Phillipa McGuninness writes about skin, power and beauty

ASTRID: Welcome back to The Garret, Phillipa.

PHILLIPA: Thank you so much for having me, Astrid. I'm really pleased to be here.

ASTRID: We spoke about four years ago about your first work, The Year Everything Changed: 2001, and I feel like everything has changed again. Kind of a joke question, but also not really. Would you ever write a sequel to that book?

PHILLIPA: You know, I think about that often, but not seriously. I think about it as a kind of intellectual exercise, I guess, not something I would do. But in 2016, when I was writing the 2001 book, it did seem as if everything was changing with Trump and with Brexit. I thought, ‘Wow, this is quite a momentous year in and of itself, but hasn't there been a lot of news since then?’ I feel like we really are living through extraordinary times and there's so much going on with the pandemic, with Black Lives Matter, with Ukraine, with the rise of authoritarianism around the world. And I think, I mean, we're all in the thick of it. I don't have the distance to write hardly even about a particular day, let alone a particular year because there's so much happening. It is a really good question though, because it makes you think, what's going on?

ASTRID: Thank you for that very considered answer to my somewhat tricky question. We are living in times where the news is sped up more than I can comprehend it, to speak for myself only. The reason why I wanted to start talking to you today about your formal book is because we are living through history now and everything that we see on the news, it's based on what happened previously. It's based on what happened a decade ago or a century ago. And that was why your book 2001 was so important. So many things did change in that year, and sitting here now in 2022, we can draw a direct line to what's happening now back to so many of those things in that extraordinary year. I just feel like someone should write 2016 or 2020 or 2021, or probably 2022 as well. But, yeah, your work stands out. Thank you, Phillipa.

PHILLIPA: Yeah. Well, thank you. Thank you.

ASTRID: On a more serious note and a more personal note, your first book was not just about modern history. It also had a great deal of your personal story in it. And before we get into your new work, I wanted to ask, as a writer who is now publicising your second book, you've done it before and you've had a lot of your own personal story out there. What has that been like knowing that people you meet know intimate things about you?

PHILLIPA: Yeah, it's interesting because, do you know what Astrid? I think a lot of people forget. No, seriously. I think we are so bombarded with so much information about everything, including deeply personal information, that some people know, they probably recall, especially since a lot of people talking to me now won't necessarily have read that book. I think they'll have some vague recollection that I wrote about some tragedy, but they might not really recall the details of it. Another answer to that question is that with everything we all know that we may have a particular story, whether it's triumph or tragedy, but it's one part of the whole. It's not all of us.

I guess there's more to me and my story and my life than losing a son through stillbirth. I don't always even expect everyone to remember it or acknowledge it or even talk about it. But for me writing that book did shift something within me that made it, I think, easier for me to be more upfront about a whole lot of things, although I think Skin Deep is definitely less personal. I mean, there's a lot of me in there, but I'm really using some of my experience, I guess, as a device to tell a story rather than as an intimate self.

ASTRID: I did not know what I was going to read when I picked up Skin Deep: The Inside Story of Our Outer Selves. I thought, is this about skin? Is this about skin colour? Is this about cancer? Is this about beauty? I don't know. And it is about all those things and also so much more. So you just started, opened the door to talk about Skin Deep and it does have a little bit of your personal experience in there, but how did you find this idea? And then, how did you find your way into exploring our skin?

PHILLIPA: Well, I feel like in some of the radio interviews and other kinds of interviews I've done lately, I've launched into this story about where the idea came to me, but the fact is, it is true because it seems too neat to be true, but this is how it panned out. I was sitting in the very busy waiting room of the dermatology practice I go to and it's packed. It's hard to get an appointment. I think there are about eight, maybe 10 doctors who work there, so it's a busy place. And as happens so often with medical appointments, the doctor was running late. I had a long time to look around, and most of the patients there were older than me. I'm 55. There were a lot of people there who would have been in their 70s, but there was a mix of ages.

And statistically, I guess, that they were probably there for reasons to do with skin cancer, but it wasn't... And now of course I know all those horrifying statistics much better. I could tell by looking at them because very often people emerged and they were sutured or they just had stitches out or they'd had something burnt off. And the thing about skin is it's so obvious. You can't hide it. I thought, ‘Wow, this is really messed up that I'm in this packed waiting room with people seeing doctors about a skin cancer that is generally preventable, but because most of these people are white and we're in a very sunny country, here we are. There is a story here’. And then of course I looked around and there was a boy with acne. Again, one of the brutal things about acne is that it is so obvious.

