The Artist

Room detail, Metropolitan Museum of Art in NYC

Over twelve years ago I met an artist.

What she had was a gift. I never had to tell her what to do. It was like she just knew. Left to create on her own she did the most amazing work.

Today was my last appointment with her. 

My hair stylist is retiring and I am grieving. She was the first and only person to ever take charge of my hair and make it look GOOD. She made me feel better about my hair, about myself. I cannot put into words how important and life changing that was.

When I ask patients what they do, often I’ll get the, “I’m JUST a…. fill in the blank.” Hair dresser, office worker, mail handler, Mom, etc. I hate, hate, hate that phrasing. 

Never doubt that what you do has an impact. No matter what your job happens to be, it matters to someone. 

It matters to me.

Maybe I will find someone just as good. 

Maybe I won’t. 

I loathe this kind of change so it will be a growing experience regardless but for now, I grieve. She was an artist in the true sense of the word and she will be missed.

The Boobs Have It

Display in museum in New York City
Do you know how many breasts I have touched? 

Thousands of them.

It is staggering when I reflect upon it. 

So many breasts. So very many. All shapes and colors and sizes. Hairy. Not hairy. Moles and rashes and skin tags galore. Droopy. Perky. Somewhere in between.

During breast exams I have for years and years referred to the exam as the “boob check.” Whenever I made reference to my breasts of anyone else’s I nearly always called them boobs or boobies. 

To be honest, I thought it was cute.

Touching another woman’s breasts makes me uncomfortable, maybe even a bit embarrassed. I feel the same when someone else is looking at or touching mine in a nonsexual, clinical sort of way. So I made fun of breasts and joked about the situation. It took some of the sting out of the situation to act goofy.

One of the many beautiful things about blogging  is that from time to time someone says something that makes me reexamine a part of my life and causes me to make some changes. 

Mark at Exile on Pain Street made a comment on one of my blog posts a while back (ok, maybe it was WAY back in July of 2015) that has stuck with me:

“I hate that word. Boobs…. Boobs sounds comical and crude. It lacks decorum. They’re beautiful! Not something to make fun of.”

This. From a MAN. 

At first, I blew it off. What does he know about women’s bodies anyway? What gives him the right to tell me what is disrespectful about the term boobs. I can can dang well call them anything I want, can’t I? I own a pair after all.

But it ate at me. 

And I felt kind of guilty.

I would take that comment out from time to time and chew on it. The word boob is, after all, another way to refer to someone who is a fool. An idiot. My breasts are way better than that, aren’t they? So are every other woman’s breasts for that matter. They give pleasure. They give life. Right or wrong, so much of who we are as women is wrapped up in these exocrine glands. I would never tell a man to show me his “twig and berries” if I were doing a genital exam. Why do I persist in denigrating the female anatomy during office visits? 

Excellent question.

Yesterday I was telling a woman to change into my lovely blue paper gown so we could do a breast exam when it struck me…

When was the last time I called them boobs?

It had been a long, long time, I realized.

And that made me smile…

Uncovered

Mission ruins, San Antonio

“Mommy!” my daughter gasped urgently. “Look, she’s a mermaid…” There was reverence and surprise in her voice. 

Imagine meeting a mermaid here!

“Yes, she is…. now, shhhhhh,” I responded.

I held my breath waiting for my little girl with no filter to say something about the woman’s size. She was probably close to 400 pounds and she was wearing a two piece bright purple and turquoise mermaid swim suit like it was the most natural thing in the world.

Mercifully my daughter said nothing more. Instead she snuggled up against me wrapped in her towels and fell asleep, smiling. I am grateful that she and the towels completely cover up my thighs.

I found myself very jealous of that woman. If I could have even half of that confidence, I could… 

But then, I remembered, what I saw was probably only just the tip of the iceberg so to speak. What kind of ugly things had been uttered by people under their breath as she walked by? Was she really, truly confident or was her swim suit an act of defiance, a f**k you to the world wrapped up in flashy purple and turquoise lame fabric? I would never know the reality of what lies beneath.

In contrast to the mermaid, there was a woman who must have been a size 4 standing in the wave pool with a voluminous hot pink coverup who looked so incredibly self conscious and miserable. I felt and understood her pain. She hid her body but did not succeed in hiding her discomfort. 

“Nothing makes a woman more beautiful than the belief she is beautiful.” —Sophia Loren

I looked around me at the hundreds of other men and women, bodies of all shapes and sizes and the swimsuits of all sorts, each one an act of courage. Bacne, surgical scars, stretch marks, cellulite, fat rolls, belly bulges, love handles, etc. all exposed. 

My body is a blessing.

“You are the best looking woman out here,” he whispers in my ear as I take off my cover up. I’m not. The mermaid is, but I love that he can make me feel like he believes it is the truth. 

