by Anthony Youn
He hands her back the photo. “I’m going to do the best I can. But I understand your baby has had some major deforming injuries.”
She blinks, either not understanding or in deep denial.
“Your baby is severely deformed,” Dr. Kanner says slowly. “I can only promise you that I will do my very best to make him look as good as I can. As good as humanly possible.”
“Well, Dr. Kanner, that sounds like a load of shit. How old are you? How long you been doing this? This your first time? You are a doctor, right?”
She practically spits these words in Dr. Kanner’s face. I smell the alcohol on her breath then. Dr. Kanner was wrong. She’s drunk, an idiot, and an asshole.
“I’m a board-certified plastic surgeon,” he says. “You can look me up. I’ve had all the necessary training and years of experience, and I’m here at three in the morning to take care of your baby. If you want me to go home, you’ll have to take that up with the hospital administration. Right now I’m going to do my job, which is to figure out what I can do for your baby. Now, if you don’t mind, Miss Ellison, get out of my way. Please.”
A stare-down.
After ten full seconds, Miss Ellison drops her arm with a slap on her thigh and moves aside, allowing Dr. Kanner and me to pass.
I follow him to the foot of the bed. He scans the baby’s body, moves up, and lowers his head over the baby’s face. He studies every inch, as focused as a camera, then goes to the sink in the room. He scrubs his hands, pulls on sterilized gloves. He nods toward the supply cabinet. I pull open a drawer. He nods again, and I open some gauze packs and tubes of antibiotic ointment. He walks back to bed, peels open the baby’s eyes, murmurs something that almost sounds like a prayer, then squirts an entire tube of ointment over the remains of the baby’s face, laying gauze over the exposed areas.
“I’m going to take some pictures in a minute,” he says. He drops his hand onto the baby’s forehead and caresses his few thin blond hairs. “I’m gonna do my best, little man.” He stands straight up, erect as a sergeant, yanks off his gloves, and shuffles into the far corner of the room. He reaches into his shirt pocket, pulls out a pen and small notebook.
“Let me give you an idea of what we’re going to do.” He looks up at me as if in afterthought. “You had any experience in plastic surgery?”
“No. I’m in my third year, last rotation. I’ve finished general, but we didn’t spend any time on plastic surgery.”
“Yeah, I know. I think you miss out. My humble opinion. But that’s what fourth year is for.”
“Choose my own adventure.”
“Exactly. We’ll talk. Okay, let’s see what we can do.” He begins sketching the baby’s face on the pad. “You draw?”
“I do, actually.”
For the second time since we’ve met, he lifts an eyebrow. “That will serve you well. There. Our first issue is that he’s got a lot of growing to do. That makes the reconstruction even more complicated, as if it weren’t complicated enough. For example, I could re-create his nose by flipping down the skin of his forehead.”
Dr. Kanner draws an outline of a nose on the baby’s face. “But the reconstructed nose probably will not grow with him in an anatomically proportional fashion.”
“So, we’re looking at further nose reconstruction as he gets older.”
“That’s almost a given. Our first priority here is to get coverage of his open wounds.”
“I see. That way he won’t have exposed cartilage and other organs of the face.”
“Yep. We’re going to need to bring in tissue from another part of his body to remake his lips and mouth. I won’t be able to reconstruct his lips and mouth perfectly—”
He sketches in lips and mouth. As I watch Dr. Kanner draw, I realize I’m no longer tired. Despite the horror of the baby’s mutilated face, I feel a kind of thrill, the thrill of possibility, the thrill of hope. For a brief single moment I imagine that I am Dr. Kanner. I am sketching the replacement face for the eight-month-old child, and I am the one accepting the responsibility for rebuilding his face. I wonder how that would feel.
Dr. Kanner snaps his notebook shut. “Time to talk to the mom again.”
We step into the corridor, eerily vacant except for one nurse at the nurses’ station. We head in that direction.
“Tony, if you want, call me and we’ll have coffee,” Dr. Kanner says. “This is not the time to talk about it, but plastic surgery covers a lot of territory. The obvious elective-cosmetic stuff to stuff that’s, well, like this. Here’s my card.” He zips open his camera bag and hands me a business card.
“I will call you,” I say.
