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'Tell me what you don't like about yourself.' The words from the early two-thousands television show by Ryan Murphy were emblazoned on my ten-year-old mind. They started me down the road to becoming one of the top cosmetic surgeons in the country. I live well, take care of my shit and have a great life. I only have one guilty luxury. My Lamborghini Sian Roadster, my baby, goes from zero to sixty-two in less than three seconds! Eat that, Dom. I opened the B-U-Tiful Center for Cosmetic and Reconstructive Surgery five years ago and never looked back.
Today I'm sitting in my office having a berry smoothie before my next appointment. A referral from my friend Ainslie says that the guy coming in has a little girl who suffered some disfigurement from a fire. I got the records from the Children's Burn Center in Reno, and my heart breaks for her, as it does with every child I have seen. She was lucky, though. The team did everything right.
“Excuse me, Miss Fuze?” Dakar my administrative assistant pings in.
“Yeah?” I gulp down the last of my drink, making sure I haven't dribbled on my crisp pastel pink blouse.
“Your nine-fifteen is here.”
“You may bring them 'round.” I stand and drop my drink in the trash while hitting the com quickly. “Dakar? Execute a code purple, would ya?”
“Yes, Miss Fuze.”
A code purple means that when he sends Millie with a refreshment tray, he's sure to put out an array of juices, milks, and crunchy granola bars for our little guest. I've already checked her allergies, and she hasn't any regarding food.
My office is down a whitewashed hall with scenic photos of the coasts I have taken on my road trips. I change them out with the seasons. Massachusetts and Washington State are absolutely gorgeous in the fall. I don't plaster the usual cosmetic promotions or credentials on my walls. I may work in fantasy, but I'm not that egotistical.
I see them before they enter. He's tall, with brownish hair with a little length on top. In the short sleeves, I can see muscular arms covered in grayscale ink, cradled protectively around the little girl. Not unseen here in Cali. I glance down at my notes, Saint Westmoreland. Now, if that's not a mouthful.
The door opens as I come around my desk, having slipped back into my Candies. My hand extends in greeting, my eyes lifting at least five inches connecting with the bluest eyes I've seen in a long time. “Mister Westmoreland, welcome. I am Doctor Toney Fuze.” The little girl who has on a little half-sleeved summer dress has her face buried in his broad shoulder. “And you must be Ciara,” I pronounce it like the musical artist.
“It's actually, kee-Ra.” His voice is a mixture of California sunshine with hints of an Irish brogue. Ainsley said he lived off the grid and wanted to pay cash. Which had given me pause, but one look at that little girl, and I couldn't turn them away.
He shakes my hand firmly. Not taking my gender as a reason to soften. I appreciate this in the first meeting. “I do apologize. Ciara.” I repeat her name correctly. “Please have a seat, and we can discuss your expectations.”
He takes a seat and places Ciara on his lap with a nod. “Thank you for seeing us. Ciara hasn't had the easiest life, but I'm hoping to make it better for her.”
“I understand that you've come from the Reno Children's Center, where Ciara spent twenty-seven days in their care before being transferred to the rehabilitation clinic, and that it's been nearly eighteen months since the incident that caused the burns to Ciara's back and upper extremities. While they've done an excellent job, you are looking for private care. Is that correct?”
“Yes, her mother has passed away, and I live here. I want to find her a team closer to home. She's been working with a speech and rehabilitation therapist. I want her to be able to have a normal life. A friend of mine said you were the best. I can pay you whatever. I just need to know how to make this little girl be proud of herself, and I don't know how she can be because people are cruel.”
I lower my eyes with a small nod. “I’ve seen the reports and the photographs, but the eyes and hands find truth the camera can miss. May I?” I gesture my need to approach.
“We’ve got to take your shirt off, baby, and show the doctor your scars.” He tells the little girl softly. She freezes up as I squat down to her level, and a knock comes on the door.
