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Authors: Naomi Wolf

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Surgical Futures

The Victorians’ definition of operable kept expanding. “Moral insanity,” like ugliness, was a “definition that could be altered to take in almost any kind of behavior regarded as abnormal or disruptive by community standards,” writes Elaine Showalter. “Asylums opened for ‘young women of ungovernable temper . . . sullen, wayward, malicious, defying all domestic control; or who want that restraint over their passions without which the female
character is lost.’” So does our definition of operable keep expanding, for the same reasons. In the 1970s, intestinal bypass surgery (in which the intestines are sealed off for weight loss) was invented and it multiplied until, by 1983, there were fifty thousand such operations performed a year. Jaw clamps (in which the jaw is wired together for weight loss) were also introduced in the feminist 1970s, and stomach stapling (in which the stomach is sutured together for weight loss) began in the US in 1976. “As time went on,” reports
Radiance,
“the criteria for acceptance became looser and looser until now anyone who is even moderately plump can find a cooperative surgeon.” Women of 154 pounds have had their intestines stapled together. Though the doctor who developed it restricted the procedure to patients more than 100 pounds overweight, the FDA approved it for “virtually anyone who wants it.”

Intestinal stapling causes thirty-seven possible complications, including severe malnutrition, liver damage, liver failure, irregular heartbeat, brain and nerve damage, stomach cancer, immune deficiency, pernicious anemia, liver failure, and death. One patient in ten develops ulcers within six months. Her mortality rate is nine times above that of an identical person who forgoes surgery; 2 to 4 percent die within days, and the eventual death toll may be much higher. Surgeons “aggressively seek out” patients, and “have no trouble getting patients to sign informed consent forms acknowledging the possibility of severe complications and even death.”

One is not surprised by now to learn that 80 to 90 percent of stomach and intestinal stapling patients are female.

At last, all women are operable. Liposuction is the fastest-growing of cosmetic surgeries: 130,000 American women underwent the procedure last year, and surgeons sucked 200,000 pounds of body tissue out of them. According to
The New York Times,
as we saw, 11 women have died from the procedure. At least 3 more have died since that article was written.

But I would not have known that from the conversations I had with “counselors” when I posed as a prospective client:

 

“What are the risks from liposuction?”

“The risks aren’t great. There is always a risk from infection, that is small and a risk from anesthetic, that’s small.”

“Has anyone ever died?”

“Well, maybe ten years ago, with very obese people.”

“Does anyone ever die these days?”

“Oh,
no
.”

“What are the risks from liposuction?”

“There are no risks, none at all.”

“I read that people have died from it.”

“Oh God. Where did you read that?”

“The New York Times.”

“I know nothing about that. I know nothing about
The New York Times.
I’m sure if that were true it would be making headlines. They make a fuss over the least little thing.”

“Are there any risks involved with liposuction?”

“No, no. Generally speaking, no risks involved at all, no, no. No problem at all, no.”

“I read that there have been some deaths.”

“Mmm. I have heard something about that. But as long as you’re in the hands of a skilled practitioner, you should have no problem, no problem.”

“What are the risks involved with liposuction?”

“There is very little risk, very little.”

“Does anyone ever die from it?”

“I would never think so.”

“What are the risks involved with liposuction?”

“They’re tiny, very very small. They are very very minimal, whether one million to one or whatever. It’s very simple, there’s very little to go wrong in terms of permanent side effects—very very little to go wrong.”

“Is there any risk of death?”

“None whatsoever, no, no. I haven’t heard of any complication like that.”

You could call death a permanent side effect. You could definitely call it a complication. Stretching a point, you could say risking your life is the least little thing to fuss about, a very very little risk, tiny, very small, very very minimal. Liposuction deaths
aren’t real deaths—a comforting thought for the families of the deceased. The surgeons say that “the benefits far outweigh the risks,” which is a value judgment about the relative importance of their version of “beauty” to that of a woman’s life.

