In 2019, I had a red bump on my forehead that would not go away. I applied different creams and ointments. I tried covering it up, I tried airing it out. Nothing worked.

I thought that maybe my skin was irritated by my motorbike helmet. But when I went to the states for a month and didn’t wear it, there was no improvement.

After doing a “skin cancer” google image search, I decided I would get a biopsy. There are not that many dermatologists in Mali. I sought advice on a facebook group and was given the name of a Dr. Traore, who did one of his weekly consulting sessions at the hospital just next door to the Sleeping Camel. Perfect.

Dr. Traore was convinced I did not have skin cancer. According to him, the lesion was not worth a biopsy. He repeatedly said I was too young to have a skin cancer. All of this was baffling as I was not, in fact, too young, and my complexion made me exceptionally prone.

In the end, I had to insist on the procedure. Dr. Traore reluctantly twisted out a chunk of flesh with what I can only describe as a corkscrew (it is officially known as a punch biopsy) and packed it up to be shipped off to a French laboratory.

A few weeks later, Dr. Traore phoned me up. “Monsieur Paoletta, you have a skin cancer.” Oh? “Please let me know when you would like to schedule the excision.” Right. Sorry, Dr. Traore, but I just might be seeing another doctor for that.

Not long before all this, Matt traveled to South Africa to have a basal cell carcinoma of his own removed. A dermatologist was recommended to him and he was now recommending that dermatologist to me. Dr. Rakesh Newaj. Matt said he was good, if a little overconfident. He also mentioned that he was very direct and did not particularly appreciate questions. Perhaps arrogant is the word we are looking for.

I googled his name and found his info alongside a dozen or so reviews. The first one I read was not encouraging:

I thought maybe Dr. Newaj would have some conciliatory words in response, or maybe an apology? Maybe it was all a misunderstanding? Or maybe Dr. Newaj was not the type of dermatologist that responded to google reviews. Oh, but he is.

Dr. Newaj came back with this:

Did I really want to fly across the continent to pay this guy to excise a mass of cancerous cells from my face?

Dr. Newaj did have 4 and 5-star reviews, some of them with glowing commentary. And Matt doubled down on his endorsement in spite of Natalie’s testimony. Then I found one of those dirt cheap, glitch-in-the-matrix airfares. Once I learned what Matt paid for the consultation, procedure and lab fees — an astonishingly low $200 USD — I was on my way.

To be perfectly honest, I was not worried. I had a long track record of being a submissive patient. And I certainly didn’t need to be friends with Dr. Newaj. As far as I was concerned, Dr. Newaj could rip up my file and hurl a few insults at me for good measure if it meant a successful removal of the basal cell carcinoma on my forehead.

Some weeks later, I shivered my way out of my humble motel room in the Kempton Park neighborhood of Johannesburg and walked over to the Arwyp Medical Centre. It was winter in South Africa and I had forgotten about this thing called the southern hemisphere.

There was a crowd in the waiting room. I wanted to introduce myself, maybe fill out some paperwork, but the receptionist made an unmistakeable gesture indicating I should just sit down. Many of Dr. Newaj’s negative reviews also assailed the office manager and/or the receptionist. I remembered the protocol: follow orders, don’t ask questions. Don’t try to be friends with anyone.

The only open seat was to the left of a large gentleman who had a large growth emerging from the left side of his head. I considered standing by the entrance, but the piercing stare of the receptionist told me that was not an option. She had a look on her face that suggested my mere presence had completely ruined her day. I quickly sat down and waited for further instruction.

I was nervous, and it had nothing to do with skin cancer. I felt like I was about to be examined by my high school basketball coach. He used to put a trash can next to the court if anyone needed to vomit during practice.

The receptionist gave me the all clear to approach. I readied myself for some preemptive apologizing. I wanted my obedience to be on full display. But the receptionist was all smiles now, and she was apologizing to me. She apologized for the wait, for having me sit, for the crowd in the waiting room. She might have even apologized for the weather!

Shortly after filling out the requisite paperwork, a nurse practitioner called me back to Dr. Newaj’s office. I had a succinct speech prepared in my head. I would mention Matt’s recommendation, acknowledge Dr. Newaj’s expertise, thank him for seeing me, and briefly explain my basal cell carcinoma diagnosis.

