“Keep an Eye on It”: A Motor Deputy’s Melanoma Story

The following account was shared with us by an anonymous sheriff’s deputy in Florida who spent most of his career on a motorcycle. We’re publishing it because in twenty-plus years of department physicals, not one person ever looked at his skin — and his story is far from unique.

I’ve been on motors for sixteen of my twenty-one years. Central Florida. Do the math on that — eight to ten hours a day in the sun, most of it stopped on asphalt running traffic or working a crash scene. We wear long sleeves now, but for most of my career it was short sleeves, no neck protection, and whatever sunscreen I remembered to put on at 0530, which was usually none.

Two years ago my wife noticed a spot behind my left ear. Dark, uneven, maybe the size of a pencil eraser. I showed my primary care doc at my next visit. He looked at it for about five seconds, no magnifier, nothing, and said, “You’re low risk. Doesn’t look like much. We’ll keep an eye on it.” That was the whole exam.

Nobody kept an eye on anything. I sure didn’t — I can’t see behind my own ear. Eight months later my wife said it looked bigger and darker and she was done waiting. I couldn’t get a dermatology appointment for four months, so she found one of those services where you send in photos. The PA who reviewed them called me the next day and told me to get a biopsy that week, and helped set it up.

Melanoma. Stage IB. I had surgery to take a chunk out of my neck and a lymph node checked. I got lucky — it hadn’t spread. My surgeon told me another year of “keeping an eye on it” and we’d have been having a very different conversation.

What Actually Happened Clinically

The deputy’s story contains a textbook failure of skin cancer triage. A new, dark, asymmetric, growing lesion in a chronically sun-exposed location on a middle-aged outdoor worker checks nearly every box dermatologists are trained to act on — the ABCDEs (asymmetry, border irregularity, color variation, diameter over 6mm, and evolution). “Evolution” — a spot that’s changing — is the single most important of the five. His lesion had it twice over.

What he got instead was a five-second naked-eye glance. No dermoscopy — the lighted magnification tool that substantially improves a clinician’s ability to tell melanoma from a harmless mole. No measurement or photo to make “keep an eye on it” mean anything. No referral. Watchful waiting can be a legitimate strategy, but only when someone is actually watching: a documented baseline, a photo, a scheduled recheck. A vague plan to monitor a lesion the patient physically cannot see is not surveillance. It’s a coin flip.

The stakes are steep in both directions. Caught early, melanoma is one of the most survivable cancers there is — localized disease has a five-year survival rate near 99 percent. Once it spreads beyond the skin, that number falls off a cliff. The margin between those outcomes can be months, which is exactly what this deputy nearly lost.

Why This Keeps Happening

Start with the exposure. Solar ultraviolet radiation is a Group 1 human carcinogen — the same top classification as tobacco and asbestos — and outdoor workers absorb multiples of the UV dose that indoor workers do. Motor officers, traffic units, marine and mounted patrol, school resource officers on car-line duty, wildland firefighters, and anyone working extended crash or fire scenes are occupationally sun-exposed workers in every sense except how their health care treats them. Research on outdoor workers has repeatedly linked occupational UV exposure to skin cancer, particularly squamous cell carcinoma — and firefighters carry documented extra risk: a large NIOSH cohort study of career firefighters found more malignant melanoma than expected compared with the general population, on top of the soot and combustion-product exposures that hit the skin directly.

Yet skin surveillance is essentially absent from first responder medicine. Department physicals check your hearing, your vision, your EKG, and your waistline — almost none include a full-body skin exam. NFPA 1582 and typical law enforcement fitness-for-duty exams don’t require one. Primary care rarely fills the gap; a routine PCP visit seldom includes undressing for a skin check, and studies of outdoor workers consistently show they’re under-screened relative to their risk.

Then there’s the access problem the deputy ran into: dermatology wait times of three to six months are common in much of the country. When the front-line gatekeeper waves a lesion off and the specialist is a four-month wait, the system has built a corridor where a growing melanoma can run undisturbed.

What a Better Path Looks Like

You do not have to accept “we’ll keep an eye on it” as a plan. Here’s what actually protects you:

1. Get a real baseline. Ask for a full-body skin exam from a dermatology clinician — ideally annually if you’ve spent years working outdoors, and promptly for any new or changing lesion. If you’ve never had one, book it this month.
2. Know the ABCDEs, and treat E as an alarm. Asymmetry, irregular borders, multiple colors, diameter over a pencil eraser, and evolution. Any changing spot gets professional eyes on it — not a recheck “sometime.”
3. Use teledermatology to jump the line. Store-and-forward photo services reviewed by dermatology clinicians can triage a suspicious lesion in days, not months. If a spot is flagged, they can fast-track the biopsy. This is one of telehealth’s clearest wins for shift workers.
4. Enlist a second set of eyes. Scalp, ears, back of the neck, back — the high-sun real estate you can’t see. A spouse or a phone camera on a monthly self-check beats hoping.
5. Demand a “watch” that’s real. If a clinician wants to monitor a lesion, the minimum is a photo with a ruler, a documented size, and a recheck date on the calendar. No photo, no date — push for dermoscopy or referral instead.
6. Fix the exposure itself. SPF 30+ on face, ears, and neck as part of putting on the uniform; reapply mid-shift. Neck gaiters or flaps on motor and marine units, shade at extended scenes, and long sleeves in summer-weight fabric. If your agency doesn’t treat sun protection as PPE, that’s worth raising — some fire departments now run on-site skin screening events, and it’s a policy any union or wellness committee can push for.

The Bottom Line

This deputy did the right things — he noticed, he asked, he showed a doctor. The system still nearly let a curable cancer become an incurable one, because nobody treated two decades on sun-blasted asphalt as the occupational exposure it is. If you’ve spent your career outdoors, you’ve earned a skin exam the way a structure firefighter has earned a cancer screening. Get the baseline, watch what changes, and when a provider offers you a plan that consists of nothing, go find one who will actually look. Your job put the risk on your skin. Don’t let anyone glance at it for five seconds and call it medicine.

This account was submitted anonymously. Details have been edited for privacy. This article is for informational purposes only and does not constitute medical advice. BadgeBiohacking (policefire.health) is a comparison and review site. We may earn affiliate commissions from links on this site. Always consult a qualified healthcare provider before starting any treatment.