Beauty

I've never really considered myself a super vain person- I don't take a long time in the bathroom in the morning, I don't pore over fashion magazines, I don't buy expensive clothes or wear a lot of makeup. Beauty is inside, I believe.
Yet today while spending some time in surgery I was confronted with a few very strong emotions that I had a hard time rationalizing to myself.
I entered the operating room with Dr. D and another medical student and the patient was already lying on the table asleep.
"She had a lump in her breast," Dr. D explained. "We're just taking it out for biopsy."
As I drew close to the patient I noticed how smooth her skin looked, how relaxed the lines of her face. I picked up her chart and the other medical student leaned over my shoulder and pointed at a number. She was only 18 years old.
I watched anxiously as the surgeon made the incision around the girl's nipple.
"Is it going to leave a scar?"
"Actually, she will hardly be able to notice it. It's amazing how normal it looks after it heals."
The biopsy went smoothly, except for the other medical student getting squirted in the eye with blood, and when they bandaged the patient up I tried not to imagine what she would be thinking when she looked in the mirror for the first time. Hopefully it wouldn't scar too much.
The next patient was an older woman who had had a mastectomy (breast removal) for a cancerous lump, and was in to have the other breast removed and reconstructive surgery. A team of 7 surgeons and nurses (plus myself and the other student) were around the table. I was intrigued to see the details of the operation. A blue radioactive dye was injected into the breast tissue, and after a few minutes, the surgeon passed a gamma ray detector over the breast and confirmed that the dye had moved into regional lymph nodes in the armpit. The surgeon cut through the skin of the breast, lifted it up and cut away all the tissue underneath and removed it en masse. Then a wide swath was cut across the lower abdomen (only leaving the belly button intact and dangling like a forgotten limb). The pocket where the breast had been was hollowed out and all the skin and fat lifted from the abdomen like opening a giant envelope. Then, still attached to it's arteries and veins, the graft from the lower abdomen was stuffed up into the breast pocket and stitched into place. The lower abdomen was pulled down in the fashion of a tummy tuck, with the belly button re-inserted and stitched into place. The involved lymph nodes were cut out and on the instrument tray the surgeon waved the detector over them and it beeped loudly. Then she waved it over the armpit and breast and it was silent. They'd got all the radioactive cancer out. Amazing.
But while the patient had the shape of normal breasts, they were covered in incisions.
"how will the scars look?" I asked.
"Not too bad. At least we were able to get all the breast tissue and involved lymph nodes out."
"What about her nipples?" I asked dubiously.
"Almost all my patients elect to have reconstructed nipples." the surgeon explained. "We tattoo them on and use a polymer implant for shape. They look not bad."
I'd seen patients who had had breast reconstruction or implants before. On the outside it looked all right, but underneath their chests were covered in ugly scars. I hugged myself and determined to look for lumps when I got home. I didn't want to end up on this table.
I felt desperately sorry for the poor woman. Perhaps she felt sorry for herself too. Or perhaps she was glad to be alive and rid of the cancer. I'm afraid of breast cancer. It's not like skin cancer on your shoulder that you can cut off, or colon cancer that you can get a part removed. Somehow it is very different and I think it strikes a chord very deep in the heart of many women. Even though we know it shouldn't be, a lot of our sense of personal worth comes from our physical beauty. For a woman to have a mastectomy and to lose her hair from chemotherapy is devastating in a way that pain and nausea isn't. It can crush her dignity and her sense of feminine beauty.
My brother's mother-in-law died last week from cancer. I saw her last in February standing outside in the snow, her eyes were bright blue like a summer sky and she was so very alive. It's hard to imagine that she is gone now. I think it takes a tremendous amount of courage to not only face one's own death, but also the gradual disappearance of one's beauty and dignity and feeling of worth. I know that Pat will be remembered not only as someone who was beautiful on the outside, but someone who on the inside possessed that inalienable beauty and strength that does not diminish.
As hard as we try, we can't keep what's on the outside looking good forever. We don't live forever. But the scripture says that as the outer person grows weaker, the inner person grows stronger and stronger and more beautiful as it conforms to the image of Christ. And that's beauty that does not fade with scars laced across the body; it only grows stronger and brighter in the twilight of a life that is slipping away.