Confessions of a Park Avenue Plastic Surgeon

by Cap Lesesne

  In short, if you want to succeed as a Park Avenue surgeon, you are always on call. Your social life is an extension of your professional life; the main difference is that you’re not wearing scrubs. You’d better own a good tuxedo and know the right way to hold the stem of a flute. You’d better have a decent grasp of what’s going on with geopolitical conflict and trade policy. You’d be well-served to speak, or at least know several phrases in, something other than just English (I know French fluently, and enough German, Italian, Spanish, Turkish, and Japanese to get by). You’d better attend parties, be gregarious, serve on the board of prestigious museums, and make it to charity functions.

  Worldly people are interesting, diverse, and fun to be around. You want to be their friends because they improve the quality of your life. But sometimes they become more than just an operation.

  Sometimes, a lot more.

  I agreed to do a face-lift, eyelidplasty, and rhinoplasty for a queen and her lady-in-waiting. Months before, one of her representatives had begun to investigate me, unbeknownst to me. It was never clear what exactly Mohammed Ibraham’s title was; “ambassador without portfolio,” he called himself. An attractive, impeccably groomed man dressed in fine English suits with French cuffs, Mohammed spoke several languages with a true accent. He could charm the pants off a dictator. Occasionally, we would bump into each other at a cocktail party. He included me at state dinners. He was immensely likable. I just thought he was one of those fascinating people you meet in New York, Gstaad, London, or Hong Kong.

  After several months he said, “I would like you to meet Her Majesty.” He declined to say which country she was majesty of, though I had my suspicions. I thought it was just a social encounter – an honor, of course, but that was it. When she and Mohammed appeared one day at my office, I remembered to bow low. And to be polite. It quickly became clear that she and I could communicate neither in English nor her primary language; she spoke Japanese, as well, so I used the little Japanese I’d studied in college. She was trim and smartly dressed in Western-style clothes. She had a dark complexion, beautifully shaped brown eyes, and long lashes. She’d had acne as a child, so there was some facial scarring. Her smile was quick.

  After a few pleasantries she quizzed me.

  “Do you do face work?”

  “Yes,” I said.

  “Can you do my eyes?”

  “Yes.”

  After ten minutes she seemed satisfied. “I would like you to do it tomorrow morning.”

  I was floored. “That’s not possible,” I told her. “There’s lab work to be –”

  There was a knock on the door. I walked over and opened it. Mohammed stood there, a folder in his hand. I looked at it. All the queen’s labs had been done – blood test, EKG, stress, everything.

  “Well,” I said, “it’s not so easy. I’d have to move a lot of things around…”

  Mohammed shot me an expression that said, Be real. I’d had experience with movie stars and wealthy South Americans expecting to be fit in quickly, but this took the cake.

  I called the head of OR at one of the hospitals I’m affiliated with, and asked what the odds were of getting a room the next day – no, make that two ORs, which Her Majesty required for the privacy and comfort of her bodyguards. Before he could object, I said, “It’s a queen. Of a country. Money is no object.”

  All of a sudden, doors opened up. I called the chief of anesthesiology and got what I needed.

  The next day, the queen was wheeled into the operating room followed by the chief of the king’s security detail, assigned to the queen. Heavily built, hair slicked back, five foot six on tiptoes, Ali’s professional style was as hostile to the concept of “subtlety” as mine was measured by it. When he smiled, I could see every crooked tooth. He had a gun. In a shoulder strap. In his sterile gown and coverings and surgical mask and cap, his bulk looked almost absurd.

  I scrubbed. The anesthesiologist stood there, waiting. As I readied to be gowned and gloved, Ali offered the most memorable vote of confidence I’ve ever heard.

  “If she dies,” he said in heavily accented English to my anesthesiologist, and I could tell by the crinkles around his eyes that he was smiling his crooked-toothed smile under the mask, “I will kill the doctor and you.”

  The anesthesiologist stared at him.

  “I have diplomatic immunity,” he said.

  The anesthesiologist, shaking, turned to me. “Does he?”

  “Yes,” I said.

  Excitement, international people … it’s not as if my out-of-the-OR life didn’t have its moments.

