My Skin, My Sanity
by Kat Duff
When I turned fifty, the only scar on my body was the thin trace of an incision on my right thumb where a doctor removed a sliver when I was nine
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My Skin, My Sanity
When I turned fifty, the only scar on my body was the thin trace of an incision on my right thumb where a doctor removed a sliver when I was nine. One minute I was gleefully racing down the steps to the beach running my hand along the wooden railing, and the next - days later - I was sitting on the table at the doctor’s office staring at the slit-open pad of my thumb. I fainted. A few seconds later the doctor’s smelling salts brought me round, but I’ve never forgotten that glimpse of the meaty-red flesh of my insides pulsing frantically. Nor have I lost my gratitude for that thin, breathing membrane we call skin that envelops and conceals our riotous insides.
When I turned fifty-one, I had a crimson scar careening from the depths of my right armpit across my chest to my sternum. It’s a neat surgical scar that is now – one year later - beginning to loose its thickness and color, but not its fluid arc. When I raise my arm it appears to swim up the side of my body.
It’s easy to forget there was once a breast there.
Salamanders regenerate tails and legs, but mammals cannot even grow back a baby toe. Once a breast is removed, it’s gone forever. Surgically reconstructed breasts may give the appearance of bosoms under the cover of clothing, but they cannot respond to touch, secrete milk or otherwise function like them. Without reconstruction, one is left with an absence traversed by a conspicuous line, like the cicatrix left by a fallen leaf.
When the human body is cut or otherwise injured, it summons extraordinary resources to repair the damaged tissue. It cleans the wound of debris, spins fibers between the sides to contract and close the fissure, inserts collagen “glue” in the remaining holes, extends nerves and blood vessels, prompts epidermal cells to multiply and creep in from the edges to cover the sensitive new tissue and, finally, sloughs off the scabs. In the end, the skin is regenerated and the wound healed, but the repair does not return us to the earlier perfection of unblemished skin. It leaves the smudge of a scar that is part of the body but set apart from the surrounding flesh by its density and milky, underbelly-pink color. Given the extraordinary sophistication and complexity of the human ability to heal, one would almost think that this final lapse into imperfection was intended, the way Navajo weavers make tiny “mistakes” in their rugs to let the spirits in.
When I left the hospital after my surgery, I had two tubes coming out of my chest connected to clear plastic bulbs safety-pinned to my shirt by the post-op nurses. The bulbs slowly filled with a bright reddish pink fluid - a mixture of blood and pus - that my partner learned to empty and measure twice a day. The presence of those tubes was harder for me than seeing the incision-in-place-of-my-breast two days later when my surgeon removed the bandages.
My surgeon explained that the tubes were needed to drain fluid collecting in the space left by my breast so that my skin could begin to adhere to the muscle underneath. “The body abhors a vacuum,” she added, “and fills the tertiary space with whatever it can find.”
Then she yanked out one of the tubes with a swift swing of her arm. It felt as though someone had just pulled a string through my insides. Woozy white splotches swirled around me, and I steadied myself with a hand to the table until the room came back into view with its familiar peach-colored walls and instructional posters of dissected breasts.
I immediately noticed that the tube my surgeon held in her hand was twice as long as before and realized that a good ten inches must have come from inside me. She opened the lid of the trash bin labeled “BIO-HAZARDS,“ tossed the tubing with its dangling bulb inside, and turned back towards me.
“Everything looks good. Any questions?”
“Aren’t you going to take out the other tube?” I asked, hoping she had forgotten.
“Oh no, not now. We have to wait for the fluid to diminish. Make an appointment for ten days from now.”
In the days that followed, I became accustomed to holding the tube when I changed my clothes and tucking the bulb into my pants to keep it from tugging, but the sense that something was not right, that some sacred boundary had been violated, never left me. That boundary, I realized much later, was my skin.
Some people are afraid of drowning, others of suffocation or fire. My greatest fear, which inevitably returns whenever I become overwhelmingly upset, is that gale winds will rise inside me and blow my skin up like a cellophane balloon until I explode. The fantasy always ends with the explosion, for there would be no “me” or “world” once the membrane that divides and defines the two is ruptured. Inside and outside would mingle in a great roiling confusion of disintegration.
Fortunately, skin is usually present to protect the integrity of the body-self. It works day and night to maintain optimum moisture and temperature levels in our bodies through complex mechanisms of cooling, heating, lubricating and sweating. Fluids that transgress the boundary of skin – urine, blood, vomit, spit, and mucus – inspire visceral reactions of disgust akin to the sense of sacrilege I felt about my drainage tube. It would seem that the protection skin affords to our physical life extends to our psychological life, indeed our very sanity.
