So You Don’t Like The Way You Look?
Well, would you change your face if all it took was the price of a good stereo, a few days’ living in bandages, and some tiny scars even if your closest friends wouldn’t notice—that is, if that was all it took?
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“I’m running scared,” said Muriel only slightly facetiously. “I brought my daughter in for moral support.” Lyn Lowery, an attractive, fashionable woman in her mid-thirties, sat on the sofa across from Muriel. “You know,” said Muriel, again half seriously, half in jest, “I’d like to turn into a beautiful thing overnight with no pain.” At that Gilmore, sitting in the armchair on the other side of the table from her, pulled his chair up and began to touch her skin very softly.
As Jim examined her, Muriel began to describe her own face as if she were appraising a not-so-choice piece of real estate. Her nose, she said, was ugly. Her jowls were too pronounced. Her upper lip was wrinkled, as was her forehead. Her mirthful demeanor had crinkled the corners of her eyes. Worst of all, her eyelids—which were at the moment behind two enormous designer-frame-mounted lenses that served more to magnify them than to conceal them—had the characteristic hooding and sagging of old age. “I guess you’d just like to tear me up and start all over from scratch?” she drawled rhetorically.
With that Gilmore pulled his chair even closer and looked her in the eye. “Is it important to you at this time in life?” he asked. “If it isn’t, don’t do it.”
It was obviously important enough for a protracted discussion of procedures by Jim, Muriel, and Lyn, who was coaching her mother the way Tom Landry handles the Dallas Cowboys. What the women were discussing was essentially a collection of products—face lift, eyelid lift, brow lift, forehead lift, nose job—that could be purchased singly or in any combination. And what principally concerned them about those products was how good they were. How long would they last? Would a chemical peel—one solution to the minor wrinkles above the lips and at the corners of the eyes—be too painful? Would Muriel be away from her business for too long? Could there be damage to the facial nerves? And most important, would the scars be visible? Addressing his remarks to both women, Jim went down their shopping list point by painstaking point.
Finally Muriel seemed to come to a conclusion on at least the quantity of her order, should she decide to make it. “It’s just like making repairs to a house,” she said with the laconic self-confidence of a head of state who might know nothing of the complex technical subtleties of an issue but who will nevertheless make the right decision due to some unerring leadership instinct. “If you just do a partial job, it doesn’t do any good. You might as well not do it at all.” That meant that she would go for the eyes, forehead, and face, and if she liked the results she might come back for a go at the nose. But she still wasn’t sure about the quality. “How long have you been doing this?” she asked. And the matter of the scars still bothered her.
Just when it seemed that the dialogue would never get anywhere, Gilmore suggested that they set a date—about two weeks away—for surgery; Muriel, like every patient, could retain the option of backing out until the second the knife went to work. This proved to be a satisfactory compromise. Muriel could contemplate and question at her leisure, but should she decide to go through with the operation, she wouldn’t have wasted her valuable time. And while she was at Gilmore’s office, she might as well let Sara take her pictures. When Sara came into the room, both Lyn and Muriel took a look at her face and rubbed their fingers along the junctions between her ears and her face. All three women seemed to glow at the touch, and at that moment it seemed that some of the belief passed like a current between them. They went off to have the pictures taken and then back to Sara’s office to formalize the dates and the fees.
Broad Palms, Long Fingers
Jim Gilmore was born outside Lufkin in 1937, a third-generation Texan. His father had grown up on a farm, never earned a college degree, and moved from job to job with regularity. An intelligent man, skilled with his hands, he simply never seemed to be satisfied with anything, so he worked variously as a printer, florist, banker, and oilman. One thing he made clear to Jim was that if a man really wanted to be successful, he needed a vocation or profession he could stick with.
There were forty students in Jim’s graduating class at Grapeland High School, and more than a few of them—Jim included—had their lives indelibly marked by Mrs. Lorena Schoultz, their speech teacher. Mrs. Schoultz taught her small-town students that there were no limits to the human mind and that with sufficient will and effort anything was possible. She inculcated in Jim a passion to excel and a tenacity in pursuit of his goals. But at the time Jim wasn’t sure what he wanted to excel in. He knew that he didn’t want to spend the rest of his life in a small town, but he still had small-town ideas of what constituted an honorable profession. He thought he would like to be an engineer or a military officer.
After spending his freshman year studying chemical engineering at Texas A&M, Gilmore lost his appointment to West Point when he flunked the physical because of an old football injury. He had soured on the military routine at A&M anyway, so he transferred to Stephen F. Austin College in Nacogdoches and entered the pre-med program. He finished the next three years’ worth of work in two, reasoning that since he was paying for it he might as well get it done as quickly as possible. He worked on road gangs, in the oil fields, in the labs, and as a teaching assistant to pay his tuition and living expenses. And by the end of his second year he had gotten pretty well locked into the pre-med program. He wasn’t sure what medicine would be like, but it sounded like an honorable profession.
Jim worked his way through Southwestern Medical School as well, primarily by assisting in surgery, and while doing that he learned a very important thing about himself. His big, broad-palmed hands with the long, sensitive fingers, the kind of hands that looked like they could handle a plow or palm a basketball or play a piano with equal facility, were very, very dexterous in the operating room. Jim Gilmore could do things in surgery much faster and with greater precision than just about anyone else.
But when he graduated from medical school in 1962 he experienced a definite sense of depression. The goal he had worked so hard for was behind him, but he couldn’t be sure that he was doing exactly what he was meant to do. He assumed, however, that he wanted to be a general surgeon, and when he went into the military in 1963 he became a surgeon in the Strategic Air Command at Grand Forks, North Dakota. His case load was varied, but what really began to interest him was reconstructive, plastic, and cosmetic surgery. He even did a few noses. And when he came back to Parkland Hospital in Dallas for his residency in general surgery, he began to focus on reconstructive surgery of the head and neck. When he finished up, he was a certified otolaryngologist—or ear, nose, and throat man.
Gilmore hung out his shingle as a private otolaryngologist and set himself up in his own office, although a little later he had to go in with a group of doctors to cut his overhead. He did lots of reconstructive work and general surgery on cancer and trauma patients, but he also started doing a good bit of purely cosmetic work. Gradually the cosmetic surgery began to involve him more and more—he liked having an aesthetic aspect to his surgery—and by the mid-seventies he reached the point where his work was about half cosmetic.
Gilmore’s evolution wasn’t unusual. He was just one of thousands of ophthalmologists, dermatologists, general surgeons, dental surgeons, and ear, nose, and throat specialists who were being lured by the burgeoning demand for cosmetic and plastic surgery. Their crossing of professional lines was facilitated by the Federal Trade Commission, which in 1978 took a somewhat controversial “if you can do it, you can advertise it” position against anti-competitive practices in Yellow Pages listings. What this mean was that, for example, a dermatologist who performed scalp transplants or other cosmetic surgical procedures could bill himself as a plastic surgeon in the Yellow Pages without board certification as a plastic surgeon. The only thing that he had to exhibit was an ability to do the surgery itself.
This didn’t sit well with the board-certified plastic surgeons. Each of them had earned his board certification—just as Jim had earned his otolaryngology—by completing a residency or training program in plastic surgery that met the standards of the academicians who constituted the national board. What this meant (and still does) was that as far as board certification goes, a doctor was pretty much restricted to the specialty in which he had done his residency. So while an oral surgeon might do the best jaw resectioning in the business, he could never be a board-certified plastic surgeon. Under the FTC ruling, however, the consumer wouldn’t have to know the difference.
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