I knew there would've been people there for their psoriasis or eczema or any number. Like, there are thousands of skin conditions and there were a few women there whose skin looked particularly smooth or lips looked particularly plump or whatever. And I thought, ‘Well, that's a story, too’. I think that's really where the idea grabbed me, but I think it had been in the back of my mind for a long time, so it fell on fertile ground, so to speak. And when I came to write the... Once I had signed a contract and was thinking about structure, I'm always thinking about structure, I thought, ‘Wouldn't it be interesting to go around that waiting room, as a snapshot, at any particular point on any day, and ask each of those people...’ I mean, there'd be all kinds of permissions and ethics processes involved in this, ‘Why are you here?’ And use that as a starting point. But of course, COVID put paid to that.

ASTRID: You start the work with AOC, the American Congresswoman Alexandria Ocasio-Cortez. Firstly, that was a surprise and a very intellectually engaging surprise, I guess, because it immediately allowed you in the first page or so to get straight into discussions of race and power and privilege and beauty. Great start, I wanted to say, but also…

PHILLIPA: Thank you.

ASTRID: ... it immediately, by doing that, shifted my expectations of a reader as to what I was going to get and why I had to sit down and read this whole thing now. I guess when you're writing non-fiction, you've previously been a publisher and you are now a non-fiction writer, the angle and the why you, and why this exploration of this particular topic at this particular time is so important to engage your reader. You said that you are always thinking about structure. How do you think about making that bang? Getting your readers' attention?

PHILLIPA: Well, it wasn't as if I was sitting down one day thinking, ‘If only I could find a video that encapsulated everything this book is about’. It popped up in my feed and I have been very interested in AOC, as she's known, as she was running for Congress in her district in New York City, because she's a very compelling, charismatic person. She's a celebrity politician. And when I watched her makeup tutorial, from which, as I say in the book, I truly learned a lot of practical skills because I'm of a generation, we did not have makeup videos. We had clunky how-to drawings in Dolly or Cosmo, and word-of-mouth, and our eyes. We could look and see what other people were doing. But there's AOC kind of remaking the genre that is the makeup tutorial talking specifically about policy to do with COVID, in this case, but she ranges far and wide. She's explicitly feminist.

She talks about gender in a very inclusive way. She also talks about power. She talks about her own ethnicity, and this is in this, what is it? 20 minutes of makeup tutorial that she has made for Vogue, and there was just something so zeitgeisty about it on one level, but profound in another way, even though it seems like it's all surface, it's all superficial. I remember coming to the end of this video and thinking, ‘She has encapsulated all the things of the book that I want to write. I can use that’. And I think people are really surprised by it because they expect me to start with the kind of story that I've started with here, where I'm talking about sitting in the dermatology waiting room. But it's like, ‘Wow, it's this famous American politician doing a makeup tutorial? Really?’ And I'm sure to be frank, Astrid, that turns a lot of men off who I would hope would read the book. There's a lot in there for everyone. But I think for a lot of other people, it really grabs their attention.

ASTRID: There is a lot in here for everyone. I mean, you are talking about our skin. That is fundamental to all of us. And I recently interviewed Jane Caro and she jokes that all of us women should not buy or read any more books by men until they start reading our own. And that is my only comment that I will share with you here, Phillipa, about men choosing not to read your book because you start off with a fantastic story about AOC. We are both white women, Phillipa, and this book includes a lot of discussion about race and how that is a cultural construct. It has zero bearing or zero evidence in the science. As a white woman engaging in a 200-plus page discussion on race and the privilege that comes with white skin, how did you research it? Who did you speak to? And how did you approach the nuance and minefields in it?

PHILLIPA: I always knew that, of course, I was going to write about skin colour. I remember somebody said to me, a white man actually, ‘Oh, you're not going there, are you?’ And I thought, ‘Well, how can I not? It would be so dishonest’. It doesn't take courage to do this, of course not, but you've got to be honest. I could not not write about skin colour. What was I going to talk about? How melanin works in our skin, why do some people's cells produce more melanocytes than others, and leave it there? I could not do that. I think what I found was that race became a thread through the whole book, but there are a few chapters that are explicitly about skin colour and race. And I make it clear in the book, and frankly through my whole life, that I don't want to talk about other people's experiences, particularly people of colour, as if I know what that might be like. I don't. I never can.

