To Cut or Not to Cut?

This is a piece from 50 Ways to Leave Your 40's, the book I'm co-authoring. It's from a chapter entitled, "Love Thy Body."

“Love thy body,” we say. Well, what if you don’t? What if you, like many mid-lifers, look in the mirror and pine for days gone by and a body gone bye-bye? What if you don’t WANT those basset hound eyelids, that turtle neck or the sumo belly? And where the heck have your boobs slouched off to now?

“Hey, kiddo,” says the little voice. “You don’t have to look like this. It’s a new century! They’ve got ways to FIX you!”

It’s true. A nip here, a tuck there, a little suction and augmentation and voila! The new you. Why not? Why “love thy body” when you can just “fix thy body”?

You’d certainly be in good company. More and more Americans are pursuing their lost youth in operating rooms, to the delight of the cosmetic surgery industry, which raked in 9 billion dollars in doctors’ fees in 2005. In that year, almost two million people went under the knife for cosmetic purposes alone. This includes, by the way, a dizzying array of possible procedures, from the familiar Facelift and Tummy Tuck to the newer Butt Boost and Vaginal Rejuvenation. If you add to that the number that had “minimally invasive” procedures like Botox injections, laser hair removal and dermabrasion, the number skyrockets to over ten million men, women, boys and girls.

Why do we do this? Why subject ourselves to the risks of surgery, the likelihood of scarring, the chance of a blighted outcome, all for looks?

Clearly our society suffers from a nasty case of Youth Worship. Physical beauty is defined always in terms less than thirty years of age, and everywhere you go, big glossy ads scream "value equals looks!" But it seems to me that by midlife, most of us have done enough living to know better. We’ve learned the value of experience. We see more clearly with the perspective of years. Most of us wouldn’t be 20 again if you paid us. So why do we still try to look that way?

“Well, why not?” argues the little voice. “It’s just a little nip and tuck. It’s not like it can kill you or anything!”

Ah, but it can. You might remember Olivia Goldsmith, author of The First Wives Club, who died following a facelift operation in 2004. It was not even close to her first such procedure, which made her death from anesthesia complications all the more shocking. A month later, another death in the same hospital from the same procedure set the medical grapevine buzzing. Alas, these are not isolated incidents. The American Society for Aesthetic Plastic Surgery cites a 1-in-57,000 chance of death and a serious complication rate of less than half of 1 percent for outpatient procedures. Less than half of one percent. That means, if 2 million people had cosmetic surgery in 2005, a “mere” ten thousand of them had “serious complications.”

What complications are there? First of all, there are the usual risks from general anesthesia, which include airway obstruction, abnormal heart rhythm, brain damage, heart attack, nerve damage, paralysis, malignant hyperthermia, stroke, and death, among others. Then there are risks common to any surgery, including bleeding, infection, pneumonia, blood clots and wound separation. Cosmetic surgery adds risks of skin necrosis, asymmetry, slow healing, numbness and tingling, abnormal fluid collections, and “irregularities, dimples, puckers and divots” (http://www.smartplasticsurgery.com).

I had a patient a few years ago who stopped by on her way to the plastic surgeon’s office to show me why she was returning to him 2 months after her “boob job.” In tears, she lifted her shirt to show me her “surgical result” which could best be summed up as “cockeyed.” One breast went northwest, the other, southeast, the result of asymmetrical scarring. The surgeon would have to put her back under general anesthesia and then basically yank and pull on her “augmented” breasts until the scar tissue tore loose enough for him to try to even things up with brute force.

Still want to get that nip and tuck?

Allow me to interrupt myself a moment to say that I have the utmost respect for the Plastic Surgery profession. What they do for kids with cleft palates, trauma victims, and women who have had mastectomies is heroic. What I’m objecting to is the use of plastic surgery for mere cosmetic purposes.

There is no fountain of youth. No magic wand. Rearranging a few skin cells will not reverse the aging process. Next time you look in your mirror, mirror on the wall, consider this: wouldn’t an Attitude Boost be much less expensive and risky than a Butt Boost? Is it possible that you can “love thy body” in gentler ways, or at least “accept thy body” without cutting it up?

