December.

Beverly Hills. Movie stars, pop icons, and miles and miles of work done on boobs, eyelids, lips, noses, tummies, and butts, much of it shaped, enlarged, reduced, and reconstructed by Dr. Romeo Bouley, PSS—Plastic Surgeon to the Stars.

I ease my rented Ford Escort onto Century Boulevard outside of LAX and hit the 405 on‑ramp. Forty minutes later, I coax the Escort up the Pacific Coast Highway and head to the Malibu Beach Colony. Every car I pass is a Benz, BMW, Jag, Rolls, or Bentley. Every car. And every driver shoots me a look that says this guy’s either lost or someone’s gardener.

Dr. Romeo Bouley’s house sits along a beach as white as talcum powder, the house framed by two leaning palm trees embracing fronds like an elderly couple, darkening the front of a three-story Spanish mansion in shadow. Dr. Bouley has insisted I drive right from the airport to his house for a drink. He wants to get acquainted before we jump in first thing in the morning. I park my rented clunker in his driveway behind two Benzes and a Rolls. I walk up to his front door, pause to soak in the late-afternoon Southern California sun. Man. December, seventy degrees, and everyone owns a fifty-thousand-dollar car. I could get used to La La Land.

I step onto Dr. Bouley’s Spanish-tiled front patio, aim my finger at his doorbell, and freeze. The cost of my three one-month electives suddenly whips into my head like a ripped cash-register tape. I’m beyond broke. Choosing My Own Adventure has emptied my bank account and forced me to take on new loans on top of my old loans. And I’m about to shell out even more money. Next month, I will begin traveling the country to interview for residencies in both plastic surgery and general surgery, my backup in case I get completely shut out of plastic surgery. It could happen. My sneak-attack interview with the chief resident in Springfield still stings. Since plastic surgery is so competitive, I figure I’ll need to apply to at least fifty residencies. I crunch some quick numbers in my head and nearly choke. The moment I become a doctor, I will owe over $100,000. The number nearly sends me running straight back to my rented Escort. Screw it. No point worrying now. At least I’m saving a little money this trip because my brother has moved to Los Angeles and invited me to stay on the floor of his apartment. A big hello once again to Mom’s Korean sleeping cushion.

Whap. The front door jerks open, knocks me back to reality. A large man, six-three at least, thick shoulders, trim waist, white hair sculpted into what looks like two sand dunes, an impressive sloping beak of a nose, sparkling gray eyes, glistening teeth, grips me in a handshake strong enough to bend iron. He wears dark blue scrubs with Romeo Bouley, MD embroidered on the pocket. The first time I’ve seen designer scrubs.

“Saw you out here, wondered why you didn’t ring the bell. Tony, right?”

“Yes, Dr. Bouley—”

“Romeo. Come in, come in. Let’s get you a drink. You look thirsty.”

He slaps my back hard enough to dislodge a chicken bone. I step into his living room and stop dead in my tracks. It looks as if I’ve wandered into an antique store—Oriental rugs, ornate chests of drawers, end tables, dining room sets piled on top of each other, trumpets, tubas, clarinets, two accordions, violins, harps, and at least one lute.

Most of all, scattered throughout the room on all of the furniture, on the mantelpiece, and stacked in every corner are lamps, hundreds of lamps—shaped and painted like naked women.

“Impressive, huh?”

“I’ve never seen anything like it. Like them. Like your collection.”

“I know. I must have fifteen hundred naked-women lamps. I get ’em from all over the world. Some of the boobs light up. You can read by ’em. Use ’em for a night-light. What are you drinking?”

“Water is fine.”

“No, no. I got a beauty from Sonoma breathing in the kitchen. I’m talking about a wine.” He roars. “You want to see the rest of the house?”

“Yes, sure, love to.”

I trail him through four thousand square feet, five bedrooms, six bathrooms filled with antiques and the other thousand naked-lady lamps. They’re everywhere—on the kitchen counter, on the stairs, atop the refrigerator, on the back of toilets. We circle back to the living room. Romeo pushes aside a pile of crap on a velvet love seat, sinks down, and pats the seat next to him. I crunch into a velvet whoosh.

“How do you like Beverly Hills? Kinda reminds you of Springfield, doesn’t it?” Head thrown back, another roar. A moment later, he socks back half his goblet of red wine, throws a long thick arm across the entire length of the love seat onto my shoulder. “So, what do you know about me?”

I actually do know something about Romeo Bouley, MD. I checked him out online. He carries the reputation as the go‑to plastic surgeon among actresses, models, and strippers and has dated at least one A‑list actress. Allegedly. He’s also loaded. Allegedly.

“Nothing, really,” I say.

“Oh yeah? Bullshit.”

“Well, Dr. Kanner says you’re the best.”

He shrugs, drains the rest of his wine. I’ve barely touched mine.

“Another,” he says.

“Oh, no, thank you, I’m fine.”

“I was talking to myself.” He laughs so hard the love seat shakes, then wriggles his butt, extracts himself from the divot he’s made in the cushion, and propels himself into the kitchen.

“Everything you’ve heard about me is true,” he says over his shoulder.

He returns in five seconds, a meaty hand wrapped around a dusty wine bottle. “You’re a smart kid. I assume you’ve done some research.

Be disappointed if you haven’t.” He catches me in midsip. Before I can answer, he says, “I’ve done some research about you.”

“Okay, I have read a little about you.”

“Good. You’re opening up. So you know. Now, look, starting tomorrow, you’re gonna see some shit. So let’s be straight with each other from now on, dig?”

“Yes. Sure. Dig.”

“What do you want to know?”

I reach my wineglass over to the antique map chest Romeo uses as a coffee table. I set it down. “Have you ever dated a patient?”

“Never. I do date actresses and models, but they’re never my patients. That’s rule number one. Never date a patient. Rule number two, never date a patient. Don’t go near a patient’s boobs outside the operating room. Dig?”

“Not a problem. I have a girlfriend.”

“I have a couple.” Romeo plops back down on the love seat, landing like an anchor. “You’re not in Kansas anymore, big guy. Or Grand Rapids. Or Springfield. We don’t do a lot of Farmer Fred losing his pointer in the wood chipper. We do Miss September. Miss March. The Playmate of the Year. The star of a certain sitcom. The whole cast of a daytime soap. Vegas superstars. Most of the Nudes on Ice. They’re all stunning, and most are available. We’re the rock stars of medicine, Youner. We get all the tail, all the glory, and all the money. A lot of docs hate us. I get it. They’re jealous. Most of them want to trade places with us.”

I stare at him until he blinks. “What?”

“How did you know people call me Youner?”

Romeo Bouley, MD, once again lifts himself up from the love seat. “Told you. I did my research.”

Third elective. Day one.

I stand outside the office of Romeo Bouley, MD, in Beverly Hills. I gape at the stained-glass windows in the burnished oak doors. I rub the stained glass lightly, shake my head, and step into the waiting room— leather couches, modern art, an Oriental rug, and twenty more naked lady lamps. The receptionist, a former or potential centerfold, directs me to Romeo’s office down the hall. An Oriental runner leads me to him. On the way, I pass framed covers of magazines that have featured Romeo—People, Us Weekly, Playboy, Penthouse, and a shocker, The Saturday Evening Post.

I knock at his door frame; the door is open. He beckons me in, waves me to an armchair.

His office? Leather, leather, leather, naked-lady lamps.

“You meet Heather?”

“The receptionist? She’s very nice.”

“Unbelievable, right? I did them. And no, I never did her. You cannot date your staff, either. That’s another rule.”
“For me, it’s not an issue. I have a girlfriend—”

“Okay, listen. Lesson number one.” He jabs a button on his desk. Behind me, the door whirs, rattles, and closes with a thwack. “Plastic surgery is like dating.” He pauses to let this sink in. “Patient comes in for a consultation. Your first date. You make small talk, feel each other out, see if you’re compatible. You have to look good, Youner. You look like crap, sloppy, whatever, she’s outta there. She comes in because she wants to look good. How you look matters. Dig?”

“Yes.” I sneak a look at what I’m wearing. White shirt, cords. I shaved. Showered. Applied deodorant. Combed my hair. Slapped on cologne. I think I’m all right.

He sees me checking myself out. “You pass. Now. While she’s feeling you out on this first date, you’re feeling her out, too. Main thing we’re looking for is crazy. We want to avoid crazy. We see crazy, we run like hell. You know BDD?”

“I don’t think so.”

