A Scar is Born

I hesitate for a second and then whip off my sunglasses. Dark and oversized, they're my signature accessory; I’m a modern day Jackie O.

My breath quickens, the panic settling in as I wait for the inevitable consequence of this ordinary, familiar action

“Oh, my god! What happened?” An audible gasp, the words escape from his mouth like firefly’s freed from a glass jar, “you were so pretty?” The sentence stings, but I brush it away with my shades. “I mean, what am I talking about? Of course, you’re still pretty, it’s just that… I wasn’t expecting it.”

We grab lunch. He waits for the food to arrive before asking me what happened. I take some satisfaction in this, his self-restraint, and I tell him. It’s mundane and unsexy, “Misdiagnosed with a spider bite of all things.” We laugh and then we cry. So much has vanished. He moves to my side of the booth and puts his arm around me. They say time heals all wounds, but it doesn’t account for the scars left behind.

My feeble attempts not to dwell on my disfigured face are thwarted every time I glance in the mirror. I go to bed at night and dream it never happened. And in the morning, there is a cruel reminder of its very real existence as I rise from my slumber, a waking nightmare. There it is, staring back at me, my major adulting failure. I didn’t get a second opinion. It hadn’t crossed my mind and then it had happened, so fast, in dream-like slow motion. How long had I been sick waiting for the antibiotics to work? Days? Weeks? It had been a cold, and then the flu and then pneumonia and then life–threatening? How could this be? I was 25 years old.

The gurney moves towards the operating room doors propelled by surgeons. They jog anxiously by my side, hovering over me with life-or-death urgency as we arrive at the double doors of the surgery suite. The sudden stop surprises me and I wonder why they would halt at this point?

I know better than to expect a miracle.

“Laura, before we put you under, we need your consent.” Consent? Consent for what? They had already taken my clothes, my personal effects, and my purse. The IV line drips icy cold into the top of my hand. I want to rip it out but don’t have the strength. My hand feels like dead weight, like it’s died before the rest of me, getting a jump on what’s sure to be the eventual outcome. The technician had struggled with the tube, making several attempts with the needle before getting it inserted. “You have baby veins.” I winced at the word baby. Where were my girls? My 2-year-old and 6-month-old. Who will pick them up at day care? Does anyone know this is happening to me? I can’t think. Hot, thick poison swirls in my brain like lava.

“We’re going to attempt to go in through your nose, but there is a very good chance we’ll need to make incisions in your face. Do you understand? We might need to cut open your face and I need your permission.” The Doctor’s head is hovering inches above mine. He is staring down at me, a clipboard in his hand. I see his green mask and glasses. We’re so close that I can make out the salt and pepper sand paper texture of his beard, count the lines on his forehead. His words are menacing. I don’t want to give my consent, but I know I don’t have a choice. They've taken me this far; there's no turning back.

The emergence of tears means defeat as I give up hope and succumb to darkness. Sticky tears stream down my left cheek. The right half of my face is swollen grotesquely and throbbing painfully from the top of my forehead to my jawline. My right eye shut tight like a prizefighter who’s been in the ring too long. I try to lift an arm but can’t, they’re strapped down or my arms are just too heavy to lift or I just don’t work anymore. I don’t know. I can’t think. I think I'm going to die. Pretty sure this is it and can’t bring myself to care that much. I know I should be more alarmed, but I'm utterly exhausted from excruciating pain. It’s all futile now. Death appears to be the respite I need.

“Not my face, no, I won’t consent.” Whispering the words, shaking my head, feeling my hair grabbing onto the pillow. “No.” “Please, another way, some other solution, there has to be another way.” I live in my face, I won’t scar well. I’ll be disfigured. I know it. I know it. Somehow I realize my entire life has been leading up to this.

“Laura, we’re going to try and save your life, we’re going to do our best to save your life, do you understand?” I nod. I understand, but he doesn’t get it.

“You have a bacterial infection in your brain, you’re not thinking straight.”

I am a pretty little girl. People stop my mother on the street and tell her I look like a doll, like a china doll. I grow up and strangers constantly ask me my secret, how do I have such flawless skin, tell me that I am pretty. I have no secrets, though, no special lotions or homemade potions. I am just lucky. Only I haven’t always been so.

When I was an adolescent, I had scoliosis surgery. The surgeons cut my back open from the top of my neck to the crack of my butt. They straightened and stretched out my spine and attached stainless steel rods. The resulting scar had been a disaster. The cells mutating one on top of another forming an ugly raised red and angry line way beyond the original incision. I had spent my adult life covered up, backing out of pools and bedrooms. “Magician trick gone wrong,” I would laugh nonchalantly, my carefully practiced, witty retort.

“You know, when they cut the woman in half.”

“Keloid scar,” the orthopedic surgeon had said. “Be glad it’s not your face.”