Scars mark the places where life and sanity were threatened, ordeals endured, wounds opened and closed. They evoke a queasy awe in the best of us. We stare and look away, want to ask what happened but don’t dare broach the subject, as if these patches of mended flesh identified experience beyond the realm of human discourse. Perhaps it’s no coincidence that the word “scar” is one letter away from “scare.” I couldn’t bring myself to touch my mastectomy line for weeks, and it wasn’t that the skin was sensitive. No, I was afraid of what would happen if I got that close to something so not-me. At the same time, I couldn’t keep away from this sutured break in me and kept inching my fingers closer, only to jerk my hand away.
When the home health nurse checked on me a week after my surgery, I confessed my difficulty. We were sitting side by side on the blue jean couch, and she was wrapping a blood pressure cuff around my “good” arm, the one that still had a breast nearby. “Don’t worry about it,” she responded emphatically. “It’ll get easier with time. Many women can’t even look at their scars at this stage.”
Later, when she was writing down my blood pressure in her chart, she added: “Some women never look at themselves.”
Clearly there’s more involved than fear or disgust. There is the culturally-induced shame and secrecy that comes with cancer, especially when it attacks parts of the body involved with sexuality, and the stigma that attaches to people whose bodies don’t live up to the cultural ideals of femininity and masculinity – all of which contribute to this self-shunning. There is also a taint of failure that attends those who bear scars.
The scarred are flawed and disfigured, their perfection besmirched by this graphic sign of defeat. A friend of mine who has undergone several surgeries in the course of a sex change says that the worst part of the entire process has been ending up with visible scars from the skin grafts. Now he wears long sleeves all the time, even in summer. People go to great lengths to cover, hide or erase their scars in our society, and the rest of us collaborate by never mentioning them.
My aunt and grandmother had mastectomies when I was a child, but I didn’t find out until I was well into adulthood, and never felt free to ask them about their experiences, much less view their scars. Images of women who have had their breasts removed are few and far between in our society, and many (like myself) enter surgery without any idea of what we will look like afterwards. That’s why I show myself whenever I get the chance. I’ll flip up my shirt for anyone who expresses interest in seeing my scar just to defy this culturally enforced invisibility that is euphemistically termed “privacy”
The only people who benefit in stature from the visibility of scars are the warriors in our world: soldiers, gang members, criminals, those who have given up trying to be perfect (if they ever had a chance) and need to inspire fear to survive. Even they will sometimes cover themselves so their scars cannot be used to identify them later.
In the 19th century, bounty-hunters identified runaway slaves by the scars on their backs from whippings. Deserters from the British Army were branded with the letter “D” so they would be recognized for the rest of their lives. Conquerors have inflicted marks on their captives since the beginning of recorded history. Witness the Nazi practice of tattooing identification numbers on the arms of concentration camp prisoners.
When scars are inflicted to exert power, then those who are scarred are made to exhibit powerlessness. It may come as a surprise to learn that people in powerless situations (prisoners, battered women, victims of childhood neglect or abuse) often resort to cutting or burning themselves. Many report that nothing works better to regain control over one’s body, defy the powers that control one’s life, and provide relief from unbearable states of overwhelming anxiety. In short, it prevents disintegration. Paradoxically, self-mutilation helps to reinstate the skin boundary between self and other and maintain one’s integrity. The scars that result declare one’s existence in the face of annihilation.
Skin is our “face” to the world, the banner we fly for others to see and read, whether we like it or not. It displays identity the way gloves show the hands within them. Blemishes, birthmarks, moles, pock marks, freckles, liver spots, wrinkles, warts, splotches, pimples and scars are all letters in the scripts of our lives that are written on our skin.
When I turned fifty-two, I had two long scars running from my sternum to my armpits in the place of breasts. Viewed together, they inscribe a large V across my chest, which I take for the victory of surviving breast cancer despite two mastectomies. Some of my friends see it as the wings of a bird taking flight. I could put on my clothes and try to forget about all of it, but scars don’t let us forget. By definition, they persist long after the events that caused them have gone the way of all things. They write us into history, continually reminding us of what happened and alerting others that something happened.
In the end, we are known and recognized by our scars. They become us – or we become them – until they are as much a part of us as our fingerprints. While fingerprints reveal what is given at birth, some would say pre-destined, scars reveal destiny’s detours, the ones that take us beyond our births and make us who we are, transcribing our stories onto that flexible, renewable parchment we call skin.
|Kat Duff is the author of The Alchemy of Illness (Bell Tower). Other
essays have appeared in Parabola, The Taos Review, and Women of Power.
She works as a child forensic interviewer in New Mexico.