I have a three-inch scar on the right side of my head from the top of where my ear meets my skull upwards. This wouldn’t be noticeable except for the fact that I also have pretty standard male pattern baldness and so I sport a fresh clean shaven head. The result is a hand carved seam down the right side of my head. I don’t see it everyday myself as it’s outside of my field of vision. When taking my photograph though I do request you only use my good side. This is in all my contracts – or rather it will be if you’ll just sign on this line here… and then initial here… Great, now here’s the story:
I was fairly complicit to the installation of this flaw on the side of my large but otherwise perfect cranium. One of my cheekbones failed to come forward during development leaving me with a distinctly asymmetrical face. The medical term for this is, I believe, a craniofacial anomaly. In researching for this post I found that Lincoln was known to have this as well, although his may have been caused by being kicked in the head by a horse. What an interesting fact that no-one mentioned to me while I was younger. Looking back it seems to me the attitude was always that this needed to be corrected. Mom and Dad both work in the health insurance industry so the focus was always in getting this documented and thereby covered by insurance. The word deformity stood out. The idea of keeping the face I was born with never occurred to me.
When I saw photographs of myself when I was younger this defect was all I could see. Now I often don’t notice my cheekbones at all, even though one of them is made from ground coral mixed with my own blood to form a bone-like substance and an overall effect of having two accurately formed cheekbones. I do in fact notice the three-inch scar much less often than I would the lopsided face I was granted at birth, so I consider this entire effort to be a net gain – analytically. I’m realizing that sometimes the scars we bear aren’t just the ones on our surfaces.
Cheryl St. Germain wrote a moving collection of poems in her book Making Bread at Midnight including a piece about scars. The full text escapes my memory but I do remember this much:
And the scar is not the wound but a reminder:
Something happened here
Letting the this idea sit with me for a moment I can say that I don’t usually focus on the history of any of my scars. I have two others that mean much less to me. My thoughts usually languish towards wondering if I should have done something differently. In the case of this elective surgery, they did indeed offer to “go in through an incision inside your mouth” which scared the hell out of me. I saw the demon dentist of rural Dallas growing up – he was just bad at anesthesia – but the idea of going in through my gum line wasn’t even broached until the morning I was already wearing a backless gown and purple marker on my face, so I didn’t have much time to think before I simply said “no”. This is still how my knee jerks when I’m in fear.
My father tells me that during the various check-ups as I was growing up – when my progress was all logged in a seemingly air-tight case my mother was building to get insurance to pay to correct my face – a surgeon explained during the 80’s that they would be happy to go in and work on my face. The process at that time would involve incisions circumnavigating my visage and then lifting it off entirely. This was still a few years before Buffalo Bill asked his captive to Put the Lotion on it’s Skin or else, so my father, as any protective authority might have, took a pass on the pay us to turn your child’s face into a meat mask version of this procedure. As I write this I wonder what my scar might have looked like in that case. I also wonder if maybe I should have waited another decade to see what other, possibly less invasive, procedures they are doing these days.
There’s a recent movement among patients rights groups saying that the terms Invasive and Non-Invasive and Less Invasive in regards to surgery need to be more clearly defined to patients. I can tell you that while the procedure I underwent was much less Invasive then what the Dr’s from the Hannibal Lecter School of Maxillofacial Chicanery and Other Forms of Voodoo might have done to me, but I now suggest caution to friends and loved ones that ask me or even mention having anything ‘done’. Sometimes it’s better to choose the Devil you already know. In this case what was done to me was less invasive than what they used to do. That didn’t make it a walk in the park.
Moments before the operation, a handsome and suave young anesthesiologist came in and took my hand. He looked into my eyes and insinuated a tiny little heavenly drip into it. So light, so supportive and upbeat this man was. His good looks were matched only by the potency of his elixir. He asked me to count backwards and as I did, my hand then my elbow and then my shoulder each in turn relaxed into a blissful easy euphoria. Even now as I think of it I can see what Michael Jackson was on about with Propofol. Then I went to sleep.