I had safeguarded my face since then. Now his words echoed in my ears. I’d done nothing that might jeopardize its unmarred porcelain smoothness, lest it wind up like my back.

“Without your consent, we cannot operate. Do you comprehend this? You need to think about your family now and the people that rely on you. Think about the people that love you Laura.”

I think about my babies now and nod. I want to see them again, to hold them, to tell them how much I love them. To smell them, Renee with her lingering, just-born powdery sweetness and Nicole, my firstborn, my little angel, always wanting to please me, to make mommy happy, to make me smile. I see her, as she was this morning, in her pull up training pants, little legs jutting out from elastic. I’m sitting on the stairs in my ratty terrycloth robe. My head is enormous; I am the elephant man, face disfigured, misshapen and puffy. My teeth hurt, my hair hurts.

“Help mommy and give Renee some breakfast.” I slur the words, my mouth misshapen, syllables won’t form, but she gets it. I can’t move. My head is too heavy to hold, the weight of a mountain on my shoulders. Nicole stands on the little wooden stool, goes into the pantry and brings down the cereal box. “This one mommy, is this one ok?” It’s the sugary one, reserved for weekends and special occasions. I can’t respond. Any movement will topple me over. “Ok mommy, this one.”

Nicole puts the cereal in a red plastic bowl, Renee army crawls over, arm over arm, she is drooling. I cannot move. They are sitting on the kitchen floor in their diapers eating dry cereal and staring at me. I need help. I need an ambulance.

“We’re putting you under now. Count backwards from one hundred.” I use all the remaining energy I have to take the mask off, holding it inches from my head. My voice is barely above a whisper, “Please don’t cut open my face, I keloid.” I’m relieved my brain finally found this magical word I was scrambling for, the medical word that will stop them, a valid excuse beyond my vanity. I need him to understand, to convince him, and make him comprehend my terror. I am outraged that he doesn’t seem to care, he is angry now. “We’re trying to save your life!” Mask back on. But you’re going to kill me.

One hundred.

I’m under now, nothing hurts. The pain disappeared. Maybe I will die. I make peace with it immediately. In my typical type-A fashion, I devise a plan for the afterlife. My afterlife, if there is one. First, get the lay of the land; find out who’s in charge, some protocol for checking in. After that, get to the children, find the children, stay with the babies, and never leave their side. I promise myself to be the best possible spirit-mother ever. If there is no afterlife, then there will be nothing and that will be the end. Can’t do anything about that. Acceptance. I attach my being firmly to the insides of my body. Try to feel my soul into the bottoms of my feet, right up to the insides of my toes. I want to stay, but not like this. It’s okay if I go. I will miss my kids; I wanted to get to know them, to see them grow up. I sear their faces into my eternal memory. Nicole with her saucer-sized bottomless blue eyes and Renee with her wide, gummy toothless smile. I instruct my soul to never leave their sides.

Nothingness.

It’s freezing, I’m dead and in the morgue and I am freezing and someone is crying, whimpering. It’s bright like heaven, but so cold, like the tundra. Teeth chattering. Heaven can’t be this cold by its very definition, but the morgue must be. My throat, my throat is the desert. Can’t swallow. My inner being is still inside my body, but I can’t feel it. I’m completely numb. Nothing is responding. My mind is functioning frantically, but my body is motionless. Try. Try to move something.

They sewed my eyelids shut, can’t lift them. Maybe there are coins on them. They’re stuck together. My teeth are making jackhammer sounds in my ears. Struggling, groaning, crying, It’s me, I am alive. Medical equipment beeps at me from both sides of the bed.

“Hi honey, you’re awake now, that’s good, you were in surgery a long time.” She is asking me if I am cold, do I want another blanket. “You’re in recovery now.”

“Water. Need water.”

“You can’t have any water, but I can give you some ice chips. Would you like ice chips?” I nod, barely moving. She’s back now with the ice chips in a Styrofoam cup. She feeds them into my mouth with a wooden stick.

She is chatting, bringing me up to speed. The kindly nurse. “Your sinuses were completely infected and sealed off. You were on your way to developing meningitis and sepsis. The surgeons spent a long time operating on you trying to drain your face of the poison. You’re a lucky woman.” Funny, I don’t feel lucky. Lucky would have been going to the doctor and getting a proper diagnosis the first time.

“My face,” did they… I don’t wait for her to answer. Gingerly I touch my face, feeling the tug of the IV on top of my hand. This damn thing. Hurts so bad. I put my fingers on my face and feel around. All I can feel are bandages and tubes everywhere. There is no exposed skin. What the hell exactly happened? I want some answers.

She takes my wandering hands away from my face. Sternly now she says, “Talk to the doctor, he’ll come and see you soon. You’re lucky to be alive.” I wished she would stop saying that.