I guess on one level, this process made me interrogate my own whiteness more, but I think also I'm a writer who thinks historically about things because that's how I am. But also because of my 25 years as a book publisher where I published a lot of colonial history. I published a lot of Australian history, so I have grappled with these issues in my mind for a long, long time. I always read widely. I always have. And I think that, in ways that I can't really appreciate now, that reading over a long time informed the book. But I'll mention a couple of other things that I think specifically informed the book and shifted the way that I wrote about race and certainly gave racial justice more urgency than perhaps it would've had otherwise. As I was writing in 2020 the Black Lives Matter movement really took off, and in the thick of COVID I went to some protests.

I listened to what people were saying and felt like we were maybe developing a new language and people could see the connections between Black Lives matter in Australia and say the Uluru Statement from the Heart. I felt like maybe people, particularly white people, were thinking, ‘This is a thing’. I'm seeing these connections. There was that. But something else I think had a profound impact on my thinking that I'm only really grasping now, and it shows how conversations can really have a huge impact. I went to the Broadside Women's Festival at the Wheeler Centre in Melbourne in 2019, I think that was. And just sitting there listening to Aileen Moreton-Robinson whose work I had read, Tressie McMillan Cottom whose work I had not read, Zadie Smith, a whole lot of women, and Helen Garr, for that matter. That had a really big impact on my thinking about gender and race and power.

Yeah, I'm not sure I've really answered your question, but it is kind of unanswerable because, as I say in the book, we have been grappling with racial thinking for 500 years. It takes a lot of work to overturn those assumptions, but I had to look at myself and indeed my own skin, and think, ‘I would not be having the issues with basal cell carcinomas and other skin cancers that I have, had my forebears not moved to this side of the world from Ireland and Scotland’. It's very complicated, but I did not want to shy away from writing about it, but I wanted to do it as sensitively as possible and bring in as many voices and experiences historically and contemporary voices as well.

ASTRID: The historical angle in Skin Deep I found quite informative. I am also a very big reader, Phillipa, and no discussion of skin colour in Australia can be complete if there is no acknowledgement of not only Colonisation, but the state policies of assimilation that essentially went on for decades and tried to change people's skin colour, and the hurt and damage from those state policies continues. You point this out in Skin Deep, and that is something for all Australians to grapple with because that legacy still has impacts today, and it is brought up in Skin Deep.

PHILLIPA: Yeah. I mean it informs the whole book, but you'll know there is one story of somebody I talked to who reflects on his own experience, finding out through a DNA test, of all things, which is something that people are very familiar with, so you know that is something I write about in the book because often people think that genetics will explain their skin colour or something about themselves. But I think it ends up in some ways reinforcing this furious idea of race as a biological fact. But I do talk about somebody who is the grandson of, he discovered, of a woman who was removed from her family. And I just don't think we can come to terms as white Australians with the ongoing trauma of this that comes through generations. And for him, skin colour was a part of that because he said, ‘I'm actually quite fair’. And yet this is his culture, not something he claims because he understands that that takes work much more than a DNA test result. But history runs very deep.

ASTRID: You also go through the science of skin. Now I confess I remember my high school biology very badly, and this was a very good refresher for me. But I do have to ask, there is a section where you talk about how we all sweat and humans are the mammals that sweat the most, and a few of us don't sweat. And I just have to ask, that did make me think of Prince Andrew. Do you have any insight there on sweating or not?

PHILLIPA: Yes. Some people, for various complicated reasons, do not sweat. And I don't mention Prince Andrew specifically, but Astrid, it's funny you mentioned that because there is a kind of secret reference to him in a footnote where I read something which had a heading like... I think it was in The Conversation, ‘Why don't some people sweat’, and it mentions him. But, I mean, everyone sweats to a degree. We wouldn't be human if we didn't. It's an essential mechanism. It's an essential physical function. But with many people it's much less obvious, and for whatever reason the bacteria on their skin, I don't want to get too gruesome here, don't gather around sweat so it doesn't smell.

And then, of course, conversely, there are people who sweat excessively, and I had quite a lot of fun rewatching Broadcast News, which has a famous scene of a flop sweat, so I write about that. And I thought twice about whether even mentioning Rudolph Giuliani's notorious kind of... It was like he was melting, and he had hair dye running down his face. The whole thing was just so disgusting, but I knew that people would remember it, so I mentioned it. But I actually had a lot of fun, more than I expected, with the science research that I did. That was, for me, one of the big surprises of this book for me as a writer. I discovered I really like writing popular science kind of stuff.

