There was a long period of time, almost a year, during which I never looked in a mirror. It wasn’t easy, for I’d never suspected just how omnipresent are our own images. I began by merely avoiding mirrors, but by the end of the year I found myself with an acute knowledge of the reflected image, its numerous tricks and wiles, how it can spring up at any moment: a glass tabletop, a well-polished door handle, a darkened window, a pair of sunglasses, a restaurant’s otherwise magnificent brass-plated coffee machine sitting innocently by the cash register.
At the time, I had just moved, alone, to Scotland and was surviving on the dole, as Britain’s social security benefits are called. I didn’t know anyone and had no idea how I was going to live, yet I went anyway because by happenstance l’d met a plastic surgeon there who said he could help me. I had been living in London, working temp jobs. While in London, I’d received more nasty comments about my face than l had in the previous three years, living in Iowa, New York, and Germany. These comments, all from men and all odiously sexual, hurt and disoriented me. I also had journeyed to Scotland because after more than a dozen operations in the States my insurance had run out, along with my hope that further operations could make any real difference. Here, however, was a surgeon who had some new techniques, and here, amazingly enough, was a government willing to foot the bill: I didn’t feel I could pass up yet another chance to “fix” my face, which I confusedly thought concurrent with “fixing” my self, my soul, my life.
Twenty years ago, when I was nine and living in America, I came home from school one day with a toothache. Several weeks and misdiagnoses later, surgeons removed most of the right side of my jaw in an attempt to prevent the cancer they found there from spreading. No one properly explained the operation to me, and I awoke in a cocoon of pain that prevented me from moving or speaking. Tubes ran in and out of my body, and because I was temporarily unable to speak after the surgery and could not ask questions, I made up my own explanations for the tubes’ existence. I remember the mysterious manner the adults displayed toward me. They asked me to do things: lie still for X rays, not cry for needles, and so on, tasks that, although not easy, never seemed equal to the praise I received in return. Reinforced to me again and again was how l was “a brave girl” for not crying, “a good girl” for not complaining, and soon I began defining myself this way, equating strength with silence.
Then the chemotherapy began. In the Seventies chemo was even cruder than it is now, the basic premise being to poison patients right up to the very brink of their own death. Until this point I almost never cried and almost always received praise in return. Thus I got what I considered the better part of the deal. But now it was like a practical joke that had gotten out of hand. Chemotherapy was a nightmare and I wanted it to stop; I didn’t want to be brave anymore. Yet I had grown so used to defining myself as “brave”—i.e., silent—that the thought of losing this sense of myself was even more terrifying. I was certain that if I broke down I would be despicable in the eyes of both my parents and the doctors.
The task of taking me into the city for the chemo injections fell mostly on my mother, though sometimes my father made the trip. Overwhelmed by the sight of the vomiting and weeping, my father developed the routine of “going to get the car,” meaning that he left the doctor’s office before the injection was administered, on the premise that then he could have the car ready and waiting when it was all over. Ashamed of my suffering, I felt relief when he was finally out of the room. When my mother took me, she stayed in the room, yet this only made the distance between us even more tangible. She explained that it was wrong to cry before the needle went in; afterward was one thing, but before, that was mere fear, and hadn’t I demonstrated my bravery earlier? Every Friday for two and a half years I climbed up onto that big doctor’s table and told myself not to cry, and every week I failed. The two large syringes were filled with chemicals so caustic to the vein that each had to be administered very slowly. The whole process took about four minutes; I had to remain utterly still. Dry retching began in the first fifteen seconds, then the throb behind my eyes gave everything a yellow-green aura, and the bone-deep pain of alternating extreme hot and cold flashes made me tremble, yet still I had to sit motionless and not move my arm. No one spoke to me—not the doctor, who was a paradigm of the cold-fish physician; not the nurse, who told my mother I reacted much more violently than many of “the other children”; and not my mother, who, surely overwhelmed by the sight of her child’s suffering, thought the best thing to do was remind me to be brave, to try not to cry. All the while I hated myself for having wept before the needle went in, convinced that the nurse and my mother were right, that I was “overdoing it,” that the throwing up was psychosomatic, that my mother was angry with me for not being good or brave enough.