To dwell on the teeny tiny death risk, a surgeon might say, is to overreact: The deaths are a fraction of a percentage of the whole. Surely—for a medically necessary operation. But for the reconstruction of healthy young women? How many will die before it is too many, before we draw around ourselves a line of safety? Fourteen dead women and counting, each of whom had a name, a home, and a future. And each of whom had healthy concentrations of flesh where fat distinguishes female from male sexual development; for which all the rest had to be staked on the wheel, all gambled for double or nothing and, for these fourteen women, all lost. When is it appropriate to notice blood on a doctor’s hands? Will we go on to twenty? To thirty? To fifty healthy women dead before we feel resistance, before we question the process that has women gamble their lives for a “beauty” that has nothing to do with us? At this rate, those deaths will be just a matter of time. Liposuction is the fastest-growing procedure in a field that triples every other year. Before this trend escalates until it can never again be considered appropriate, now is the time to stand back and notice fourteen dead bodies, real ones, human ones. Fourteen women dead was enough for Kenya, but not for the United States.

What is liposuction (assuming you live through it)? If you are reading one clinic’s advertisement, it looks like this:

 

FIGURE IMPROVEMENT BY IMMEDIATE SPOT FAT REDUCTION. . . . One of the most successful techniques is that developed to refine and reshape the figure. With Lipolysis/Suction assisted Lipectomy a tiny incision is made in each area of excess fat. A very slender tube is then inserted and by gentle, skillful movements aided by a powerful and even suction this unwanted (and often unsightly) fat is removed—permanently.

If you are reading an eyewitness account by journalist Jill Neimark, it looks like this:

 

[A] man force[s] a plastic tube down a naked woman’s throat. He connects the tube to a pump that, for the next two hours, will breathe for her. Her eyes are taped shut, her arms are stretched out horizontally and her head lolls a little to the side. . . . She’s in a chemically induced coma known as general anaesthesia . . . what comes next is almost unbelievably violent. Her surgeon . . . begins to thrust the cannula in and out, as rapid as a piston, breaking through thick nets of fat, nerves and tissue in her leg. The doctor is ready to stitch her up. Nearly 2,000 millilitres of tissue and blood have been sucked out of her, any more would put her at risk for massive infection and fluid loss leading to shock and death. . . . He peels the tape back from her lids, and she stares at him, unseeing. “A lot of people have trouble coming back. Bringing someone out of anaesthesia is the most dangerous part of an operation.” . . . [which] can lead to massive infection, excessive damage to capillaries and fluid depletion resulting in shock and coma.

Liposuction shows the way to the future: It is the first of many procedures to come for which all women will be eligible by virtue of being women.

 

Eugenics

Women are surgical candidates because we are considered inferior, an evaluation women share with other excluded groups. Nonwhite racial features are “deformities” too: one British clinic offers “a Western appearance to the eyes” to “the Oriental Eyelid,” which “lacks a well-defined supratarsal fold.” It admires “the Caucasian or ‘Western’ nose,” ridicules “Asian Noses,” “Afro-Caribbean Noses (‘a fat and rounded tip which needs correction’)”, and “Oriental Noses (‘the tip . . . too close to the face’)”. And “the Western nose that requires alteration invariably exhibits some of the characteristics of (nonwhite) noses . . . although the improvement needed is more subtle”. White women, together with black and Asian women, undergo surgery not as a
consequence of selfish vanity, but in reasonable reaction to physical discrimination.

When we examine the language of the Age of Surgery, a familiar degradation process echoes. In 1938, German relatives of deformed infants requested their mercy killings. It was an atmosphere in which the Third Reich stressed, writes Robert Jay Lifton, “the duty to be healthy,” asked its people to “renounce the old individualist principle of ‘the right to one’s own body,’” and characterized the ill and weak as “useless eaters.”

Recall the reclassification process and how it moves, once violence begins, from narrow to wide: The Nazi doctors began by sterilizing people with chronic disabilities, then with minor defects, then “undesirables”; finally, healthy Jewish children were placed in the net because their Jewishness was disease enough. The definition of sick, expendable life soon became “loose, extensive, and increasingly known.” The “useless eaters” were simply put on a “fat-free diet” until they starved to death; they had “already been fed insufficiently and the idea of not nourishing them was in the air.” Remember the characterization of parts of women as already wounded, numb, deformed, or dead. “These people,” the Nazi doctors declared of “undesirables,” “are already dead.” A language that categorized the “unfit” as already less than alive eased the doctors’ conscience: They called them “human ballast,” “life unworthy of life,” “empty shells of human beings.” Remember the use of “health” to rationalize bloodshed; the doctors’ worldview was grounded in what Robert Jay Lifton calls “the healing/killing reversal.” They stressed the therapeutic function of killing deformed and weak children as a means to heal the body politic, “to ensure that the people realize the full potential of their racial and genetic endowment” and “to reverse racial decay.”

