There was a time in my life when I was too broke to care about ethics.
I was inside the dermatologist's office, resting my chin on my hand, trying to look as casual as possible while being examined. My wristwatch was equipped with a hidden camera, which I hoped would capture a "gotcha" moment. The men who had hired me actually thought the hidden camera footage might make it onto 60 Minutes as part of a grand expose on how "Big Pharma" was trying to squash the poor, misunderstood indoor tanning industry.
I felt dirty as I sat with my shirt off on an examination table, pointing at moles on my body and asking the doctor if she thought they were cancerous. I hoped she would say they weren't but would report them as such, and then I could capture this on my ill-functioning hidden camera watch. Gotcha! The men who had hired me would be very pleased.
But that's not what happened. "If you want to get things removed for cosmetic reasons, I don't know if your insurance will balk at that," the dermatologist told me. "I've had patients come in and remove seven moles at once, and they were all for cosmetic reasons, and the insurance said we're not paying for any of that and she got a huge bill."
Oh. I was sent on my way with a gift bag of sample skin moisturizers and sunscreen while my mind tried to spin how some sort of point was just made.
This happened in 2010, when I was a hired shill for the tanning industry. The company that hired me represented the largest network of indoor tanning salons in America. Their job was to mobilize tanning salon employees against industry critics, and they had set up a nonprofit that promoted the merits of vitamin D, to spin the health risks of indoor tanning. My job was to go undercover into dermatologists' offices and try and show that these medical professions were only after profit in scaring the general public about the dangers of tanning.
I was broke and needed any gig possible. So I put on the hidden camera watch.
The tanning industry was dealing with some seriously bad PR, since excessive tanning causes, you know, cancer. To survive as an industry, they needed to go into serious PR mode and spin the story to make themselves look good, the same way old-timey cigarette ads claimed that doctors thought smoking was healthy.
In their minds, Big Pharma was trying to shut down their industry. The tanning guys called my undercover plight a "sting operation." I called it "completely selling out all my integrity for a paycheck."
Last year, a study reviewed the scientific evidence against tanning beds and suggested that the devices account for as many as 400,000 cases of skin cancer each year in the US, including 6,000 cases of melanoma. The problem, researchers say, is that those who use tanning beds use them a lot. That's likely due to the relatively recent phenomenon of tans being sexy. Until the 1920s, being pale was the definition of beauty; it meant you weren't out toiling in the sun like some kind of common worker. Now making people less pale is a $5 billion industry.
A recent New York Times article highlighted how drastically times have changed since 2010, when I was sneaking around with the hidden camera watch. Last year, the Surgeon General called on Americans to reduce exposure to tanning beds to prevent skin cancer. The FDA invoked its most serious risk warning, lifting tanning beds to the category of potentially harmful medical devices, and 41 states set restrictions on tanning salon use by minors thanks to internet sensation "Tan Mom," who horrified viewers when she took her five-year-old daughter to tanning sessions. Tanning is on the verge of falling out of fashion.
But back in 2010, the tanning industry was still desperately trying to stay in vogue despite the World Health Organization's classification of tanning beds as "carcinogenic to humans." Tanning-based businesses were scrambling to discredit critics—mainly dermatologists and the American Cancer Society—by calling them the "Sun Scare" industry.
Their conspiracy theory went something like this: Dermatologists benefited by frightening people into their offices, and the American Cancer Society benefited through donations. These groups, it was claimed, were possibly killing more people than tobacco by causing a deadly epidemic of vitamin D deficiency—and doctors were dangerously trying to cut off our access to it. The tanning industry implemented Big Tobacco–style marketing tactics to make medical professions look like the evil villains. The key, like all conspiracy theories, was to find isolated incidents, connect the dots, and create a broad generalization to conveniently fit their argument. People of the sun unite!
Of course, I didn't believe any of this bullshit. But I needed money. So I signed on and was provided a briefing sheet entitled "Undercover Sting" that posed numerous questions in the same way Creationists pose questions when confronted about the world being more than 2,000 years old. The US has 4.5 percent of the world's population, yet if you compare the American Cancer Society's melanoma estimates to those of the World Health Organization, we have 47 percent of the world's melanoma cases. How can you explain this?
