Leith, William

by The Hungry Years

disguise.

  No Trouble

  I met a woman who wanted to walk around in disguise. To me, Anne's face looked fine. Certainly, there were some crow's-feet around the eyes and some lines between the nose

  and the mouth. Her brow was slightly wrinkled. She also had something of a double chin. But Anne was fifty-three. Her facial expressions, made from the movements of the lines, wrinkles and muscles of her face, had an air of integrity. They were the outward manifestations of the thoughts of a woman in her early fifties.

  To me, Anne's facial lines were part of why her face looked fine. But I was not Anne. Anne did not want to look like a woman in her fifties. She wanted to look like something which, to her, was significantly different a woman in her forties. She wanted, superficially, to pass for someone who was born, not in the era of Glenn Miller, but around the time when Elvis was beginning to make an impression. She wanted to have the appearance of a younger version of herself. Looking less old, she believed, would improve her life.

  Anne was due to have a facelift, and some liposuction, the next day. The operation would last nearly four hours. She invited me to watch it.

  `It should take five or ten years away,' Anne explained. She told me what would happen to her. It frightened me. Just the idea of it frightened me. She would be anaesthetized. The skin around her ear would be cut with a scalpel. Not pricked, or jabbed, but sliced. Next, her cheek would be separated from the flesh of her face. Her facial muscles would be rearranged. Her skin would be stretched. Excess skin would be cut off. Then she would be stitched up. The whole process, of course, would be repeated on the other side. Then her eyelids would be cut open with a laser beam. Fat would be removed from

  the eyelids.

  Looking Younger, Anne said, would improve her `confi—

  dence'. She was already relishing the thought of looking in the mirror and seeing the difference.

  She said, 'You may think: Small problem, silly woman. But it's about what you feel like inside.'

  Anne's husband, Derek, who was fifty, said, 'I'm passionately in favour. If it doesn't do any harm, then it's got to be good for everybody.' He himself had had fat sucked from under his chin.

  We discussed the reasons for Anne's facelift. Finally, she said, 'Men mature, whereas women age. Men look quite good when they look older.'

  I said, 'Why is that?'

  `I don't know. I don't know why. But it's true. For instance, grey hair looks nice on a man. Not on a woman. It's very, very hard to say why, but it's a fact.'

  I drank the champagne Anne poured for me. Having entered the final twenty-four hours before the operation, Anne was not allowed to drink.

  `Are you worried?'

  She said, `Oh, yes, I'm anxious. I'd be abnormal if I wasn't.'

  Anne's facelift was to be performed in a small private clinic in Highgate in north London. As I approached the clinic the next day, feeling hollow and nauseous, I realized that I had mixed feelings about cosmetic surgery. I couldn't shake off a feeling of discomfort. But why is it wrong? If it is ageist, so is jogging. So is yoga. If it is a superficial change masquerading as a more significant one, so is wearing a suit. Did I believe that beauty was divinely ordained, or that there should be only so much of it around? My misgivings were elusive, but

  persistent.

  The clinic was a former Edwardian house in a residential street. Anne was watching television in an upstairs room. She was quiet. She looked nervous. I was terrified. She had opted not to have a 'pre-med', an injection to quell her nerves. The television rumbled away. We did not say much to each other.

  To attend the operation, I had to wear 'scrubs' a blue, square-necked T-shirt, blue cotton pyjama-like trousers, a blue elasticated paper cap, and white slip-on sandals with, for some reason, a little heel.

  The administration of the anaesthetic was a shock for which I had not prepared myself. Anne was wheeled into the room on a trolley. She was lying on her back. Dr Chang, the anaesthetist, who had himself had cosmetic surgery on his eyelids and his ears, stuck a needle into Anne's hand. The needle was joined to an open socket. Chang was whistling. Anne said, 'I'm very calm, actually. Yes. Just a slight apprehension in the last few minutes, but nothing dreadful.'

  Chang said, 'Anne, have a nice sleep.' Then he took five syringes and, with practised ease, pumped their contents, one after the other, into the socket in Anne's hand. There was a muscle relaxant, the anaesthetic itself (which is white and soya-based), a painkiller, a steroid to ease swelling and an anti-sickness drug. (Later, Chang would tell me there is still some medical mystery about how the anaesthetic

  works.)