So I decide to walk around like I am, like I really do believe I am beautiful in my deep cobalt blue velvet one piece swimsuit. I don’t like my body but that is OK. I am not this body. I am not this swimsuit. 

I am beautiful.

A Down Sizing

Mission San Jose in San Antonio

I see and touch an awful lot of breasts. 

Just about every “uninhanced” woman on the face of this Earth has one breast that is slightly larger than the other. I certainly do. As I age it becomes more and more obvious… the left is fuller than the right. Every time I put on a bra or look in a mirror, I am acutely aware of it and I wonder if other women notice or care about their subtle discrepancies in size. Not that I would ever bring it up in the clinic, mind you. That would be akin to your beautician asking if you want her to wax your upper lip… creates a paranoia if there was not one there to start with. 

Thankfully, I have never had a man look at my chest and run away screaming.

Every once in a while I come across a patient with a more dramatic mismatching, like the woman with one breast a cup size A and the other one a size DD. It created a serious self esteem issue. She had never had a relationship as she was terrified of anyone see her naked. She stuffed her bra with whatever she could find until someone sewed her a pillow to tuck in there instead.

Hey! Sugery can FIX that for you…

You would think this would be a no-brainer, but no…. Invariably the response from insurance companies on the request for augmentation or reduction is, “Not medically necessary.”

I always wonder who the people are making these decisions. Men? Women? If a man, would a woman make a different decision? Or vice versa?

I know the angst I have had over the years over my slightly different sizes. I cannot imagine the psychological burden carried by these women with their really noticeable differences. So what determines medical necessity? We allow breast reconstruction in breast cancer. Is is “medically” necessary? Maybe not. But it is psychologically necessary. 

So then, what determines something being psychologically necessary? What size disparity is traumatic enough to warrant coverage? One size? Two? Four? How do you measure something so subjective?

And then what else causing cosmetic angst should be covered? I had a mole removed from my face while I was still in med school. Right next to my left nostril. It wasn’t huge in real life but in my brain it covered half my face. Best thing I ever did for myself, getting that sucker whacked off. 

So, what are your thoughts? How is your breast size? What do you think about insurance covering breast augmentation or reduction? 

Pecking Order

Flamingos fighting

Just take a nip 
Here and there
So I can be pretty
Fix my hair
Pull and tuck
Gouge at my eyes
Make me look pretty
Slim my thighs
Whiter teeth
A larger bust
I’m still not pretty
Another adjust
Raise those cheeks
Now my nose
Got to look pretty
Paint my toes
Some fuller lips
Sharper jaw
She is so pretty
Fills me with awe
Chisel me down
Tighter skin
I could be pretty
If I were thin
Sew me up
Dress me up
Give me more pain
So I can feel alive
So I can feel loved 
Still not happy
Just a pinch more
Want to be pretty
Want to be adored
Soon I’ll be there 
You wait and see
Soon I’ll be pretty
Soon I won’t be me

Hanging Out

Old Ferris wheel in black and white

I find that I am more and more conscious of my own nose hair. What is interesting about this is that I never, ever notice the nose hair of other people and if I did happen to see some bits poking out of a nostril it would not gross me out. So WHY on Earth do I care about my own nostril hair? 

Is this because my nose hair is getting longer? 

Perhaps I am growing more and more sensitive about the change of appearance that comes with aging and I am finding myself more interested in controlling the things that I can have some influence over? 

And then I wonder if there are people who do care about other people’s nose hair and if so, why do they care? What else do they do in their free time?

These are the thoughts I have on a Sunday morning after yet again having one of those pesky hairs ripped from my poor tender nostril by the stupid nose hair trimmer that is supposed to CUT the stupid things. I swear, next time I may as well just tweeze them out….

Pointing Ahead

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I thought I would do something a little different for the last post of 2016…

On A Slave to the Face from the other day, DM made a comment that got me thinking about our perception of beauty. What do we think the world wants to see in us and how does that compare to what we actually want to see in others. How does it compare to what they see in us?

What attracted you to your partner? How do you let them know what you find attractive about them? Do you think they believe you? What does your partner say about you? How do you feel about their compliments? What would you change about yourself? What would you change about your partner? Why?

This year I resolve to be freer with my own words of praise and a more gracious recipient of compliments from others.

A Slave to the Face

Victorian tombstone
I am going to let you in on a little secret: I own a Princess Leia slave costume. 

Yes, for those purposes. I am not going to claim that I ever looked good in it but I did purchase it and have worn it more than once. Well. Maybe more like *not worn* it….