At the nurses’ station, Dr. Kanner scans the hallway, shrugs in confusion. “Where is she?”
“She went home,” the nurse says.
It takes us both a while for this to sink in.
“She went home?” Dr. Kanner says.
“She said she was tired.”
Dr. Kanner raises his index finger as if he’s a student in class with the right answer. Then he forms a fist and knocks softly on the nurse’s desk.
“Yeah,” the nurse says. “I know.”
“Well, I’m going to go back to the room,” Dr. Kanner says.
“I’d better head back over to pediatrics. Thank you, Dr. Kanner.” I offer my hand.
He grips it firmly. “Call me,” he says.
FOUR A.M.
Back in general pediatrics. Slouching toward the call room. I walk in a kind of dream state. Images bombard me—the baby’s face, Dr. Kanner’s cool confidence, the unbelievable reaction of the baby’s mother, the idea that I might want to look into becoming a plastic surgeon—
But I can’t shake that baby’s face.
How much can Dr. Kanner do? What will happen to that poor kid?
A baby’s shriek jars me.
The shriek builds to a frantic cry.
After what I’ve just seen—
I stop at the nurses’ station. A beleaguered nurse takes her time before she raises her head and sprays me with attitude. “Yes?”
“I don’t mean to bother you, but that baby—”
“We’re monitoring him. He’s not in any distress.”
“He sounds like he’s in distress.”
“He’s not. Look, we got a lot of sick kids up here. We’re not a babysitting service.”
She turns away from me. I’m not even remotely pissed. Two weeks away from completing my last rotation, I get it.
When you constantly have to function on zero sleep, you sometimes get a little testy.
The baby’s crying intensifies to a piercing wail.
I follow the sound.
I come to the door of his room, slide the chart out of the plastic holder on the wall outside, flip through it. Daniel Kwan. Thirteen months old. Half Asian, half Caucasian. Diagnosed with a respiratory syncytial virus infection.
In English—runny nose, wheezing, hard as hell to breathe.
I push the door open with my shoulder and walk in. Daniel, frail, small for his age, wearing a hospital gown and a diaper, his head reared back as he howls, a mop of brown hair sticking straight up, stands inside his crib, his tiny hands gripping the metal bars. He is alone in the room.
“Hey, buddy,” I say. I reach my arms over the crib.
He stops crying, takes a step back, wheezes, sniffles, studies me with uncertain wide brown eyes.
“I’m Tony.”
He gurgles, then holds his arms out and waddles over to me. I lift him out of the crib and press him against my shoulder.
“Rough night, huh? I hear you.”
He whimpers, revs up, starts to wail.
“Hey, hey, it’s okay. I got you.”
I find a blanket lying on a rocking chair facing the window. I grab it with two fingers, drape it over Daniel, and sit down with him on the rocking chair.
His crying hits overdrive.
“It’s okay,” I say. “Shh.”
I start to hum t
he first song that leaps into my head, the only song I can think of—“Every Rose Has Its Thorn” by Poison.
“You like metal?”
Daniel wails.
“Me, too. All right.” I rock him slowly to the rhythm of the power ballad, humming the chorus.
“‘Every rose has its thorn,’” I sing.
Daniel stops crying.
“‘Every rose has its thorn, just like every night has its dawn—’”
Daniel coos. I fight to remember the rest of the lyrics, can’t, so I repeat, “‘Every rose has its thorn, just like every night has its dawn,’” over and over, softer and softer, until Daniel, precious baby, yawns, coos again, and fades into a sleep so deep that he snores.
“Oh, man. I saw some stuff tonight, Daniel. I saw some stuff.”
I clutch him into my chest and rock him slowly.
V Fourth Year
18
Thanksgiving Story
Fourth year.
Choose Our Own Adventure.
After a solid year of endless days and sleepless nights of hospital rotations during which we felt mostly clueless and in the way, we ready ourselves for the year in which we find ourselves. The year we determine the kind of doctor we’re going to be.
I alone on Flower Street feel uncertain. From day one, Tim has announced that he will be a psychiatrist. A wise decision. For the sake of humanity, he should be kept far away from medical equipment and sharp instruments. Ricky has opted for pediatrics and will work at a top children’s hospital on the East Coast. James has fallen in love with internal medicine—somebody has to—and will spend much of his fourth year abroad.