ASTRID: Look, we all need to understand science a little bit better. I would like to just touch on the chapters on dermatology and dermatologists. Now, full disclosure, I have multiple sclerosis, which listeners of The Garret know, but what is relevant here is as a side effect of my MS medication, I have a variety of extremely severe skin conditions. I've been seeing a dermatologist for years and that doctor has let me keep my confidence. And often my skin concerns upset me more than the actual MS, which is not rational, but is nevertheless my emotional response. And you talk a lot about why dermatologists sometimes aren't considered real doctors, and all sorts of things like that, despite the fact that we all hope we present okay to the world in order to function in it.

PHILLIPA: Yeah. It's a huge paradox where people say, and it's often people with very good skin who have no problems, who don't have to worry, they'll dismiss skin concerns as being trivial and they'll say, ‘Oh, it's what's inside that counts’. This book in some ways is a reaction to that because I guess what I'm saying is, ‘Look around. Look at how the world works. Look at how power is structured. Clearly it's not just about what's on the inside that counts’. And I think for better or worse that a lot of dermatologists are kind of caught up in this. However, I feel like I've used this phrase many times through our conversation, it's complicated because it is. Dermatologists earn a lot of money. I think when you look at the hierarchy of specialist income in the medical profession, they're right up there, and they can do a mix of private work.

There aren't enough dermatologists in public hospitals, and of course they can do cosmetic work and charge, basically, whatever they want and people will pay. I think there's probably some professional jealousy there. Also, skin conditions can be deadly. They can have terrible psychosocial impacts, but most of the time people don't die from their skin condition. They'll die from something related. And even with melanoma, which while it is much less deadly than it used to be, still has a terrible, terrible death rate. Thousands of people in Australia die from melanoma every year. Most of the time, the dermatologists are not going to be dealing with patients with severe melanoma. It's the oncologists, or others in the profession. I think that a lot of their fellow doctors dismiss them. They say it's just all creams and antibiotics for acne. How hard can it be?

My admiration for dermatologists grew in some ways, in many ways while I was doing the book and talking to a lot of them. But I really had a reality check when I spoke to an extremely confident articulate young woman in the book who has suffered for her whole life, since she was a baby, from extreme, full-body eczema. She hates dermatologists. She says they've ruined her life, they've ruined her mother's life. Nobody looks at her chronic condition as being chronic in the way that people think about other chronic illnesses. She was angry and I could see why, because she felt like she'd been dismissed by dermatologists. There are all kinds of nuances and complexities even within the profession. But she asked me a question, which has been resonating through my mind for the past however many weeks since the book came out. ‘What do dermatologists think of it? How have they responded?’ She said, ‘What are they saying?’ And I don't know. I've heard very little.

ASTRID: Well, I'm going to give this book to my dermatologist so I will keep you posted.

PHILLIPA: Yeah. I would love that. My dermatologist liked it, but maybe that's just because he's in it and he's a very generous person. But I wrote something about dermatology and the challenges that the profession was facing in The Guardian recently, and I sent it to the Australasian College of Dermatologists. Nothing. Complete silence. So I am really interested to know what they think, but I'm not an expert. I'm not pretending to be an expert. I've never published anything in the American Journal of Dermatology and I never will. But I think they would learn something about how they're perceived.

ASTRID: I have no doubt. Phillipa, can I ask, what next? What is your next project?

PHILLIPA: I don't know. I genuinely do not know. At the moment I'm working as editor of Openbook, which is the magazine of the State Library of New South Wales. I'm finding that publishing a quarterly glossy magazine is all-consuming. I had had an idea percolating in a very gentle simmer, like hardly discernible at the back of my mind for a book. But I saw recently that quite a well-known American non-fiction writer has just published that book that I wanted to write. Damn him. I don't know. I truly do not know, but something will come.

ASTRID: It definitely will. And I would like to suggest to you, do the book for the Australian context because we are not Americans.

PHILLIPA: Yes. It's true. It's true. And that would work in this particular... I don't want to give anything away.

ASTRID: I won't ask any more questions. I won't. I won't dig anymore. Phillipa, thank you so much for your time today.

PHILLIPA: Oh, it's been a pleasure. I love talking to you, Astrid.