Pain is real when you can get other people to believe in it. If no one believes it but you, your pain is madness or hysteria or your own unfeminine inadequacy. Women have learned to submit to pain by hearing authority figures—doctors, priests, psychiatrists—tell us that what we feel is not pain.
Women are asked to be stoic in the face of surgical pain as they were asked to be stoic for childbirth. The medieval Church enforced the curse of Eve by refusing to permit any alleviation of the pain of childbirth, according to Andrea Dworkin’s analysis of misogyny, Woman Hating. “The Catholic objection to abortion,” says Dworkin, “centered specifically on the Biblical curse that made childbirth a painful punishment—it did not have to do with the ‘right to life’ of the unborn fetus.” The poet Adrienne Rich reminds women that “patriarchy has told the woman in labor that her suffering was purposive—was the purpose of her existence, that the new life she was bringing forth (especially if male) was of value and that her own value depended on bringing it forth.” The same is true for the “new life” of surgical “beauty.” In maternity wards, asserts the Brighton Women and Science Group in Alice Through the Microscope, the mother-to-be “is usually expected to dissociate herself from her body and its behaviour, to remain in control of herself and behave ‘well.’ The woman who screams in labor, or who cries afterwards, is often made to feel that she ought not, that she has lost control, that her own feelings are not natural, or that she should not give in to them.” Women who have undergone cosmetic surgery report the same experience.
Most women can think of many occasions on which they were told that what was hurting them was not. I remember a gynecologist with thick and senseless hands, who expanded the speculum angrily and shot a meteor of pain to the base of my spine; the fontanelles in my skull seemed to separate and pain poured in like ice. “Stop making faces,” he told me. “This doesn’t hurt.” Or the electrologist a woman told me about who asked, “Have you ever had electrolysis before?” “Yes,” said the woman. “What do you know about it?” “It hurts like hell.” “It does not,” she contradicted. Or the voices one hears over a rape crisis hot line: “They said they didn’t know why I was so upset. There weren’t any bruises. It wasn’t like he’d hurt me.” Or the career woman who described to me her nose surgery: “It was after a bad love affair that I literally cut off my nose to spite my face. They said if I was a good patient there would be no real pain and only a little blood. I couldn’t bear it. I said it hurt. They said I was overreacting. There was so much blood my sister fainted when she saw me. They said, ‘Now look what you’ve done.’”
A “scalpel slave” in a magazine describes a face peel: “Essentially, it is no different from a second-degree burn. . . . [It] makes you go brown and crispy, then a scab forms and drops off . . . [it] takes several hours because it is so poisonous and you can’t risk getting it into the bloodstream.” Dr. Thomas Rees minces no words: “Abrasion and peeling traumatizes [sic] the skin . . . with either procedure, the skin can be removed too deeply and result in an open wound. . . . deaths [from cardiac arrest] have followed a chemical peel . . . the skin is frozen [for dermabrasion] until it assumes a boardlike quality that facilitates the abrasion from a rotating wire brush impregnated with diamond particles.” (“Skin planing,” he informs the reader, “originated in World War II, done with sandpaper to remove shrapnel embedded in the skin.” Plastic surgery developed after World War I in reaction to wartime mutilations never witnessed before.) A woman who has witnessed skin planing said to an interviewer, “If we found that they were doing that to people in prison, there would be an international outcry and [the country] would be reported to Amnesty International for torture of the most horrific kind.” Chemical peeling, that “torture of the most horrific kind,” is up, according to Rees, 34 percent.
It is not easy to describe physical pain, and the words we agree on to convey it are rarely adequate. Society has to agree that a certain kind of pain exists in order to ease it. What women experience in the operating theater, under the mask of acid, laid out open to the mouth of the suction machine, passed out cold in wait for the bridge of the nose to be broken, is still private and unsayable.
Their pain is denied through trivialization. “It can be uncomfortable.” “There is some discomfort.” “A little, little bit of bruising and swelling.” One is not yet allowed to compare American and European women’s pain for beauty to real pain, to Amnesty International pain. The comparison will be called overstatement. But the comparison must hold, since women are dying of understatement.
Surgery hurts, it hurts. They hold you underwater just long enough to stop you struggling. You breathe with newly cut gills. They haul you out again, logged and twisted, facedown on a bank with no footprints. Your spirit held in suspended animation, they drive a tank carefully over your ignorant body.
Waking up hurts, and coming back to life hurts horribly. A hospital, though it is called “luxurious” or “caring,” degrades: Like a prison or a mental institution, wherever the old identity meant trouble, they take away your clothes and give you a numbered bed.
For the time you were under, you lose your life, and you never regain those hours. Visitors come, but you see them through the waters that have closed over your head, another species: the well. Once you have been cut into, no amount of good living can ever erase what you know about how easy, how accommodating death is.