He whams back in his chair, links his hands behind his spectacular snowy-beach hairdo. “Body dysmorphic disorder. Affects about one percent of the population, about five percent of plastic-surgery patients. In Beverly Hills, ten percent, easy. Maybe twenty. Gum?”

“No, thanks.”

He unwraps three sticks, pops them all in his mouth. He chews like a ballplayer, cheek puffed out as if working on a chaw. “This is a condition where a person looks in the mirror and sees something that doesn’t exist. Or sees a distortion of the truth. You look in a mirror, you see a tiny bump on your nose. Mosquito bite, say. A person with BDD sees that same mosquito bite, and to her, it’s the size of a big fleshy peach. I’m serious.”

He chews violently for three more seconds, tears off a page from a prescription pad, spits the wad of gum into it. “Plastic-surgery patients with BDD see themselves as ugly and deformed. Doesn’t matter how great the surgery turns out or how many times you perform a surgery to correct the first one, which they see as botched. In real life, they may look like Heather, but they look in the mirror and think they look like crap. And they blame you.”

“Crazy,” I say.

“A nightmare,” Romeo says. “You can’t always catch it, but you try. We get sued more than anyone. My lawyer loves me. Sends me on a cruise twice a year. Anyway, back to dating.”

He taps out three more sticks of gum, unwraps them, jams them into his mouth. I’ve known Romeo Bouley, MD, for under a day, but based on his naked-lady lamp collection, the fact that he lives in the middle of Antiques Roadshow, the way he compares plastic-surgery consultations to dating, and how he chews a pack of gum every five minutes, I’m calling this guy quirky.

“So, okay, the consultation goes well, you agree to see each other again. Now we’re talking Botox, collagen, that kind of thing. First base. That goes well, you move to second base. Lipo. Then you swing for the fences.”

“Breast augmentation.”

“Bingo. Start with a good-night kiss. Botox. Next you make out. Lipo. Then you do the deed. Boob job.” He rips off another page from the prescription pad, wads up his gum. “I feel you, kid. You got a future.”

Days two through twenty-nine.

A guy could get used to this.

Five, six, seven, a dozen gorgeous women a day. Professional women who act, pose, escort, strip, and screw for a living, all talented enough to appear on the cover of Maxim or in the pages of Playboy. The startling part is that if I’d ever met one of them in college, I’d have stammered, blanched, and launched into a monologue about my mother’s cooking. Now, wearing a white coat in Dr. Romeo Bouley’s office—even though I always identify myself as a medical student—I’m treated like another doctor. These women share with me their fear of surgery, explain why it’s a curse having a beautiful face and gorgeous breasts, even confess their most intimate problems with husbands, boyfriends, parents. I listen sympathetically, and when they ask for my assurance—they always do—I promise I’ll be right there with them throughout their procedure. Many grip my hand with heartfelt thanks. At times I feel like Romeo Junior.

“I tell you more than I tell anyone,” a porn star, a favorite of Tim’s, coos to me as Romeo begins her post-rhinoplasty follow-up visit. She has asked him to make her look more elegant, less trashy. She hopes to transition into mainstream acting at some point, which, from what I’ve seen, would be a blow to the porn industry.

“Everything looks good,” Romeo says. “Healing nicely.”

“I have a photo shoot tomorrow. Is that okay?”

“It’s fine. You don’t have to miss work.”

“Can I hang from the ceiling by my wrists and ankles?”

“Just make sure they don’t touch your nose.”

“Can they put a cue ball in my mouth?”

I cough, mutter, “Warm in here.”

“They tell us everything,” I say to Romeo one afternoon.

“Oh, yeah,” he says. “You know what they call us? Shrinks with knives.”

No doubt Romeo Bouley is quirky; he’s also a talented surgeon and a gifted teacher. He’s fast and steady with a scalpel, patient and generous with me. He allows me to suture more than anyone else has and even offers me a few incisions of my own. As I near the end of my month in Beverly Hills, Romeo invites me to return for a longer apprenticeship after I’ve established my residency. I accept his offer. I’m no longer hooked on plastic surgery. I’m obsessed. I’ve found my calling. I would love to work side by side with Romeo. Wouldn’t mind living in Southern California, either, at least for a short time.

My last day. Our last procedure. Romeo will perform breast-implant surgery on Michelle, a stripper who’s recently celebrated her fortieth birthday, a difficult birthday for many people, the end of the line for most strippers. For over twenty years, Michelle’s stunningly oversize breasts have been her signature. Now they have literally become weights, causing her severe neck and back pain and brutal headaches. She has gone from performing at prime time in top Hollywood and Vegas clubs to stripping at noon in a dive by the airport. She wants to find a new line of work and needs her breasts reduced.

The anesthesiologist knocks Michelle out, we scrub up, gown up, prepare for surgery. Before Romeo makes his first cut, we ponder her pendulous breasts, the most imposing mountains of silicone I’ve ever seen.

“Gigantomastia,” Romeo says. “Okay, I’m going in.”

He makes a flawless incision around the areola of the right breast and starts cutting down to the implant.

“Grade-four capsular contracture,” he says as he cuts. “I’ll break down the grades for you. Grade one. Buttah. The way a breast should feel. Natural. Like you’re back in high school. Grade two. Firmer than normal. Looks fine, feels a little firm. Most people can’t tell the difference between one and two.”

He pulls back, waits, allows the bleeding to stop. “Grade three. Too firm, appears abnormal. We’re talking Nerf football. Not what you’re looking for in a breast. And then there’s this. Grade four. A bowling ball. The scar tissue is so severe it makes the breast round, hard, and cold. Here, feel.”

He puts my hand on her left breast. Massive, rock-hard, cool to the touch. Forget stripping. How did she walk with these?

“Guys like these?” I say.

“You can take your hand off now, Tony.”

I have already.

“I amuse myself,” Romeo says. He chuckles, resumes cutting into the breast, going farther toward the implant. “I’m at the capsule,” he says. “This scar tissue is thick. Knife, please.”

The surgical technician passes him a scalpel. With immaculate precision, he works through the scar tissue down to the implant. Finally, sounding like an egg cracking, the implant pops through the scar tissue. Romeo puts aside the scalpel, grabs the edge of the implant, and yanks out a slice of clear silicone shaped like a discus, high as two Big Macs. He hands the implant to the surgical tech and peers inside the open breast pocket. “She’s stacked,” he says.

“She is huge,” I say.

“No, Youner. She’s stacked. There’s another implant in there.” He grunts and pulls a second implant out of the breast pocket. “You don’t see this often. It’s extreme. Anna Nicole Smith time. Only the truly insane plastic surgeons do stack jobs.”

“You ever do one?”

“All right, now for the left side.”

After Romeo removes the stacked implants in her left breast, he focuses on the scar tissue, which has progressed to such a severe state that it has turned the inside of both breasts into a chalky, calcified mess resembling the plaster of a cast. For over an hour, Romeo chips away meticulously, removing every bit of scar tissue, piece by piece, until all that’s left of her breasts is a mass of stretched-out skin.

He then inserts temporary sizer implants that look like small inflatable balloons. On his count, we raise Michelle to a sitting position so Romeo can determine what size he should make the new implants. We lay her back down, and he begins to fill the sizer implants, inflating her breasts as if pumping up a tire.

“This looks good. Around a D cup. Two five-hundred cc implants, please.”

The OR nurse opens two new breast implants and hands them to Romeo. He inserts one into each breast cavity. These implants will never fill out Michelle’s breast in the same way as the stacked two-baggers, which is, of course, the point. Instead they settle into the bottom of each breast socket.

“Rock in a sock,” Romeo says. “That’s seriously what we call it. And now for the breast lift.”

He begins suturing the nipples onto their new, higher location. He cuts off the excess breast skin and stitches the incisions back together, working with the concentration of a jeweler. The process takes over ninety minutes. At last he takes one step back. Before us lies Michelle and her new breasts, smaller, youthful, beautiful. Together, Romeo and I apply gauze dressings.

“Oh, shit,” Romeo says.

“What?”

“Her nipples.” He retreats another step. “Shit. Look. They’re turning purple.”

A moment ago her nipples were full and pink. They have darkened to the color of an eggplant. Romeo speaks faster than I have ever heard him. “Sometimes when you perform a breast lift on a woman with implants, the blood supply to the nipples becomes altered. Needle.”

A small needle appears in a flash. He stabs the areola lightly, repeatedly.

Dark red blood oozes out.

“Fuck. Her nipples are congested. Let’s get some of these stitches out. We’re looking for the nipples to turn pink.”

