Ear Today, Ghoul Tomorrow?

Before and after surgery photos taken on patie...
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Ear Today, Ghoul Tomorrow?

I don’t plan to grow old gracefully. I plan to have face-lifts until my ears meet. – Rita Rudner

Life, for most mortals, is a zero sum game. As one enters middle age, you begin receiving physical past due notices requesting payment for every  act of vanity, gluttony, sloth and stupidity.

Having grown up on the beaches of Southern California, I became accustomed to enduring a permanent state of sun burn.  My delicate adolescent epidermis was in a perpetual cycle of burn and tan – always followed by a reptilian peeling of the skin. In the days where dermatologists existed to treat teens for acne and ancient beachcombers for melanoma, parents did not force kids to lather up with SPF 50 sunscreen. When overexposure to the sun produced second degree burns, mothers would simply apply a greasy, white industrial ointment known as zinc oxide to the afflicted area and hustle you back out into the sun.

Like the Aztecs of ancient Mexico, we were a society of sun worshippers. A tan was considered a healthy measure of a man’s cultural, physical and financial prowess.  Stars like George Hamilton and Robert Wagner personified the benefits of melanin and masculinity. Despite my light eyes and County Kerry skin, I was constantly in search of the savage tan. As with all the seven deadly sins, the Fates never forget to remind you of your deal with the devil.

At the ripe, young age of 35, I noticed a small patch of flaking skin above my left eye that never seemed to heal.  It was no larger than a thimble top. It had a predictable six to eight week cycle of itching, peeling and healing.  I mentioned it in passing to my physician during a rare physical. As a precaution, he sent me to a dermatologist who, after conducting a biopsy, surprised me with a diagnosis of basal cell carcinoma.

My skin doctor further unnerved me by sharing that the basal cell’s removal would require the assistance of a plastic surgeon as the particular area in question had little skin to suture the quarter-sized area that would need to be excised. He went on to describe a Frankenstein type of procedure that would graft skin off my temple by twisting clockwise over open eyebrow.

Only in my mid-thirties, the notion of plastic surgery unnerved me.  I assumed that the only people in real need of plastic surgeons were public enemy number one criminals attempting to alter their physical appearances, aging celebrities and of course, Joan Rivers.  I instantly recalled the Frank Capra Halloween classic, “Arsenic and Old Lace”, where a sociopathic murderer played by creepy Raymond Massey, returns home to threaten his family after being disfigured by his drunken plastic surgeon, Peter Lorre. My active imagination transferred his scars on to my face – a face that not even my dog could love.

I endured the surgery but developed am embarrassing post operative complication when excessive scar tissue accumulated underneath the incision. It appeared as if I was growing a small horn. Since it had been several centuries since horned, pan flute playing fauns were in vogue, I was eager to receive a “horn-ectomy.” Yet, an infection would require that I wait six months for this critical second plastic surgery. In the interim, I learned a lifetime of insights about my own vanity.

The “horn” incident left me with a strong motivation to return to my dermatologist every six months to be probed for suspicious moles, foreign freckles and dubious discolorations.  If the doctor found anything, he would deploy his trusty canister of liquid nitrogen and proceed to “freezer burn” the cells gone wild. Aesthetically, my doctor never seemed to consider the fact that I had a social life. Perhaps he assumed I was a research librarian. You see, a man with freezer burns across his nose, cheeks and forehead looks like someone in the early stages of leprosy. It was inconvenient but I did finally come to realize that the person who most noticed my burn marks– was me.

Fast forward to October, 2010. It had been years since I had been diagnosed with any epidermal irregularities. I was beginning to think that I had finally gotten the skin cancer monkey off my back when the doctor found a small patch of flaking skin on the inside of my ear. What was thought to be a patch of eczema was instead, an aggressive squamous skin cancer that needed to be immediately removed.

The excision surgery called Mohs, involved removing the lesion and any surrounding tissue that might have been corrupted by the cancerous cells. The doctor essentially keeps expanding the radius of his incisions until the adjacent skin is cancer free.  What might start as a laser thin surgical bore can grow into the Grand Canyon. While preferable to the more medieval skin surgeries of the past which usually resulted in pieces of one’s body being removed, Mohs was still invasive surgery in an area comprised predominantly of cartilage – which is slow to heal, quick to infect and impossible to disguise.  I was not quite ready to go Van Gogh.

