A 50-year old female
patient enters a doctor's room. She appears dynamic and selfconfident,
trusting and friendly. Her - typical - statement: "I feel much younger than
I look." The questionnaire says her hobby was golfing. She has spent years
on the Canary Islands where she maintained a banana plantation. In other
words: high exposure to sun. A typical feature among our female patients
many of whom are golf players. The sun (as well as nicotine) accelerates the
"consumption" of the skin. The visible aging process of the skin starts
earlier.
Preceding this consultation
about rejuvenation surgery, the patient has consulted three other surgeons.
There is nothing wrong with that. On the contrary, in my guide lines for
plastic surgery patients I even advise patients to consult more than one
surgeon. If a patient does not feel comfortable with one surgeon, he/ she
should see 2 or 3 other surgeons before making a final decision. While this
might increase the consultancy costs, it will become easier for the patient
to make comparisons and to gain a better idea of the options on offer.
The conversation becomes
more relaxed, the level of confidence seems to be rising. Oliver Wendel
Holmes said: "Medicine is science. Yet winning a patient's confidence is a
form of art." More simply put: "The chemistry between patient and surgeon is
important." The various ways of building up confidence are just as
inexplicable as the creation of a piece of art, or of a child growing up.
During the consultancy
session the question occurs: "Which kind of music would you like to be
played during your surgery?" Our patient Mrs Lansch smiles and dismisses the
question mildly with a hand gesture: "You better put on your own favourite
music, music that inspires you." Then she frowns and asks quietly: "Or do
you happen to have Mozart's concert for clarinet?" Luckily, we have it in
our stocks, a version played by Benny Goodman.
After that Mrs Lansch
shares with us an incredible story of her life: 11 years ago, she was
diagnosed with breast cancer. She had to sell her banana plantation and had
to reorganise her life completely. A surgical test confirmed the previous
diagnosis, and she was overcome by a feeling of devastating certainty. Three
days after the operation she was listening to Mozart's above mentioned
concert thinking to herself (with reference to all the beauty in life): "If
I could listen to this concert a couple of times more, I would feel a kind
of happiness." Four days after the operation, she went to see her notary.
Deeply determined in her intentions, she founded her own business, her
bottles of Redon, remnants from the operation, still in her coat's pockets.
The notary offered to take off her coat. She politely refused the offer.
Mrs. Lansch won the fight
against this evil disease. While the surgeon had removed the malignant parts
of her breast, she kept the healthy parts of her breast: The powerful symbol
of feminitiy helped her mobilise her full psychological defence mechanism
and take up the fight against cancer. I strongly believe that 'our' Mozart
played a role in her healing process. Perhaps Mozart even acted as the magic
doctor. Perhaps we, the medics, only assisted him?
I was once told how the
"boy wonder from Vienna" received inspiration for his music: he would smell
the slightly sweet scent of slowly decaying apples in the drawer of his
desk, and he would raise his arms toward the sky to receive orders from the
highest authorities.
This anecdote encouraged me
to continue my research for which I required a suitable, cooperative
patient. I had to assume that some kind of tension would always last with
the patient until the operation was successfully finished. Mrs. Lansch
however showed little nervousness and cooperated courageously. My plan was
to take two plaster face impressions - one before and one after the
operation - in order to receive three-dimensional evidence of a facelifting
operation.
She agreed. But I had
underestimated the extent of the experiment. The pre-surgery procedure took
three and a half hours - longer than the actual surgery itself. I apologized
to Mrs Lansch after freeing her from several hours of darkness underneath
the plaster mask and concluded: "We cannot repeat the same procedure after
the operation, it is too time consuming." - "Yes, we can", she insisted,
"otherwise all our efforts would be worth nothing."
We played the concert of
our divine Mozart, we listened to Benny Goodman's magic clarinet several
times while taking off the mask and during the surgery on the following day.
The surgery took an incredibly simple, smooth course - very similar to the
accompanying music. As if Mozart had interfered once again.
Just as the
scars from previous surgeries, the traces of our face-lifting operation took
an ideal development on Mrs Lansch. In fact, they were barely visible after
only a couple of weeks. As surgeons we are very grateful if patients bring
their own optimism and their own fast-healing-flesh.
After we
had finished both masks, Mrs. Lansch came up with another surprise. Her
friend Ingrid, an abstract painter, had made portraits of her before and
after the operation. On a rainy Sunday we all went to visit her studio in
the "Bergisches Land" region. I was curious: abstract portraits? Well, both
pictures had an effect on us, similar to an inner sun. And on the
post-surgery picture Mrs. Lansch appeared much younger.
Mrs Lansch
is a power woman living in Bonn, she employs 100-200 people, she is highly
regarded in business circles. And she is a good buddy. She "outed" herself
openly as a face-lifting patient, she answered questions from inquiring
patient candidates on the telephone.
She has
become the Nofretete Clinic's best friend, our figurehead. Joseph Murray,
the only Nobel Prize winner among the world's plastic surgeons, once gave
advice in a ceremonial address: "If you make many friends in your practice,
you are on the right track." Yes, our patients sometimes become our friends,
and sometimes our friends become our patients.
Browsing
through the bible occasionally can be a fruitful experience. Solomon says
for example (VI, 14): "Finding a friend means increasing one's wealth". My
encounter with Mrs Lansch has, in a way, increased my wealth.
D.Panfilov