We remove a few of the sutures that hold the nipples in place.

Still purple.

“Well, Anthony, we got a situation. Purple means there’s blood flowing into the nipple but not going out. The blood is pooling up in there.”

“Sorry, this means—?”

“Worst case? Her nipples will turn black and fall off. Instead of a nipple, she’ll have a gaping hole.”

“Shit,” I say.

“Yep. Deep shit.”

“What do we do?”

“Leeches.”

I laugh. I can’t help it. You have to love how Romeo keeps it loose even during a crisis.

“I’m serious,” he says.

“Leeches?”

“Be fancy. Call it leech therapy. I’ve done it several times. We bring her to the hospital and attach a bunch of the bloodsuckers right there.”

He points to each of Michelle’s nipples. “They suck the old blood out. In a few days, her body will create new blood vessels that will take over for the leeches. Hopefully.” He turns to the OR nurse. “You know the drill. Call an ambulance.”

“Wow,” I say. “Leeches.”

“New technology, my ass. We’re going medieval.”

. . . .

Romeo escorts Michelle to the hospital. I stay behind. I say goodbye to Heather and the rest of the staff, then I run an errand on Melrose Avenue in West Hollywood. By the time I head back toward Beverly Hills, the sun’s starting to set. I drive into the hills, find a spot to park on Mulholland Drive, and watch the lights of the San Fernando Valley flicker on. It looks as if I’m peering down at a second night sky. At around seven, I head to the hospital to check on Michelle.

As I exit the elevator, I hear a scream. A woman stands in the middle of the hallway and points at the floor. She shrieks again and backs up slowly. I jog toward her and see a bloody trail coming out of Michelle’s room. At the end of the trail sits a huge, bloated leech.

“It’s nothing,” I say. “Leech therapy.”

The woman stares at me, horrified, her hands over her mouth. I push open Michelle’s door and find her lying in bed, sound asleep, the rest of the leeches locked up in a jar somewhere.

Beverly Hills.

Movie stars. Pop icons.

Leeches.

—

In the parking lot, still in his scrubs, Romeo leans against my rented Ford Escort. “I couldn’t let you go without saying goodbye.”

“I was going to find you, too. Thank you for everything.”

“You got to see pretty much my whole bag of tricks. And I’m serious. Come back.”

“I’d like that. Hey, I have something for you.” I pop open the back of the Escort, reach in, and hand him a gift-wrapped box. “A little token of my thanks.”

“Get outta town. What did you do?”

Like a kid at Christmas, he rips off the wrapping paper and flings off the cover of the box. He stares inside. His eyes begin to water. He shakes his head and pulls out my present.

A lamp shaped like a naked woman.

He bites his lip. “She’s beautiful.”

“The nipples flash the SOS distress signal.”

He throws his arms around me, locks me in a bear hug. “You feel me.”

“I feel you,” I say, crushed in his embrace.

Too bad they’re attached to a fourteen-year-old boy.

I ease the black marker out of my lab coat pocket and start drawing on my first surgery patient of the day. Phil. An overweight African-American boy. Phil has severe gynecomastia—in layperson’s language, ginormous man boobs. Poor Phil. Bad enough being fourteen, awkward, and a nonathlete in a tough urban Detroit school. Now he has to deal with breasts?

Two weeks ago.

I sit in my office with Phil and Mrs. Grier, his grandmother. Phil lives with his grandma, who’s raised him since he was ten, when his mom died. He’s never known his dad. Mrs. Grier sits on a chair in front of my desk, her hands folded in her lap. She’s a large woman, nervous, well dressed in a light blue dress and matching shawl. Phil, wearing what looks like a toga, sits on a chair next to her. He stares at the floor. “It happened fast,” Mrs. Grier says. “He shot up, his voice got deeper, he started to shave.”
She speaks in a low rumble. She looks at her grandson, tries to catch his eye. He can’t see her. He keeps his head down, eyes boring into the floor.
“Then he became quiet. Withdrawn. He would spend more and more time in his room alone, listening to music. He would walk around all day wearing his headphones. Seemed like he was trying to shut out the world.”
Mrs. Grier slowly shakes her head. “Phil’s a good student. But his grades have gone downhill. He doesn’t want to go to school. Says he’s sick. I tried to talk to him, tried to find out what was wrong. He would just say, ‘Leave me alone, Nana.’ That’s all he would say.”
Phil clears his throat. He keeps looking at the floor.
Mrs. Grier shifts in her chair. “One day I accidentally walked in on him when he was drying off after a shower. That’s when I saw . . . you know . . . them.”
Phil flinches. Mrs. Grier reaches over and touches his arm. After a moment, he swallows and says in a near whimper, “Can you help me?”
“Yes,” I say.
I say this one word with such confidence that Phil lifts his head and finds my eyes. He blinks through tears.
“Please,” he says.

The night before Phil’s procedure.
I can’t sleep. I lean over and squint at the clock on the nightstand. I twist my head and look at my wife, deep asleep, her back arched slightly, her breath humming like a tiny engine. I exhale and study the ceiling.
A shaft of light blinds me like the flash from a camera. My mind hits rewind, and I’m thrown backward into a shock of memory. One by one, as if sifting through photographs, I flip through other sleepless nights, a string of them, a lifetime ago in medical school, some locked in the student lounge studying, some a function of falling into bed too tired or too worked up for sleep. Often I would find myself staring at the ceiling then, the way I am now, talking to myself, feeling lost, fumbling to find my way, wondering who I was and what I was doing. The memory hits me like a wave, and for a second, just as in medical school, I feel as if I am drowning.
My eyes flutter and I’m back in our bedroom, staring blurrily at the ceiling. I see Phil’s breasts, pendulous fleshy torpedoes that have left him and his grandmother heartsick and desperate. I know that his emotional life is at stake and I am their hope. I know also that isn’t why I can’t sleep. I blink and see Phil’s face, and then I see my own.

I was Phil—the outsider, the outcast, the deformed. I was fourteen year-old Phil.

I grew up one of two Asian-American kids in a small town of near wall- to-wall whiteness. In elementary and middle school, I was short, shy, and nerdy. Then I shot up in high school. I became tall, too tall, too thin. I wore thick Coke-bottle glasses, braces, a stereotypical Asian bowl-cut hairdo, and then, to my horror, watched helplessly as my jaw began to grow, unstoppable, defying all restraint and correction, expanding Pinocchio-like, protruding to an unthinkable, monstrous size. I loved comic books, collected them, obsessed over them, and as if in recognition of this, my jaw extended to a cartoon size. I was Phil. Except I grew a comic-book jaw while he grew National Geographic breasts. Like Phil, I only wanted to look and feel normal. I just wanted to fit in.

It hits me then.

My calling—my fate—was written that summer between high school and college, the Summer of the Jaw. My own makeover foreshadowed my life’s work. Reconstructing my jaw showed me how changing your appearance can profoundly affect your life. Now, years later, I am devoted to making over others—helping them, beautifying them, changing them. I have discovered that plastic surgery goes beyond how others see you; it changes how you see yourself. On occasion, I have performed procedures that have saved lives. I believe that I will save Phil.
My mind sifts through my days in medical school, and in a kind of hallucinogenic blaze, I conjure up every triumph, every flub, every angst-filled moment. I remember each pulse-pounding second of the first two years of nonstop studying and test-taking, interrupted by intermittent bouts of off-the-hook partying. I see myself in years three and four, wearing my short white coat, wandering through hospital corridors trying to overcome my fear that someone—an administrator, a nurse, or God forbid, a patient—would confuse me for a doctor and ask for medical attention. I teetered a hair’s width away from those moments that might mean life and death, facing the deepest truth in the pit of my stomach: that I had absolutely no idea what I was doing. And neither did any of my medical-school classmates, those doctors in training who stumbled around me.
But things changed. Thanks to my small circle of close friends, my focus, work ethic, and drive to succeed, I slowly grew up. I entered medical school a shy, skinny, awkward nerd with no confidence, no game, and no clue. I came out, four years later, a man.
A smile creeps across my face. My eyelids quiver. I catch a last glimpse of the face of my younger self in the ceiling as it shimmies and pulls away. Sleep comes at last.
Phil’s surgery goes well. Ninety minutes, no complications. I lop off his breasts with a scalpel, slice off the nipples, then suture them back onto his now flat chest. I nod at his new areolas. They have decreased in diameter from the size of pie plates to quarters. I leave Phil stitched up and covered with gauze, a normal-looking high school freshman. Good news, Phil. You will not break new ground and become the first male waiter at Hooters.

