly, I would like to eradicate the shame and awkwardness that comes from being a never fully acknowledged member of the family. Do I have the ethical right to “out” myself to these siblings?

Emily Yoffe: Oh, the power of parents, even ones who didn’t raise you. You and your half-siblings are all adults, so it is not his choice about whether you can contact these half-sibs; it’s yours. Your father actually can’t do anything to keep you from reaching out to them—except threatening to withdraw his relationship from you. Since your father has kept your existence secret for decades, be prepared that your appearance is going to profoundly reshuffle the family dynamics and that it’s possible not everyone will welcome you. Give your father fair warning that you’ve waited long enough and want to get a chance to know your siblings. If he won’t break the news to them, tell him they’ll hear it directly from you.

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Houston: When my daughter was young, I molested her on many different occasions. She never told anyone, probably because no one would have believed her if she had: My wife and son have always viewed me as a model husband and father.

My daughter died in her mid-20s after being hit by a drunken driver. I eventually grew to feel remorse for my crimes, and I have taken great efforts to avoid spending time with children so that I never do such a thing again. The problem is, my son now has children of his own, and he asked me to take care of them while he is on vacation, and my wife agreed. She, however, is out of the house often, and I am very worried about what might happen. I can’t help but feel aroused every time I look at my youngest granddaughter. I keep trying to think of ways to get out of this, but I can’t come up with any that won’t sound suspicious. Please help a dirty old man.

Emily Yoffe: At least you recognize the enormity of your crimes and want to keep from repeating them. You need help. You can start by contacting organizations that deal with sexual offense. One is Stop It Now (www.stopitnow.com). They should be able to refer you to experienced counselors, who can also give you strategies for dealing with your grandchild and the issue of disclosure. As for the excuses you make in the meantime, I don’t care how ludicrous they sound. You are aroused by your granddaughter, so if you have to shoot yourself in the knee to keep from being alone with her, you do whatever it takes to stop yourself from destroying this child.

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Dallas: I was married at 19 and divorced at 23. I remarried at 27. (I’m now about to turn 61.) My (current and last) husband and I have a 24-year-old son whom we have never told about my first marriage. He is so proud that HIS parents have remained together, since so many of his friends’ peeps have divorced. Should I tell him of my first marriage at this point? I fear he WILL find out someday and I might not be around to tell him I was young and foolish and that the parting was mutually amicable.

Emily Yoffe: This reminds me of an anecdote I read about a woman in a similar situation. When she finally told her teenage daughter, the daughter took it so well that Mom felt moved to add, “Actually, your father is my third husband.” You should have told your son a long time ago. You’re a 61-year-old woman, and you’re still defensive that you ended a bad youthful marriage. Why? Ending that marriage allowed you to enter into a good one and have your son! I think it’s always helpful for children to understand that their parents aren’t paragons and that they struggled with the same difficulties the kids are struggling with. When you tell, just keep in mind this isn’t a shameful secret, but a great lesson: that it’s better to know when you’ve made a mistake and fix it than let it determine the entire course of your life.

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Madison, Wisc.: Perhaps the LW concerned about molesting his granddaughter could consult his doctor about chemical castration, an effective yet reversible treatment to reduce his libido while she is around.

Emily Yoffe: It might be for the best if he makes it permanent.

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New York City: I graduated from college a few weeks ago and am lucky to have landed a job that I love. Everyone has shown me great support and enthusiasm regarding this next chapter in my life. The problem is that whenever I am talking about my new job with my friends or acquaintances, someone usually asks me how much money I’m making. I find this question to be inappropriate as I was taught to never talk about financial matters with people outside of the immediate family. Am I wrong to think that this question is a little bit rude? What is the best way to answer this question? I’ve just been answering my friends honestly, but I would prefer not to tell everyone how much money I am making. I am not making massive amounts of money, as I have an entry-level job, but I’d still rather not discuss my finances.

Emily Yoffe: There is a school of thought that if we lifted the taboo on salaries, we’d all be better off because then people would know, for example, if women in equivalent positions are consistently being paid less. I can understand that your friends are asking both out of nosiness and because they’re trying to figure out what kind of salary they can expect or ask for. However, all that matters here is that you are uncomfortable giving out this information—and, yes, asking, “So what do you make?” is rude. You need an ambiguous answer that shuts down further discussion. So say something like, “Just enough to feed myself and start paying back my loans.” If they press you, just say, “Sorry, I’m not comfortable discussing my finances.”