Cosmetic surgery is not “cosmetic,” and human flesh is not “plastic.” Even the names trivialize what it is. It’s not like ironing wrinkles in fabric, or tuning up a car, or altering outmoded clothes, the current metaphors. Trivialization and infantilization pervade the surgeons’ language when they speak to women: “a nip,” a “tummy tuck.” Rees writes, describing a second-degree acid burn over the face: “Remember when you were in school and you skinned your knee and a scab formed?” This baby talk falsifies reality. Surgery changes one forever, the mind as well as the body. If we don’t start to speak of it as serious, the millennium of the man-made woman will be upon us, and we will have had no choice.
Choice
“Beauty’s” pain is trivial since it is assumed that women freely choose it. That conviction is what keeps people from seeing that what the Surgical Age is doing to women is human rights abuse. The hunger, the nausea, and surgical invasions of the beauty backlash are political weapons. Through them, a widespread political torture is taking place among us. When a class of people is denied food, or forced to vomit regularly, or repeatedly cut open and stitched together to no medical purpose, we call it torture. Are women less hungry, less bloody, if we act as our own torturers?
Most people will say yes, since women do it to themselves, and it is something that must be done. But it is illogical to conclude that there is a different quality to blood or hunger or second-degree burning because it was “chosen.” Nerve endings cannot tell who has paid for the slicing; a raw dermis is not comforted by the motive behind its burning. People respond illogically when confronted with beauty’s pain since they believe that masochists deserve the pain they get because they enjoy it.
But moreover, women learn what we have to do from our environment. Women are sensitive to the signals that institutions send about what we have to do with our “beauty” to survive, and the institutions are giving us a very clear message that they endorse any level of violence. If struggle for beauty is women’s warfare, the women who draw the line are treated as cowards, as are male pacifists. “Who’s afraid of cosmetic surgery?” taunts a surgeon. Women’s choice in the Age of Surgery is not free, so we have no excuse for refusing to see their pain as real.
Women will have a real choice about cosmetic surgery only when:
If we don’t do it, we can keep their livelihood. We saw how surgical alteration has become a requirement for women’s employment and promotion. Surgical brochures emphasize career pressures on women to look “youthful.” That requirement is actually criminal. According to the Occupational Safety and Health Act of 19
70, “Employers can no longer . . . purchase the agreement of workers to subject themselves to unsafe or unhealthful working conditions.” Surgery, Retin-A, and chronic caloric deprivation are unhealthful and unsafe, but women faced with the professional beauty qualification lack the choice to resist them and keep their means of support.
If we don’t do it, we can keep our identities. “Choice” means nothing if the choice is to survive or to perish. An animal caught in a trap doesn’t choose to gnaw its leg off. The Iron Maiden is closing now, with her razor outlines. What has outgrown the edge is trapped and must be severed. When women talk about surgery, they speak of “flaws” they “cannot live with,” and they are not being hysterical. Their magazines ask: “Is there life after 40? Is there life after size 16?” and those questions are no joke. Women choose surgery when we are convinced we cannot be who we really are without it. If all women could choose to live with themselves as themselves, most probably would. Women’s fears of loss of identity are legitimate. We “choose” a little death over what is portrayed as an unlivable life; we “choose” to die a bit in order to be born again.
If we don’t do it, we can still keep our places in the community. In traditional cultures such as Greece and Turkey, it is considered obscene for older women to wear the bright colors of youth. There are “modern” communities already—Palm Springs, Beverly Hills, Manhattan’s Upper East Side—that consider it as shocking for an older woman to leave the skin of her throat uncut.
Men usually think of coercion as a threatened loss of autonomy. For women, coercion often takes a different form: the threat of losing the chance to form bonds with others, be loved, and stay wanted. Men think coercion happens mainly through physical violence, but women see physical suffering as bearable compared with the pain of losing love. The threat of the loss of love can put someone back in line faster than a raised fist. If we think of women as the ones who will jump through hoops of fire to keep love, it is only because the threat of lovelessness has been used so far against women rather than against men as a form of political crowd control.
Women’s desperation for beauty is derided as narcissism; but women are desperate to hold on to a sexual center that no one threatens to take away from men, who keep sexual identity in spite of physical imperfections and age. Men do not hear in the same way the message that time is running out, and that they will never again be stroked and admired and gratified. Let a man imagine himself living under that threat before he calls women narcissistic. Fighting for “beauty,” many of us understandably believe we are fighting for our lives, for life warmed by sexual love.
With the threat of lost love comes the threat of invisibility. Extreme age shows the essence of the myth’s inequality: The world is run by old men; but old women are erased from the culture. A banned or ostracized person becomes a nonperson. Ostracism and banning are effective, and leave no proof of coercion: no bars, no laws, no guns. South African activist Beyers Naude said on British television that “a banning order can easily lead to people breaking down.” Few can bear being treated as if they are invisible. Women have face-lifts in a society in which women without them appear to vanish from sight.
