In January, I was going about my daily life: studying for my upcoming licensure exams, filling herbal orders, writing papers, raising children. I walked out on the deck for my morning tea, and something just gave. It was the oddest feeling: my insides spilling out of me. I felt I had to manually hold myself together.
I stopped by the university health center as soon as I could wedge a visit in between my classes and other obligations. I was diagnosed with diastasis recti (separation of the abdominal muscles) and sent to a physical therapist. The physical therapist had me lie down on a table, where I had a worm’s-eye view of the look of horror that ascended like a wave from her lips to her eyes as she palpated my abdomen. She told me I had a 5-inch-wide split from ribs to pubis and that my internal organs were starting to herniate. She sent me back to the health center, saying I had the worst case of diastasis she’d ever experienced in her years as a PT and that there was nothing she could do for me.
Meanwhile, the sense of falling-out-of-myself was steadily worsening. I could no longer practice yoga or run. I had to carefully roll myself onto my side and edge sideways to get out of bed in the morning. I could not walk, sit, or stand without wearing a stomach brace or scarf tied tightly around my middle. I could not lift my arms over my head. Life changed radically–I had always relied upon my sturdy, strong body to carry me through any difficulty and suddenly I could not walk, lift, stretch, work. It was dazing and demoralizing, this constant inexplicable pain and deterioration in the midst of the unrelenting press of work/study/job/life.
The health center referred me out again, this time to a diastasis specialist. She graciously took me into her beautiful office after regular business hours to accommodate my insane student schedule. She, too, palpated my abdomen and went very quiet. She showed me a few exercises I could do on the floor to strengthen my transverse abdominus, and then helped me stand. “There’s really nothing I can do for you,” she told me. “Try these exercises for a while, but if nothing gets better, I would have to recommend surgery.” She refused to charge for the visit and put a comforting hand on my shoulder as I left.
Reeling, I returned to the health center, where I learned that diastasis repair is considered an elective, cosmetic surgery and would not be covered by insurance.
Wait a second. Internal organs HERNIATING OUT? ELECTIVE COSMETIC SURGERY? In the hours after midnight, when I had finished my reading and my studying and the bookkeeping for my business, I began to research diastasis recti. I grew more and more enraged and affronted as I read horror stories of women who could not even stand up on their own power, denied coverage of the “cosmetic” surgery that would enable them to walk again. I learned that the condition of diastasis recti in women is “a normal biological consequence of childbirth” and therefore treating it is “a cosmetic choice” yet if it is incurred by a man (most frequently through playing golf) it is considered a “sports injury” and fully covered by most insurance carriers.
I hit all kinds of walls. I had been referred out to a plastic surgeon—I had my boyfriend take a photo of me in front of the sign that declared PLASTIC SURGERY, overcome by the surreal turn my life had taken. That surgeon told me he could repair my diastasis and I’d be “very pleased with the improvement to my appearance”. He would not address my concerns about my strength returning, or an end to the pain. He kept talking about how satisfied I would be with my “new silhouette”. He told me the surgery would cost $6,000 that I could pay upfront out of pocket and then charged me $300 for the consultation. I walked out of his office, tore the bill into tiny pieces, and cried.
I felt defeated by this battle. The sexism disgusted me: on one telephone discussion with an insurance representative I was basically told that I was biologically obsolete after carrying children so I wasn’t worth their investment. Yet I was so overwhelmed with the demands of my 15 credits of graduate coursework, my comprehensive and licensure exams, my business, my 20-hour-a-week counseling internship and my 10-hour a week assistantship, my children, my custody battle, that I simply could not find the energy to fight this. I make soap for a living. I have a lot of soap boxes to stand on. But I couldn’t muster the energy to climb up.
The things that feed me: long walks outside, laughing bouts of contra dancing, intense yoga sessions, seated meditation—I could no longer do. I spiraled further and further from my center as I tried to cope with the pain and the weakness and the frustration, even guilt, that there was nothing I could do herbally or physically to take care of myself. I went through the paces of life the best I could, but life felt very heavy and disconnected. It was a strange time.
