To Natalie, With Love

from Botox to Breakdown

Hello lovelies, welcome!

I’m Soul Surgeon, Dr. Tamy, inviting you into a weekly contemplation to unlock the freedom and peace within, one Permission Slip at a time.

Today’s Permission Slip : I give myself permission to share a personal experience vulnerably with you✨

Hello lovelies,

In today’s pub I’m sharing a piece I wrote for my memoir. It’s an experience I lived while working as a plastic surgeon. Not sure it’ll make the final book (and it would need some more polishing) but it feels vulnerable to share it with you, so here goes. Settle in, this is a long one, ~2700 words so if you don’t get through it, I understand. But if you do read, please read it to the end. Not for me. For Natalie.

Unfortunately, women like Natalie often came to see women like me. The Donuts, I called them. Pronounced Do-Nots, because they do not need plastic surgery. They came to me believing I had the magic potion for the donut hole of their soul. When it came to the aesthetics department, I soon found out that Natalie got all she needed from her parents’ perfectly woven double-stranded DNA. One week earlier, Noria, my office manager, referred Natalie, her longtime friend, to see me. I made myself available by staying later that Monday evening so that Natalie wouldn’t need to take time off from the ultrasound department, where she worked as a technician.

It was Monday afternoon, the day after the ten-year anniversary of 9/11. The remembrance ceremonies were thick in the air. The sweet smile of my best friend’s husband, Eric, still reverberated in my mind. He was one of the 2,753 people killed in the towers that morning. As I waited for Noria to bring in Natalie, the next patient on my printed daily schedule, I drew in a deep inhale, then exhale, bringing my mind back to the present moment.

Noria had filled me in on Natalie. She shared how they met at a dinner party when they were in their twenties, and clicked immediately. Over the ensuing years, Noria was there when Natalie got married, birthed Jacob, and subsequently divorced. She was also there to celebrate Natalie’s news that she fell in love with a surgeon. Real love this time, Natalie told her. He was head of the Vascular Surgery at the VA hospital in South Florida and after a year of dating he proposed and invited her to travel to his native Nepal to meet his ailing mother and brother. Noria told me how enlivened and also tremendously anxious Natalie was about her upcoming trip. She shared how despite being young and beautiful, Natalie was insisting on getting a quick aesthetic pick-me up before her trip. Noria trusted me as a doctor and directed Natalie to me. I thanked Noria for the referral and assured her I would take great care of her friend.

The two women entered the exam room with broad smiles, chatting and giggling. After quick introductions, Noria closed the door behind her and Natalie and I jumped into easy conversation. Her warm honey-colored eyes never left mine. In full presence she hopped onto the exam table, making a crunching sound as the white paper gave way under her buttocks. After a few minutes of small talk, I dove into doctor-type questions and asked for her medical history, pregnancies, and if she took any medications. From her answers it was easy to see that she was the epitome of a healthy thirty-four-year old woman. The young healthy ones were my favorite patients because they tended to have fewer overall complications.

As she spoke, I watched her face attentively. I studied the forty-three muscles underneath her smooth skin tugging and pulling at the corners of her mouth, crinkling the bridge of her nose and creating little crow’s feet at the edge of her eyes. Lines of expression. Lines of life lived. Lines she wanted erased. Her eyes smiled just a split-second before her full lips. Cheekbones proudly displayed her African-American heritage. Chocolate-colored afro curls hung loose and free over her curvy shoulders. She reminded me of a young Tyra Banks, minus the ego. She was captivating and spoke a mile a minute.

Most Do-nuts had no idea how beautiful they were, and Natalie was no exception. Her aura filled the space with that it factor. That je ne sais quoi that you couldn’t put your finger on, but knew it when you met it.

Along with answering my routine medical questions, she chatted excitedly about flying halfway across the world the following week with her beloved fiance, surgeon Dr. K. “Love is possible the second time around,” she beamed.

“But this time it’s right,” she gloated with a confident smile.

Her words came out quickly and breathlessly, as if she were pushing up against time, running out of time. She tapped her fingers nervously on the crunchy paper as she spoke of her hesitancy to travel so far and leave her young son. She wasn't just nervous to meet her future mother-in-law, but also anxious to fly 8,443 miles away from her little boy. Within ten minutes, I knew how Jacob loved broccoli on long stalks so he could stand them up like trees before munching them. I knew bath time was his favorite nightly activity. When Natalie began singing you are my sunshine, my only sunshine, he would get lost in singing it back to her, allowing his curls to be lovingly tamed. I nodded as she spoke, understanding her life intimately since my youngest son was just a few months older than hers. For a few minutes we were two moms sharing love and war stories of raising our toddlers on the battlefield of life. She glowed telling me his favorite phrase: You’re the best Mommy in the whole universe.