At some point a tube is placed down my throat to take over my breathing. This is necessary so they can slice the side of my head open, tunnel over to where my cheekbone had failed to report for duty, and then insert a piece of bone made from ground coral. Evidently this is not well tolerated while the patient is still awake even if just enough to handle their own autonomic functions.
So 
after the cheek implant is placed and another on the side of my nose, it’s time to close up and take the tube out, wake the patient up and thankfully offer him some pain meds. True to the consultation I was given, when I awoke I felt like I had indeed been hit in the face with a baseball. I’ve never taken a Beat Down but I imagine this is what one feels like. Remember Lincoln was kicked in the head by a horse so I’m still in good company. Where is my monument? And can I get some ice chips?
My head was wrapped like a giant Q-tip and a device called a drain was in place. Before I explain what a medieval device the drain is, let me take a moment to explain why they tell patients that “all surgery involves a certain amount of risk”. I recall dreamily drifting back towards the sound of my name being called. When I realized I needed to wake up, someone inclined the chair I was in so that I was sitting upright. My head was throbbing. Gauze was wrapped around my head and jaw making movement difficult. Then I coughed. I tasted rich copper. I covered my mouth to cough again and when I withdrew my hand I saw bright red blood.
Evidently when the intubation tube comes out there are sometimes issues. One of these issues is called a laryngospasm– the scrabble word of your wet dreams – which in my case meant “bleeding into your own lungs due to removal of giant tube.” Luckily a nurse in the recovery room was sitting with me and she acted quickly when she saw me gasping and coughing up blood. She shouted orders and I fell back asleep to her assurances I was going to be ok. I welcomed the dreaming state again as the throbbing wasn’t there with me in that blissful drifting. Did anyone get the number of that horse?
When I next awoke I was in a regular hospital room. Systems Check: Head like a Q-tip? Check. Massive throbbing headache? Check Plus. Hunky anesthesiologist? Back in my dreams. Damnit. My parents were now present. I can recall the dark green of my fathers’ suspenders with his belly protruding between them, his arms resting on top of that. His undivided attention on me, propped up in the hospital bed on a large mound of foamy pillows. There’s a plastic tube with a dark fluid obstructing it running down from my head attached to a depressed plastic bulb the size of a grapefruit. This is referred to as a ‘drain’. It was most certainly a drag. The plastic tube ran into my head through the still bleeding incision above my right ear. This was not the pretty side of plastic surgery. My father told me I had ‘done well’. I complained about the pain and was given two of the largest pills I’ve ever seen.
In the morning I awoke early with the throbbing of my head still present and nudging me out of the cocoon of medicated blissful snoozing. I tried to lift my head and it was then I realized that my pillow was soaked with blood. As was the pillow beneath it. This was an alarming amount of red. It made returning to sleep unlikely. I was an avid fan of the hit TV Series E.R. and the Honorary Doctorate bestowed upon me by NBC for all my faithful years of viewership was telling me this was not good. Code Blue people, CODE BLUE!
My nurses were rather nonplussed about the whole thing. They assured me that with steady pressure the bleeding would stop. I thought the ruined pillows to be rather alarming but as I say, the nurses took this all in stride. If they were concerned it didn’t show. I can imagine there must be some giant foam pillow dispenser where they can simply grab another and then another when this happens. Like Post-it notes or PEZ you can just grab another.
Hours went by with me holding pressure to the side of my head in an attempt to stop this bleeding. It wasn’t a torrent of blood, this wasn’t some scene from Monty Python’s Salad Days skit. It’s just a drip like a faucet some surgeon left running in the side of my scalp. It’s exactly like that.
Surgery was on a Friday. I know this because it was Saturday and my Doctor wasn’t answering phone calls at 730am. Finally some genius Nurse let us know that my Dr. needed to cauterize the blood vessel that was leaking through my Gauze Bandage Burqa. As I sat there I contemplated my faith. Was I being punished? Could I wear this head wrap in public for the rest of my life, and how long would that be?