The health center called me to ask why I hadn’t followed through with the plastic surgeon, and asked me to give this another shot, to try a surgeon in Greensboro. I went through the rolodex of surgeons with the receptionist and I watched as surgeon after surgeon hung up on her at the mention of “diastasis”. Finally, one place said yes. I booked an appointment for the following week. By now, it was April.
And then the miracle happened. The surgeon who said “yes”. He spent an hour on the phone with the insurance company, going to bat for me. He was gentle and understanding and he listened to my concerns and he looked into my eyes and said “we can fix this.” He had never met me before, but he used his understanding of the system to stand up for me, and with his help, I was able to afford the surgery that put me back together.
It’s called a “tummy tuck with diastasis repair”, what I had done, and that phrase makes me wriggle. I’ve been a lifelong feminist and proponent of natural beauty, of owning our beauty, of loving ourselves as we are. The idea of plastic surgery has always made me queasy and angry and sad; the idea that women feel they need to be surgically altered to become acceptable. The idea that I have had plastic surgery still incites so much cognitive dissonance that when it passes through my brain I feel dizzy. And yet.
I have learned so much about myself in this process. I have learned about the judgments I make upon women who do decide to augment their beauty with surgery. I have learned that there is an ugly, cruel sense of superiority that I held within me toward women who make that choice. I have learned that there is a whole frontier of self acceptance that I have yet to travel into, a world of ways I judge myself and others and make myself wrong according to standards I absorbed somehow along the way and have never fully examined. I learned that it embarrasses me to tell people that I had plastic surgery, and that I cannot simply state the procedure I had done without immediately adding a flood of qualifications to distinguish “my” kind of tummy tuck from “theirs.”
But I’m done with that. I make a stand for beauty, I care about women, and that kind of self-judgment and smug line-drawing is beneath me. I had a tummy tuck. The man who performed it, Dr. Gerald Truesdale, is an artist. His artistic expression is the healing of bodies that hurt, bodies that don’t function anymore, bodies that don’t match the way their owners want to feel about themselves. I am so very grateful that he was willing to use his artistry on my behalf, to restore my ability to walk and sit and run and do yoga and lift my children and dance. When the surgery was over, my mother asked me how I felt, and, still reeling from the anesthesia, I told her “it’s like an internal hug!”
I am two weeks into recovery, and it still feels like an internal hug. Now that my muscles have been rejoined, I can feel how weak they’ve been all along, how for ten years I’ve gradually relied more and more on my back and thighs and arms to compensate. I am so grateful for this privilege to have my strength restored.
At the same time, there is guilt I struggle with. A small part of me still thinks I “should” have been able to fix this with yoga and chi gong and herbs. A part of me feels disgusted with myself when I think of the food and drink the cost of this procedure could have provided to a hungry family. I think about those who fight tirelessly for peace and human rights and the way they put their bodies and health on the line, day after day, sometimes enduring torture, sometimes even dying for their beliefs. And here I am, taking weeks and weeks to recover from an expensive surgery that serves only myself. Here I am, waddling around like Groucho Marx, needing to be waited on hand and foot while I regain my strength, very conscious of my mortality and the difficult balance between giving and taking, caring for oneself and selfishness. I feel weak and needy and old and the questions arise about how I am living my life, what I am doing with my life. What could I do with my life that would make this costly investment of time, resources, others’ care, and money—into the maintenance of this one physical body— worth it to the world?
It is so easy, in the press of the day-to-day, to forget that we are living LIFE. This is it—this moment at the breakfast table, clearing away the dishes and sweeping the floor. This moment in front of the computer, paying the bills. This is life, this is our message and our legacy. Sitting here, healing, day after day, all of the artificial pressures of school and work and internship laid to the side for the time being, taking the privilege of this time to heal, I have become very aware of this ticking heart, this imperfect body, the message of this life. What is the message of this life?
Living the question—still living the question. Life keeps taking me to places I can’t explain. So far the answers that have come are: tell the truth about it. laugh about it. make sure you give as much as you’ve gotten. don’t lose sight of the world you want to live in, and how you can create it for others. Still living the question, tummy tuck and all.
~My heartfelt thanks to Dr. Gerald Truesdale, an artist and a truly kind, inspired surgeon and human being.~