You can say all sorts of things about sex and slavery and the subjugation of women and how wearing such a costume betrays feminism at its very core but here’s the thing: Princess Leia choked the ever lovin’ life out of Jabba the Hut while in that costume. She strangled that slimy, disgusting bastard with the chain that bound her to him while wearing a bikini. She wasn’t cowering in a corner, ashamed of how much she hated her exposed thighs. She owned that chain and she used it to her advantage. That is some kind of woman. I long for that kind of confidence.

I am not who you think I am.

You will remember in my post last year that it really bothered me how much criticism Carrie Fisher took for her appearance in The Force Awakens, how I didn’t think it was about her so much as it was about our own aging and mortality. For many of us, she was a tangible way of measuring the passage of time. Her appearance spoke to our own finite existence, our own mortality. It was like holding a mirror up to our souls and for some recognizing that we did not like what was reflected there.

She looks older. 

So do I. 

I am not what others see in me.

There was a time that I would get told by complete strangers that I looked like Nicole Kidman or Jullianne Moore or Bree from Desperate Housewives. No one says that about me now. My face and my body are changing. The days of Star Wars kink fests are over.

I am not who I think I am.

I grappled with the anxiety and panic of that for a few years. I tried laser… once. The pain from that was indescribable. And Botox… once. Let me tell you, there is nothing quite like the contortions and fasciculations from Botox wearing off. Then, I smeared the most godawful smelling stuff derived from baby foreskin on my face twice a day while choking back my own vomit.

My face is NOT all over the big screen and yet I freaked out, doing crazy stuff in a vain attempt to hold onto my youth. There was the dysphoria of not recognizing the face staring back at me from the bathroom mirror and the despair of feeling my sex appeal dwindle away.

Who am I now?

I cannot even imagine what Carrie Fisher went through in her lifetime, the tremendous courage it took for her to play the role of Leia once again decades later. As a little girl I wanted to be like Princess Leia. I wanted to learn to shoot a blaster, sure, but I also wanted to look that good in a bikini slave costume. What I did not realize at the time was that virtually all women, no matter how beautiful, suffer from a distorted image of themselves. Princess Leia suffered. Carrie Fisher suffered. Now I find that Carrie Fisher herself is my hero even more so than her character ever was. 

But then Carrie Fisher died.

So will I.

Suddenly a face seems like such a triviality. I won’t say I am completely over myself or my vanity, but I am working on it.

May we all rest in peace…

Unkempt

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“Um, Doc, I can’t do that.” A look of horror crossed her face.

“You are here for your physical, right?” I checked the schedule again to make sure I was not hallucinating. Then, I double checked her preventive care, just in case. She was indeed due.

“Well. I wasn’t expecting to have to do… that.

“Technically, I can’t force you to do anything. It IS your body, after all.” I shrugged, trying to use my body language to convey that I was not trying to pressure her. 

“It’s just,” she leaned forward and whispered, “I didn’t shave my legs.”

“Look, I haven’t shaved my legs in ages, either, so you have nothing to worry about.” I lifted a pants leg to show off a bit of scruffy ankle. “See? No judgement here!”

We both laughed.

She got her PAP done.

Comparing 

zinnia in black amd white

Life is made of joys and sadness. Ignoring the sad, painful times neutralizes the joyful ones.

One of my office managers keeps insisting that we not talk at all about the negatives of our job. He would prefer that the staff and physicians only project happiness, sunshine, and roses at all times. I am not sure that is entirely healthy.

This is the way of life lately. No one wants to hear or even acknowledge the negative. Sadness makes us uncomfortable. It is painful. It is a natural thing to want to avoid it.

Why can’t you just be happy?

The problem is that completely ignoring it promotes isolation. It keeps us from recognizing who is suffering, who is at risk, who needs help. This is a tough job for all involved. What is wrong with acknowledging that so we can all work through it together? 

Am I the only one who feels this way? What is wrong with me?

And it takes away the drive to get better. 

If everyone is happy, why do I have to do it right?

The worst part is that it takes away the celebration of the real triumphs. 

What? Can we BE more happy?

It is OK to feel fear, doubt, sadness, frustration. It is what we do with those emotions that is the key. How do we respond and use them constructively?

I see this in patients, too. So many believe they should not have to feel any negative feelings, that such feelings should be avoided at all costs. 

I know I should still be happy. I am going bankrupt, my wife left me, and my son is in jail, but I should be happy. Everyone tells me I should just be happy. Make me feel happy.

Doc, I am really, really trying to stay positive. I have metastatic cancer and I am in pain all the time and chemo is kicking my butt. Everyone tells me I should stay positive or I won’t beat this but I really just want to cry. I need to cry.

You know what? Being sick sucks. Having cancer sucks. Sometimes life just sucks.

And it should be OK to say it sucks. It should be OK to grieve and be sad and to cry if need be, even if it makes others uncomfortable. 

What we need is balance. Not a cult of happiness.