  For a tiny moment, Anne concentrated on her hand. Then, horribly, all expression on her face collapsed. It was like watching the moment of death. The eyes rolled in their sockets and the head, suddenly heavy, slumped down on the pillow. I had an overwhelming sensation of disgust. (It's

  gone wrong! They've killed her!) While Anne's face was being injected with adrenaline, to reduce blood flow, I slipped out of the room, and, breathing deeply, took a seat in a room next door where a surgeon was eating a turkey sandwich. 'I'm having lunch between faces,' he told me.

  A trolley was wheeled in. A nurse said, to a patient, 'Come on, Julia. Julia! Time for you to wake up. Keep waking up! That's better. Listen! Stay awake for me.' The patient's face was heavily bandaged. She was gently moaning.

  Superficially calm, I walked into the operating theatre. It struck me that my misgivings about cosmetic surgery might simply be a fear of blood and unnecessary violence. Also, the more people who do it, the more chance there is that, one day, it will be my turn to feel the pressure. Anne had talked of the influence of older film stars who looked good because they'd had facelifts. Julie Christie, Joan Rivers, Burt Reynolds: their nips and tucks have crept into the culture.

  Anne was on her back, on a trolley. She looked like a corpse. She looked like a dead old bloke. She had tubes coming out of her mouth; a machine was breathing for her. Mr Prakash, the surgeon, was standing by the side of the trolley, in scrubs. Two thick magnifying lenses were protruding from his glasses like frog's eyes.

  The first thing Mr Prakash did was to make a hole under Anne's chin, and insert a cannula, which looked like a thick needle. This was for liposuction, or, as cosmetic surgeons prefer to say, `liposculpture'. The cannula was attached to a clear plastic tube. Mr Prakash jabbed the cannula under the skin of Anne's neck. After a moment or two, a bubbly pink substance, like strawberry milkshake, was sucked back

  through the plastic tube. This was the fat. This was the double chin.

  When Mr Prakash took the cannula out of Anne's neck, it slurped, as if it were a straw sucking the last drops of the milkshake from a glass. He had, he told me, performed this operation seventy times. He replaced the cannula, and jabbed away, with a great deal more vigour than I would have expected.

  There was more fat on the left side of her face than the right. The fat bubbled back through the tube. Mr Prakash smoothed his gloved hand over the flesh, as if moulding putty.

  He said, 'See how the bulkiness has gone?'

  It was when Mr Prakash picked up a tiny scalpel that I started to feel sick. The blood left my head. My legs felt hollow at the sight of a man, with a blade, preparing to insert it into the face of another human being. I found a chair and sat, head in hands, swallowing saliva. I needed a few moments.

  One of the reasons often cited by the opponents of cosmetic surgery is that it is a simple, painless process. You go into the operating theatre unbeautiful, and, hours later, emerge, beautiful. All you have done is paid; somebody else has done the work. (I've heard people take the same tone with fake suntans: you don't have to work for them, so, in some way, You have taken an unfair advantage.) Looking at Anne, though, whose grey, open-mouthed, open-eyed face resembled that of an old man hovering between life and death, I dismissed

  11inissed this idea. In the end, she might look younger, or

  better; she might have fewer w
rinkles and a taut neck. But, on some level physical, mental, spiritual she looked like she Was paying for it.

  Mr Prakash told me that, to combat my nausea, I could try bending over Anne's face and concentrating on small details. It worked. Mr Prakash sliced into Anne's flesh. He went around her ear with his scalpel. The wound did not spurt with blood. There was a slight welling. The adrenaline injections had done their job. Mr Prakash said to the nurse standing on the other side of the trolley, 'Have you seen the breast girl?' He was referring to his next patient.

  Mr Prakash said, 'Pull the ear, please!'

  Dr Chang said, 'Now comes the interesting bit.' And, with a pair of tweezers, Mr Prakash began to peel Anne's skin away from her cheek. Or was it that he was peeling her face away from her head? He started behind the ear and moved around to the front of the ear. Underneath, the flesh was pink and slightly runny, like raw veal. As he pulled the skin away, he cut the membrane joining it to the layer of muscle underneath. You can see why some people who have had facelifts lose sensation in their faces for a while. Their nerves have been cut.