I once saw an episode of Grey’s Anatomy in which a character suggested that she—and every doctor—experienced an “aha moment” when she realized she had become a doctor. That never happened to me. I experienced an accumulation of many moments. Some walloped me, left me reeling. Others flickered and rolled past like a shadow. They involved teachers, classmates, roommates, friends, family, actors playing patients, nurses, the family of patients, and patients themselves, patients who touched me and who troubled me, patients whose courage changed my life and who taught me how to live as they faced death, and of course, doctors—doctors who were kind, doctors who were clueless, doctors who were burned out, doctors who inspired me and doctors whom I aspired to be, doctors who sought my opinion and doctors who shut me down.
Thinking about all these people and moments, I see no pattern. Each moment feels singular and powerful. They stunned me, enveloped me, awed me, but more often flew right by me unnoticed until days, weeks, months, years later. Until now.

This is my Book of Moments.

To read an IN STITCHES excerpt about Gross Anatomy called “I See Dead People,” click here.
To purchase IN STITCHES, please click below.

Mike Ragogna: Tony, what drove you to write In Stitches?



Dr. Tony Youn: First time out, I decided to shoot for the stars. I set out to write the definitive book about growing up Asian-American, going through four years of medical school–all true, unadulterated, unfiltered, behind the scenes, warts and all–and becoming a doctor. I think, ultimately, In Stitches represents real life. Real life can be laugh-out-loud funny, shocking, heart-breaking, and heart-warming, that’s what I wanted In Stitches to be. I’m gratified by what readers and reviewers have said so far, they’ve called it “disarming,” “fast-paced,” “hilarious,” and “touching.” I’m very pleased and humbled by these descriptions because that’s what I was going for.

MR: Congratulations. How much did your childhood challenges with your jaw influence you to choose plastic surgery as your profession?

TY: I grew up one of two Asian-American kids in a small town of near wall-to-wall whiteness. But while I looked different from the kids around me, inside, I felt I was just like them, an American. Other Asians would call me “Twinkie” or “Banana”–yellow on the outside, white on the inside. Once I reached high school, I became too tall, too thin, I wore thick Coke-bottle glasses, braces and a stereotypical Asian bowl-cut hairdo. Then, to my horror, I watched helplessly as my jaw began to grow, expanding Pinocchio-like, protruding to an unthinkable, monstrous size. Surprisingly, I couldn’t get a girl to show any interest in me until the end of my senior year in high school.

Now that I’m a plastic surgeon, I have tremendous empathy for my patients, especially those with any sort of deformity, because of what I went through with my jaw. I know how self-conscious they feel. I’ve been surprised how many of my patients have read my book and told me how they related to my horrible “Summer of the Jaw.”

MR: How do you think having such a stern father played into your approaching life’s challenges with humor?

TY: Like many Asian-Americans, I had a Tiger Father. My dad grew up on a small rice farm in rural Korea, my grandparents put away every nickel they could to send my father to medical school. The hopes of his entire family–all six of his siblings–rested on him becoming a successful doctor and sending most of his earnings back to Korea. Incredibly, like many first generation immigrants, he was able to live the American dream. Unfortunately, all he knew were two extremes, being dirt poor in Korea and being a wealthy doctor in America–nothing in between. That’s why the day I was born, he decided I would be a doctor, too–probably before I was born. He feared that if I became anything else, I would end up living in the kind of poverty he’d worked so hard to escape.

Because my father was so strict, so tyrannical, and so controlling, if I didn’t try to see his humorous side, I would have ended up bitter and depressed. Besides, how could anyone not see humor in a father who says, “You want to be a pediatrician? Little people, little dollah! Spend all day giving suckers to little babies!” If I didn’t laugh, I would have cried.

MR: Your father is definitely a huge part of the story and, obviously your life. Can you share, perhaps, another story about him, one that wasn’t in the book?

TY: For twenty years, my dad was the only Ob Gyn in my hometown of Greenville, a tiny Michigan town. During his career, he delivered virtually an entire generation of children. He always took pride in the fact that he was never sued. He would often tell me, with a gleam in his eye, “Daddy’s patients all trust and appreciate Daddy. If you work hard and are always available for your patients and do the best you can, your patients will not sue you. Daddy has worked 20 years in the most litigious field of medicine and has never been sued. Not once. Daddy is so proud of that.”

Less than a year before his retirement, the hospital began to post congratulatory messages and notices that my dad was going to retire after a long and distinguished career. Suddenly, boom, boom, boom. Three lawsuits came out of nowhere. I don’t know the specifics of those cases, but I do know that none of them ever went to court. I suspect they had to do with opportunists figuring out that my dad had saved up a nest egg for his retirement and that he was fair game.

These lawsuits devastated my father. The once proud first generation Korean immigrant who toiled in the field and in the operating room, who saved countless patients’ lives and the lives of their babies, for the first time, questioned his legacy and career. Even worse, he questioned himself. During the time of those lawsuits, I remember seeing the pain in his eyes as he walked down the hallway in our house in the evening before he went off to bed. The gleam in his eye was gone.

MR: What has your father’s reaction been to the book?

TY: Ever since writing In Stitches, I’ve dreaded showing it to my parents–especially my father–because I knew I had been honest and pulled no punches. I showed the way he really was. I was afraid that he would be angry with me over stories that were funny. For example, his real name is Suck Youn Youn. While this is awkward, at least he wasn’t stuck with my uncle’s unfortunate handle–Suck Bum Youn. I was also concerned about stories that showed his sensitive side such as the one in which I describe him weeping in front of me while my mother underwent a dangerous medical procedure.

So, I waited. And waited. One week before the book’s release date, I mailed two copies to my parents. My mom read it immediately. After she finished it, she cried for two days. She told me that she was sad that their strict style of Asian parenting created so many difficulties for her children. She also told me that she was afraid of my dad reading it.

My dad did finally read it. I didn’t hear from him for days. I was a wreck. I bit my nails and cuticles down to bleeding stumps. Finally, he called me. He told me he loved it and was proud of me.




MR: What’s your relationship with your brother like now?

TY: My brother Mike and I are very, very close. Unlike me, he had the inner strength and determination to stand up to my parents and choose his own path in life. Although he, too, was anointed “Doctor” at birth, he figured out early on that medicine was not right for him. After many arguments and turmoil, he broke free of my parents’ expectations and discovered his true calling. He is now an extremely successful executive in Hollywood. I admire my brother very much. As a kid, I looked up to him. I still do.

MR: How wild did dorm life/campus life get, and how adversely did your alcohol intake affect your life and studies during med school?



TY: Med students have a reputation–we party like rap stars and drink like Irish poets. Uh, no. False. We like to think we party hard. We attempt to portray ourselves as debauched, out-of-control frat boys with stethoscopes. We’re not. No matter how we appear or act, even if we’re great-looking and smooth, we are, at our core, nerds and lightweights. Sure, I can think of a few exceptions. They all become orthopedic surgeons.

In medical school, I drank only the night after a big exam. That’s it, and usually three Bud Lights would do the trick. I’d combine these with a tasty McRib sandwich, and then hope I didn’t yack into the Red Cedar River on the way home. The next day, it was back to classes and regretting the night before.




MR: (laughs) How close are you to your fellow students, especially those that you lived with during school?

TY: I’m still really close to my gang of friends, especially my roommates from the house on Flower Street. We’re all practicing physicians now. We recently got together with our wives to see Rock of Ages, except for Ricky. He lives on the East Coast with his partner and enjoys a much more exciting life than the rest of us. He’s probably the only one of the four of us who still hangs out at the bar until closing time. The rest of us pass out by eleven and get awakened by our children five hours later.

MR: Would you have them perform any procedures on you knowing them as well as you do?

TY: Heck, no! We practiced giving each other shots in medical school, but that’s where it ended. Tim is now a psychiatrist. He wouldn’t know which end of the needle to use. In med school, his manual dexterity was so poor he couldn’t tie his shoes properly. If he had to perform an actual procedure on me today, I’d be afraid my stitches would come undone and my guts would fall out all over the sidewalk. James is a successful primary care physician who also happens to be my doctor. While I think he’s a fantastic doctor, I still won’t let him do a hernia check (turn and cough) on me. It would be too weird. I guess I’d let Ricky–he’s a pediatrician–look in my ears, as long as he didn’t have something sharp in his hands.

MR: (laughs) Same kind of question, did you have any teachers/doctors who you are grateful never performed any procedures on you?