After a seemingly uneventful surgery, my ear was wrapped and I was sent home to convalesce.  The bandage looked like a battlefield medic dressing and screamed out to anyone passing by, “look at me!”.  It was enormous and came to a rather unattractive point at the top of my ear appearing as though I was either preparing for a journey to Modor or readying for a Star Trek convention. My spouse did what all good spouses do – she lied to me saying, “You – – can hardly notice it.” She was so confident of its total invisibility that she suggested we go to the local Varsity football game to get my mind off the surgery. I was reluctant to appear in public as I knew two-thirds of our entire community would be gathered to socialize and stare at my ear. I could already envision four-year old kids coming up to me and handing me scribbled notes asking me if I would not mind “giving their list to Santa.”

At the football game, I skulked in the shadows like Boo Radley convinced everyone was fixated on my head. I lasted two quarters and declared that it was time to leave.  Later that evening, under a bright vanity mirror light, I surveyed the bullet hole wound and the exposed cartilage. I felt like “Massive Head Wound Harry”, a disgusting character made famous by Dana Carvey on Saturday Night Live.  I started second guessing whether I should have asked the doctor for an appointment with a plastic surgeon.

As a healthcare professional, I had philosophical reservations about elective plastic surgery. Americans spend up to $13B a year on non-essential procedures. What was once a medical profession designed to improve the quality of life for those unfairly dealt deuces in the card game of life, had now become a multi billion dollar industry catering to the insecurities of a society that glorified youth and whispered promises that physical perfection led to personal happiness.

As an addictive personality, I could easily see myself getting caught up in the body image spiral. Despite a regimen of rigorous exercise, there remain parts of my body that categorically refuse to recognize me as their sovereign. These untamed regions of my legs and arms resist my periodic offensives to tame them. As I survey my wobbly inner thigh or stubborn love handles, popular culture chips away at my self-confidence. I  am a failure for somehow not bringing these rebellious bands of bagginess under heel. Perhaps getting my ear fixed would create more problems – like buying that new couch and then suddenly waking up convinced that I needed to remodel the entire house.  Within a few years, I would end up looking like a 15th century samurai.

I do not know what it is about middle-aged men and denial. While men generally age gracefully, they cannot always see the dignity of their salt and pepper patina. Take for instance, my hero Olympic Decathlete Bruce Jenner who now resembles the illegitimate offspring off an orange orangutan and an iguana. Bruce, who should be a star in a TV special, “When Good Facelifts Go Bad”, presides like a eunuch over a harem of micro-celebrity Kardashian women.  He spends his day playing with toys and sleeping while his B-list step daughters disrupt various public places across the US. Bruce is not the only sad sack of surgery. Have you seen singer Kenny Rogers, aka The Gambler, lately? Old Kenny has been stretched more times than salt water taffy and looks as if he is permanently walking into his own surprise party.

And do not think I would forget the ladies!  Ironically, these nymphs of the knife who spend tens of thousands each year to look “different” have actually become increasingly interchangeable.  Between their collagen injections, Botox, liposuction, tummy tucks, forehead lifts, chin contouring and implants – they have created their own subhuman race of taut, buxom human carp. The lists of cosmetic casualties that refuse to go gently into that good night include Janet Jackson (She and Michael are the same person), Meg Ryan, Donatella Versace and Melanie Griffith. Between the collagen gone bad, shifting saline and sagging facelifts, these Brides of Frankenstein are walking warnings of the price paid for listening to that nagging inner critic that keeps whispering that your butt looks big.

In the end, my ear will heal.  I’ll eventually stop worrying that I look like Evander Holyfield.  The bandage will come off revealing a scar and gasp, more imperfection.  It may detract from my physical appearance but in the end, it will be another unique brush stroke on my canvas – a flawed Dorian Gray portrait replete with scars, gray hair moments, crow’s feet and laugh lines.  I will play the cards God gave me, and continue to wage conventional warfare against those untamed physical regions that seem immune to my best intentions.

Who knows, in the end, I may look back and find that the only real terrorist that existed in my life – – was my vanity.