Dr James Barnes has been a skin cancer specialist for 16 years. Despite living in the northern beaches, he tries to avoid the sun after growing up in a family plagued by skin cancer tragedies. This summer has been his busiest yet at Dee Why Skin.
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8.30am: The morning is a flurry of consultations, diagnoses and biopsies. Dr Barnes uses a dermatoscope to check patients from head to toe, between the toes, behind the ears, everywhere. He asks them about family history, medication, occupation and previous illnesses.
Working mothers are always the first ones in the office, getting a quick check-up before work.
9.45am: Self-employed tradies, retired rugby league players and surf junkies make their way through the office. To every patient, Dr Barnes stresses the need to wear a hat, long sleeves, sunglasses and regular sunscreen. Australia has the highest rate of skin cancer in the world.
Some patients have already had two or three melanomas removed, but they still come in red faced from the sun. No matter how often Dr Barnes tells them to protect themselves, they don't listen.
11.30am: For many of the older Anglo-Celtic patients, their childhood days of frolicking in the sun have caught up with them, leaving their pale, sun-damaged skin susceptible to new cancers that pop up every few months. As people get older, their immune systems are not as good at fighting off cancer.
12.45pm: One man in his 90s comes in with a squamous cell carcinoma that has erupted on his cheek like a little volcano. With a flat-out schedule, the only time to perform urgent surgeries like this one is during Dr Barnes' lunch break. It takes half an hour to cut out the cancer, sew the patient's face up and bandage the wound.
2pm: After a quick lunch, Dr Barnes has a busy afternoon of skin check-ups and minor operations. He's finding a lot of cancers, which is a good thing. Particularly in summer, a big dose of the sun can turn vulnerable skin cells malignant.
3.30pm: The waiting room fills up with kids in school uniforms. Grandparents, parents and children come in together. Those with a family history of skin cancer, like Dr Barnes, are at greater risk.
5pm: Dr Barnes performs the last operation of the day before heading home. Today, he's diagnosed one melanoma and about 10 non-melanoma skin cancers.