Face-lifts cause nerve paralysis, infection, skin ulceration, “skin death,” scar overgrowth and postoperative depression. “What a shock! I looked like a truck had hit me! Swollen, bruised, pathetic . . . I looked freakish . . . about this time, I was told, many women begin to cry uncontrollably.” “It’s quite painful afterward, because your jaw feels dislocated. You can’t smile, your face aches . . . I had terrible yellow bruising and trauma.” “An angry infection . . . hematoma . . . a half-circle bruise and three distinct lumps, one the size of a giant jawbreaker. . . . Now I enjoy putting on makeup!” Those are quotes in women’s magazines from women who have had face-lifts.
I wish I could forget the sight of someone I love lying in St. Vincent’s Hospital, bandages on her eyes smeared with a sulfurous matter. An intravenous tube dripped into a delicate vein. Groggy, her head rolled across the pillow like a blinded calf s. She could not see the people who cared for her standing awkwardly around her high-railed bed. Down the magnificent cheekbones, over the celebrated mouth, a line of bright blood descended. She seemed to be lying there because she was sick or hurt, but before she entered the hospital, she hadn’t been. She was there because she was less beautiful, some might say, than she used to be.
Women are learning to smile grimly at such tales, because the alternative, we are told, is really intolerable. Old women disappear. Our mothers’ mothers disappeared, their social worth diminished when their child rearing days ended.
But whatever the pressures of the present, the surgical future is one without choice.
Surgical Futures
The Victorians’ definition of operable kept expanding. “Moral insanity,” like ugliness, was a “definition that could be altered to take in almost any kind of behavior regarded as abnormal or disruptive by community standards,” writes Elaine Showalter. “Asylums opened for ‘young women of ungovernable temper . . . sullen, wayward, malicious, defying all domestic control; or who want that restraint over their passions without which the female character is lost.’” So does our definition of operable keep expanding, for the same reasons. In the 1970s, intestinal bypass surgery (in which the intestines are sealed off for weight loss) was invented and it multiplied until, by 1983, there were fifty thousand such operations performed a year. Jaw clamps (in which the jaw is wired together for weight loss) were also introduced in the feminist 1970s, and stomach stapling (in which the stomach is sutured together for weight loss) began in the US in 1976. “As time went on,” reports Radiance, “the criteria for acceptance became looser and looser until now anyone who is even moderately plump can find a cooperative surgeon.” Women of 154 pounds have had their intestines stapled together. Though the doctor who developed it restricted the procedure to patients more than 100 pounds overweight, the FDA approved it for “virtually anyone who wants it.”
Intestinal stapling causes thirty-seven possible complications, including severe malnutrition, liver damage, liver failure, irregular heartbeat, brain and nerve damage, stomach cancer, immune deficiency, pernicious anemia, liver failure, and death. One patient in ten develops ulcers within six months. Her mortality rate is nine times above that of an identical person who forgoes surgery; 2 to 4 percent die within days, and the eventual death toll may be much higher. Surgeons “aggressively seek out” patients, and “have no trouble getting patients to sign informed consent forms acknowledging the possibility of severe complications and even death.”
One is not surprised by now to learn that 80 to 90 percent of stomach and intestinal stapling patients are female.
At last, all women are operable. Liposuction is the fastest-growing of cosmetic surgeries: 130,000 American women underwent the procedure last year, and surgeons sucked 200,000 pounds of body tissue out of them. According to The New York Times, as we saw, 11 women have died from the procedure. At least 3 more have died since that article was written.
But I would not have known that from the conversations I had with “counselors” when I posed as a prospective client:
“What are the risks from liposuction?”
“The risks aren’t great. There is always a risk from infection, that is small and a risk from anesthetic, that’s small.”
“Has anyone ever died?”
“Well, maybe ten years ago, with very obese people.”
“Does anyone ever die these days?”
“Oh, no.”
“What are the risks from liposuction?”
“There are no risks, none at all.”
“I read that people have died from it.”
“Oh God. Where did you read that?”
“The New York Times.”
“I know nothing about that. I know nothing about The New York Times. I’m sure if that were true it would be making headlines. They make a fuss over the least little thing.”
??
?Are there any risks involved with liposuction?”
“No, no. Generally speaking, no risks involved at all, no, no. No problem at all, no.”
“I read that there have been some deaths.”
“Mmm. I have heard something about that. But as long as you’re in the hands of a skilled practitioner, you should have no problem, no problem.”
“What are the risks involved with liposuction?”
“There is very little risk, very little.”
“Does anyone ever die from it?”
“I would never think so.”
“What are the risks involved with liposuction?”
“They’re tiny, very very small. They are very very minimal, whether one million to one or whatever. It’s very simple, there’s very little to go wrong in terms of permanent side effects—very very little to go wrong.”
“Is there any risk of death?”
“None whatsoever, no, no. I haven’t heard of any complication like that.”
You could call death a permanent side effect. You could definitely call it a complication. Stretching a point, you could say risking your life is the least little thing to fuss about, a very very little risk, tiny, very small, very very minimal. Liposuction deaths aren’t real deaths—a comforting thought for the families of the deceased. The surgeons say that “the benefits far outweigh the risks,” which is a value judgment about the relative importance of their version of “beauty” to that of a woman’s life.