TY: In the summer between my high school and college years, I had major plastic surgery to break my jaw and reset it. It hurt beyond all imagination. We’re talking Guantanamo-type pain. I would’ve given away state secrets, ratted out friends, and handed over my dad’s checking account numbers. After having this surgery performed, I’ve sworn off having anything else. Seeing as the majority of my teachers were plastic surgeons, plus the fact that I’m only 38 years old, I don’t think there are a lot of procedures that would apply to me anyway. I don’t think I’d look good with Lindsay Lohan-style fish lips or a pair of breast implants.

MR: What about the health industry? Do you feel it needs a little surgery or something even more invasive?

TY: The entire health industry is a mess. Not enough people have access to care, the care they receive is too expensive, insurance companies find loopholes to avoid paying, and malpractice liability is astronomical. Doctors and nurses are becoming more and more disenchanted with the whole system. There really isn’t an easy solution. Should we ration care to those who need it most? Should we refuse expensive tests and treatments on those with little chance of survival? The real solution probably includes a combination of electronic medical records, health insurance policy changes, malpractice liability reform, and some form of rationing. I wish I had the answer.

MR: Of your three phases–shy, nerdy kid, overly-expressive med student, and successful plastic surgeon–which is the one you secretly identify with the most to this day?



TY: Believe it or not, I still see myself as a skinny, nerdy kid with big glasses, bad hair, and a cartoon jaw. Although I’m more confident today, there will always be a part of me that identifies with the kid who had low self-esteem, couldn’t find a date, and spent a lot of time alone, especially during college. Yep, I couldn’t find a date in college. Not one. I went zero for four years, a record that will last longer than Joe DiMaggio’s consecutive game hitting streak.

I think a large percentage of the population has felt like an outsider at one point in their lives. For me, this was mainly caused by the color of my skin and my off-the-wall interests. For others, their outsider status may be due to gender, sexual preference, body shape, or religion. My hope is that anyone who has ever felt like an outsider can identify with In Stitches.

MR: What’s your advice for students about to enter the medical field?

TY: When you are done with work, do things you enjoy. Find moments of happiness each day. I think the turtle in Kung Fu Panda said it best. “Today is the present, and that’s why it’s a gift.”

MR: Tony, this has been fun, thanks for your time and all the best with the book.

TY: Thanks so much.

Thank you to Mike Ragogna for the great interview!
For the interview on Huffington Post, click here.

Summer of the Jaw.

School ends with a flurry of graduation parties and drunken sendoffs. For months I’ve been trying to distract myself from the painful and obvious fact that my jaw has started to jut out more than ever; I look hideously deformed. When I’m hanging out with friends, I try to hold my jaw in tight, the way a heavy guy might hold in his bulging stomach. I know, though, that as mightily as I attempt to impede my jaw’s dreadful progression, nothing can stop it. My jaw continues to grow, millimeter by terrifying millimeter. Finally, my mother and I agree that the week after my last graduation party, I will go under the oral surgeon’s knife.

I don’t fight this at all. I want to have the surgery. I can’t stand my ugly underbite and monstrous chin. I can’t wait to put an end to ten years of braces. I long to shred that bizarre cloth chin-cup contraption I strap over my head every night like a leatherhead football player. I want to start college with a clean slate and a brand-new jaw.

Of course, like most patients, I focus on the result of the surgery and allow my mind to skip over the details of the procedure itself. One example: when Dr. Schwarzman, my oral surgeon, says that he will have to break my jaw, it doesn’t register somehow that he means he is going to break my jaw.

Do you know what happens when someone breaks your jaw?

I’ll tell you.

It fucking hurts.

It hurts beyond any pain you can imagine. We’re talking Guantánamo-type pain. I would’ve given away state secrets, ratted out friends, given Dr. Schwarzman all of my father’s account Numbers. That kind of pain. And it isn’t enough for Dr. Schwarzman to break my jaw once. Because he’s a cackling sadist—that’s how I imagine him in my drugged-out stupor—he breaks my jaw twice, in two places, sets it back into its original position, and then wires it shut . . . for six weeks. No solid food—nothing but liquids and mush—for a month and a half. I drop from a rail-thin 135 pounds to a 120-pound stick. After the surgery, I pop pain pills like PEZ and guzzle milk shakes. Mostly, I crave pizza. I stock up on frozen pizzas, microwave them, shove one nuked slice at a time into the blender, liquefy, and drink.

Yum.

To purchase In Stitches, please click here.

I’m deep into my final clinical rotation:  Pediatrics.  Peeds, for short.  Not my favorite.  Or as my dad says, “Little people, little dollah!”  But that’s not why I don’t love pediatrics.  Treating a child is like treating Fido.  The patient has no clue why he or she is here.  Why is that mean person in the white coat hurting me?  And after the mean person in the white coat hurts me, why does he give me a sticker or a milkbone?

Today I have the joy of spending nine hours straight in the outpatient pediatrics clinic.  Hour six.  My thirtieth patient of the day arrives.  Timmy.  A three-year-old linebacker with a blond Mohawk.  And he doesn’t exactly arrive.  His mom carries him in, kicking, screaming, scratching, and howling.  Par for the course.  I’ve spent this entire rotation wrestling three-year-olds to the ground so I can look into their ears with my otoscope.  Fun.  And because I’m both obsessive and curious, I’ve kept track of the number of patients I’ve seen and/or wrestled during the rotation so far.  Timmy makes 531. 

I size Timmy up.  He snarls, lunges.  I back up.  I’m not worried.  I’m pretty sure I can take him.  Pretty sure.  He does have an advantage.  He’s built low to the ground and he has long nails.  His hands look like claws.  I wonder if he has a lot of teeth.  The last kid I went for sank his baby teeth into my forearm and locked his mouth there for thirty seconds before I could escape.  My arm looks like a pin cushion. 

Most medical students choose pediatrics because they love kids.  At least that’s my guess.  And most pediatricians are by nature calm, nurturing, and nonviolent.  They start by trying to connect to the kids on their level.  Meaning, bribery.  They wear dorky cartoon-character ties and offer sheets of stickers up front.  They tell corny jokes that the kids hate.  They talk in high pitched cartoon voices, which usually scare the kids rather than soothe them.  As a last resort, they lie.  They tell the kid that Mickey Mouse has moved inside the kid’s head and Doctor Happy wants to look at Mickey and Minnie’s new condo.

Like any kid is going to buy that.  Especially a kid like Timmy who resembles a midget ultimate fighter.  No way I’m going the Mickey Mouse route.

“Okay, Timmy,” I say, bending over him with my otoscope.  “I’m going to find Nemo now.  Did you know he just moved inside your head?”

He slams his palms over his ears.

He glares at me.  I regret the Nemo move.  Fair enough.  The idea of a Disney character lodged inside my skull would freak me out, too, even more than knowing I had an infection.  I decide to go for total honesty.

“Timmy, okay, Nemo does not live inside your skull.  Nobody does.  All I’m going to do is take a quick look inside your ears to make sure that you don’t have any bad yucky gross gunk growing in there, okay?”

I step toward him.

He backs up.

I move left, he goes right.  I circle right, he spins left.  I fake left, go right. 

Pay dirt.

I take him down.  I scramble for my otoscope.  Timmy squirms, but I’ve got him pinned.

          Wait a minute?  Have I lost my mind?  What am I doing?  He’s three.

So I’m straddling three-year-old Timmy’s chest.  Somehow I manage to squirrel over and peer into each of his ears. 

Pink. 

Damn.  I was hoping for either beige or lobster red so I could call his ears clear or infected.  Now I’m undecided.  Worse, the glance into each of Timmy’s ears leaves me vulnerable.  He grabs my stethoscope, holds it up to his mouth, and screams.  My eardrums explode.  I howl and loosen my grip.  That’s all the daylight Timmy needs.  He wriggles away and streaks toward the door.  I reach  from the floor, a conga drum sound pounding inside my head—bambada bam bambada baaaa—snag Timmy’s ankle and reel him back in. 

“Timmy, I just want to see if you’re all right,” I say, the words banging against my head like a rap song. “I want, to, check, your, vital signs.  It won’t hurt a bit.  I promise.”

I try a reassuring grin.

Timmy growls and kicks me in the throat.

“Grrragh,” I moan.  I fold my arms under his knees and wrestle him back down.

“Fun times, huh?” I say.  “Okay, I’m going to count your heartbeats.  You want to count with me?”

“MOMMMMY!”

“You’re hurting him.”  A tortured voice from across the room.

“I think it’s the other way around,” I say.