That’s when I knew—he was her world.

This is how most of my consultations went. Being a mother of five children made me relate to my patients deeply, since most of them were mothers,. I possessed the unusual melange of patience and genuine interest, capable of discussing broccoli and bathtime as much as breast implants and tummy tucks.

“I would love to see a picture of Jacob,” I said, wanting to put a face to her precious son. Natalie eagerly dug into her huge Valentino purse and pulled out a colorful Polaroid print taken at the Farmer’s Market the previous weekend. There sat Jacob high on a black and white spotted cow, his ears peeking out from under a red cowboy hat, smiling with his whole being. I sounded my oohs and aahs as she continued pouring like an open faucet.

“He began to read letters and name his colors,” she said proudly. “He’s so active that by evening he needs his bedtime routine. I’m worried about leaving him with his father, my ex, because I know he won’t get him to bed on time.”

I listened attentively, understanding her more than she imagined.

“My ex always forgets to feed Jacob his broccoli in his favorite blue bowl. It’s the cutest! Pooh holds a balloon with My favorite day is Now written in the middle and when he’s done eating his broccoli forest he names each letter. You know how that is, kids are reading by kindergarten nowadays, so competitive!”

I nodded with recognition. Having an ex-husband who rarely checked on our kids’ vegetable consumption, nor paid attention to their bedtime routine, I understood her discomfort. I reassured her that he would be okay even if he didn’t eat all his broccoli or have a proper bedtime for the two weeks she was gone. After all, it was just two weeks.

After our maternal exchange, I began wondering what a gorgeous young woman like her thought she needed from a plastic surgeon, like me. “What can I help you with, Natalie?” I gently asked, offering her an invitation to share her needs.

“Whatever you think, Doc. Just do something. Anything, I need to feel refreshed.” She pointed to her smooth forehead devoid of wrinkles, soft laugh lines, and voluptuous lips. “Just fill me up, Doc!” Her eyes squinted sweetly as she laughed.

I smiled. “Natalie, I’ve always been an honest doctor and I’m sorry to tell you that you really don’t need anything from me.” Knowing this was not what she wanted to hear, I used my gentlest tone so as not to make her feel like what she asked for was in any way wrong.

“Come on Doc, I’m going to meet his entire family, I need to look good," she continued. I wondered if her future mother-in-law would notice? Was her energy spent erasing forehead wrinkles or surviving Nepal’s monsoons and floods, the country’s gender inequity, and underage marriage challenges?

“I don’t do anything for myself, the one thing I’ve been dying to try is Botox! Pleaaaase,” she begged, smiling ever more brightly.

I understood. I wasn’t doing anything for myself either. Like her, I was busy chasing my toddler and four other kids, and working. I too craved a few drops of magic potion to make me feel whole. Complete. Enough. I knew what Natalie needed from me was to fill the invisible donut hole of her soul.

I got her because I was her.

She needed to quiet her feelings of inadequacy with needle pricks. She was not alone. So many women came to me believing the self-love they seeked was at the end of a needle. Insecurities often brought them to sit in a Plastic Surgeon’s office, begging for Botox.

“Please, Doc,” she said, but this time she frowned and I saw the two fine vertical lines between her brows. Fortunately for her, the people pleaser in me could not say no. I reiterated that she didn’t need anything but since she insisted, I could inject her with the most minimal amount of Botox between her brows.

“You may not even see much improvement,” I said.

Her face lit up as she chimed, “You’re the best, Doc.”

After drawing up the Botox in a syringe, I lowered the top of the exam table, allowing her to lay back and rest her full head of curls on the crunchy white paper pillow cover. I injected the most minuscule amount of Botox I could, while still staying honest. Once finished, she walked over to the full-length mirror leaning against the wall. She looked in the mirror and exclaimed, “I look better already! Look!” I explained how Botox needs seven to ten days to take effect in relaxing her muscles before giving its smoothing results. Still in her own thought bubble, she turned to me and said, “I knew this would work! I needed this!” I laughed and assured her that Botox had definitely not yet done its magic.

We walked out of the exam room together as I left her to check out at the front desk with Noria, urging her to come back and see me after her trip.

“I want to see photos of you in a bright orange sari with Dr. K by your side, riding on an elephant’s back with your smoother forehead.”

