Those of us who have had abdominal surgery realise sooner or later that scars take on a look of their own. Our bodies are each unique, as are the skills of a surgeon, the standard of their work, the course of healing and the interaction of all these factors over what is typically a 2 year healing period.
Adults usually choose when to have surgery and sometimes their surgeon, and as a result they have some sense of involvement and perhaps sometimes even some control as to the outcome of their surgery and the appearance of their scar. In the course of my lifetime of work with people, I have been amazed how many adult people regard their new scar as an interesting showpiece, even a badge of their fortitude or survival skills!
This is not always so after infant surgery. I had pyloric stenosis (“PS”) surgery at the tender age of 10 days, and cannot remember being greatly aware of my scar until almost 6 years later. It was then that I remember feeling traumatized by continual embarrassment and humiliation as my parents stonewalled my questions about the weird and alien “thing” on my belly, and by feeling lost both for words and emotionally in dealing with the curiosity of classmates and grown-ups.
Now I realize that my PS scar is above average for 1940 surgical work: not unnecessarily large but a bit untidy (off center) and surrounded by a galaxy of sizeable pockmarks from the kind of needlework which of course grows with the baby and is now used very much less routinely. I am especially struck by the number of people who having had infant surgery and have considered or acted to have their scar modified and reduced. Only the most extroverted and confident of us whose lives were saved by early surgery seem to find it easy to talk about or flaunt our scar.
Now at last, after almost a lifetime, I have come to terms with my stomach scar, and have learnt that this is what most of us find as we age. I also realize it’s not bad compared with some others of the time, and don’t think it can be much improved now. But knowing my own and others’ struggles with this bit of self-acceptance, I am rather too often angered by the haughty, patronizing, dismissive or flippant way some surgeons go into print about their attitude to their work of cutting into and repairing their clients’ bodies and to their patients’ feelings and deeper needs. Here is an example –
In the vain world in which we live, patients often consider the quality of the skin closure as a benchmark of our technical skills. Although it is of minimal overall importance, clean, neat and well approximated skin edges without evidence of suture material often impress and please patients.
(Reference available on request.)
If this petty peeve were an isolated example, I would not be writing about this subject.
Almost all of us whose lives have been saved by infant surgery are I am sure thankful for this gift, but it is very difficult for any patient to be grateful for the insensitivity of this and similar surgeons. They should find other work, perhaps in a butcher’s business, an abattoir, or a veterinary clinic. Not strutting their stuff on my and other people’s bodies, especially when their little patients aren’t near old enough to challenge them about their work or attitude… something that’s also too often impossible among adults.
Most medical workers have very clear ideas about which doctor they would consult and which surgeon they would allow to work on their body. I wonder why? The medical world may take many of each year’s smartest and most promising students – but it still has a lot to learn.
I am glad that one of the most-read posts on this blogsite is devoted to a better understanding between doctors and patients. Here’s hoping.