“He’s three.”

“I doubt that,” I mutter.  “Kid’s a midget wrestler.  A pro.”

I try my best then to hear his heart and lungs.  Between Timmy’s wailing and the mom’s repeated complaints, I can’t hear a thing.  I try to locate his pulse.  Can’t.  Resigned, I lean back and look at Timmy.  The kid certainly seems lively, no sign of lethargy, even though I can’t track any vitals.  At least not yet.  I won’t give up.  Two reasons.  First, I’m in medical school and I’m extremely conscientious, bordering on dogged.  Second, I don’t want to get marked down.

“Tell you what.  Let’s take a five.  Go to our neutral corners.  Then you let me listen to your heart and lungs.  Because if you don’t, I’m not allowed to give you a Lightning McQueen sticker when you leave.”

Timmy glowers.  He stands at attention and gives me a serial killer stare.  Then he sneaks the ace out of his sleeve.  He drops his pull up, grins, and grunts.

“What?  Oh, no.  NO!” I yell.

“Timmy, don’t!  Timmy!” The mom skids into view, her arms flailing toward Timmy’s tossed away training pants.

Too late.

Code brown.  Boom.  Right on the exam floor.

Checkmate. 

I lose.

Peeds. 

And poos. 

Yeah, forget pediatrics.

My first Christmas home from college.

The Christmas from hell.

First semester, over and done. I can’t wait to chill out at home. See friends. Go to parties. I even entertain thoughts of hooking up with Janine. Desperate men do desperate things.

My brother came home from Northwestern a day earlier. When I walk into the dining room and see Mike’s face, I know we’ve got a problem.

 “Dad wants to talk to us.”

“About what?”

He shrugs, drums his fingers on the oak tabletop. If he knows, he’s not saying. I don’t press him. We sit without speaking for ten achingly long minutes until my parents arrive in the dining room. My father nods at my mother, steps farther into the room, leaves her framed in the doorway. “Your brother,” my father says to me.

A lump rises into my throat. Mike must be sick. I look at him. He looks down. I turn to my father. “What’s wrong?”

“Look.” My father slides a sheet of paper toward me. It flutters against my outstretched hand.

I pick up the paper and start to read: Northwestern University Official Transcript. I hand the paper back to my father. “This is none of my business. These are Mike’s grades.”

“No. Read. Please.”

I hesitate, then reluctantly scan the transcripts. One A, the rest B’s. I look helplessly at Mike. I don’t know why I’m here, why I’ve been included in what should be a private conversation between Mike and my father. Mike stares straight ahead. He looks numb.

“Your brother,” my father says, “has shamed the family.” He lowers his voice, speaks solemnly. “How can he become a doctor with grades like these? No way. Impossible.”

Normally, at this point, my brother would stand up to my father. But today, a week before Christmas, he doesn’t fight at all. He seems defeated.

“Michael, how?” My father leans back, then shoots up both hands in surrender. “How you get into med school? You need to study. Both of you.”

I blink, not understanding.

“You don’t study?” my father says, his voice rising. “You can’t become a doctor. You end up bum on the street. You have to study every day. Christmas, too.”

“I’m sorry,” I say. “I’m not sure what’s happening here. We finished school. Took our finals. We don’t have anything to study.”

My father pulls out a chair. On the seat, he has placed a stack of MCAT-prep books. Each one weighs in at three hundred pages, minimum. “You study these. MCAT prep.” My father holds, waiting for the fight in Mike to come out.

Mike shakes his head, amazed, stunned. I try a tiny laugh to soften the moment. “You mean a couple hours a day—”

“No, no,” my father says. “All day, every day. Otherwise—” A massive helpless shrug aimed at my mother. She nods sadly from the doorway. None of this is making sense. I look at my mother to get my bearings. She stares back, her mouth flat-lined in compliance. I look back at my father. “I thought we were going to L.A. for Christmas to see Grandma. We have plans, plane tickets—”

“No more,” my father says. “Not going to L.A. Not this year. This year you boys study. Very important. This year Daddy cancel Christmas.”

Mike swears under his breath. He jerks a book out from the middle of the pile, causing the rest of the stack to topple and crash onto the floor. My father flinches slightly but shows no other reaction. Mike opens his book in slow motion, drops his chin an inch above the page, and starts to read, moving his lips. My father pivots and walks out of the room, my mother at his heels. Mike and I look at each other and then, the dutiful sons, now prisoners, begin silently reading, studying for the MCAT.

Every morning after breakfast, Mike and I return to our bedroom and hit the books. Or so my father thinks. We alternate standing watch, two-hour shifts each, while the other lies in bed dozing, reading comic books, or listening to music. In reality, we study not at all. At times when my father surprises us with a random check-in, I force myself awake, spin the book around on my chest, hoping it’s not upside down, and pretend to be glued to the page. We take half-hour breaks for lunch and dinner, then “study” into the night until my father dismisses us. My mother and sister do fly to L.A. for a shortened Christmas holiday. On Christmas Day, my father goes to a friend’s for dinner. Mike and I microwave hot dogs and sneak some TV until we hear my father’s car in the driveway. We shut off the set, shove the dogs in the trash, and hustle upstairs, taking our positions in our beds, eyes trained on our MCAT books.

In those two weeks, during the moments when I daydream—and I daydream a lot—I think about my father on the farm in Korea. I imagine how hard he must have worked and how disciplined he must have been to escape from that dirt-poor farm overrun with eight brothers and sisters, not an inch of space for privacy or study, and while I want to hate him for killing my Christmas, ruining my winter break, and humiliating my brother, I can’t. It’s crazy, but I feel a rush of respect for him. I’m also royally pissed and so antsy that I’m jumping out of my skin and embarrassed beyond words to tell my friends the truth, that I’m stuck home studying because my brother bombed his grades and my dad freaked out.

But what the hell. Here I am. I have no other choice. I might as well accept my fate and embrace it. Yes, I’m locked away. But you can’t really call this prison. I’m in my room, all the snacks and soda I want, hanging out with my brother, whom I love, and with whom I’ll laugh about this someday. It could be worse. For my father, it was worse.

The afternoon of New Year’s Eve, my father releases us from our room. I quickly patch together a sketchy New Year’s Eve plan and head off for some party in hopes of finding Janine, which doesn’t happen. My brother, sullen, vague, talks about attending a party with some friends, but he doesn’t really seem into it and stays home.

Three days later, my backpack riding shotgun in the fussy Ford Tempo, I return to Kalamazoo College to my dorm, my suite-mates, my group of nerd friends, and no women, no women at all.

Before I leave, my father announces that he has transferred my brother to Kalamazoo College and moved him into a dorm not far from mine. What I know in my heart but dare not utter is that no matter how many MCAT books my father forces him to study and how many Christmases my father cancels, my brother will never become a doctor.

To read more Excerpts from In Stitches, click here.

I see dead people.

Eighteen bodies covered with plastic, lying on gurneys. An occasional toe protrudes to verify that beneath the shiny black tarp, a dead person lies.

I smell dead people, too.

Or at least the thick chemical stench of formaldehyde, tearing at my eyes and packing my nose, enough liquid preservative in here to float a yacht. The smell rises from the bodies and from a dozen large clear plastic bins—similar to the type you find at IKEA—lining the back wall of the lab, some stacked on top of each other. The bins contain body parts and organs, all of them cataloged, numbered, and labeled.

We sit at desks in an adjacent classroom, the eighteen bodies lurking behind us, lying in wait. In my lab coat I feel like Igor, the mad scientist’s assistant, but in reality I’m sitting in anatomy class, by reputation the most furiously intense class we will take in first year, maybe in all of medical school, especially since our section is taught by the infamous Dr. Gaw, the most ruthless, unforgiving professor who has ever lived. If you believe in reincarnation, Dr. Gaw has returned from her previous life as Attila the Hun in the form of an eighty-five-year-old nightmare who lives to terrorize us. She walks as erect as a pencil, her skeletal face a frozen fanged scowl resting atop one throbbing purple vein. According to our school catalog, Dr. Gaw has won awards, a trophy case full. To this day I can’t imagine how.

