The Shit Never Falls Very Far From The Bull
I’m quitting my lying, gaslighting, two-faced plastic surgeon and his patriarchal crap.
I visited my plastic surgeon for what will be the last time the other day. I left his office feeling more demoralized than ever, and that’s a lot, because when I’m honest with myself, this happens every time.
First, let me set the stage.
There’s a waiting room the size of my house. The minute I step through the tall double doors I am knocked down by the smell. I feel my body absorbing the toxic stench of an air “freshener” I imagine is probably called something like Fresh Breeze. If only.
This, I choke on, while I sit on gauzy pink chairs and gaze at a display of brochures. These offer hints about what goes on here inside the pink and gold encrusted walls. The offerings are too many to name, but range from all manner of injectables, to various “body contouring” options, to things that have to do with hair. It seems us women have either too much or too little, and it’s constantly sprouting up in all the wrong places. These treatments, and everything else they do to a human body here, seem to be based on the assumption that nature got something wrong.
The skin treatments all have fancy names that sound as though sports cars and Rambo got together and had a baby: Dysport, Restylane, Revance, Daxxify.
The receptionist’s face appears to be stuck in a very surprised expression. I suspect her job includes some perks, like discounts on laser eyebrow hair removal and Botox. It’s also possible things were so dire, she reached for Morpheus 8. That’s what you’ll need if you have to address “deeper imperfections.” The whole thing makes me want to go to sleep.
I shouldn’t judge; I live in a glass house. I’m here because I opted for replacement breasts. It’s an insane procedure, in which the source material was harvested from my very own belly.
In fairness, all my options were shit. I just chose the one I thought I’d best be able to live with. Whether that turns out to be true or not remains to be seen, as right now things hang suspended in limbo. I’m waiting for the re-purposed tissue to adjust, so everyone can see what I’m left with once the dust settles. All along, I’ve been promised that this would be a two-phase process: first, the transplant and hope for its survival, then four to six months later, the revision. That’s when they plan to fine tune things.
When it comes time for the revision, the technique used to achieve this small miracle is called fat grafting. It comes down to sucking fat from one area of the body, and injecting into another. Hopefully they’ll be able to address asymmetry, make me some convincing nipples, and even out the ripples and valleys that currently spread from armpit to armpit across newly formed mounds which are supposed to resemble breasts. It’s like abstract art right now; if I stand way back from the mirror and squint without my glasses on, I can almost see it.
All of this follows the double mastectomy I had to have in February because of a non-cancerous breast disease that was causing endless, dangerous infections. Enroute to exploring that problem, a ton of masses were found, which were well on their way to becoming cancerous. So it was that all of a sudden, the boobies had to go.
I couldn’t get right with the idea of going flat. I didn’t want plastic in my body, so implants were out, and this was my other option. It’s called DIEP Flap reconstruction, so named for the Deep Inferior Epigastric Perforator vessel that had to be harvested from behind my abdominal muscles. The result is that now, my belly is where my boobs should be.
I’m only eight weeks out, and while the scars on my body resemble those of people who have come to this clinic opting for “Mommy Makeovers,” breast enhancements and other “body contouring” options, I’m not actually here for fun. I’m not trying to win any beauty pageants. I’d just like to feel whole, and to have the trauma of an unexpected double mastectomy smoothed over a bit.
I want to pause for a moment to point out that all the aforementioned procedures available at this clinic are aimed quite specifically at women. Here are just some of the options on the menu:
Diamond Glow, Microchanneling, Dermaplaning, Microneedling, Chemical Peels, Arm Lifts, Body Lifts, something called “Body Tite,” Liposuction, Thigh lifts, Tummy Tucks, and much more. This is by no means an exhaustive list.
If you happen to possess a different arrangement of chromosomes, your choices are much simpler. In that case, just choose from three options under “Men’s Services.” Men’s Botox, Love Handle Reduction, or Male Chest Reduction.
This quick comparison offers a glimpse into how many fewer things seem to be inherently wrong with men. There are far less in the way of flaws that need fixing in order to make them presentable, and their defects get cute, unscientific names. Love handles and chests are so much easier to talk about. They just roll off the tongue, unlike complicated words such as areolas and abdominoplasty.
Once I am called back into an exam room I have to sit on the uncomfortable table in my one-size-fits-none gown, staring ahead at a glass display case on the wall. This advertises a very expensive and much more private option: Vaginal Rejuvenation. I guess this conversation is something they save for the exam room, to discuss in hushed tones on the down-low, as it were. After all, it bears the dark mark of the V word.
I can’t bear to look at this nonsense, but when I do, I see red. It tells me that 90% of women do not seek help for vaginal anatomy symptoms. I am a little confused. What is the problem, exactly? Symptoms are a sign of a problem, yes? But here, it seems the only issue is that one was born with anatomy that included a vagina.