  Every now and again, there was a sizzle, and a smell of cooking. Mr Prakash was cauterising those blood vessels which were still seeping. When Mr Prakash had cut the side of Anne's face, as it seemed, free of the muscles underneath, all the way down to the corner of her mouth, a clamp was inserted, tenting the cheek.

  Now, there was a cavernous space, inside which were stalactites of fat, and glands, which resembled sweetbreads, and the flesh itself, stringy and bright red and gently oozing. With tweezers, Mr Prakash inserted a cloth to mop up the blood. Then he placed the cloth on a tray.

  Into the hole in Anne's face, Mr Prakash inserted a needle—

  contraption. thread

  d aption. He put a stitch in each of the facial an—

  muscles and pulled them upwards, holding on to the thread, his gloved hands dextrous, twirling. It took ages. The stitches, he said, would dissolve in 120 days.

  `Ear, please.' While the nurse held Anne's ear, Mr Prakash gently pulled on her skin. And the skin, stretched, fit over the bottom half of the ear, as if it were a rubber mask. Mr Prakash cut the excess away with a pair of scissors. He went around the ear, cutting little triangles of fleshy skin. He placed the skin on the tray. One bit had hair on a triangle of scalp. Again, the blood left my head.

  Ninety minutes passed. Mr Prakash repeated the procedure on the other side of the patient's face. When Anne was stitched up, he slid metal eyeball-guards underneath her eyelids, which he would slice open with a laser gun. Anne looked like an android. We put on goggles, to protect our own eyes from stray laser beams.

  Using the laser contraption, which looked like a dentist's drill, Mr Prakash cut across each eyelid. As soon as the beam touched, the flesh seemed to spring apart. Then, with a pair of tweezers, he pulled out the fat. It came out in worms, and looked like bloody snot. Finally, he ran the laser along some of Anne's facial lines. His smock was smeared with blood. Next door, through a glass panel, I could see a man lying on a trolley. He was writhing and bucking. Minutes later, a young woman walked towards the Operating theatre with a trolley by her side. 'I'm walking in,' she said. It was the breast girl.

  `MY next victim,' grinned Mr Prakash.

  Five months later, I knocked on the door of Anne's large Victorian house in the Sussex countryside. The door opened. The woman on the other side of the door, while recognizably the woman I met before the operation, looked changed. She looked ... tighter. There was something different around the eyes. She smiled. Her smile was not exactly the same smile. She led me into her kitchen, where we both sat at the table.

  I said, 'Well!' She poured me a glass of wine. One of her eyelids looked slightly tighter than the other. She no longer had a double chin. She had a single chin, like a younger woman. She had a more defined bone structure. Her face conveyed her thoughts in a flatter, less complicated way, in a way that resembled the expressions of a younger woman, although her skin, as she pointed out, was not the skin of a younger woman. Her skin was 53. She looked younger, but not, I imagine, precisely like her younger self.

  She was, she said, 'very happy' with the operation. She had, she'd been told, 'lost a good eight years'. In a way, it was true. Having been a young-looking 53, she could now pass for 45. `When I'm 63,' she says, 'I'll probably look mid-fifties, or perhaps 57.' Friends she had not told about the operation had been remarking on how well she looked.

  `My confidence,' she said, 'is boosted 100 per cent.' Her husband was 'over the moon'. There were pictures of him on the kitchen door before liposculpture and, younger looking, after. Anne's children, who had thought she was 'mad' to have the operation, were pleased. Now she was no longer negatively conscious of her neck. 'I hated looking down,' she said. 'To look down was awful.'

  After the operation, Anne felt 'tight', as if she was 'perma—

  nently blowing up a balloon'. Later, there was discomfort, swelling and bruising. The bruising takes weeks to go down. i told my children I'd look horrible,' she said, 'but you can't prepare people.'

  Looking at Anne, I could see that her facelift both had and hadn't worked. She had dispensed with her double chin, which she hated, and various wrinkles. But it was not perfect. She had the air of a woman who had had her wrinkles removed, rather than one who was too young to have wrinkles. Looking at Anne, with her new smile and firmer chin-line, made me understand a bit better my misgivings about cosmetic surgery. It is one more example, in the modern world, of the superficial being offered as a substitute for the profound, of image being traded for meaning. The terrible, secret worry I had been carrying around about cosmetic surgery, I began to realize, is that it might actually work.