I begin my summer of fourth year sitting in a medical building cafeteria having coffee with Dr. Kanner, seeking direction.
“I think of myself as an artist, I really do,” Dr. Kanner says, pumping his coffee full of sugar. “You’re always shaping, sculpting, creating, and re-creating, but your canvas is the human face and the human body. You get to make people over. It’s amazing. Kind of powerful. Never boring. Have I hooked you yet?”
“I’m intrigued. A little overwhelmed, too.”
“There is a lot. And you need to experience all of it, the whole breadth of plastic surgery, see what we do, cosmetic, reconstructive, the whole deal. You need to travel to Mecca.”
And so, thanks to Dr. Kanner’s patience and prodding, I start on a series of three one-month plastic-surgery rotations, beginning in the Mecca of the Midwest—Grand Rapids, Michigan.
SEPTEMBER.
Grand Rapids, Michigan, the Furniture City, population 197,000. Second-largest city in the state. Home of the minor-league West Michigan Whitecaps and the Gerald Ford museum.
In my month rotation, I have no time to take in a Whitecaps game, I skip the Gerald Ford museum, and I observe no furniture of note, other than the catalog-issue metal chairs, tables, and gurneys in the plastic surgery center’s operating room. I’ll live without experiencing these thrills. Because I take in something way cooler.
My first breast-reduction surgery.
For the squeamish—Tim, jump ahead—this is one bloody surgery.
Basically, the surgeon carves the breast completely apart, scoops out the insides, reshapes it, then puts it back together. And the blood? Rivers. Spurting. Gushing. Like a grenade going off in there. I watch, my mouth wide with wonder. How is this surgeon ever going to put that breast back together and mold it into something beautiful? Well, he does.
And what’s more, I want to do it.
I’m so excited that after my first day, I call Amy to tell her that at the eleventh hour, when I was feeling lost, when Tim and Ricky and James had all found themselves and I felt like a kid left at the side of the road while the school bus pulled away, I figured it out.
I call my father and tell him that I won’t be going into family practice. I will go into surgery after all, plastic surgery, hopefully, and if I don’t get into a residency, I’ll bite the bullet and go for general surgery.
“Oh, Tony,” he says. “That’s good, that’s fine. But if you want family practice, it’s okay. You go into debt, you won’t be able to afford a house, or a car, or new clothes, or food, or shoes, and you cry yourself to sleep every night, but it’s okay. Daddy’s not mad.”
“I’m not going into family practice, Dad.”
“Thank God.”
During my month in Grand Rapids, I assist on several breast reductions. Each surgery takes four hours. After my second one, the surgeon aims the spotlight right on me. He asks me to suture. My first reaction is Wow, these people think I’m worthy. I’m ready. And I know I can suture. I spent a year practicing on frozen pig’s feet. Not the same as a live woman’s breast, but still—
Then I realize that Grand Rapids is Mecca. I have to get accepted into a plastic-surgeon residency, and Grand Rapids is where I want to be. For a slew of reasons—close to home, close to Amy, everyone is welcoming and patient and kind, and it’s the best plastic-surgery residency in the Midwest, if not the country.
I prepare to suture. I suddenly feel everyone’s eyes on me. I start thinking, They’re watching me. They’re checking out my hand-eye coordination. They’re scoping my skills. This is a trial, a test. Like a final exam. If I mess up this suture, they’ll never accept me into residency here.
No, no, no. Now is not the time for my hands to shake. Great. I’m doing a suture solo, and here comes a nervous tremor. Beautiful. I’m a dead man.
I take a deep breath, visualize, see myself suturing this woman’s breast, watch myself do it again, and then I begin and I’m smooth, and within seconds people stop watching me and move on to what they’re doing. I relax, I take my time, I suture. I feel accepted. I feel as if I’ve arrived.
I want this.
NOVEMBER.
Next stop, the home of Abraham Lincoln, Springfield, Illinois, a boring six-hour drive away. Now that I’ve decided on plastic surgery, I want to check out the top residencies in the country. When it comes to hands, no place tops the clinic in Springfield, Illinois. And as I will discover, when it comes to small towns, nothing feels smaller than Springfield, Illinois.