Yet each week, two or three days after the injection, there came the first flicker of feeling better, the always forgotten and gratefully rediscovered understanding that to simply be well in my body was the greatest thing I could ask for. I thought other people felt this appreciation and physical joy all the time, and I felt cheated because I was able to feel it only once a week.
Because I’d lost my hair, I wore a hat constantly, but this fooled no one, least of all myself. During this time, my mother worked in a nursing home in a Hasidic community. Hasidic law dictates that married women cover their hair, and most commonly this is done with a wig. My mother’s friends were now all too willing to donate their discarded wigs, and soon the house seemed filled with them. I never wore one, for they frightened me even when my mother insisted I looked better in one of the few that actually fit. Yet we didn’t know how to say no to the women who kept graciously offering their wigs. The cats enjoyed sleeping on them and the dogs playing with them, and we grew used to having to pick a wig up off a chair we wanted to sit in. It never struck us as odd until one day a visitor commented wryly as he cleared a chair for himself, and suddenly a great wave of shame overcame me. I had nightmares about wigs and flushed if I even heard the word, and one night I put myself out of my misery by getting up after everyone was asleep and gathering all the wigs except for one the dogs were fond of and that they had chewed up anyway. I hid all the rest in an old chest.
When you are only ten, which is when the chemotherapy began, two and a half years seem like your whole life, yet it did finally end, for the cancer was gone. I remember the last day of treatment clearly because it was the only day on which I succeeded in not crying, and because later, in private, I cried harder than I had in years; I thought now I would no longer be “special,” that without the arena of chemotherapy in which to prove myself no one would ever love me, that I would fade unnoticed into the background. But this idea about not being different didn’t last very long. Before, I foolishly believed that people stared at me because I was bald. After my hair eventually grew in, it didn’t take long before I understood that I looked different for another reason. My face. People stared at me in stores, and other children made fun of me to the point that I came to expect such reactions constantly, wherever I went. School became a battleground.
Halloween, that night of frights, became my favorite holiday because I could put on a mask and walk among the blessed for a few brief, sweet hours. Such freedom I felt, walking down the street, my face hidden! Through the imperfect oval holes I could peer out at other faces, masked or painted or not, and see on those faces nothing but the normal faces of childhood looking back at me, faces I mistakenly thought were the faces everyone else but me saw all the time, faces that were simply curious and ready for fun, not the faces I usually braced myself for, the cruel, lonely, vicious ones I spent every day other than Halloween waiting to see around each corner. As I breathed in the condensed, plastic-scented air under the mask, I somehow thought that I was breathing in normality, that this joy and weightlessness were what the world was composed of, and that it was only my face that kept me from it, my face that was my own mask that kept me from knowing the joy I was sure everyone but me lived with intimately. How could the other children not know it? Not know that to be free of the fear of taunts and the burden of knowing no one would ever love you was all that anyone could ever ask for? I was a pauper walking for a short while in the clothes of the prince, and when the day ended I gave up my disguise with dismay.
I was living in an extreme situation, and because I did not particularly care for the world I was in I lived in others, and because the world I did live in was dangerous now I incorporated this danger into my secret life. I imagined myself to be an Indian. Walking down the streets, I stepped through the forest, my body ready for any opportunity to fight or flee one of the big cats that I knew stalked me. Vietnam and Cambodia, in the news then as scenes of catastrophic horror, were other places I walked through daily. I made my way down the school hall, knowing a land mine or a sniper might give themselves away at any moment with the subtle metal click I’d read about. Compared with a land mine, a mere insult about my face seemed a frivolous thing.
