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January 13, 1999
Massachusetts General Hospital
Boston, MA 02114
TO THE DOCTORS INVOLVED IN MY SURGERIES AT MGH
My New Year's Resolution is to take definite action to resolve the problems that have plagued me since my surgery at MGH. The results of these operations have ruined my face and my life. My unsuccessful attempts in getting real help, not just empty words from those responsible have added to my turmoil. From the beginning I pleaded with everyone involved to recognize that there was a problem, yet a year has passed and I am still waiting. What have you actually done to help me?
I am putting plans into action hoping they will provide a desperately needed resource of information that will prevent others from suffering an experience similar to mine.
I have enclosed some photos I intend to use at informal talks I will be giving to anyone interested in learning one woman's story of what can go wrong with cosmetic surgery. It is the story that never gets written about: not the story of the results that are so disfiguring and unsightly that people turn their eyes away; not the story of the positive change that takes place in a person's life and health when all goes well and the results are successful. My story is one about an alteration in appearance that has transformed my best features into my worst; of surgery that has robbed my once pretty face of its most essential qualities: my expressions, my means of communicating my feelings; and will follow me into middle age with a face more aged that I would have had before my surgery at MGH.
I want women to know there is a possibility they will loose this quintessential aspect of their being , identity and spirit, and it takes just a few millimeters of muscle and skin moved in the wrong direction to ruin your face for the rest of your life. I want women to know that the stakes can be higher than they can ever afford to pay.
Every day I have to face a reflection in the mirror that makes my heart sink and my stomach turn. I have not been able to feel comfortable about smiling or any facial expression for almost a year . My awareness that the skin on my face is like some
foreign, inanimate material that is lifeless and stretched without hope of its being restored to a normal appearance is constantly present. The appearance I now live with has effected every aspect of my being. It contaminates every thought; it sends signals of stress to my entire body, day in and day out.
What would your life be like if every spontaneous urge to laugh or smile sent the message of "ugly and grotesque" to your brain? Take a look at the pictures of what laughter does to my face and tell me there is nothing wrong. Would you want to see your wife, sister or mother live like that? This is what the surgery at MGH has done to me. If you can not understand my anger and its being directed toward everyone who has had a hand in these
operations, you should not be doing cosmetic surgery.
I am placing invitations to my talks in local newspapers of the Cape Cod, Worcester and Framingham areas with the help of businesses who have offered the use of commercial space for my purpose. These talks will be open to the public and directed toward those who are contemplating cosmetic surgery . I want them to witness up close, to hear and feel for themselves the experience of a woman who has had both successful and "undesirable" surgery; to learn of the profound effect that both have had upon every aspect of my life, and the circumstances surrounding my present situation and the daily challenge it presents. . I will present nothing but the absolute truth in every detail
regarding my decision to have surgery, my preparations, interactions with doctors, recovery and complications both physical and emotional, and the difficulties I have encountered in my attempt to get to the truth about what happened to me and why. I will have at least two friends present who will testify to the obvious detriment to my appearance and negative personality changes since my surgeries at MGH, in contrast to the person they have known for years, what I looked like and how I felt about my life before these
operations.
I am tired of hearing Dr. May and the others mention the pre-op photos taken by Dr.
Driscoll and ask how I can question the improvement. I challenge any plastic surgeon to look at those photos and tell me they think the changes made in my face are aesthetically pleasing. On the contrary, what was done to my face is probably irreversible and in the poorest of aesthetic judgment. In this I am referring to the facelift. The rhinoplasty was excellent, but unfortunately, post-op swelling , too soon on the healing facelift, has
permanently damaged that skin, where it is no longer attached to the underlying tissue, and creates a distorted appearance when my facial muscles move and the skin on top of them does not.
The failure of the doctors at MGH to either recognize or admit the existence of this
condition only proves the resistance with which I have had to cope in addition to living with an unsightly face that was pretty before I set foot in the Residents' Clinic.
I gave everyone involved ample time and opportunity to recognize there was a serious problem. You have all remained ridged in your views, except for Dr. Feldman. I thought he truly wanted to help me, but I have not had a response from him to my last letter. You have all run out of time. If you think the desperate tone of my communications will make me appear unreasonable and irrational, thing again. People are not as stupid as you would like to believe. Many of them have been intimidated by doctors whose words of authority go unquestioned. They will understand how someone who was polite and cooperative can change and be consumed by the betrayal of those who hold that sacred position of physician. I have spoken to enough of them to know their frustration. The difference between most of them and myself is that I intend to hold you accountable in whatever manner is at my disposal. I do not have money to hire someone to speak on my behalf, so I will speak for myself.