  `The thing that went wrong with my eyelid,' Anne said, `was that it bled so much. It's very rare for this to happen. But that's why it's healed like this.' She put her finger up to the eyelid. She said, 'But that won't be any problem. Mr Prakash can put that right. No trouble.' She moved her finger across her eyelid, as if it were a surgical tool.

  We sipped at our wine. Anne was getting the feeling back in her cheeks. The nerves were joining up again. You could see that the cheeks, tighter now, were almost back to a natural look. The scars around the ears were minimal. She nearly felt right again. Some people don't for a year. Some never do.

  Extrinsics

  No, I'm thinking as I drink the last of my coffee, facelifts are not the answer. At best, facelifts disguise you as a more attractive person, in the same way that credit cards disguise you as a rich person, mobile phones as a connected person, cocaine as a happy person, painkillers as a person without a hangover, diets as an untroubled person who never got fat, never stuffed their face. But, with all these things, the economics are not good. You end up with a net loss. Overwhelmingly, people who diet end up still feeling fat, and eventually getting fat. People who have facelifts still feel wrinkly; many book themselves in for repeat surgery. Credit-card debt is increasing exponentially; more debtors commit suicide every year. Cocaine makes you depressed. Painkillers give you headaches.

  Treat the symptoms, not the cause. That's what we're always being told. What can you do if you're feeling sad? Take Prozac. Get a new kitchen. Have a wardrobe makeover, an operation, a new set of teeth. Have a botox injection in your lunch-break. Have a cushion inserted into the sole of your foot, so you can wear higher heels. Get a tattoo or a piercing. Play the lottery. Fly to a secluded beach. Become famous.

  In an essay entitled 'The Dark Side of the American Dream', sociologists Tim Kasser and Richard Ryan wrote about people who pursue what they call 'extrinsic goals' money, fame, and beauty believing these things make then, happy. But they don't, of course. They experience lower quality of life' than people who are less materialistic. But they are not just miserable they spread misery, too; they have `shorter, more conflictual, and more competitive relationships with others'. People with extrinsic goals, writes the Australian economist Clive Hamilton, 'tend to be more depressed than
others, and they tend to suffer from higher levels of psychological disturbance.' Romantically, they are more jealous. As teenagers, they commit more vandalism. And when they achieve their goals, Hamilton says, they are `no happier'.

  And when one person gets a facelift, others will want one, too. This exponentially increasing pursuit of the superficial, Hamilton believes, is the West's most significant problem. Every Western government, he says, is obsessed with economic growth. But how does the economy achieve growth in a time of abundance, when everybody has what they need?

  By making them want what they don't have, of course. By making them dissatisfied with what they've already got. By making them feel abject, hungry, isolated. And by making them overspend and overeat, by lending them money at high rates of interest, and pumping their bodies full of insulin, and then telling them the problem, the real problem, is fat, sugar and salt.

  That's what I'm thinking, sitting here on the bench with the last of my coffee. Extrinsic goals are not the solution.

  But what, then, is the solution? Therapy?

  Really, I Was Fine

  I was late for my first session. Twenty minutes late.

  `Sorry about this,' I said. 'You see, when you gave me your address, you gave the number as 130. Which is right, of course. But, see, I took it down as 30.'

  `Don't worry.'

  `I took it down wrong.'

  `That's fine.'

  `So I get to number 30, and nobody's around. No answer. And then this woman arrives, walks up the garden path, and says, can I help you? And I say, well, I hope so. And she says what do you mean, and I say, well, I think you're my therapist. And she looked really scared at this point. It was getting dark. So I said, actually, I might have the wrong

  number.'

  `I see.'

  `And that's when I worked it out. I thought, you know, this is a long street. And the only other number it could have been

  was 130.'

  `Right.'

  `So here I am.'

  I've read that, during therapy, you're not supposed to notice your surroundings, but I took everything in. I was sitting down on a small, neat armchair, not a couch, and my therapist, Naomi, was sitting on an identical chair. Sort of like the chairs you would get in a hotel lobby, chairs to be quite comfortable in, but not totally relaxed. The room was minimally furnished. White walls. Neat carpet. Journals on a shelf.