We laughed as she pulled out her wallet to pay. “And give your beautiful boy an extra hug for me," I said, and walked back to my office, overhearing her say, “I know I’m gonna miss him more than I can ever imagine.”

* * * * *

Monday, exactly two weeks later, I was done with an early-morning breast augmentation at the surgery center. I had the rest of the day off to catch up on mundane tasks like my weekly food shopping. Still in my green scrubs, I drove to the supermarket located between my house and office. I stood at cashier number eight piling mountains of food for my growing family on the moving belt, using my left hand to line up the items and my right hand to press speed dial. Being the multitasker that I was, it felt like the perfect time to check in with Noria. I called her daily on the days I didn’t go into the office, since it was mid-morning I didn’t expect a long conversation. After all, how many patient questions or complaints can one get by lunchtime?

I don’t know what exactly prompted me to call at that very moment, but within seconds, Noria answered. Her usual, “Good morning, this is Dr. F’s office, how may I help you?” sounded muffled, I could barely understand her.

“Noria? What’s wrong?” As soon as she heard my voice she began to cry uncontrollably. All I could make out was, “No, Doctor, no, this can’t be!” Over and over again. “No, Doctor, no, no!”

“I’m coming, Noria.” My years of training at a Level One Trauma Center in the Bronx kicked my adrenaline into immediate overdrive. I left my food on the belt, letting the cashier know I had to leave for an emergency.

I drove the short five minutes to my office and threw open the glass door pushing on the etched silhouette outline of a woman’s body that I had designed years ago. Noria sat where she always did, her rolling desk chair appeared nailed to the floor of the reception area, her eyes transfixed to the desktop computer screen in front of her. Noria shook her head as she kept repeating over and over again, “It’s Natalie. I know it’s her. It’s Natalie.”

Natalie? Her friend Natalie? My patient Natalie?

I slid briskly around the spotted granite countertop and bent over to hug her with my left arm as I took the mouse in my right hand, scrolling through the newsreel on the screen. Noria had been reading the news as she did daily while having her morning coffee. On this day she was met with the headlines about a prominent local surgeon and his fiancé who were visiting family in Nepal and suffered a crash of the small Buddha Air plane into the side of the Himalaya Mountains. My eyes opened wide as I swallowed hard and slowly.

“Are you sure?” I asked incredulously, knowing the devastating answer before the words came out of my mouth.

There were no names given in the article, but Noria knew. She knew, like I knew. The kind of knowing you feel in your gut before your mind catches up and processes the painful reality you are about to confront. We both knew that metal doesn’t circumvent mountains and there was only one Miami surgeon and his fiance visiting Nepal this time of year.

My heart sank. Suddenly there was no ground to stand on. I was a floating head without a body. I released the mouse from my right hand as I kneeled down on the clear plastic mat under her chair and hugged Noria. I couldn’t feel my body. Not my hands. Not my arms. My chest tightened as my mind reviewed every minute of the forty-five minute consultation with Natalie. Her smile, the softness of her curls, the whiteness of her teeth all flashed through me. How I reassured her that Jacob would be fine without her for two weeks. Why didn’t I tell her to stay? Of course he wouldn’t be okay without her. Not for a day, not for two weeks, not for a lifetime.

Random thoughts continued racing frantically through my mind. Did her Botox have time to kick in? Did her mother-in-law notice her beautifully smooth forehead? Did she feel pretty that day? Who would brush Jacob’s curly hair? Who would sing to him? What was her last thought?

* * * * *

The next day we received the unwanted confirmation as the headlines read Miami VA Surgeon and Eighteen Others Killed in Nepal, Buddha Air Crash. Nineteen people boarded the short flight designed to give a breathtaking glimpse of the Himalayas’ Mount Everest. Nineteen people forever etched in the mountainside, succumbed to bad weather and poor visibility. The article had one sentence about Natalie: “his fiance was survived by her son.”

Seven words for Natalie. Seven words weren’t enough to hold her smile. Her radiance. Her love for her son.

* * * * *

Eleven years later, on a gray October morning in 2022, I was seated in the window of row 14B, flying over the Himalaya mountains with my mother. We were on our way to meet the princess of Bhutan. With tears on my cheeks and my cloudy blue eyes revering the Himalayan mountain peaks, I felt a one-word prayer arise deep within my being. Natalie.

Closing Thought✨

Life.

Is.

Now.

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I invite you to write your own PS :  I give myself permission to…

With gratitude, light, and a dash of humor,

Dr. Tamy, Soul Surgeon ✨

TheMindFul Space/ https://www.tmfspace.com/

*p.s. i love you❣️