When her brows furrowed, I knew her Google source had indicated that “No” was the wrong answer. “Why not?” she asked, showing genuine concern. I paused for a moment as I thought back to the day twenty years before when I’d heard my little girl’s screams and saw blood streaming down her face. The warm July Saturday had beckoned my 19-month-old daughter and me outside. Little Siena, toddling along the sidewalk and shrieking with laughter, dodged left, then right, then left again to escape my reach. Still on the run, she tore down our neighbor’s steep aggregate cement driveway in a fit of giggles. I bounded in pursuit, but before I could reach her, she pitched forward, landing on her face, her body flipping over her head like a Slinky. My first thought was her spinal cord. Was she a quadriplegic? No, I rejoiced, she was moving. But then I stared in horror as her screams bubbled through blood. I scooped her up and ran home, yelling for help in between sobs. As my husband opened the front door, I ran straight to the bathroom to rinse off the blood so I could assess her injury. Her few teeth glistened white and whole, and as I ran my fingers along her bones, I felt no step offs and elicited no additional screams. Next I looked at the source of her bleeding. Spanning her upper lip from beneath her nose to her beautiful Cupid’s bow was a curved, jagged laceration. She’d need sutures, and at her age, that meant general anesthesia. I cried right along with my little girl. I cried because I’d been too slow to catch her; I cried because she needed surgery, and I cried because her perfect face would be scarred forever. As my husband mopped up the bloody bathroom floor, he looked up and said quietly, “If you’d stop crying, she’d stop, too.” I slowed my breathing and controlled my tears, and soon Siena was sucking her thumb and nestling her head into my shoulder. My husband and I are both plastic surgeons, which made the situation both easier and more complicated. As a general policy, we don’t treat our family, so we discussed whom to call. But then Paco said, “I can do it. I can sew up her cut.” “Really? You’d feel comfortable?” “Sure. I’ll be fine.” I thought about it, and after a minute I said, “I could do it, too.” “Then you’d better do it, because if it isn’t perfect, you’ll blame me forever.” He gave me a knowing smile, and I smiled back because I knew he was right. Later that day, Siena lay on a narrow bed in a cold operating room in the anesthesiologist’s hands. Not wanting to see the induction, I stepped outside to wash my hands. After my ablutions, I pushed my shoulder into the swinging door to re-enter, and I stopped in my tracks. My daughter was deathly still. Instead of laughter, a plastic tube emerged from her mouth. As calm as I was, and I was finally calm, this felt too close to a catacomb. But there were advantages to operating on my daughter. I didn’t have to double glove, since I’d be at no risk of contracting HIV or hepatitis C. I was about to tell the scrub tech to forget the second pair, when I caught myself. No, I would do everything the way I always did. If I strayed from my routine, I’d make a mistake. For the next hour, I had to forget that the little girl on the table was my daughter. She was my patient, my patient, my patient. Just my patient. Once I’d covered her with sterile drapes, with little more than her mouth and nose exposed, I could almost forget I was my patient’s mother. After I injected the local anesthesia to help control bleeding, I studied the wound through my loupes. The cement had shredded her skin. I marked what I’d have to discard, and then I picked up a scalpel. I reminded myself that one slip of the blade would add another scar, but that warning played in my head with every patient. When the wound edges were sharp and clean, I spread my scissors beneath the skin to disperse the tension when I closed. Tension could lead to thick, wide scars. Then I closed the gaping wound with several fine sutures. After I applied antibiotic ointment, I was done. That night I fell asleep next to my injured angel. But at midnight I awoke, shaken by the realization that my daughter’s face would be scarred forever. My surgeon’s voice said, “Don’t worry; it won’t be noticeable.” But I was my patient’s mother. When she was in kindergarten, when she graduated from college, when she got married, and when she retired, she would have that scar — forever. The woman with the three pages of questions didn’t say a word as I concluded my story. “All I did was put stitches in my daughter,” I told her. “Just stitches. Nothing more. If my little girl had had a cleft lip rather than a cut one, I would have found a good plastic surgeon — one who wasn’t family.” These many years later Siena’s scar is visible only in a certain light. Rather than horrifying me, it conjures up memories of how much I loved that bouncing toddler who flew herself headlong into life, drinking it up with gusto, much as she does today. Source