  While at a fund-raiser for the Conservation Committee at the Museum of the City of New York, I was seated next to Sarah Ferguson, Duchess of York – Fergie – and her lady-in-waiting. We danced, we talked, we laughed; she was funny and vibrant and amazingly chipper for someone who’d once undergone worldwide scrutiny and humiliation, from a toe-sucking to divorce to public ouster from a certain family in England. Good for her not to allow her natural effusiveness to get beaten out of her.

  Unless I was mistaken, she was making a pass at me. “So what are you doing next week?” she purred, leaning over the table and smiling.

  Stunned, I didn’t reply.

  “We’re going to India,” said Fergie, gesturing at her lady-in-waiting to show that there would be a chaperone. “Would you like to come along?”

  I’m sure I turned some shade of beet.

  “I have to work,” I stammered, an unfortunate excuse.

  I was invited to a formal reception at the French ambassador’s residence on Park Avenue in honor of Louis de Bourbon, a member of French royalty. The walls were covered with Matisses, Manets, and paintings on loan from the Louvre. There were ambassadors from Europe, Africa, and the Middle East, all chatting and laughing with each other. The Russian and French contingents parried over which nation really had a better understanding of fascism, while the Moroccan ambassador and the U.N. representative from Spain playfully jabbed at each other. The Moroccan said that Spain should return the three towns it occupied that rightfully belonged to Morocco.

  “We’ll give them back,” said the U.N. rep, “when you get the British to return Gibraltar to us.”

  Just before dinner, a commotion broke out across the room. Two gorgeous women in their midforties, in ballgowns, were slapping at each other.

  “Bitch!” one yelled.

  “Screw you!” the other said.

  Then they really started clawing.

  The rest of the room – mostly men – stood and watched. No one did anything. A roomful of diplomats and experts in international relations, and no one wanted to get involved. Which side to choose?

  As the only person there not involved in diplomacy, I grabbed each woman by an arm and separated them. But then I thought, What do I do now? They were still fighting. The first order of business was to get them outside. I led them down the long, winding staircase, as they continued swearing and swinging at each other.

  We walked out onto Park Avenue.

  It was freezing. They were in their ballgowns, me in my tuxedo.

  I hoped a cooling of body temperature would have the desired effect on their systems. The ladies continued yelling at each other, but they had given up on taking swings, preferring to use their arms to keep themselves warm. Still, they continued the verbal attacks.

  “Bitch,” one of them said halfheartedly, shivering.

  The other one, hugging herself, didn’t bother to reply.

  After another moment, I finally asked them what had happened.

  The lady in the yellow ballgown, the wife of an ambassador, accused the lady in the pale blue ballgown, the girlfriend of another ambassador, of having stiffed her dressmaker.

  I nodded. We walked around the block. I admonished them for embarrassing themselves and their partners. But even more bothersome is that we had embarrassed our gracious host. How, we all wondered, could we possibly return? We needed an excuse to re-enter the party. They
looked to me. I said that I wasn’t sure what we would say, but I would figure something out by the time we returned.

  As we walked up the stairs, thoughts raced through my mind. As we turned the corner to the dining area, it was like a scene from a movie: Fifty couples in black tie and formal gowns, surrounded by servants, all stopped their conversation to stare at us.

  The three of us stood there.

  I said the only thing I could think of: “It’s amazing what people will do to get a consult. And I’m not going to tell you what part of their bodies they asked about.”

  Everyone laughed. I got a kiss on each cheek. The party resumed.

  It was late afternoon. I had finished surgery for the day; Park Avenue seemed quiet. Across the street, Le Cirque had been turned, for several days, into a meeting place for peace talks between the Israelis and the Palestinians. The police had closed the street to cars, so the usual white noise of New York traffic outside my office was notable for its absence.

  I was standing in my reception area, in scrubs, checking charts, when the door opened. Two Middle Eastern men walked in.

  Yasser Arafat and his bodyguard.

  I can’t say I knew how to react. Arafat looked at me, sizing me up and down. He broke into a huge grin.

  “I clearly have the wrong place,” he said in heavily accented English.

