12/25/2011 11:51 am ET | Updated Feb 24, 2012

Bethlehem, 'Perfection' and Our Birthmark: Why Perfect Is the Enemy of Good!

Among the big medical news stories of the past week is an increasingly global tale of failing French breast implants. According to Reuters, as many as 400,000 women in multiple countries are potential victims of defective implants, prone to leakage and made using a grade of silicone never approved for cosmetic surgery by a French company shut down in 2010.

While the true magnitude of associated risks remains speculative, there is concern about both cancer and autoimmune disease. Such associations with silicone breast implants in general have largely been refuted by objective data, but the current situation is enough of a departure to propagate legitimate anxiety among those affected, from the women who received the implants, to public health authorities around the globe, to the French policy makers on whose watch these serious corporate transgressions played out.

Any connection of this worrisome story to events in Bethlehem 2,000 years ago seems at first limited to happenstance; this news happens to be breaking, and I happen to be writing about it, shortly before Christmas. But while undeniably goaded by such temporal serendipity, I do see a connection of deeper significance.

For the faithful of a certain faith, Christmas is about more than oddly-clad elves, expedited gift delivery, and flying ungulates. We all know the holiday is ostensibly a birthday celebration for Jesus, but that just scratches the surface. If true meaning can be found beneath all the layers of pagan and pop-culture veneer, it is about redemption. Jesus was sent to us to embody a perfection unattainable for us; to atone for sins we are incapable of avoiding; and ultimately to fall, and rise, on our behalf -- and thereby absolve the worthy.

The story reverberates more deeply for those who believe than those who don't, of course, but the case is not hard to make that it is evocative for us all, regardless of faith. We yearn to be more perfect than our modest aptitudes allow. We are, as we say, only human, and thus inescapably imperfect. Jesus was sent here to help us confront that limitation.

We cannot cross that threshold on our own, and the stakes of trying tend to be high.

Perhaps no one since Jesus has made that point as clearly, and compellingly, as Nathaniel Hawthorne, in his famous short story, The Birthmark. Hawthorne tells of a scientist married to a woman so beautiful that by all accounts, her beauty is nearly perfect; she is a rival to Helen of Troy. Her nearly perfect beauty is marred only, and ever so slightly, by a birthmark on her cheek.

The scientist contemplates his wife's near perfect beauty, and becomes seduced by the concept of "perfect" beauty. He thinks to himself: after all, I'm a scientist -- I have the power -- I can do this!

The story then builds in an ominous crescendo as the scientist prepares an elixir in his lab, and prepares his wife for the procedure. When at last all is ready, he stretches his wife out on a bed and administers the elixir to her. Lo and behold, the birthmark disappears -- and her beauty is... flawless.

But alas, Hawthorne wrote this story for a religious audience of his day as a moral parable about the unattainable conceit of human perfection. So, in fact, the seemingly superficial birthmark was nothing of the sort, but rather the mark of the heroine's inescapably imperfect humanity. The elixir did remove the birthmark, but it traced its remedial effects from the woman's skin, to the very core of her -- to her heart -- and rendered her beauty perfect, even as it killed her. She could not be perfect and still be a living, breathing human being.

This tale is of surprisingly timely relevance. It is germane to all who aspire to the figures of air-brushed, half-starved super models. It seems germane to those who accept the risks of liposuction, rather than embrace the harder, but safer and more rewarding commitment to using feet and forks as well as possible. And it seems germane to hundreds of thousands of perfectly healthy women, now worrying about the loss of that health for the sake of more perfectly contoured breasts.

I am not faulting the women -- I am challenging their potential successors to reject the faults in a culture that prioritizes perfect boobs over perfectly good health. Never mind the men whose favorable attention the perfectly shaped breasts are presumably crafted to attract. I am speaking past them (us?) to the women.

Ladies: Why would a woman allow anywhere near her a man who is more concerned about the size and symmetry of her breasts, than whether she put her health in jeopardy to get there? The scenario reminds of Woody Allen's irony, noting he wouldn't want to join any club that would accept him as a member. None of us should want anything to do with someone who wants us because of surgical enhancements for which we potentially and electively mortgaged our health.

All truly worthy effort leads toward good, but not to perfect. Perfect is out of reach for the standard issue Homo sapien. Perhaps perfect breasts do happen -- but if so they are invariably accompanied by imperfections elsewhere.

The truly worthy generally also requires some genuine effort. Liposuction removes fat expeditiously, but confers none of the health benefits of weight loss achieved by eating well and increasing physical activity. Even Jesus was denied a quick fix or silver bullet -- and instead endured a crown of thorns. In meaningful efforts to better ourselves, we all have our crosses to bear.

That hundreds of thousands of women around the world will spend this holiday season under dark clouds of anxiety about their health would be bad enough if they had been driven to that predicament by true need. That they do so replicating the fate of Hawthorne's hapless heroine is testimony to the superficial values of our culture, our misguided notions of both perfection and health, and our failure to learn from the follies of history.

Perfect is the enemy of good, because we can't get to perfect. Jesus tells us so. Hawthorne wrote it out for us. If a French breast implant company begs to differ, who do you choose to believe?

As a new year looms, we might consider abandoning the quest for superficial perfection -- and embrace the pursuit of humbler, but deeper good. The particular advantage of good over perfect is... We could actually get there from here.


Dr. David L. Katz;