Wouldn’t you know it, Dr. Newaj was also smiling. He gave me a firm handshake and pulled me towards him. I would normally find such a Trump-like power move distressing, but I realized it was part of the examination. He looked at my forehead and squinted. “You have a skin cancer there.” I nearly passed out with relief. Dr. Newaj was friendly and competent!

He asked me a few questions about my medical history and then did a full body scan, noting suspicious spots that would need to be monitored. He then explained that a small surgical intervention would be needed to remove the basil cell carcinoma on my forehead. No worries, Dr. Newaj. At this point, he could have told me to run through a sliding glass door and I would have done it.

Forty five minutes later, the nurse practitioner was injecting lidocaine into my forehead. Dr. Newaj worked methodically, cutting me up with a pair of scissors while chatting with the NP about her weekend plans. It was somewhat unnerving that the operation seemed to be secondary to the weekend plans conversation, but maybe that should have been reassuring. As in, Dr. Newaj has done so many of these he doesn’t even need to pay attention? Anyway, I didn’t have much time to dwell on it. The whole thing was over within 15 minutes.

Three days later, I came back for the follow-up. Dr. Newaj was pleased. The sutures looked good and there weren’t any signs of infection.

At the risk of destroying my credentials as a cooperative and borderline sycophantic patient, I decided to ask a question. I wanted to know whether or not the tissue Dr. Newaj removed would be analyzed in the lab. I could see the red ink going into my file: “PATIENT ASKED A QUESTION.” Dr. Newaj smiled and responded with a curt “that won’t be necessary — I got everything out.” Ah, I see. Well, that’s good. I mean, that’s great.

“Do you have any other questions for me?” There is a way of asking this question when you genuinely want to continue the conversation. Dr. Newaj did not ask the question that way. “No, doctor, thank you. Thank you for everything. Hopefully I never have to see you again. I mean, I hope to not see you in this context. It would be great to see you at the mall or the park or anywhere else really.”

That was five years ago. My forehead is still free of basal cell carcinoma. Well, that part of my forehead anyway. It seems Dr. Newaj knew what he was talking about.

I recently poked my head into his google business profile to see how things were going. Not much has changed.

I excerpted the most relevant part of a long winded response by someone on his team. Either that or Dr. Newaj has started speaking in the 3rd person, a development that would not entirely surprise me. I don’t know what kind of misleading statements Mrs. Vrey was making but I hope she is ok!

I think this was the first one where he used all-caps more than once in the same response. Please add “YOUR OWN STUPIDITY” in all-caps to the Dr. Newaj bingo card.

“it may be advisable to see a psychologist or similar professional.” Yikes.

I don’t doubt the sincerity of Dr. Newaj’s one star reviews. He is an experienced and highly qualified doctor, but he’s also kind of an asshole. For an uncomplicated basal cell carcinoma removal, he might be your guy. He might not be your guy if you have a stubborn case of eczema or a mercurial fungal infection. He is definitely not your guy if you need anything close to sympathetic bedside manner. Or if you have questions.

In any case, Dr. Newaj could have ended his response to Jacquelin with something like “Sorry for any misunderstanding” instead of “We are baffled as to how this is rude” followed by “you should see a psychologist.” To be honest, I don’t really know why Dr. Newaj is warring with patients on his google business profile. He clearly has plenty of business and his review responses only serve to make him look petty and childish. Oh, right — he is kind of an asshole.

I do understand Dr. Newaj’s desire to defend himself. Reviews increasingly drive customer behavior and please slap me across the face if I ever start another sentence like that. Anyway, you know what I mean. Too many reviews talking about files getting torn up and leaving the doctor’s office in tears are not good for business.

Thankfully, there is not a platform on which people can review Postcards from Timbuktu. It takes a long time for a postcard from Timbuktu to arrive in someone’s mailbox in Arizona or Auckland or any city or town in Italy. The estimated arrival time is too long to be useful, and there is no way to track what we send.

Despite red text at the top of the homepage explaining the challenges we face, I still get emails from customers asking where their cards are a week or two after ordering. Some of the emails politely request a refund. Others are angry and threatening, accusing me of fraud. I’ve even had someone threaten a class action lawsuit!

But most of the PFT customers are understanding — and appreciative! — of the logistics gymnastics that take place. Most of them are amazed that they can receive this handcrafted, one of a kind item from such a faraway place that some of them thought was actually imaginary until they stumbled upon the website.