I was supposed to lean on a handful of cases where dermatologists have been convicted of fraud for misdiagnosing patients with skin cancer for the purpose of collecting insurance dollars. What the tanning guys wanted me to do was make it appear like this was an industry norm, and therefore the reason for increasing incidences of American melanoma. I had to show that harmless moles were being removed, insurance companies were paying the doctors, and false skin cancer information was being added to the melanoma statistics.
It turned out that every dermatologist I encountered was pretty goddamn ethical.
"Start by finding several moles that are obviously not skin cancer and that you would want removed for strictly cosmetic reasons," the tanning guys suggested. "You want to make it clear that you know this isn't skin cancer and you want the doctor to confirm that it isn't as well. We want to prove that this is blatant fraud by removing what is known by all parties to be a benign mole and billing the insurance company as a skin cancer."
After being examined, I was supposed to try and get the doctor to turn the procedure into my insurance as a "pre-cancerous lesion" or some form of skin cancer. This would prove that derms were lying for money and part of a rogue network responsible for fraudulently boosting the US's melanoma numbers. Gotcha Big Pharma!
So I made appointments at several dermatologist offices and loosely followed the script: "Hi Dr. X. I have this mole that I wanted to have checked out. I've been reading a lot about melanoma recently, and I'd really like to get this removed."
But you know what? It turned out that every dermatologist I encountered was pretty goddamn ethical. "I'm sorry, but your insurance doesn't cover it," the first doctor told me. "You could go to some derm offices that would lie and say that it's irritated. I can't do that. It's something I don't want to do—start lying on charts. They might do that for you. But I just like to do things how they are done."
"Has anyone else in your family been diagnosed with skin cancer?" another dermatologist asked during my examination.
"Yes, my dad," I said, concerned. He recently had skin cancer surgery, putting me on edge since familial melanoma is a genetic condition. (Or does Big Pharma just want us to believe it is?)
Most dermatologists said things like, "Just be responsible. We do need sun to produce vitamin D. Be responsible. If you know you're going to go to the beach for two hours, then use sunblock. Just be reasonable."
One particular dermatologist pointed out veins on my nose that were a direct result of damage from excessive sun exposure without sunscreen. This actually got me into applying more sunscreen in my daily life. Gotcha Big Pharma!
I ended up writing two undercover stories for the tanning industry. They were both accurate representations of what happened during my encounters with dermatologists, but they were spun to suit the tanning industry narrative. It was an ethical dilemma—if people believed this misinformation I was helping to spread, it's possible their health and safety could be on the line—but I was broke, so I did it anyway.
When my initial story ran on the Huffington Post, it got picked up by almost every tanning site on the web—sites like MegaTan, Get Brown, and Tan World, who displayed titles like: Undercover Dermatology Sting Exposes Sun-Scare Tactics. Meanwhile, the Huffington Post article was raked with comments from legitimate dermatologists that began with words like "crackpot," "irresponsible," and "crazy."
If people believed this misinformation I was helping to spread, it's possible their health and safety could be on the line—but I was broke, so I did it anyway.
In the end, the indoor tanning guys wanted me to write one last article. What would it be this time—more pestering of dermatologists? Would I go to a sunscreen factory and catch them taking kickbacks from Big Pharma in large bags with dollar signs on them?
With low expectations, I jumped on a call with the tanning guys. It was worse than I imagined: They wanted me to call the mother of a young woman who died from melanoma brought on by excessive indoor tanning. I was supposed to pose as a reporter wanting to do a story on her daughter's life—and get her mom to admit that her deceased daughter's skin cancer condition started long before she became addicted to indoor tanning. Gotcha!
Her mother, an outspoken advocate against the tanning industry, wrote this on her a website:
My precious baby girl was my best friend, my hero, and the light of my life. I will do everything I can to continue her fight against melanoma because I know that is what she would have wanted.
I miss you, SweetiePea, and love you with all my heart.
"So what do you think?" they asked.
I felt like vomiting. Or crying. They wanted me to use tabloid tactics to make a grieving mother disgrace the memory of her beloved dead daughter for the sole purpose of selling more tanning beds.
I never spoke to the tanning guys ever again. Still, people will continue to tan, browning their bodies like rotisserie chicken, much like people continue to smoke cigarettes even though everyone knows they cause cancer. Gotcha?
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