Well, you know what would really rejuvinate my vagina? Not being made to feel badly about my body or my face, or even the accursed peach fuzz that covers it and other unseemly places it has dared to grow. Perhaps when these people look at me, all they see are dollar signs where deeply set lines lie in grooves between my eyebrows.
But goddammit, I’ve earned these wrinkles fair and square, laughing, living a textured life, and worrying about REAL PROBLEMS for the last nearly five decades.
I’m feeling my frown lines deepening by the time the doctor finally makes his appearance. By this point, I’ve nearly forgotten why I’m there because I’m just burning with one very important question: Who, exactly, benefits from us feeling badly about our vaginas?
On the website there’s a series of mugshot-like photographs. Headless front and side views show us the before and after shots of brave people who have undergone “Mommy Makeovers.” There is a brief description with stats on each subject that reads like an ad for new tires.
51 year old female, mother of 3, 5’5”, 167 pounds, pre-operative bra size 36B, post-operative bra size 36DD.
More important statistics and a little more information might offer deeper insights as to why these women’s pre-operative breasts hang heavily toward the floor. I’m sure there’s a perfectly reasonable explanation for why her nipples sag, her shoulders slump forward, and her pre-tummy tucked tummy boasted such an excess of wrinkly skin.
Here’s an idea for a rewrite:
This strong woman gave 30 months of her 51 years over to carrying 3 children inside her incredibly resilient skin. Using pure grit, she spent a cumulative 96 hours pushing these babies out from between her pelvic bones, then spent 1,467 days nursing them. In the process, she lost approximately that same number of nights of sleep, missed out on other meaningful work to care for sick children for decades (on average, about 10–20 days per child, per year). She lies awake worrying one out of every three nights since becoming a mother in her early twenties, and has been ignoring her own needs in favor of fulfilling those of her family for most of her natural life.
When you put it that way, it’s pretty easy to see why breasts might become tired and bow their weary heads. In a world fashioned after my own design, such a body would be celebrated, known to contain all the wisdom it has earned through every minute of its hard-won age.
Alas. No one asked for my input when they were designing worlds.
The “beauty” industry is not getting rich by saying you’re just fine as you are. These corporate muckymucks line their pockets with our poor self-esteem. My doctor, with his white coat and thin lips that never smile, is certainly looking to be doing quite well in his exploits of our insecurities. The five-figure interior decorating job it must have taken to slather everything here in such petal soft pink and tasteful golden hues, along with his brand new shiny Escalade sitting out in the parking lot tell me so.
Of course I understand perfectly well that it’s every woman’s right to have these “enhancements” done, if she so chooses. I totally support people having full agency over their bodies. Of course! What I am questioning are the many insidious forces that have caused her self-loathing in the first place. I do not judge anyone for electing to undergo these painful procedures, only the society that has created them.
What brought me back to the clinic today are dark spots on my newly reconstructed breasts.
Necrosis is a risk with this surgery. I was warned early on that if any shadowy spots emerged after my operation, no one would be doing anything to address them until well after four weeks. It would take at least that much time to differentiate between bruising and discoloration and such. I understand this is just what comes with the territory of having one’s body run through the Cuisinart. That’s why I’ve watched and waited. That’s why, recently, I sent pictures through the app so that the nurses, the gatekeepers, could decide whether my request to see the doctor was truly valid.
By now, in all of our back-and-forth, I’ve heard them say both that I’d need to wait for four weeks to further evaluate this problem, and also that by now, it’s unlikely anything is wrong. So which is it?
Things have been shifting — settling, I guess you could say — since the surgery, and not for the better. I’m so weary of the dysmorphic relationship I’ve been having with my body since…well, forever. But in particular, I’m very much looking forward to the getting past the revisionary surgery I’ve been promised at the 4–6 month mark. Most of all, I’m sick to death of the pain that I’ve been having to endure for such a long time, first leading up to the surgery, but now more acutely, since.
After two hours in the waiting area (because they had to squeeze me in), and fifteen minutes in the exam room, the doctor finally waltzes in. He barely addresses me before he’s opening my gown, poking, prodding, and squeezing my half-finished breasts.
“Looks good. Better than in the picture, really.” Now he stands with one hand on the doorknob. This is his go-to move, and if I had to choose only one thing to fire him for, it might be this.
“How do I know if there is fat necrosis?” I ask.
“Well, it is fat necrosis, by definition.”
“Okay. Soooooo, what do we do about that? Is it something you’ll just address during the revision, or…?”
“Oh there’s no way I’m operating on you again. Not for at least six months. And I don’t mean six months from the first surgery — I mean six months from now. Not with the amount of pain you’re saying you’re still having.” He chuckles a little and shakes his head. “And even then, we’ll just have to see.”
