The saddest thing about living in LA is how quickly you become immune to the freakshow parading around Robertson, encapsulated on The Hills, immortalized in weekly glossies. I'll defend it when I get back to the UK. "No, not everyone's had plastic surgery," "It's really quite a normal place to live," "of course people have a sense of humor," "there are many angelenos who aren't obsessed with fame." But cliches become so for a reason, and after 24 hours back home, I realize that it is possible to have a conversation with someone whose face moves when you talk to them, and that this same conversation might exclude movies, celebrities, television, awards ceremonies, wealth or plastic surgery. And then you kind of think to yourself, 'Oh fuck.'
And it's about this time -- when you're too small for European sizes, and the fact you've had juvederm and botox is met with horrified silence at the dinner table, and it's deemed a clinical illness that you do yoga five times a week and you don't drink and your ex is a millionaire former crack addict -- that you realize there is actually something quite wrong with LA, and while we're all sniggering at it, regarding ourselves immune, we've caught the same damn disease as everyone else in this tinpot tinseltown.
And then along comes Heidi Montag and you feel normal again.
After enduring near death to emerge as a broken person with ridiculous water-melons on her chest and a nose that stays on purely by self-will and scotch tape, Heidi still finds time to frolic alone in the Costa-Rican surf, feigning the open-mouthed booby-pop for the cameras, and revealing to us, pitifully, how she wants to reverse her surgical procedures, but can't, because her plastic surgeon fell off the PCH whilst texting and accidentally killed himself. Dr. Ryan is the only person Heidi trusts, she says. Heidi was his "best, most cautious patient" (a euphemism if ever there was one). Dr. Ryan warned Heidi not to go too big, but she ignored his advice, to her regret.
There's something I don't get about this whole scenario, and it's nothing to do, specifically, with Dr. Ryan, as I'm not into picking on the deceased. But it's certainly something that Heidi's predicament aptly demonstrates. Growing up as the daughter of a doctor, I'm aware of the Hippocratic oath, malpractice, etc. Medical Malpractice is defined, simply as a "treatment that doesn't meet acceptable medical standards, which causes injury to the patient."
The amount of women, like Heidi, I see in Los Angeles walking around like blow up dolls, victims to the horrific mental disorder of body dysmorphia -- is huge. Body dysmorphia is as much as a disease as anorexia, as bulimia, as over-eating, as alcoholism, drug addiction. These are mental disorders which manifest themselves in physical self-harm.
I fail to see how embarking on eleven different surgeries in one day, nearly dying from too much Demerol, and emerging, afterwards, with a nose which looks perfect but could drop off at any second, and boobs which prevent you from sleeping, moving and exercising -- how can this not be defined as causing massive injury to the patient?
With alcoholism, a doctor wouldn't give an alcoholic booze, unless it's to alleviate DT's and avoid death. Similarly, an anorexic wouldn't be kept on a lettuce diet at the hospital, a bulimic would not be prescribed laxatives or be induced to vomiting, a heroin addict would not be given cash to go and pick up some dope on skid row... so why, if Heidi Montag and countless other women suffering extreme body dysmorphia -- a disease which makes them unable to distinguish between positive procedures which might enhance their natural beauty, and procedures which may kill them and render them fragile to the point of breakability -- why are these women allowed to undertake these procedures without their surgeons suffering punitive action?
If Dr. Ryan had cared so goddamn much about Heidi, he wouldn't have warned her DDD was too big -- he would have flat-out refused to have given her the operation. Like so much of the unregulated US healthcare system, damage to the patient isn't a priority. Of course a plastic surgeon wouldn't refuse a Hollywood starlet, because he wants the cash and he wants the exposure. He's running a business. Privately, he may care she's doing damage to herself -- but he doesn't care enough to stop.
A close friend of mine is a plastic surgeon. I asked her -- honestly -- if I need any surgical procedures. She looked at me and said, flat out "No. You're too young for Botox. Maybe a little juvederm. But give it a few years." With her professional opinion in mind, I visited five other plastic surgeon in the LA area -- all of them told me Botox was their most popular procedure, and they suggested I get 400 dollars worth as a "precautionary measure."
My experience with plastic surgeons is confined solely to those LA board-certified surgeons I called up, and the horror stories of people like Heidi, sad figures frolicking in their obscene, broken bodies for the perusal of the paps. But something to me seems very wrong with this picture.
I remember my father, a GP, arguing with patients who thought they knew better than he did. They thought they knew what self-diagnosed diseases they had, what treatment they needed. My Dad never caved in and gave someone chemo for a small cyst, addictive prescription drugs which weren't necessary. Similarly, shouldn't plastic surgeons -- possessed with those Deus-like powers of transformation -- be taught how to say 'no' to a mad, insistent starlet who doesn't need DDD's and a third nose job, but would probably instead benefit from weekly yoga, intensive therapy, and a spell out of the spotlight?
As the child of a doctor, I always thought doctors knew best. And then I moved to America.