Remember the trivializing language of the surgeons; when the German doctors culled children by syringe, it was “not murder, this is a putting-to-sleep.” Remember the unqualified surgeons’ bureaucratic obfuscations; the Reich Committee for the Scientific Registration of Serious Hereditary and Congenital Diseases, Lifton writes, “conveyed the sense of a formidable medical-scientific registry board, though its leader . . . had his degree in agricultural economics. . . . these ‘observation’ institutions . . . 
provided an aura of medical check against mistakes, when in fact no real examination or observation was made.” Medical experimentation was justified on “creatures who, because less than human, can be studied, altered, manipulated, mutilated or killed—in the service . . . ultimately of remaking humankind.” Remember numbness; both victims and experimenters existed in a state of “extreme numbing,” for in “the Auschwitz atmosphere . . . any kind of experiment was considered possible.”

As Lifton writes: “The doctor . . . if not living in a moral situation . . . where limits are very clear . . . is very dangerous.”

Progressive dehumanization has a stark, well-documented pattern. To undergo cosmetic surgery, one must feel and society must agree that some parts of the body are not worthy of life, though they are still living. These ideas are seeping into the general atmosphere with a nasty stench of eugenics, for the cosmetic surgeon’s world is based on biological supremacy, something Western democracies are not supposed to admire.

 

The Iron Maiden Breaks Free

Women are in jeopardy from our current misunderstanding of the Iron Maiden. We still believe that there is some point where surgery is constrained by a natural limit, the outline of the “perfect” human female. That is no longer true. The “ideal” has never been about the bodies of women, and from now on technology can allow the “ideal” to do what it has always sought to do: leave the female body behind altogether to clone its mutations in space. The human female is no longer the point of reference.

The “ideal” has become at last fully inhuman. One model points out in
Cosmopolitan
that “the ideal today is a muscular body with big breasts. Nature doesn’t make women like that.” And, in fact, women no longer see versions of the Iron Maiden that represent the natural female body. “Today,” says Dr. Stephen Herman of Albert Einstein College of Medicine Hospital, “I think, almost every popular model has had some type of breast augmentation operation.” “Many models,” another women’s magazine concedes, “now regard a session with the plastic surgeon as part
of their job requirement.” Fifty million Americans watch the Miss America pageant; in 1989 five contestants, including Miss Florida, Miss Alaska, and Miss Oregon, were surgically reconstructed by a single Arkansas plastic surgeon. Women are comparing themselves and young men are comparing young women with a new breed that is hybrid nonwoman. Women’s natural attractions were never the aim of the beauty myth, and technology has finally cut the cord. She says, I feel bad about this; he cuts. She says, What about this here; he cuts.

The specter of the future is not that women will be slaves, but that we will be robots. First, we will be subservient to ever more refined technology for self-surveillance, such as the Futurex-5000, or Holtain’s Body Composition Analyzer, a portable fat-analysis machine with infrared light, and a hand-held computer that applies electrical currents through electrodes placed at wrists and ankles. Then, to more sophisticated alterations of images of the “ideal” in the media: “Virtual reality” and “photographic re-imaging” will make “pefection” increasingly surreal. Then, to technologies that replace the faulty, mortal female body, piece by piece, with “perfect” artifice. This is not science fiction: the replacement of women has begun with reproductive technology. In Great Britain and the United States, research is well under way to develop an artificial placenta, and, according to science writers, “we are now moving into an era when we will have the scientific and technical knowledge to deny women the opportunity to reproduce, or to reproduce only if they use the genetic materials of others.” That is, the technology exists for wealthy white couples to rent the uteri of poor women of any race to gestate their white babies. Since childbirth “ruins” the figure, the scenario of rich women hiring poor ones to do their ungainly reproductive labor is imminent. And cosmetic surgery has given us little reason to doubt that when the technology exists for it, poor women will be pressed to sell actual body material—breasts or skin or hair or fat—to service the reconstruction of rich women, as people today sell their organs and blood. If that seems grotesquely futuristic, cast yourself back just ten years and imagine being told that the invasive alteration on a mass scale of women’s breasts and hips would come to pass so soon.

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