I notice how he builds his statement around a doubt in my credibility, pointing out that it’s only me saying I’m having pain, not someone with actual authority. Does he think I’m making this up?
I don’t have time to reflect on that linguistic nuance just now, or even the fact that he seems to be leveling my own pain against me, weaponizing it, almost. With the tone he’s using, it’s like the second surgery is a delicious dessert that I’ll not be granted until I stop whining about having to finish my Brussels sprouts. Father knows best.
I am reeling, and truly shocked. Denying the existence of my pain is one thing, but denying me the revision is something else entirely.
We’ve had an ongoing conversation about my persistent pain since I was still in the hospital, and now we’re having it again. With his hand on the fucking doorknob.
“I mean, am I any different than anyone else at this stage? You said I would have the revision four to six months from the initial surgery date, because it takes that long to heal. So why wouldn’t I still hurt at eight weeks?”
I have been talking to several women who have gone before me into the realm of DIEP Flap reconstruction, and they’ve all told me to expect months and months of pain. More than one of them is still eating nerve pain medicine more than a year out. So I’m not expecting to be out of the woods just yet.
Now he doubles down, because, God forbid, I’m keeping him in the room with me, and worse, I might be an informed woman. I can tell he’s just dying to get the hell out of here.
“Look, I’m not going to promise anything about when we’ll do the surgery. Notice how I don’t even say what I’ll do, in terms of a revision? (Oh yes, I’ve noticed.) That’s because I can’t tell what you’re going to need until more time passes. You might not even get that surgery. For sure, though, you cannot still be in pain, going into it.”
When I make it clear I’m not done discussing this, with an exasperated sigh he releases his death grip on the doorknob and sinks down onto his rolling stool with a a big flop, for effect. The leather upholstery hisses under the weight of him.
“Look, don’t base your life around the idea of a certain date for the revision. Some women go years before the revision. Right now it’s time for you to go back to the normal activities you were doing before the surgery. If you were a rock climber, go to the rock gym. If you ran marathons, sign up for a race. You shouldn’t be having any more pain at this point. If you are, it’s because you’re not working hard enough to get back to your normal exercise routines. Join a pilates class. Because I’m telling you, everything looks fine.”
I can barely contain my emotions now. I’m not sure what part of this speech angers me most. My physical therapist has instructed me not to do any abdominal exercises for twelve weeks. I tell him this, and he says if I’ve come to him for answers, his answer is: join a pilates class.
“If you keep going to a bunch of different people seeking guidance, you’re going to get confused.”
“But… you referred me to the physical therapist?”
I’m so mad, I could spit. Because, as it turns out, I do happen to be basing my life around this. Besides the little tiny fact of how painful and limited my body feels, going through ten years of breast disease, which culminated in relentless infections, four biopsies, three MRI’s, countless ultrasounds, mammograms, a ductogram (that was fun!), and two surgeries just since December, you’d better beleive this little problem of mine has been dictating everything about everything. Not to mention, my husband is patiently waiting for this series of operations to be behind us before trying to get a better job. And this, he desperately needs.
As an aside, have I mentioned how much I abhor bounce back-culture?
It’s a capitalistic crock of shit that the need for incessant productivity dictates we should never take any time to rest, to grieve, or to feel the things that are happening to us. Most of all, I can’t stand that we expect women to leap up with rejuvenated vaginas from period cramps, childbirth, miscarriages, breast disease, or any number of other calamaties we endure, to put on white miniskirts and act like nothing significant is going on.
My own beloved vagina is going to shrivel up and die if I have to listen to one more word of this abusive gaslighting. And I promise, there’ll be no product under the sun strong enough to resurrect it.
I don’t try to explain any of this to the doctor. Nor do I question his horrific bedside manner, or even call him on his outright lies. Why? Because I’m busy trying to use my allocated three minutes of his precious time to get what I can in the way of help and actual answers. Namely: Are my breasts rotting off my chest? When will we fix this nightmare that is my chest? And is the pain that is my chest anything that he’s planning to address, ever?
It is about this last point that he tells a flat out lie.
For days I’ve been going rounds through messages on the app about the need for more nerve pain medication for this invisible barbed wire bra I seem to be stuck in. I was told to seek any future refills from my primary care physician. This made no sense to me or to her, once I was sitting in front of her asking for it. I tell him that now.
“By the way, my doctor was confused as to why you referred me to her for post-operative pain relief.”
“I didn’t,” he says.