According to Billy, our go-to second-year consultant, who hooked up with a first-year from another orientation group and is now all smiles and helpful when we see him, anatomy is even more of a bear than biochemistry, which, even though I aced it going away at Kalamazoo, is right now kicking my ass. I try to explain this to Shelly. I tell her that med-school biochem is a lot different than college biochem, and I’m happy to share my notes or study with her—my one final feeble attempt to get us alone, where we might resume rubbing our knees together in the hope of progressing upward—but she turns out to be not only a gunner but a first-class ass kisser as well, a lethal double threat, the kind of medical student who takes no prisoners, plays every angle, murders every exam, laughs at every teacher’s joke, lives for extra credit, hangs out with professors before and after class, and along with a cabal of other gunners and ass kissers, scores invitations to their homes for brunches and barbecues and even gets hired to babysit their children. I give up on Shelly. She’s not my type. My type defined as any woman showing a vague interest in me.

At our first class, Dr. Gaw hands out equipment, including latex gloves, goggles, and what I really want, nose plugs, which I stuff into my nostrils, hoping to at least partially deflect the stench. The nose plugs don’t help, so except for gloves, I go commando. I figure I might as well get used to the smell. I’ll have to, if I ever do become a real doctor. Most of the other first-years wear as much protective covering as possible. One guy, a gunner, shows up on the second day of anatomy wearing a hazmat suit. The whole ball and tackle. Goggles and ventilation mask. Dr. Gaw says nothing, but I think I see her scowl flutter, and I imagine her dropping Hazmat’s grade.

Tim and I scramble to find seats together. Tim, I’ve learned by now, has exactly zero mechanical aptitude. A week into medical school, we’ve eliminated the possibility that he will ever become a surgeon. He struggles to pull on his gloves. This first day, I face him and yank them on for him. Once they’re secure, I turn back and find Dr. Gaw standing over me. She reeks of formaldehyde. She holds a moist body part in one bony gloved hand.

“Dr. Youn.”

How the hell does she know my name?

“Yes, Dr. Gaw?”

“Which valve of the heart am I holding?”

Am I glad she said heart. I thought she was holding a liver. I take a shot. “Mitral valve?”

“Congratulations.” Do I detect a trace of a Nazi accent? “This is the aortic valve.” She spits the words at me. “You have the deductive ability of a monkey. I pity your future patients, Dr. Youn.”

She limps away.

Tim whispers, “If it makes you feel any better, I thought it was the

small intestine.”

Dr. Gaw suddenly materializes in front of Tim. Where did she come from? It’s as if she stepped out of a fog.

“Do you have something to add to the class, Dr. O’Laughlin?”

“Me? No. Not at all. Not at the moment.”

“I assumed as much. If you have any reasonable hope of passing this class, I would suggest that you and Dr. Youn refrain from talking and joking and making fools of yourselves. Oh, and a helpful suggestion. As doctors, you will find it useful if you can distinguish the heart from the small intestine.”

I’m shaken. I’ve never found myself in such unfamiliar territory. Academically—from elementary school through college—I have always excelled. I’m the school scholar, the student hotshot, the freaking valedictorian. Within seconds, Dr. Gaw has trashed all that. To her, I’m the class idiot.

I’m left with two choices. I can shrink away. Or I can bounce back.

It takes me two seconds to decide.

I am going to dominate anatomy.

Starting tomorrow.

Today I’d like to disappear.

To read more, click HERE to purchase IN STITCHES!

According to our brilliant publisher and editor, the right title means only everything. 

A good title seduces you.  It lures you to the book, commands you to pick it up and caress the cover, urges you to flip the cover over and read the luscious flap copy on the attractive jacket, then sucks you in and gets you to read a paragraph or two before closing the deal… convincing you to plunk down a mere twenty-five bucks and take the book home. 

Or ordering it on Amazon for less.

Or downloading it on your E-book for even less.

All because of the title. 

Because a good title elicits an emotion.    

A good title is evocative;  it reveals the nature of the book… the book’s tone… in potentially two words or less.

Our first title?

Short White Coats.

No, said our publishing team.  Not good.  Short White Coats?  What is this, the memoir of a Good Humor Man?

We dumped that title and came up with the following—

So many, in fact, that it will take up two blog posts.

Read ‘em and weep. 

And please don’t think less of me.

Here then, a few of the ones that didn’t make it and why:

Too movie-oriented:

-DR. T AND THE WOMEN

-SUPER SIZE ‘EM

-CODE BLUE: ELECTRIC SHOCK-OR-TWO (can anyone guess what this is from?)

Too music-oriented:

-OOH, I WANNA STITCH YOU UP!

-LIKE A SURGEON: CUT FOR THE VERY FIRST TIME

-DOC AROUND THE CLOCK

-I LIKE D CUPS AND I CANNOT LIE!

-P-P-P-POKE HER FACE!

Reminds me too much of other books:

-TALES OF A MED SCHOOL NOTHING

-THE POKY LITTLE MEDICAL STUDENT

-DOCTOR IN THE RYE

-PORTRAIT OF THE DOCTOR AS A YOUNG MAN

-SWEAT, PRAY, GLOVE

Too medical:

-THE BOY WITH THE SERPENT AND STAFF TATTOO

Trying too hard to be funny:

-FUNNY BONES: LAUGHING, CRYING, SCREAMING MY WAY THROUGH MEDICAL SCHOOL

-PLASTIC RAP

-EVERY DAY IS A SICK DAY (THANKFULLY)

-PANTS ON THE GROUND

-THIS WON’T HURT AS MUCH AS THE BILL

Too violent:

-THE FIRST TIME EVER I SAWED YOUR FACE

Just too Seinfeldian:

-AND THEY’RE SPECTACULAR: LIVING LARGE IN MEDICAL SCHOOL

—————

So… we all agreed to go with IN STITCHES as our title. 

It spoke to us.  It seemed…

Provocative.  Catchy.  Memorable.   And loaded with subtext.  Says in two words that this is a book about a doctor—most likely a surgeon—and it’s funny. 

Amazing that we struggled so long and so hard to find it.  Especially with all of these wonderful suggestions that just didn’t quite make the cut—

Too movie related:

-THE 40 YEAR OLD SURGEON 

-I SEE DEAD PEOPLE (AND OTHER MED SCHOOL ADVENTURES)

Too sexual:

-I READ PLAYBOY FOR THE PICTURES

-THAT’S A STETHOSCOPE IN MY POCKET AND I’M HAPPY TO SEE YOU

-TALES FROM THE SILICONE VALLEY

-PLAYING DOCTOR: THE NAKED TRUTH ABOUT MEDICAL SCHOOL

The rest of these just don’t quite work:

-FUNNY BONES: LAUGHING, CRYING, AND SCREAMING MY WAY THROUGH MED SCHOOL

-CUT UP: FROM MEDICAL SCHOOL ZERO TO PLASTIC SURGERY HERO

-FOOL ON THE PILL:GETTING A CLUE IN MEDICAL SCHOOL

-THIS WILL HURT A BIT

-WARNING: THIS BOOK HAS BEEN DOCTORED

And one last one which ALMOST made it:

-TRUST ME, I’M ALMOST A DOCTOR

And these are the ones I dared allow myself to print!

Well, if there’s a sequel, an IN STITCHES 2, at least we’ve got a couple dozen titles to start with—and reject.

Unless you have a suggestion for a title that’s even better than IN STITCHES.   Or for the sequel.  What might it be? Let me know!

In med school and in life, it’s good to know who’s in charge.

Year three.  Clinical rotations.  The hospital.

In my short white coat, I pick at a questionable Chinese chicken salad in the hospital cafeteria with Dr. Yomama (a made up name).

“So, Tony,” he says, dabbing at some mustard that’s clumped and hardened at the corner of his mouth like a mole.  “Who’s in charge?”

I have no idea what Yomama is talking about but I don’t want to seem like your typically clueless third year so I stall.  “By in charge, you mean what exactly?”

“By in charge I mean in charge.  In the hospital.  Who’s the boss?  Who runs the place?”

“Oh, sure,” I say.  “Well, okay—”

I clear my throat, stall some more.  Is this a trick question?

“You have no idea, do you?”

“Yes, well, no.”

“This is important, Tony.  You have to understand the hospital hierarchy.  Take a shot.  How do you think it goes?”

I lean back in my chair.  I study Dr. Yomama’s face, looking for a tell.  He’s not giving me anything.  I decide to go for it.  “Well, obviously, at the top of the food chain you have the attending physicians, you guys, the gods, the kings of the mountain.” 

“Nice,” Yomama says.  “Keep going.”

“Then you have your resident physicians, gods-in-training.”

“You’re on a roll.”

“Then comes the interns, followed by us, the medical students.  Below us you have the nurses, then the pharmacists, unit secretaries, nurses’ assistants, pharmacy students, cafeteria workers, and the cleaning crew.”

“Wow,” Yomama says.  “Impressive.”