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Concord, N.H.: I’m a 27-year-old guy and a med school student. I’ve been dating my girlfriend (also a med school student) for over a year. I love her. I’ve never cheated on her. A week ago, I met with a female friend and classmate for a friendly drink, which led to a few more drinks. Nothing happened physically, but it could have. It felt more like a date than two friends getting together. Should I talk to my girlfriend about this incident? I feel like it was an isolated incident, something I will take pains to avoid in the future, but I feel guilty. Is this misplaced Catholic guilt, or have I actually transgressed?

Emily Yoffe: I guess it’s a good thing that you didn’t get so far as to be able to do a full-body check to see if she had any suspicious moles. You had too many drinks with an attractive woman and, guess what, you started to feel all flirty and aroused. It happens. What also happened is that you didn’t take it any further. You recognized that putting yourself in this situation is not a good idea. That does not mean you can’t have female friends or get together with them. It does mean don’t put yourself in situations where you then have to say, “I had too many drinks, and I …” Be glad for your self-restraint and be relieved you have nothing to confess.

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New York City: This is kind of a weird one. My partner and I are a long-term, committed gay couple. Last summer, we celebrated our fifth anniversary by holding a commitment ceremony at a friend’s summer home. I invited my very large extended family (aunts, uncles, all 29 of my first cousins and their children, etc.) as is the custom in our family, expecting that many of them would not be able to make it. (The ceremony was held on Long Island at the home of my partner’s parents, while my family lives in Indiana.)

Most of my family sent their regrets, and about a dozen of them made the trip. Now, I have been out to my family for more than a decade, and my coming out was a complete nonevent for my pretty progressive family, which is why I was a little shocked at the reaction of one of my cousins to our invitation. While she said nothing to me, she apparently confronted my mother and said that I was making a mockery of the institution of marriage, etc. Now, it’s worth noting that this cousin has married into a pretty conservative family, though she had never before expressed any feelings—good, bad, or indifferent—about gays, as far as I knew.

This all blew over. However, a couple of weeks ago, I received an invitation to her son’s wedding. She made it clear, through our family grapevine, that my partner was not invited and should not attend. I RSVP’d no (it’s worth noting that my partner has been invited to and attended other family weddings) and sent a letter to my cousin’s son congratulating him and saying that I regretted I could not join him for the wedding.

Over this past weekend, I received an e-mail from my cousin that said, aw shucks, it’s too bad I can’t come to her son’s wedding, but here are their wedding registries, and please send along a gift as soon as you can.

Prudie, I don’t want to send her son a gift. He’s nice enough, but I don’t really know him well. If another relative of this extraction had a wedding that I couldn’t attend, I probably wouldn’t send one. And I don’t want to make a stink about it or blame him, but his mother’s hostility toward me over the past years has not made me inclined to treat her requests with anything but anger.

I know the textbook etiquette rule is that one need only decline an invitation with your regrets, but am I doing the right thing?

Emily Yoffe: Let’s see, this cousin declared your partner is not welcome at her son’s wedding, but your gift is. I would say that pretty much gets you off the hook of incurring any obligation for this wedding. Although to give the next generation the benefit of the doubt, you don’t actually know if the cousin’s son agrees with Mom or simply doesn’t know about her maneuverings. Your further silence seems like an appropriate response. However, you might be tempted to send Mom her own gift: Jonathan Rauch’s book, Gay Marriage: Why It Is Good for Gays, Good for Straights, and Good for America.”

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Mole-Dar: I’m not a dermatologist, but several members of my family have had skin cancer. I noticed a mole on the upper back of a co-worker. I was fairly certain she couldn’t see that part of her body and mentioned that she might want to have her doctor look at it. It turns out it was cancer. She recovered, but she was pretty mad at me for several months. About four years later, she thanked me for mentioning it to her. So, yeah, people will likely be mad at you. Frankly, I’m sure her kids don’t mind she was mad at me.

