Pity the Jobbing Plastic Surgeon

At the dining table next to mine, the evening got off to a terrible start. The two women were evidently friends, and had each brought a male date. After drinks were ordered, woman #1 asked woman #2’s date: “So, what do you do for a living?”.

Said date responded: “I’m a plastic surgeon”. Woman #1, clearly enraged by the ongoing PIP breast implant scandal, was off and running. He should be ashamed of his chosen profession. He was a parasite on women’s insecurities. He was a money-grubbing sexist pig. His entire field was a tool of oppression. And after that, she got critical.

The doctor was quiet throughout this torrent of abuse. When woman #1 finally paused in her indictment, he sighed the sigh of a person who has uttered a simple truth a thousand times and been ignored, but nonetheless continues in the quixotic task of educating the world around him.

He then said something like the following: “Cosmetic surgery is a sub-specialty of plastic surgery. I am one of many plastic surgeons who do no cosmetic surgery at all. My sub-specialty is pediatric plastic surgery. Pediatric plastic surgeons do not do boob jobs, brow lifts, fanny hoists, tummy tucks or lipo sucks. We repair infant boys’ penises when their urethra is obstructed or deformed. We fix cleft palates. We do skin grafts for children who have been burned. Things like that.”

The great thing about being the rude eavesdropper and not actually at the table meant I could get up and leave at this point, not having to participate in what had to be a rather awkward meal to follow.

The dinner date’s defense of his medical specialty is one I have heard from plastic surgeons before. Their entire field has become equated in the public mind with anorexic models toppling forward under the weight of silicone-filled D cups. It’s annoying for plastic surgeons both in the sense the doctor at the table next to me was annoyed (i.e., taking whatever guff the public wants to direct at cosmetic surgeons), but also because some people think all plastic surgeons are qualified and interested in giving them advice about hair implants, nose jobs, and breast lifts. If you think telling the person next to you on an airplane that you are a psychiatrist is dangerous, tell them you are a plastic surgeon and the flight may seem even longer (one colleague’s fellow passenger suddenly pulled up her shirt and asked for a medical opinion of an extraordinarily personal nature).**

This good doctor’s cause is hopeless. He will give his edifying speech a million more times before he dies, and he will be generally ignored. It is equally quixotic of me to post this statement of the difference between plastic and cosmetic surgery here. I do it not because I expect to fix the problem, but because this is a case where Sisyphus is a good egg and therefore deserving of company.


**FOOTNOTE: I learned long ago that describing oneself as a proctologist in such situations is a magnificent conversation stopper and I recommend it here to everyone in the health care racket.

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

25 thoughts on “Pity the Jobbing Plastic Surgeon”

  1. This is what the term “reconstructive surgery” is good for. (Maybe. Maybe it’s also been contaminated, but getting the word “plastic” out of there can’t hurt.)

    1. I have one plastic surgeon colleague who says she does “soft tissue” surgery. Because no one knows what that means, it gives her the freedom to define what she does before any stereotypes crash in.

      1. I am a surgeon (not plastic). Most people don’t realize that the word “plastic” surgery comes from the the greek root “plasticos” which means to mold. Early plastic surgeons did primarily reconstructive work to “mold” back damaged flesh. Unfortunately, it came to mean plastic as in artificial.

    1. Given how often we all come into contact with a**holes in our daily lives, studying them carefully, even scientifically, is a wise use of scarce resources.

  2. I once had to get an infected sebaceous cyst removed from my neck, which apparently required a plastic surgeon. We chatted about digital photography while he was whittling away: guy talk about megapixels and suchwhich. (It was a very new thing back then.) He was clearly delighted to be working on a scruffy guy who would speak in manly grunts, and didn’t care if he left a scar or not. Of course, he didn’t leave a scar.

  3. So, the woman basically stuck her foot in her mouth. But rather than inserting a mere toe, as most of us are want to do occasionally, she went right up to the thigh.

    Here’s what I find odd. How is it that a grown adult, presumably having engaged in countless conversations over the years, many with people she had only just met, not encountered a similar experience in which her eager presumptuousness led to a subsequent indulgence in moral superiority which then backfired when she was proven by the facts to have erred egregiously and made a fool of herself? In other words, how has she not learned to keep her big fat mouth shut just a tad longer?