“Come in, Millie.” I turn my attention toward the door so her little eyes follow. In comes Millie with a silver cart full of wholesome goodies. “Ciara, how’s about we boost you up onto my little table here so you can pick a drink and a snack while daddy and I take a look?”
Her little lip disappears into her teeth as her eyes grow to hopeful saucers looking at her daddy.
“It’s okay, baby. Pick whatever you want.” When Ciara doesn’t pick anything, her daddy goes through everything, and she points to what she wants. Granola and chocolate milk it is. Her daddy looks at me. “Like I said, rough life.”
We get her boosted onto my pull-down exam table, and once Millie is excited, I wash my hands, put on my gloves, and start my exam. I motion for Mister Westmoreland to come observe. “This pattern and shape of the burns indicate that she was on her belly and partially covered, as there is little to no trauma to her head, neck, or lower extremities. The grafts from her thighs and belly seem to have taken well. There’s a healthy amount of untouched skin, and it appears that some of the nerves are still intact. As shown by her forward movement when I run my fingers here.” I gently touch her spine. “Does it get itchy, Ciara?”
“She scratches a lot but nothing out of the ordinary. I assumed it was nerves.”
“Different kinds of nerves.” I shoot him a side-eye, and the vein in his neck looks like it’s about to burst. Either he’s a very uptight parent, an absentee father stuck, or he just found out about her. I clear my throat, helping Ciara back into her dress. “You wanna stay up here to finish up or go back and sit with daddy?” I come around the table and pull out the padded steps to let her independently get down. “Or how about you check out my box of orphan toys just over there? You can pick anyone you want to take home and adopt. But you have to promise to tell me what you name them. Okay?”
“Da.” Is the first thing I hear Ciara speak, but she points to the toys.
“It’s okay, baby. I’m right here.” He puts her on the floor. “Go ahead while I talk with the Doc.” He watches her for a few moments. “Tell me, Doc, what are we looking at here? Don’t sugarcoat it. I want the entire run down.”
“Mister Westmorland, there is no quick fix, no simple surgery that will make her whole. I can repair some, if not most, of the surface damage, but not all at once. She’s a growing girl, and the dermis used to repair the affected areas doesn’t grow or stretch like the rest of the healthy tissue. This means several surgeries over a prolonged length of time. There are less invasive techniques we can start with. Scar massage ROM-er range of motion exercises to keep her moving. Hydrotherapy can be good, but we have to be diligent in caring for the skin as chlorine will dry out the dermis. As for the psychological parts, you and yours treating her and looking at her like there is something wrong or that she is somehow less than will have more of a negative impact than any strangers. Love her up, and encourage her just as much as any child. A happy child is a healing child.” I watch Ciara as she scrutinizes every teddy, plushie, and beanie baby, finally digging into the piles and pulling out a toy that has been in the pile for quite a bit of time. A jumbo pink piggy wearing a Harley Davidson leather vest. It’s almost as big as she is.
I smile. “Is that the one? She’s been waiting a long time for a very special person to find her. You must be awfully special indeed.”
“Da.” She holds the pig up.
“I see it, baby. She’ll go with the rest of your stuffed toys.” He smiles, picking her up before looking at me. “I’m doing the best I can with just finding out about her. I’m assuming you will give us a schedule of where she needs to be and when.” He grabs his backpack, setting it on the table before rifling through it. I spy sippy cups, pull-ups, wipes, and a pair of sunglasses. He takes out several stacks of cash, setting them on my desk with aggression. “Ainsley said ten k would get us started. Just let me know if you need more, and I’ll take care of it.”
I note that it’s small bills but do not remark. Where the money comes from is not medically relevant, and the less I know, the less likely it is I can be called to testify to anything tawdry. It’s called plausible deniability, and when you help people like I do who don’t have or cannot use their insurance, cash is still king. “I'll have Dakar get you in for a massage on Thursday.”