In those years, not yet a teenager, I secretly read—knowing it was somehow inappropriate—works by Primo Levi and Elie Wiesel, and every book by a survivor I could find by myself without asking the librarian. Auschwitz, Birkenau: I felt the blows of the capos and somehow knew that because at any moment we might be called upon to live for a week on one loaf of bread and some water called soup, the peanut-butter sandwich I found on my plate was nothing less than a miracle, an utter and sheer miracle capable of making me literally weep with joy.
I decided to become a “deep” person. I wasn’t exactly sure what this would entail, but I believed that if I could just find the right philosophy, think the right thoughts, my suffering would end. To try to understand the world I was in, I undertook to find out what was “real,” and I quickly began seeing reality as existing in the lowest common denominator, that suffering was the one and only dependable thing. But rather than spend all of my time despairing, though certainly I did plenty of that, I developed a form of defensive egomania: I felt I was the only one walking about in the world who understood what was really important. I looked upon people complaining about the most mundane things—nothing on TV, traffic jams, the price of new clothes—and felt joy because I knew how unimportant those things really were and felt unenlightened superiority because other people didn’t. Because in my fantasy life I had learned to be thankful for each cold, blanketless night that I survived on the cramped wooden bunks, my pain and despair were a stroll through the country in comparison. I was often miserable, but I knew that to feel warm instead of cold was its own kind of joy, that to eat was a re-enactment of the grace of some god whom I could only dimly define, and that to simply be alive was a rare, ephemeral gift.
As I became a teenager, my isolation began. My non-identical twin sister started going out with boys, and I started—my most tragic mistake of all—to listen to and believe the taunts thrown at me daily by the very boys she and the other girls were interested in. I was a dog, a monster, the ugliest girl they had ever seen. Of all the remarks, the most damaging wasn’t even directed at me but was really an insult to “Jerry,” a boy I never saw because every day between fourth and fifth periods, when I was cornered by a particular group of kids, I was too ashamed to lift my eyes off the floor. “Hey look, it’s Jerry’s girlfriend!” they shrieked when they saw me, and I felt such shame, knowing that this was the deepest insult to Jerry that they could imagine.
When pressed to it, one makes compensations. I came to love winter, when I could wrap up the disfigured lower half of my face in a scarf: I could speak to people and they would have no idea to whom and to what they were really speaking. I developed the bad habits of letting my long hair hang in my face and of always covering my chin and mouth with my hand, hoping it might be mistaken as a thoughtful, accidental gesture. I also became interested in horses and got a job at a run-down local stable. Having those horses to go to each day after school saved my life; I spent all of my time either with them or thinking about them. Completely and utterly repressed by the time I was sixteen, I was convinced that I would never want a boyfriend, not ever, and wasn’t it convenient for me, even a blessing, that none would ever want me. I told myself I was free to concentrate on the “true reality” of life, whatever that was. My sister and her friends put on blue eye shadow, blow-dried their hair, and spent interminable hours in the local mall, and I looked down on them for this, knew they were misleading themselves and being overly occupied with the “mere surface” of living. I’d had thoughts like this when I was younger, ten or twelve, but now my philosophy was haunted by desires so frightening I was unable even to admit they existed.
Throughout all of this, I was undergoing reconstructive surgery in an attempt to rebuild my jaw. It started when I was fifteen, two years after the chemo ended. I had known for years I would have operations to fix my face, and at night I fantasized about how good my life would finally be then. One day I got a clue that maybe it wouldn’t be so easy. An older plastic surgeon explained the process of “pedestals” to me, and told me it would take ten years to fix my face. Ten years? Why even bother, I thought; I’ll be ancient by then. I went to a medical library and looked up the “pedestals” he talked about. There were gruesome pictures of people with grotesque tubes of their own skin growing out of their bodies, tubes of skin that were harvested like some kind of crop and then rearranged, with results that did not look at all normal or acceptable to my eye. But then I met a younger surgeon, who was working on a new way of grafting that did not involve pedestals, and I became more hopeful and once again began to await the fixing of my face, the day when I would be whole, content, loved.