Finally my Dr.’s office answered around 9am and said he’d be available after 10am to do this procedure. When the Dr. arrived he knelt over me with a tool that looked like a hot glue gun. He zapped my head as easily as operating a price scan gun. I felt nothing but the issue of blood was healed. The drain was still in place. This was to stay with me several days. I could feel the tug of sequestered life on my heart strings. I could become a shut-in, a recluse or some sort of hermit. Maybe I could live in a bell tower somewhere. It’s too bad there’s a major cathedral draught here in Texas.
In the recap from my surgery I was advised that my face would grow new blood vessels to support healing the damage from the incisions. This would lead to dark circles under my eyes. I suppose I would have agreed to these as readily as I did everything else they warned me about. How badly I wanted this surgery – nothing would have deterred me. I was 18 and this surgery had been promised to me all my life by my parents and various Dr’s. I was told we would do this ‘once his face has stopped growing.’ Looking back I see I may have lied to myself about what this procedure meant to me and what I thought I would be taking away from it. Still if the mission was to remove notice from my cheekbones then this was a rousing success.
Tina Fey wrote in her new book ‘Bossypants’ about her own scar and how she came to have it. She wrote that she can judge people based on how they handle or don’t handle their own curiosity regarding her scar. She said she doesn’t enjoy talking about it but that she feels we deserve something for having bought her book. I love a girl that puts out. (Go get her book, totally worth it) Tina not only explains her scar quickly like tearing off a Bandaid with sincere and frank language. She later shares several fun anecdotes involving times she’s been interrogated on the subject from complete strangers. Following is an attempt to provide you for free a similar experience from my life.
I was attending a conference in San Antonio with my friend Jeff from New York. Well, Jeff lived in NY for long enough to be cool, but he’s really from Dallas. Through a sequence of misleadings we ended up at a La Quinta. The event did include the phrase “World Conference” in it so it was a surprise both to me and also the man behind the counter when I walked up and announced I had just booked a room on the drive over. We were lucky to get anywhere as nice as this on such short notice.
However – In the morning there was not coffee in the room I’m not very spiritual in the manner in which I treat my fellows until I’ve had at least a sip of coffee in the morning. I headed downstairs, NY Jeff in tow, for the slowest elevator ride of the day. We stopped on a few floors and picked up a good crowd heading down to the ‘free buffet breakfast’. The others riding on the elevator are of various description most wearing the conference name tags around their necks in a way that announced at just before 7am in this overly bright La Quinta lobby, they were ready to be greeted on a first name basis. I was not wearing my tag.
I tried to take little notice of the tall man with curly hair and flip-flops we picked up from the second floor. (Come on people, one floor and you took the elevator?) As we disembarked from the elevator I slid out in front in front of the pack with eagerness. Jeff has more restraint and so the out-of-towner ended up in-between us. I felt a sharp poke in my back causing me to tense up reflexively. “Hey – did you have cancer?” I hear in a deep baritone.
A quick one-two punch of boundary crossing and I was left stunned and silent. I somehow just walked onward, desperately seeking coffee. Must. Not. Eat. Alive. How far could the dining area possibly be from the elevator? Undaunted this man pressed his concern with NY Jeff. “Hey did he have cancer? Did your friend have cancer?” NY Jeff quietly let the man know his inquiry was not welcome and rather inappropriate and then didn’t mention it to me again. I love my friend Jeff.
Looking back now I wonder if dude-guy from the elevator needed to talk about some cancer situation in his life. He had a full head of hair so I was unable to diagnose him as easily as he had diagnosed me. I probably handled things well enough. I have told people that my scar is from when ‘they had to remove part of my brain.’ Then it’s fun watching people try to figure out why it would be that ‘they’ had to remove a part of my brain. I don’t know what people think about my scar. I gave my psychic powers a few years ago. I would guess there would be a tiny thought that says ‘I hope that never has to happen to me.’
As I wrap this up and prepare to submit it I realize this is just another fabric remnant of experience that makes me the quilt of fun that all my friends adore. Horse kicks to the head were evidently more common back in Honest Abe’s day, and unnecessary surgery is way more common today. I’ll be showing this to my analyst and thank you for making it through this with me. As a reward, here’s that Monty Python sketch.
(Images from flickr.com)