    I think that we can all relate to having been there. Yet, what most of us likely took from the experience(s), was an opportunity to engage our reflective selves, to analyze our mistake, and lay down some heavy-duty neural wiring so as not to make the same mistake twice – or thrice, or however long it might have taken us. This is basic social normalization. We experience shame and thus improve ourselves. Yet she did not. Even after presumably making the same mistake many times throughout her life.

    So the interesting question is what in her psychological make-up has *actively* been getting in the way of her learning this basic social cue?

    1. The same lack of “learning” that leads so many people I know to spout right-wing political sentiments (and wear those sentiments on their T-shirts) without being encouraged to do so and without having a clue (or a care) what the beliefs of the people around them are. They send unwanted political emails along the same lines to their friends, often ones that have been forwarded for years and which have no basis in fact. These people appear to be otherwise reasonably intelligent and considerate people, but it seems that when people have deeply held convictions and opinions, no amount of information to the contrary will penetrate, never mind change them, and if evidence is presented it’s shrugged off and doesn’t even embarrass them.

    2. Eli,

      At our best, we learn from these sorts of things and change our behaviour. But a sadly considerable number of people, as you know, go through their whole lives lecturing other people, abusing them etc. and never change because whatever brain cog it is that tells humans that it is wrong to not consider the feelings of others is simply missing in them.

  4. “I learned long ago that describing oneself as a proctologist in such situations is a magnificent conversation stopper”

    This may work 9 out of 10 times but that 10th conversation is a doozy.

  5. My aikido sensei was a proctologist as his profession. I pointed out to him one day that he’s proficient in two different ways to take out assholes.

  6. It’s worth noting that one of the most famous plastic surgeons, the Brazilian, Ivo Pitanguy gained his initial fame by treating burn victims on an emergency basis from a major fire. He also donates one day a week to treating those ina free clinic he established.

  7. My guess is that most plastic surgeons would prefer not to base their livelihoods on the pampered and the vain — another casualty of our insane health care system is not just that they make a lot more money catering to this class than they do performing medically valuable services, but they do so with a lot less hassle. The same is true in dermatology. Hopefully, most learn to balance the two — but this lady — geez, even if he had been the other kind of plastic surgeon, surely just the fact that he was her friend’s date would have made her hold back a little.

    1. Yes, it’s weird that the doctor’s date didn’t stick up for him in the first place. Maybe they were all tipsy or something. It really is too bad that Americans can never discuss anything except how someone makes a living.

  8. Although obviously there are a lot of plastic surgeons who work entirely in reconstruction, the line between repair of traumatic or congenital defects and “cosmetic” surgery might not be at bright as we would like it to be. There are a lot of surgeons out there who tell their patients, at least, that they’re just rectifying conditions where nature failed to provide a satisfactory result, and promising improved quality of life post-op.

  9. Telling people that I’m a psychologist is another good conversation stopper. It’s usually followed by, “Oh, we should be careful what we say to you.”

    I typically respond by giving them my best “analyst” stare, and then say, “Don’t worry your secrets are safe with me.”

    With particularly annoying people, I’ll add, “You know that sexual issue you have? Don’t worry, I won’t say a word about it.”

  10. I believe Seinfeld covered this ground quite well, albeit with dermatologists. There’s really no way for that woman to recover from her mistake, is there…

    1. There is also the A**man episode, I forget the title. Kramer gets sent the wrong license plates.

  11. If the doctor in question really doesn’t want this kind of conversation, I recommend merely saying “I’m a surgeon” in these situations. If the other person then replies with a generally medical subject, or another topic all together, no harm done. If person does ask what kind of surgeon, then the doctor can take the opportunity to reply in a little more depth “Well, mostly pediatric reconstructive surgery.” Which again allows the doctor’s conversational partner to inquire more deeply or not, as she wishes, without bringing up any red-flag buzzwords.

    I mean, I don’t want to blame the victim here, but this really is a situation the surgeon can avoid if he actually wants to.

  12. I also have to say, except that this lady had the wrong guy, most of what she said is true! Though, even so, I don’t know that I’d blame the doctors themselves, or certainly not only the doctors.

  13. A former philosophy professor of mine told me that he never tells people on a plane that he’s a philosopher, because they want to tell him about their “philosophy”.

    He always says he’s a mathematics professor. At most, that elicits the response, “Oh, I was always bad at math.”

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