The two other businesses I’m involved with — Scoot West Africa and the Sleeping Camel — are available for review on public platforms. The Sleeping Camel has nearly 500 reviews on Google and Tripadvisor and has maintained 4+ stars despite a handful reviews from Malians who thought 1-star was the highest rating (they left a nice written review) and a smaller handful of reviews, mostly from Germans, who had legitimate grievances.

Scoot West Africa is on Tripadvisor. We have 23 five star reviews and 1 one star review. The one star review was written by a client who made it two thirds of the way through last year’s 90-day coast to coast trip from Dakar to Cape Town. Here is what Nick had to say about the trip, and what Matt had to say about Nick.

Dr. Newaj probably would have sprinkled in some all-caps, but otherwise, Matt did a good (better?) job channeling our favorite South African dermatologist. All that’s missing is the suggestion that Nick see a psychologist rather than book one of our trips.

We were about to crack the top-10 in the “Tours and Activities” in Dakar category, a feat that could have possibly introduced SWA to a few new clients. Nick’s 1-star review dropped us down to #19.

Are we blameless in this affair? No, we are not. We’ve since removed anything resembling an itinerary on the coast to coast trip page, and we’ve become much more selective about prospective clients. We should not have let Nick on the trip in the first place.

In whatsapp messages, Nick threatened to make things ugly if we didn’t give him a partial refund. Those messages coincided with multiple requests for my home address. All of this was happening while Matt was still navigating the coast to coast with the remaining clients, and I was in Bamako packing up our family home of 9 years. It was a brilliant time to receive veiled threats of violence from a Florida man (yes).

I had met Nick in person at the beginning of the coast to coast trip. I rode down with the crew from the Sine-Saloum into The Gambia. I spent my last day with them in Farafenni, an unremarkable town on the border of Senegal. It’s not a place you would race to for a holiday. The only reason we were there was because all the roads were shut down in the Casamance after Senegal’s main opposition candidate was sentenced to prison.

In the late afternoon heat, most of the clients were keen for a siesta. But Nick was up for an adventure. So were Matt and I. Farafenni may not look like much, but even dusty border towns reward initiative in West Africa. We rented a horse cart and went on the hunt for a cold beer.

We ended up in a Christian household that served as an informal neighborhood bar. There was a celebration going on. I don’t remember if it was a birthday or a baptism. There was pork on the barbecue and tall cans of Royal Dutch (8.5%). Welcoming and accommodating guests is second nature in this part of the world, and it wasn’t long before we were invited in on the action.

Nick is a filmmaker and he pulled out his camera to get some footage. Some of the off duty police officers and gendarmes attending the fete were not so impressed with this and asked him to stop. Nick did not stop. It was then that a fight nearly broke out.

We eventually convinced Nick to put away the camera and everyone calmed down. But Nick refused to believe he did anything wrong. For him, it was totally acceptable behavior to put a camera in someone’s face without asking their permission to do so. This was our first glimpse of his character. I said goodbye the following morning, but Matt would spend another 55 days dealing with this.

From the Scoot West Africa about page:

Travel is privilege. We believe in approaching it with an open-mind and a heavy dose of respect for the local customs and cultural practices that we come in contact with. We believe in discovering a place on its own terms. We do not impose. We listen, and we learn. We are constantly aware that we are visitors. We are guests. And we should act like it.

For Nick, the world is something to be consumed. You arrive somewhere and you think, what can I take from this? Not “take” as in what I can realize or learn, but “take” as in seize. You see this same approach with certain country counters and content creators. It’s about harvesting experiences and shaping a narrative. The people and the places are incidental, and very often they are collateral damage.

I don’t want to say we’re honored to receive Nick’s one star “diarrhea” review. Something like that, though. If we had 23 one star reviews from people who shared our travel philosophy and whose company we enjoyed and 1 five star review from an asshole, I would be worried. But it’s the other way around.

If and when it all goes tits up, I hope Nick is up on Mars with Elon Musk. Donald Trump can be their president and Dr. Newaj can be the dermatologist. There will probably be a lot of skin cancer with that thin atmosphere.

I will happily stay down here and try to work it out with the other 23 people that reviewed our company, and any other person that does not live life with their ego gobbling up everything and shitting it back out onto all of us.