I lay there. Scared to move, paralyzed. I can’t feel anything, now that I know there are tubes in my face I don’t want them to come out accidentally, painfully, because of something I did. There are two tubes up my nose, one in each nostril. There are bandages; my face is a mummy’s. I can’t decide which direction they went in. They cut me open, or they didn’t cut me open. The nurse was vague. Too vague. She doesn’t want to tell me the bad news.

I must have dozed off because now I hear a man’s voice. It’s the doctor.

“You’re a very lucky young woman.” God, I hate him. He is at the side of my bed; he is looking at me, surveying his work. “Are you comfortable? Are you feeling any pain?” I ignore his questions and ask my own. “Did you cut open my face?” He sighs, seems irritated that this is my only concern.

“We had to do what we had to do to save your life. All your sinuses were completely impacted which is why your nose wasn’t draining. You might not smell anything ever again. Your head was filled with poison. It took us hours and we still haven’t got all of it. You’ve lost some hearing; you’ll probably lose some vision. The pressure in your eyeballs was over 30. Normal is below 20.” He is saying something about ocular hypertension. I can hear him perfectly and see him just fine, too. Maybe something is wrong with his hearing because he isn’t answering the one damn question I have.

“Tell me.” After what seems like an eternity, he finds a chair, a stool, and carries it over to my bed. He wheels it close to me. If he tells me I am lucky one more time, I am going to lose it. My heart is pounding. He takes my hand. Why is he taking my hand? “Look.” I shake my head. No, no, no, how many times no?

“The team and I, we tried everything we could to drain your sinuses going through your nose. We had no choice so…” I knew the alternative. They had to slice open my face, make incisions to drain my sinuses. Had they cut open my entire face? I try to remember anatomy class, how many sinuses are there?

“I thought it best to make one long incision on the right side of your face, along your eye socket. I thought you would prefer this over many smaller incisions.” “You’re a fortunate woman to be alive after something like that, statistically you shouldn’t have made it.”

He’s waiting for me to say something now. Maybe thank him for saving my life, but I can’t get there. I already know what’s in store. I am disfigured now, scarred for life. No taking it back. There will be no fixing it. No one will see that I am pretty, was pretty. All they will see is the scar on my face. They prepare to move me to my room where I will stay for weeks while I recover. I can smell the antiseptic cleaner in the hallways and hear the squeaking wheels of the gurney underneath me. I'm not quite happy to be alive, but I am relieved to not be dead.

A year goes by. I have nothing but trouble with the incision. Just as I feared, the scar has become a keloid, enlarged, raised and red. Eventually, it grows to interfere with my vision, a bloody rope in the corner of every frame. People stare at me now, but for different reasons, they cannot look away. Stranger’s approach and ask what happened. A woman in the market gives me a card for a domestic abuse hotline. My face looks like someone tried to carve out my eye with a penknife.

I seek help from specialists but no one will touch it. I finally get an appointment with a renowned dermatologist, an expert in scar revision. I tell him the story, right up to the double-doors.

“Why didn’t you ask for a plastic surgeon?” His question is nonchalant, natural. Clearly I should have thought of this. I shake my head. I didn’t think of it, and no one told me it was an option. Another adulting failure.

“There is nothing I can do now that might not make it worse, much worse. It really should have been something the doctors at the hospital had thought of. I am sorry, this is a really awful scar, but I can’t help you.”

“They we’re trying to save my life,” I say it out loud, it’s on auto-pilot, pre-recorded like a robot’s voice, emotionless, with no particular conviction. Everything has changed since then, my marriage, over. My job, over. I am forever altered by this unexpected course of events. The butterfly has turned back into the caterpillar, crawled into the cocoon and died.

“Well, you could sue them, you have an airtight malpractice case. Two cases really. The first case would be against the doctor that misdiagnosed you with the spider bite when what you actually had was sinusitis and then second, these guys, these hacks.” He actually called them hacks. “You were obviously a beautiful young woman at one point, I’m sure a judge will be sympathetic to your case.”

Just the thought of standing before a judge and telling him my sob story makes me want to run out of the doctor’s office. Instead, I take another long look at my image in the mirror. It might not be as flattering or pleasing as it once was but there’s something almost comforting about noticing the magnitude of the flaw with such clarity; like an old friend accepted long ago, for who they are, without shame or regret.

Back in my car, sunglasses on, I glance in the rear-view mirror. I don’t look half bad if you ignore my eye area. I apply some lip-gloss. “Today’s not the beauty contest.” This is my mantra. I don’t live in my face anymore. Instead, I live in the here and now, the moments that make up my life which really have nothing to do with how I look or how pretty strangers think I am.

At the school, I thrill the girls with my early arrival to retrieve them. They each have artwork they want to show off. Nicole has drawn a picture of me holding her and her sister up.

“My mommy is strong” are the words she has written under her drawing.

I hug them both to me; I am lucky.