  He did not move. His eyes now slowly scanned the office – the waiting room, the stack of shelter and fashion magazines, perhaps the business cards on the desk that identified me as a plastic surgeon. He looked as scruffy as he did in photographs.

  “But maybe I have the right place,” he said, smiling.

  I smiled and shrugged. He apologized, turned, and the two men left to find the right place.

  I was invited to attend the horse races at Ascot, outside London, and had the privilege of meeting Princess Diana at a prerace reception. At the time, Diana was still with Charles. As I waited my turn to greet the princess, I thought fondly of my most vivid memory of her – watching her fairy-tale wedding on a TV over the bed of one of the patients in the cardiac care unit at Stanford University Hospital, taking in this vision of loveliness while, in my blood-spattered scrubs, I checked on the sick and dying. Seeing her now, in person, I couldn’t keep my eyes off her. She wore a navy suit and an Ascot-worthy hat, and she was inarguably attractive. But she was not what you’d call beautiful. From a strictly anatomical point of view, many women are more “perfect” than she.

  Yet she radiated something. She had great skin. There was a slight heaviness to her eyebrows and upper lids, giving her a sultry air. Her eyes were clear blue and beautiful. Her smile was quick and genuine.

  When finally it was my turn to meet her, her aide introduced me as “Dr. Cap Lesesne, plastic surgeon, from New York” – and before the last syllables were even out of his mouth, Princess Diana had lowered her gaze knowingly.

  “Oh, really?” she said, smiling. “Well, we won’t have anything further to say to you, will we?”

  A Little Romance

  My practice was humming along, quietly getting attention at cocktail parties and dinners and even opening night at the opera. Because of what we do, we’re never going to get a grateful actor or extremely satisfied diplomat to mention our skills and excellent results in a magazine profile – as a great chef or interior decorator might enjoy – the day after which your phone would be ringing off the hook. No, the right kind of attention for a Park Avenue plastic surgeon means this: Satisfied patients in the “discreet” professions – banking, law, international diplomacy, medicine – start whispering to their coworkers and friends that you’re Their Guy. That doesn’t mean I didn’t want Hollywood people or politicians; of course I did. But the foundation for a great New York practice is to quietly expand beyond just the Upper East Side, whose reach in New York City affairs may be extensive and profound, but still has its limits.

  Still, much social life and professional opportunity commingled, often on the Upper East Side. At a dinner party, I was seated next to Stephanie, the recently separated wife of one of the most powerful, visible men in the world (neither American nor European). She was attractive, intelligent, well-traveled, and likable, distracting me so that I ignored my partner to the left. Stephanie was in her late fifties, with four grown children. Ten minutes into our conversation she found an opening to say, “My husband left me for a younger woman.”

  “It makes no sense to you,” I said, shaking my head, “and frankly, it makes no sense to me. He must have gone off the deep end.”

  “I don’t understand it,” she said, expressing confusion, even longing.

  When Stephanie heard what I did, we talked about it for a while, but I thought, She’d be difficult. To my eye she’s beautiful, and if I did a classic lift, she’d lose some of her sex appeal. She would become too sculpted in the eyes, too sharp in the jawline. Little things would be better but something bigger would be lost.

  Her boyfriend came by. He was maybe fifteen years older than she, and graying. Five seconds after meeting him it was clear that he wasn’t in her league. Not sharp enough, not elegant enough.

  This woman can do so much better than him, I thought.

  Before the end of dinner, she asked for my card. “Don’t put it on the table,” she said.

  I reached under the table and placed my card on Stephanie’s skirt.

  One lady friend, after several dates, leaned over a candelit table in a restaurant and announced that she’d had her breasts done – something I was able to tell as soon as I’d hugged her. I couldn’t help myself. “When were you going to mention the work you’ve had on your ears and your jaw?” I asked.

  Sometimes I just couldn’t shut off my PSR (Plastic Surgeon’s Radar). Walking down the street or sitting at a reception, I automatically evaluated every person over forty. Yes? No? I could make out scarring that others might miss. I checked out the shape of the earlobes to see if they’d been slightly altered from what you’d expect. I might sneak a peek at the base of their nose, where some surgeons hide their scars. It was my disease.