I beam.  “Thanks.”

“Impressive.  And totally wrong.”

I blink in disbelief.  “Really?  I’m off?”

“You’re not just off, you’re barely in the same hemisphere.”

“Well, who runs this place?”

Dr. Yomama balls up his napkin and shoots it like a foul shot into a trash receptacle ten feet away.  “Come on.  I’m gonna introduce you to the boss.”

I ride the elevator with Dr. Yomama.  The doors hiss open at the third floor and Yomama springs out and sprints down the hall.  I match him stride for stride.  He pulls up at the nurses’ station.  He smiles at a woman on the phone.  She wears lime green designer glasses and her short cropped silver hair peeks out of a raised white hat that makes her look like a head chef.  Her nametag reads:  “Victoria Zwirko, Charge Nurse.”

She nods at Dr. Yomama and holds up her index finger.  She finishes her call, folds her hands in front of her.  “Hello, Doctor.”

“Hello, Vicki.  This is Mr. Youn.  Third year.  He’s curious.  He  wants to know who runs the hospital.”

“Oh.”  Vicki shrugs.  “Me.”

I fight back a smile.  Yomama and Vicki are obviously playing me.

“Well, to be more specific, the nurses,” Vicki says.

Yomama hits me now with a different smile, a smile that says, I am being real.  This is how it really is.

He turns back to Vicki.  “Help me out.  I don’t know what to do with the patient in room two fifteen.”

“Lasix twenty milligrams.”

“Great.  Take a verbal order for Lasix twenty milligrams and I’ll sign it later.  Thanks for having my back.”

They fist bump.

Nurse Zwirko cradles the phone receiver against her ear and waves at Yomama.  We head down the hallway.

“So she’s in charge?”

“Yep.  Most of the time nurses hit us with pages that are rhetorical.  They  know what to do but they need our blessing.  Doctor, would you like to give the patient a stool softener?  Come to think of it, I would, yes, thank you.  Doctor, would you like the patient to have Ibuprofen?  Yes, exactly.  Many interns are too full of themselves to ask a nurse what to do.  Big mistake.  They learn the hard way.”

“The nurses run the hospital,” I say, trying it on.

“Make it your mantra.”

“So, the hospital hierarchy, can I give it another try.”

Yomama grins.  “You’re gonna need a little help.  May I”

“Please.” 

“Top of the heap you have your benefactors, the people with more money than God, who have buildings named after them.  Then you go to the hospital administrators, the people who decide what to do with the money the benefactors give the hospital.  They make all the important decisions, decisions that may not always be in the best interest of doctors and patients.  Your turn.”

I tick them off on my fingers.  “Attending physicians, nurses…”

Yomama nods vigorously.  I continue.  “Residents—”

“Then pharmacists,” Yomama says.

“Then interns,” I say.  “Unit secretaries, then med students, right above nurses’ assistants, the other students, cafeteria workers and cleaning crew.”

“You got it,” Yomama says slapping me on the back.

“The nurses run the hospital,” I repeat.

“Never forget it.”

I never have.

The interviewer yanks off his glasses and drops his head an inch above my folder. He squints at my transcript.
“Hmpf,” he says. “Your GPA. 3.94. Impressive.”
I whistle out a breath. The interview is turning around.
My friends were right. You have to relax during your interview. The application process is a crapshoot and the interview is only a small part of that process. It’s unlikely that these fifteen minutes are going to make any difference, unless you’re a superstar or a freak. You are only guaranteed admission if you’ve discovered the cure for swine flu, escaped from a communist country in a small boat when you were four years old, won the Gold Medal in figure skating at the Olympics and you only have one leg, or your father paid for a couple of buildings at this particular med school. I’m sitting here 0 for 4, so I might as well relax.
“Unless you’re a star, don’t stand out too much,” my friends have said. “Fly under the radar. Appear hard-working, sincere, and personable. Interviewers are screeners. They’re looking for a red flag—applicants who shout obscenities, political slogans, or drool on their shoes. So be cool and try not to piss the guy off.”
“So, 3.94, huh?”
“Yes, sir,” I say.
“Top five percent of your class.”
I smile modestly. “Only two B’s in my entire four years of college.”
“What happened there?” he grunts. “Why not all A’s? Why not a 4.0?”
My smile sinks.
Dr. Evil slaps my folder. “And your MCAT scores. An 8, 9, and 10. Are these right?”
“Um, yes— ”
“Did you actually study for the MCAT?”
“I thought I did. I bought several review books.”
“Maybe you should’ve considered taking a review course.”
“Apparently,” I mutter.
“Well, a lot of people do poorly on standardized tests,” he says. “Few of them become doctors.”
He folds his hands and leans across the desk, one eye staring at me, the other looking off into space.
“So, tell me, Mr. Young, how do you plan on serving humankind?”
It is hot in here.

The interviewer blinks. Well, one of his eyes blinks. I can’t see what the other eye is doing. He waits for my answer.
“I’ve thought a lot about how I want to serve humanity,” I say, leaning in, meeting his stare with a grave look of my own. The truth is I’ve been preparing a list of key touchy-feely responses to this question for weeks. I let them fly. My mouth starts moving and I hear myself blather “family practice,” “rural,” “Appalachia” “the less fortunate,” “the homeless,” “inner city,” “free clinic,” and, my favorite, “I have a need to give back.” I stifle the voice in my head, the one I use with friends when we satirize this very moment, the one that threatens to blurt, “prescribing privileges,” “six figures,” “nice car,” “hot chicks,” “won’t accept Medicaid,” and “breast augmentation.”
Dr. One Eye keeps his one eye trained on me.
“You have a need to give back. A need.”
“Well,” I say, “A desire. Maybe that’s more—”
“Allow me to peruse your personal statement.”
Great. This guy hasn’t even read my application. He rifles through my folder, nods at a page, finds my photograph affixed to the corner and compares that face to mine, confirms that the photograph is indeed me, lowers his eye and begins reading—for five full minutes. I squirm in my chair, my eyes tracing the veins on his bald spot as he labors over the most dreaded part of the application. Took me hours to write the personal statement. As cautioned by my friends who applied last year—you have to become noticed without going over the top. You want to appear memorable, in a good way. If you’re up for a Nobel Prize or climbed Mount Everest, be sure to squeeze that into your personal statement, but always connect it to medicine. As I reached the summit of Everest, I thought about this unfortunate handicapped child I met while volunteering at the clinic—
“I find the personal statement the most telling part of the application,” my inquisitor says without looking up. “Ah, yes. Hmm.”
Hmm? I crane my neck to see what’s caused him to hmm.
He raises his head and looks at me with the slightest hint of a smile.
“Fascinating,” he says. “So you were a Candy Striper.”
“Yes, ah ha, for two years, in high school.”
“Two years.” He slowly closes the manila folder of my application as if shutting a door.
“Hmpf.” My aging wall-eyed interviewer frowns and waves a hand in front of his nose as if he’s smelling a carton of milk that has turned. “Do you have any questions for me?”
He tips his head to one side doubtfully, his right eye focused on me, his left eye staring at the ceiling.
“I do,” I say. His mouth flutters in surprise.
Thanks to my friends, I’m more than ready for this one.
“They always ask you if you have questions. We know that you don’t care if the medical school has opportunities for you to conduct bench research on mice. We know that you don’t care if there are volunteer positions available to work at indigent clinics during holiday breaks. We know you don’t care if there is a medical student suture lab. We know that like most med students you care only about passing your classes, eating, sleeping, and getting laid. Pretend you care. Prepare a question.”
I Googled this guy last night and found out that his research specialty is liver enzymes. I ask him about his research. That’s all it takes. He’s off and running. Dr. One Eye waxes rhapsodic about abnormal aminotransferase levels and alkaline phosphatase elevation for what seems like an hour. If a kitchen timer doesn’t beep in his battered leather briefcase, he’d still be going.
“Well, hmpf,” he says. “I have so much more to say on the subject but I’m afraid that annoying beep signifies that our time together has lapsed. I believe you’re scheduled to have lunch now with a second year medical student who will give you the real inside scoop. Ha. Well, it has been a pleasure, Mr. Youn. You are an impressive applicant.”
He pumps my hand as if I’ve just offered to fund a new wing in the administration building. Whew. Talk about completing a Hail Mary pass as time expires. I’ve aced this interview in the last possible second while learning an important sociological lesson:
The sweetest sound to anyone—even to an egomaniacal blowhard, especially to an egomaniacal blowhard—is the sound of his own voice.