I cram my Ford Tempo full of my clothes, books, and all the essentials I’ll need for the month—tiny twelve-inch temperamental TV, a VCR I buy for two dollars at a tag sale, a mini-microwave Tim never uses because it occasionally smokes, one pot, one pan, two cups, two dishes, and a Korean sleeping cushion my mother forces on me. I say goodbye to my parents. My mom beams, my father crushes me in a hug. I stop at Amy’s apartment after she’s completed a grueling twenty-four-hour call with an intern who makes Nancy seem like Deepak Chopra. We hold each other, and then she whispers the sentence I’ve been dreading: “When you get back, I want to meet your parents.”
“Great idea. I was thinking the same thing. When I get back from Springfield, we’ll all have dinner. I’ll check their availability. They’re pretty busy—”
“Tony, I mean it.”
“Look at the time. I better get going. Got a big drive ahead of me. Six hours. I’ll call you when I get there. Love you.”
I know she’s really exhausted because she doesn’t press it. We cling to each other silently. One last kiss and I’m gone.
SIX HOURS LATER, driving into dusk, I pass all things Lincoln—Lincoln’s home, the Abraham Lincoln museum, Lincoln’s Tomb, and the thirty-foot-tall Abraham Lincoln totem pole. And that, as far I can determine, covers all there is to see and do in Springfield, Illinois. Doesn’t matter. I’ll be wrapped up 24/7 at the hospital or hand clinic, both an easy walk from my apartment complex, a 1950s former motel with water-stained cement stairs on the outside leading to my second-floor walk-up. Road-weary, head pounding, needing a shower—I’ve driven the six hours straight through—I trudge up the flight of uneven stairs to my apartment and unlock the door. The smell of smoke nearly blows me back outside. I gag, hold my nose, and walk in.
I exhale, gag again. The place smells like an ashtray. In addition, the bar
e floor is so covered with dog hair that it looks like a shag carpet. I peek into the empty room and instantly retreat, my eyes burning from residual cigarette smoke. I shut the door and fight a sudden desire to gather my meager belongings, bolt down the cement stairs, reload the Ford Tempo, and drive the hell away from Honest Abeville.
Seeing an image of myself suturing in Grand Rapids, feeling newly welcomed into the plastic-surgery community—hoping that, anyway—I suck it up and decide to stay. I’ll make the best of it. I’ll barely be in this apartment. I’ll only sleep here.
But . . . sleep where?
That’s when I whisper a prayer of thanks to my mom. I unroll her Korean sleeping cushion, spread it out on the living room floor, and pile everything else onto the kitchen counter, including my clothes.
My apartment may be a rat hole, but at least I’ll bond with a group of great people in the world of hand surgery.
THEY HATE ME.
At least that’s how it feels. They’re certainly not warm, fuzzy, and welcoming, like the Grand Rapids guys. It could be me. I’ve been out of sorts. You have to cut me some slack. Waking up every morning smelling like a casino, mouth tasting as if I’ve swallowed a schnauzer, can make a man irritable.
Day one. I get a glimpse of the chief of surgery in action during a team meeting in a conference room as he reams out the residents, who cower as he pummels them. He’s unhappy with how they’ve treated a few of the plastic-surgery patients, and he’s letting them know. He’s apoplectic. He’s taller than everyone in the room, a chubby-faced guy with a bush of black hair and large calloused hands the size of baseball mitts. I have to follow his ream-out act by introducing myself and making nice. Nothing better than gushing like a fool, saying, “Hi, I’m Tony Youn, the new medical student. Awesome speech.” I, of course, say nothing. I smile, offer my hand. He crushes my fingers in a powerhouse handshake. He looks right past me as the surgeons slink out of the room.
No surprise that the clinic specializes in hand surgeries. Springfield lies in the center of farm country, which means farmers regularly slicing off fingertips, cutting off fingers, lobbing off entire hands. I watch with fascination as surgeons deftly reattach fingers and hands, reconnecting arteries, veins, and nerves, all done under a microscope. These plastic surgeons are masters of minuscule needles and tiny suturing, mavens of microsurgery.