  Another woman I dated, a magazine editor I liked and admired, insisted that I never tell her what work she might benefit from (I didn’t, nor was I planning to). Then, at a Thanksgiving dinner, she kept needling me in front of others about how I continually refused to tell her what she needed. “Cap keeps that info to himself,” she said.

  I’m doing nothing of the sort, I thought. Since we’d met weeks before, my PSR had not been “on” with her, nor was it on that night. I thought she was attractive and I liked her. Period.

  But she badgered me throughout the evening. I just shook my head to let others know it wasn’t true.

  “Look,” she said. “He’s looking at me like he’s figuring out what to do first.”

  Finally, unable to stop her taunting (though she was really taunting herself), I’d had it. I switched on my PSR, full bore.

  When she went to the kitchen, I followed her. From the oven she pulled an overcooked turkey.

  “Here,” she said, handing me a dull knife. “You’re the surgeon. Cut the bird.”

  It was impossible to slice the dry turkey. It just crumbled. I needed a better knife, but she crossed her arms, disappointed in my skills.

  I looked in her eyes and blurted, “You’d be so much more beautiful with a smaller nose.”

  She grabbed the knife from me. “Bastard!” she shouted, and started stabbing at the turkey. It was the beginning of the end of our relationship.

  Some clients were too pleased with my work.

  Naomi, a Stanford MBA in her forties, divorced mother of one son, was delighted by the necklift I’d performed on her; she’d had quite a bit of excess skin and now it was smooth. When she showed up for her follow-up, she was very friendly. On her second follow-up, she brought homemade cookies, as well as a CD of arias, because she knew from casual conversation that I like opera. Then she leaned forward.

  “I had a fantasy,” she said, smi
ling slyly at me. “You were in it.”

  As a doctor, you walk a fine line. You need to say the right thing to maintain professionalism, yet you can’t come off as cold.

  I just smiled.

  “Not a dream fantasy,” she continued. “A waking one. Let’s take a trip to Europe. Go to art museums. The Pergamon, the Rijksmuseum.”

  I chuckled. For once, I didn’t know what to say.

  She called the office a couple times the next week. I just hoped her infatuation would run its course, or that she would get the idea.

  At another reception, I waited on the buffet line to get dinner – and there she was: Stephanie, the charming woman I’d sat next to at another dinner party, whose powerful and famous husband had left her for a younger woman.

  Stephanie looked great. She hadn’t had any cosmetic surgery done in the meantime.

  “I’d like you to meet my husband,” she said, and tugged on the hand of the man whose back was to her.

  It was the boyfriend. The older man who couldn’t hold a candle to her.

  It lasted for only a moment, but I caught a sadness in Stephanie’s eyes.

  At times it’s unbearable to think that, simply because of how aging manifests physically, women, in particular, are less and less seen and appreciated for who they are – their character, their accomplishments, their sexiness. Way too often, others don’t see it. They themselves don’t see it. And so they settle for less than they deserve.

  Naomi, the grateful necklift patient who seemed to like me, one day appeared in my office just before noon, wondering if she could take me to lunch. I had to decline, politely.

  She was starting to creep me out.

  Walking briskly down Madison Avenue at five thirty in the morning on my way to the office, I had stopped for the light at Seventieth Street when I heard a crash. I turned to see that the plate-glass window of the Italian shoestore on the corner had shattered, and a man was emerging from the store holding a cashbox. From not ten feet away, he looked at me, and I at him, and we seemed equally startled and puzzled by each other. Then it dawned on me that he’d just that moment finished robbing the store – or, it dawned further, that he’d just finished the robbing part and had yet to begin the getaway, which was about to commence. With no help from my conscious mind, I automatically scanned him, from the top of his LA baseball cap down to his tan Timberland work boots. Navy blue parka, blue jeans. Five feet ten, 180 pounds. Mole, two centimeters from left nostril. Crooked upper-front two teeth. Brown eyes, slightly graying hair on side of cap. Pimple on upper right cheek. Attached earlobes.