That’s all he’s willing to say about that. I see the nurse turning a little red in the corner as she types away furiously on the computer. Her perfect, unflawed brow tries to furrow ever so slightly. Maybe she was the one who sent me the message about that. It’s impossible to say; no one ever identifies themselves during our mysterious online interactions. Maybe she went rogue when she refused to fill my prescription, and she’ll get chewed out for it later. Even if that’s the case, the doctor is clearly the leader here, the one who wears the pants. She’s just reading from his playbook, and there’s one thing I’ve learned: the shit never falls very far from the bull.
Either way, it’s not the only time he’s been dishonest, and I realize all of a sudden, with bile rising in my throat, that I do not trust this man. I do not like that from one appointment to the next he can’t remember anything about me or my process. He never seems to recall that I don’t want implants, so we’ve had to go over this every single time I’ve seen him. I even had to remind him of it when I was getting wheeled back to the operating room, along with the fact that I plan to have nipples again someday. He can’t keep it straight.
If my half-million dollar surgery doesn’t hold his attention, what on Earth will?
My husband told me that during my ten-hour anesthesia sleep, the doctor came out to the waiting room and said my left breast had developed a clot right at the point where the new vasculature was being constructed. “We had to tear the whole thing apart and start all over again,” were his exact words.
When I was early in the days of navigating my newly rearranged body, I had a lot of trouble with swelling under my left arm. I wondered if this had anything to do with that problem in the OR, or if this issue was coming from the drain, which had also developed a clot when I’d vomited a bunch. I brought this question to the doctor during one of my visits.
“No. That was the right breast,” he said, with no further explanation. (Hand on doorknob.)
My husband took the high road and assumed he’d misremembered which breast the doctor had told him about on that anxiety-riddled day. And I’ve been willing (up until now) to overlook his personality disorders because all I’ve heard, everywhere I’ve gone, is about the perfection of his work. When I pause to reflect, though, I realize even that has not been my lived experience.
I’ve kept having one issue after another, and a lot of confusion over what, exactly, has happened. So much so, that a few weeks back, I requested a copy of the operative report. And guess what? There’s not one mention of the clot or the re-reconstruction that happened on that fateful day. Nothing. He’s rewritten history, just like too many other men in my life. They always do seem to come out looking stainless.
I don’t pursue this, or the current angle of our conversation about my pain any further, because it’s been made clear there’s no point. However, I am confused about one thing.
If I’m “fine” enough to run a marathon, why am I in pain? And if being in pain is not normal, how am I “fine?”
But by now I’ve lost all ability for eloquence. I can no longer form sentences that carry us any closer to my goal of obtaining meaningful information. Our conversation has become circular, and I accept defeat. If he’s trying to get rid of me by driving me insane, it’s working. I want to cry and yell and throw one of the gold plated fake leaf doo-dads from the decorative shelf that serve no purpose, other than to remind me this guy has more money than heart. He bolts from the room, to literally wash his hands of me.
The nurse has some more clicking to do on the computer before she leaves the room for me to get dressed. I ask something about scheduling the next appointment and she launches into a diatribe about how I may not even be a candidate for a revision. She reviews the fact that it involves fat grafting, which means liposuction. “And lipo is really fuckin’ painful,” she says.
Oh, I see. So they don’t think I can handle it because I’m sitting in here, eight weeks out from having my breasts removed and getting my belly cut open and stuck to my chest saying, Gee, it really feels like my breasts have been removed and my belly’s been cut open and stuck to my chest.
Never mind I’ve experienced unmedicated childbirth. Never mind I’ve endured searing chronic pain for decades. Never mind I’ve done this and all manner of other hard things these people have no idea about, all while spreading love and joy to the people around me.
Well, I am damn sure not stopping the surgery train here. I do not plan to live out the remainder of my days in this half-cooked, half-rotten, mutiliated state. But you know what? Fuck these idiots. There are other plastic surgeons in the world.
Courtney Granger was a beloved musician from the area we currently call home (Lafayette, Louisiana). Sadly, he passed away a few short years after this video was made, and though we never got to meet him, he is missed terribly by everyone here. Hazel Dickens composed this song. She and Alice Gerard, two long-time-all-time favorites of mine, first released it on their album “Hazel & Alice” (Rounder 0027, 1973). Sadly, Hazel left us, too, in 2011, but Alice appears here singing harmony with Courtney and Ginny Hawker. Enjoy!
Original collage art made from recycled magazines by the author.
As I navigate my own protracted recovery, I find so much to relate to in your frustration. Since I'm a guy, and older, and recovering from an entirely different medical situation, the specifics are (obviously) different, but dammit, the attitudinal bullshit is so much the same. Thanks for sharing your story so openly; I find your bravery inspiring as I swim through my own little cesspool of doctors.
What a heartbreaking journey!
More money than heart.. unfortunately money is the heart of the pharma-industrial-complex, and many doctors buy into that business model.
Best wishes, always, with admiration for your resilience and bravery and gratitude for exposing the shit of these bulls 💕🙏