Long-term plastic surgery is not like in the movies. There is no one single operation that will change everything, and there is certainly no slow unwrapping of the gauze in order to view the final, remarkable result. There is always swelling, sometimes to a grotesque degree, there are often bruises, and always there are scars. After each operation, too frightened to simply go look in the mirror, I developed an oblique method, with several stages. First, I tried to catch my reflection in an overhead lamp: the roundness of the metal distorted my image just enough to obscure details and give no true sense of size or proportion. Then I slowly worked my way up to looking at the reflection in someone’s eyeglasses, and from there I went to walking as briskly as possible by a mirror, glancing only quickly. I repeated this as many times as it would take me, passing the mirror slightly more slowly each time until finally I was able to stand still and confront myself.
The theory behind most reconstructive surgery is to take large chunks of muscle, skin, and bone and slap them into the roughly appropriate place, then slowly begin to carve this mess into some sort of shape. It involves long, major operations, countless lesser ones, a lot of pain, and many, many years. And also, it does not always work. With my young surgeon in New York, who with each passing year was becoming not so young, I had two or three soft-tissue grafts, two skin grafts, a bone graft, and some dozen other operations to “revise” my face, yet when I left graduate school at the age of twenty-five I was still more or less in the same position I had started in: a deep hole in the right side of my face and a rapidly shrinking left side and chin, a result of the radiation I’d had as a child and the stress placed upon the bone by the other operations. I was caught in a cycle of having a big operation, one that would force me to look monstrous from the swelling for many months, then having the subsequent revision operations that improved my looks tremendously, and then slowly, over the period of a few months or a year, watching the graft reabsorb back into my body, slowly shrinking down and leaving me with nothing but the scarred donor site the graft had originally come from.
It wasn’t until I was in college that I finally allowed that maybe, just maybe, it might be nice to have a boyfriend. I went to a small, liberal, predominantly female school and suddenly, after years of alienation in high school, discovered that there were other people I could enjoy talking to who thought me intelligent and talented. I was, however, still operating on the assumption that no one, not ever, would be physically attracted to me, and in a curious way this shaped tny personality. I became forthright and honest in the way that only the truly self-confident are, who do not expect to be rejected, and in the way of those like me, who do not even dare to ask acceptance from others and therefore expect no rejection. I had come to know myself as a person, but I would be in graduate school before I was literally, physically able to use my name and the word “woman” in the same sentence.
Now my friends repeated for me endlessly that most of it was in my mind, that, granted, I did not look like everyone else, but that didn’t mean I looked bad. I am sure now that they were right some of the time. But with the constant surgery I was in a perpetual state of transfiguration. I rarely looked the same for more than six months at a time. So ashamed of my face, I was unable even to admit that this constant change affected me; I let everyone who wanted to know that it was only what was inside that mattered, that I had “grown used to” the surgery, that none of it bothered me at all. Just as I had done in childhood, I pretended nothing was wrong, and this was constantly mistaken by others for bravery. I spent a great deal of time looking in the mirror in private, positioning my head to show off my eyes and nose, which were not only normal but quite pretty, as my friends told me often. But I could not bring myself to see them for more than a moment: I looked in the mirror and saw not the normal upper half of my face but only the disfigured lower half.
People still teased me. Not daily, as when I was younger, but in ways that caused me more pain than ever before. Children stared at me, and I learned to cross the street to avoid them; this bothered me, but not as much as the insults I got from men. Their taunts came at me not because I was disfigured but because I was a disfigured woman. They came from boys, sometimes men, and almost always from a group of them. I had long, blonde hair, and I also had a thin figure. Sometimes, from a distance, men would see a thin blonde and whistle, something I dreaded more than anything else because I knew that as they got closer, their tune, so to speak, would inevitably change; they would stare openly or, worse, turn away quickly in shame or repulsion. l decided to cut my hair to avoid any misconception that anyone, however briefly, might have about my being attractive. Only two or three times have I ever been teased by a single person, and I can think of only one time when I was ever teased by a woman. Had I been a man, would I have had to walk down the street while a group of young women followed and denigrated my sexual worth?