Clearly, I have an opinion on cosmetic surgery (in case you couldn’t tell). However, if you are determined to fight nature with a scalpel, you’re going to do it no matter what I say. All I can ask is that you think first, educate yourself on the risks and benefits of the procedure, and go to a board-certified, experienced surgeon.

And then, please, think again.

Marathon Man to the Max

Have you heard about the 50-50-50 Marathon Man?

This guy, Sam Thompson, is running 50 marathons in 50 states in 50 days ! His purpose is to raise awareness and money for Katrina relief.

Yeah, sure, you say. Nice lofty goal, but he'll never make it. Well, guess what? He only has ONE MORE to go! Tomorrow he does his final 26.2 miles, ending up in Bay St. Louis, Mississippi, where he and his group of 100 volunteers help rebuild homes destroyed by the hurricane.

He even has a blog, though how he can find time and energy to write while he's running 1310 miles in 50 days is beyond me.

I'm impressed.

Addendum, Sunday August 20: He made it! Finished his last marathon yesterday. There's a nice account of it on his blog, including the fact that he'll be on The Early Show on CBS tomorrow morning. Thank you, Sam, for your inspirational journey!

PMS Blues

PMS. It's different for everyone, and different for me from month to month. In the details, anyway. Now bear with me cuz I'm there now and part of it is a distinct lack of creative energy.

This month my body feels heavy and slow...like I have molasses in my arteries. Sludge. Leaden syrup, moving like a mudslide through my body. I'm walking in waist deep ocean water, against the current. Not a strong, bowl-me-over current, just enough to have to strain and lean and put some effort into going the way I know I need to go. Just enough to have to keep part of my mind always on the current. Or it's as if I hadn't slept in a few days. Know that feeling? When you know you have to keep on going but you are soooooooooo tired. The sandman is constantly, insistently calling you, a low incessant nagging voice, pulling you down, dragging at you. All you want to do is lie down and give it up, but you keep....on....going.

And that's just the physical part. Emotionally, I can go from relatively stable (in my progesterone-poisoned opinion) to a gloomy doomsdayer, which is where I dwell most of these PMS days, ready to burst into tears at a perceived slight or a friendly hug, to a raving bee-yotch I claim not to recognize. And it's like someone else is totally in control, pulling my puppet strings this way and that, watching me jerk and twitch just for their own deranged amusement.

Dolly Parton did a wonderful song called "PMS Blues." If you haven't heard it, gals, find it and listen. She clearly knows of what she sings.

"Nothin' fits me when it hits me....Got those- -can't stop cryin', dishes flyin'--PMS Bluuuuuuuues...........................oh, whadda you lookin' at?!"

Watch it with the comments. I might smack you. But I'm not responsible, if I do. It's that demoniacal puppetmaster!

PMS Peg

I Placed in a Writer's Contest!

I'm so excited!

Last April I entered a writing contest that Southwest Writers has every year. I just joined them last winter, as a way to connect with other writers and wannabe's like me. Long story short, they called me on Friday and told me I placed first, second or third in the Short Nonfiction category!! They had 19 categories and over 500 entrants total. I'm thrilled! I won't find out until the awards banquet in September what place I actually won, but who cares? Top three! Yippee!

The piece I entered was one I've posted here, but I'm going to post it again, partly cuz I want to celebrate, and partly cuz I've learned a few things about punctuation since then, so I fixed it.

A Discharge by Any Other Name

4/3/06

Last week on NPR I heard Eve Ensler reading her essay on the "This I Believe" segment of Morning Edition. Ensler is the author and playwright of The Vagina Monologues . In her essay, called "The Power and Mystery of Naming Things," she said:

"Think about the word 'vagina'. I believe that by saying it 128 times each show, night after night, naming my shame, exorcising my secrets, revealing my longing, was how I came back into my self, into my body."

Vagina. Vagina vagina vagina vagina.

When I was a girl, I didn't know the names of my private parts. I don't think we even called them "private parts.” It was all vaguely referred to as "down there.” Until the day one of my elementary school classmates, who had an older sister versed in These Things, informed us knowingly that the word was "vovey.” So we called it "vovey,” when we called it anything, when we dared to even speak about it, which was never, and only in a whisper, and only to each other, of course. One bold day, a friend and I revealed to each other that our "voveys" produced a secretion, which we gigglingly dubbed "vovey goo.”