Emily Yoffe: Talk about blaming the messenger! I’m glad she finally came around and was appreciative that you are probably the reason she’s able to thank you four years later.
I’m hearing pros and cons about telling strangers, but most people are saying they’d be grateful for the warning.

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Boston: I am in my mid-20s and am fortunate to have a close group of friends. Almost three years ago, one of them, “Peter,” began dating a delightful woman, “Marcy,” who quickly became close with the rest of us. Peter and Marcy have lived together for the past two years. Recently, I’ve observed that Marcy and another friend in the group, “Ben,” have developed a romantic and physical relationship, and that Peter rarely comes out with us. I asked Ben about it—he confirmed the new relationship and assured me that Marcy and Peter were no longer together. However, Peter tells me that he plans to move to a new city with Marcy, where she is about to start a new job.

Part of me feels as though none of this drama, seemingly plucked out of a telenovela, is my business. On the other hand, I feel some obligation to ensuring that Peter isn’t making a big mistake with his upcoming move. I also feel guilty in continuing my friendship as normal with Ben and Marcy, since doing so gives at least tacit approval of their behavior. I know little of the specifics of the situation and its chronology, but even in a “best-case scenario,” their actions are dubious.

Emily Yoffe: Is Peter home doing the floors while Ben is out doing Marcy? Has Peter not noticed that his girlfriend has a new boyfriend? Since all of you hang out in a group, you’re certainly entitled to some clarification so that invitations don’t go to the wrong parties. Just say to Marcy that Ben has told you the two of them are a couple, while Peter has told you the same thing. Explain you’re coming to her because you don’t want to embarrass anybody inadvertently because of your confusion.

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High Finance, N.Y.: I work in an arcane corner of high finance. A dear friend of mine recently started dating someone who works in a similar field.

His job is complicated (basically buying collateralized debt obligations and “optimizing” this distressed debt, blah blah blah) but ultimately amounts to forcing people into foreclosure and squeezing out every last penny from their shattered lives. I mean, this is literally the worst sort of bottom feeding that I know has emerged from our country’s wreckage.

I think she would find this morally repugnant if it were explained. On the other hand, she’s pretty besotted (she met him in his capacity as a “philanthropist”; kudos, I suppose, for returning dribbles of the pillage), and who am I to stand in judgment? How do I decide to speak up or shut up?

Emily Yoffe: I’m reading Michael Lewis’ great book The Big Short,which explains how the economy collapsed with the help of these arcane corners of finance. It’s probably not a good idea to read this before bed, however, because the moral outrage doesn’t make for peacefully drifting off to sleep. Your friend’s beau is not actually standing on the street hauling the possessions of the foreclosed on the sidewalk. He’s doing his work from a skyscraper and a terminal and probably making buckets of money. I doubt, however, that you’re going to convince your friend that if this guy were working for Teach for America instead of buying CDOs, the world would be a better place. If she ever expresses curiosity to understand high finance better, tell her The Big Short will explain everything she wants to know.

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Washington, D.C.: RE: New York City

Prudie, you are absolutely correct in pointing out that a little more information regarding our peers’ salaries might help erase part of the gender gap in wages. Studies have shown that women negotiate less than men for salaries and tend to low-ball themselves when asking for a starting salary or a raise. This is particularly important for a young professional starting out as most gains in salary are made in the first few years of work.

Being open about our salaries with my friends has helped me double my salary within my first two years out of school and made me realize that I need to be asking for another $20,000 at my next transition.

We may have been taught that discussing money was “rude,” but it is exactly that rudeness that helps young men out-earn us directly out of college. Help a sister out, and consider at least offering a range (mid-$30s, low $60s) when your friends come to you for career information/advice.

Emily Yoffe: This is very true. Studies show that women tend to accept salaries and not ask for raises, while men consider an offer the beginning of a negotiation. However, no one should feel forced to disclose their salary if it makes them uncomfortable.

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For the anti-gay cousin: Personally, I think the gay cousin whose partner is excluded, but who is expected to cough up a gift, should reply with “Sorry, (Partner) is in charge of gift giving in our household, and he hasn’t been invited.”

Emily Yoffe: I love it!

Thanks, everyone, talk to you next week.

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