Not surprisingly, then, I viewed sex as my salvation. I was sure that if only I could get someone to sleep with me it would mean I wasn’t ugly, that I was attractive, even lovable. This line of reasoning led me into the beds of several manipulative men who liked themselves even less than they liked me, and I in turn left each short-term affair hating myself, obscenely sure that if only I had been prettier it would have worked—he would have loved me and it would have been like those other love affairs that I was certain “normal” women had all the time. Gradually, I became unable to say “I’m depressed” but could say only “I’m ugly,” because the two had become inextricably linked in my mind. Into that universal lie, that sad equation of “if only …” that we are all prey to, I was sure that if only I had a normal face, then I would be happy.
The new surgeon in Scotland, Oliver Fenton, recommended that I undergo a procedure involving something called a tissue expander, followed by a bone graft. A tissue expander is a small balloon placed under the skin and then slowly blown up over the course of several months, the object being to stretch out the skin and create room and cover for the new bone. It’s a bizarre, nightmarish thing to do to your face, yet I was hopeful about the end results and I was also able to spend the three months that the expansion took in the hospital. I’ve always felt safe in hospitals: they’re the one place I feel free from the need to explain the way I look. For this reason the first tissue expander was bearable—just—and the bone graft that followed it was a success; it did not melt away like the previous ones.
The surgical stress this put upon what remained of my original jaw instigated the deterioration of that bone, however, and it became unhappily apparent that I was going to need the same operation I’d just had on the right side done to the left. I remember my surgeon telling me this at an outpatient clinic. I planned to be traveling down to London that same night on an overnight train, and I barely made it to the station on time, such a fumbling state of despair was I in.
I could not imagine going through it again, and just as I had done all my life, I searched and searched through my intellect for a way to make it okay, make it bearable, for a way to do it. I lay awake all night on that train, feeling the tracks slip beneath me with an odd eroticism, when I remembered an afternoon from my three months in the hospital. Boredom was a big problem those long afternoons, the days marked by meals and television programs. Waiting for the afternoon tea to come, wondering desperately how I could make time pass, it had suddenly occurred to me that I didn’t have to make time pass, that it would do it of its own accord, that I simply had to relax and take no action. Lying on the train, remembering that, I realized I had no obligation to improve my situation, that I didn’t have to explain or understand it, that I could just simply let it happen. By the time the train pulled into King’s Cross station, I felt able to bear it yet again, not entirely sure what other choice I had.
But there was an element l didn’t yet know about. When I returned to Scotland to set up a date to have the tissue expander inserted, I was told quite casually that I’d be in the hospital only three or four days. Wasn’t I going to spend the whole expansion time in the hospital? I asked in a whisper. What’s the point of that? came the answer. You can just come in every day to the outpatient ward to have it expanded. Horrified by this, I was speechless. I would have to live and move about in the outside world with a giant balloon inside the tissue of my face? I can’t remember what I did for the next few days before I went into the hospital, but I vaguely recall that these days involved a great deal of drinking alone in bars and at home.
I had the operation and went home at the end of the week. The only things that gave me any comfort during the months I lived with my tissue expander were my writing and Franz Kafka. I started a novel and completely absorbed myself in it, writing for hours each day. The only way I could walk down the street, could stand the stares I received, was to think to myself, “I’ll bet none of them are writing a novel.” It was that strange, old, familiar form of egomania, directly related to my dismissive, conceited thoughts of adolescence. As for Kafka, who had always been one of my favorite writers, he helped me in that I felt permission to feel alienated, and to have that alienation be okay, bearable, noble even. In the same way that imagining I lived in Cambodia helped me as a child, I walked the streets of my dark little Scottish city by the sea and knew without doubt that I was living in a story Kafka would have been proud to write.