Twenty years later, I was a licensed physician with my own little girl. I knew the human body inside and out, and I was damned if my daughter was going to grow up without words for all of her body parts. I taught that kid "vulva" before I taught her "elbow.” I wanted her to be proud of her body, to be comfortable with all of it. Naming was the first step.

I knew that I had succeeded beyond my wildest dreams when she once shocked a Texas church potluck by standing in the middle of the room, pointing at each grey-hair in turn, and correctly identifying their gender by announcing, "YOU have a penis. YOU have a vulva." She was three years old.

The first semester of medical school, we learned anatomy, in the lecture hall and in the dissection lab. It was presented in an orderly fashion, head to toe. Where there were gender differences, the male anatomy was always presented first, followed by "the female version of this is..." Sure, it bothered me, but it fit in with the sexism that pervaded medical education.

When we got to the genitals, we learned the male anatomy first, as usual. I was amazed at the quantity of labels on the drawings, the number of named parts men have. Corpus cavernosum. Corpus spongiosum. Root. Bulb. Crus. Shaft. Corona. Prepuce. Glans. Four different named segments of urethra. Etcetera, etcetera, etcetera. I took notes dutifully.

Next slide. Female anatomy. Far fewer labels. Much briefer rundown by the teacher. As he prepared to switch slides, I raised my naive hand. "Excuse me. What are the names of those muscles?" I pointed to the striated bands surrounding the vagina at varying angles.

The professor looked confused. "What muscles?"

I showed him again.

"Oh. Those...uh, that....that's Vaginal Wall." Click. Next slide.

Now, wait a minute. I'm a woman, and half of my readers are probably women. Ladies, you know that is not just one big muscle there, and it's not only useful for "holding your bladder" either. I was shocked that there weren't at least three different muscle groups in the vagina. Come on! The male urethra, a single tube, has four different named segments. But one single catch-all label for the mysteries of a woman's depths? Puh-lease!

That was a long time ago, now, and I've (clearly) gotten over it. But that morning, hearing Eve Ensler, it all came back to me again, and got me thinking some more about this male/female naming discrepancy. I remembered "vovey goo" and contemplated the fact that there still isn't an official medical term for vaginal secretions. I'm not talking about slang. There's plenty of that, from "smegma" (sounds like Gollum's sister) to "honey" (nice, but not unique). I mean an unambiguous, descriptive, neutral word of its own. Like "semen.” That's a word that can't be mistaken for anything else. It has only one meaning, as far as I know. It's only a noun, and calls up a distinctive mental picture. Nobody gets confused about what you're talking about when you say "semen."

But what is the "female version" of "semen"? The closest I can come up with is "discharge." But this does not meet the criteria of specificity that "semen" does. No, "discharge" is a word that can be a noun or a verb, can apply to a vagina, a retiring serviceman, or a firing cannon. Not only that, I was taught in medical school that a vaginal discharge is abnormal. Part of the Patient Interview is called the Review of Systems. When you do this, you verbally list the body systems, asking if there are any abnormal symptoms in each (headache, double vision, vomiting blood, etc.). One of the questions is, "Do you have any vaginal discharge?" This is usually asked while shaking one's head and frowning slightly, subliminally communicating the right answer to the patient. Oh, no, ma'am. No vaginal discharge. Yuck, no!

Whereas in truth, feminine secretions are as normal as tears or saliva, or mucus.

I submit that we need a new word. A unique word for the entirely normal, benign, useful secretions that are produced in the vagina. What shall it be? We could call it "vuliva" (vuh-lye-vuh) or "vugucus" (vuh-joo-kus) , echoes of its cousins at the "other end." We could even stoop to "vovey goo,” although that doesn't sound quite neutral to me. Or, come to think of it, we could have several words. The stuff changes, you know, throughout a woman's monthly cycle and lifetime. The eskimos have their myriad words for "snow.” The male urethra has four separate words for one little tubule. Why shouldn't there be a different word for each variety of hormonally-influenced natural feminine product?

The devil is in the details. I can't think of a good word. I just know we need one. I'm open to suggestions. Once we get a good one, we can submit it to the American Board of New Anatomical Terminology, or wherever one submits these things. Then all we'll need is for Eve Ensler to say it 128 times a night for six years, and voila! Equal time in the anatomy lectures, and a new addition to the church potluck repertoire.