The one good thing about a tissue expander is that you look so bad with it in that no matter what you look like once it’s finally removed, your face has to look better. I had my bone graft and my fifth soft-tissue graft and, yes, even I had to admit I looked better. But I didn’t look like me. Something was wrong: was this the face I had waited through eighteen years and almost thirty operations for? I somehow just couldn’t make what I saw in the mirror correspond to the person I thought I was. It wasn’t only that I continued to feel ugly; I simply could not conceive of the image as belonging to me. My own image was the image of a stranger, and rather than try to understand this, I simply stopped looking in the mirror. I perfected the technique of brushing my teeth without a mirror, grew my hair in such a way that it would require only a quick, simple brush, and wore clothes that were simply and easily put on, no complex layers or lines that might require even the most minor of visual adjustments.
On one level I understood that the image of my face was merely that, an image, a surface that was not directly related to any true, deep definition of the self. But I also knew that it is only through appearances that we experience and make decisions about the everyday world, and I was not always able to gather the strength to prefer the deeper world to the shallower one. I looked for ways to find a bridge that would allow me access to both, rather than ride out the constant swings between peace and anguish. The only direction I had to go in to achieve this was to strive for a state of awareness and self-honesty that sometimes, to this day, occasionally rewards me. I have found, I believe, that our whole lives are dominated, though it is not always so clearly translatable, by the question “How do I look?” Take all the many nouns in our lives—car, house, job, family, love, friends—and substitute the personal pronoun I. It is not that we are all so self-obsessed; it is that all things eventually relate back to ourselves, and it is our own sense of how we appear to the world by which we chart our lives, how we navigate our personalities, which would otherwise be adrift in the ocean of other people’s obsessions.
One evening toward the end of my yearlong separation from the mirror, I was sitting in a cafe talking to someone—an attractive man, as it happened—and we were having a lovely, engaging conversation. For some reason I suddenly wondered what I looked like to him. What was he actually seeing when he saw me? So many times I’ve asked this of myself, and always the answer is this: a warm, smart woman, yes, but an unattractive one. I sat there in the cafe and asked myself this old question, and startlingly, for the first time in my life, I had no answer readily prepared. I had not looked in a mirror for so long that I quite simply had no clue as to what I looked like. I studied the man as he spoke; my entire life I had seen my ugliness reflected back to me. But now, as reluctant as I was to admit it, the only indication in my companion’s behavior was positive.
And then, that evening in that cafe, I experienced a moment of the freedom I’d been practicing for behind my Halloween mask all those years ago. But whereas as a child I expected my liberation to come as a result of gaining something, a new face, it came to me now as the result of shedding something, of shedding my image. I once thought that truth was eternal, that when you understood something it was with you forever. I know now that this isn’t so, that most truths are inherently unretainable, that we have to work hard all our lives to remember the most basic things. Society is no help; it tells us again and again that we can most be ourselves by looking like someone else, leaving our own faces behind to turn into ghosts that will inevitably resent and haunt us. It is no mistake that in movies and literature the dead sometimes know they are dead only after they can no longer see themselves in the mirror; and as I sat there feeling the warmth of the cup against my palm, this small observation seemed like a great revelation to me. I wanted to tell the man I was with about it, but he was involved in his own topic and I did not want to interrupt him, so instead I looked with curiosity toward the window behind him, its night-darkened glass reflecting the whole cafe, to see if I could, now, recognize myself.
Lucy Grealy's poetry has appeared in The Paris Review and The London Times Literary Supplement. She is currently a fellow at the Fine Arts Works Center, in Provincetown, Massachusetts.
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