People trust you with their lives. You have chosen your profession with that knowledge, though the motivation for your chosen specialty is questionable. If you can not handle the responsibility of holding someone's life in your hands, you should not be where you are. Disrespectful? To the same degree you have been disrespectful to me. The only difference is your disrespect is hidden behind a screen of pretension.
I have changed from a sensitive human being to one who is no longer effected by a gentle tone of voice, sympathetic inflections, etc. Your words may as well be spoken by a computer, as far as I am concerned. I have learned to only hear the factual content of what you say at this point. Being nice does not influence me any more. I have been disarmed by all of you at one point or another because of your excellent bedside manner. That only works when it does not carry a hidden agenda. When you start thinking like lawyers rather than doctors, you have already lost. We either both win or both loose in this situation, and the decision has been in your hands from the start.
I told everyone involved since immediately after my rhinoplasty that there was a serious problem. I have had Dr. May and others at the clinic waste hours of their time and mine n "answering" my questions. An analogy of the type of communication thus far :Question: "How did you get to the hospital this morning?" Answer: "I arrived at 6AM" the answer might continue.." I had coffee before seeing my first patient, etc." One can to on for hours in that vane, but until the answer is something like "I drove my car", the question has not been answered. . Thus, when I say Dr. May spent a great deal of time in answering my questions, I should have said he spent a great deal of time in trying to answer my
questions, or trying to make me believe he answered my questions. What seems to be the problem with all of you in delivering a straight forward answer?
In all fairness, Dr. May was not directly involved with my surgery and took it upon himself to deal with me because Dr. Driscoll and Dr. Courtiss were always "unavailable". What prevented them from answering a single letter of the several they received from me since April, 1998? Dr. Feldman, at least, answered my letters. As for Dr. Schneider, I admit to being less accusatory toward her because she truly tried to help me, and I sense she had her share of doubt as to whether she agreed with the opinion of the others. I feel that had she agreed with me or even had given my perception the benefit of the doubt she may have been ridiculed by her male colleagues. I do hope she has not voiced her agreement with the others, because I will prove in language you will all understand, exactly what happened to my face, the cause and extent of the damage and what it will mean to me in the future.
As my story reaches different people, someone will find it interesting enough to make suggestions and offer help. I would be willing to undergo tissue biopsy, invest all the time and energy I have to prove what you did should not be allowed to happen again.. A photographer, an attorney, or even an altruistic plastic surgeon who feels my situation is worthy of attention; whomever feels compelled to help me, I have faith that they will come forward. In using my misfortune to prevent the same thing from happening to others, I am certain some good will come back to me. I pray for the courage to face the many people who will be curious, as I have lived a reclusive existence since this unfortunate incident. I know the help is there. It is deplorable that it has not come from those who are responsible.
I do not know if anyone at MGH was truly sincere in their intention to help me or if their words have been empty stalling tactics. I have spent one year of my trying to get help from those who are responsible . It is important that you understand you have ruined my life by ruining my face. It is important that you realize you have done nothing to get to the cause of the problem. You have added insult to injury in forcing me to say and do things that were never in character with my nature. How many more people will suffer physically and emotionally at your hands..... hands that are supposed to be the hands of healers?
I have been told that I must let go of the negative aspect of this situation if I expect anyone at MGH to help me. That is asking me to invalidate my experience. You claim to want to help in one breath and in the next tell me I must disregard the cause of the problem?
Does that make sense? Is it good medical practice to sweep the dirt under the rug? What is the purpose of a teaching hospital? How do you prevent a mistake from
happening a second time when you refuse to learn anything from it the first time? You
were all so busy defending your opinions at the onset that you never heard me say I can accept anyone making a mistake, if they are honest enough to recognize it. I never
thought anyone did anything intentional to harm me, but your attitude has been
hazardous to my health.
I feel that the Plastic Surgery Residents Clinic at MGH should no longer perform facial
cosmetic procedures under their current guidelines. How many women with limited
financial resources that make the fee of a private surgeon prohibitive will end up with
something they did not bargain for because of the reduction in fee offered by clinics like
this.
I am a well informed patient and was certain I had sufficient information from the
doctors involved to make an informed decision regarding my surgery. I trusted I would
be given accurate information. My trust was misplaced. There is no nice way to say it. I feel betrayed because I have been betrayed.
This letter will be sent to those named in the closing list along with a chronological overview of all pertinent information from my initial consultation on October 16, 1997 to
the present. My purpose in circulating this story to such a wide extent is in the hope that
it will reach and touch someone who is willing and able to help me in any manner.
Sincerely,
Lucille M. Iacovelli
cc: Daniel Driscoll, M.D.
James W. May, M.D.
Melissa Schneider, M.D.
Joel J. Feldman, M.D.
James Mongan, M.D.
Eugene Courtiss, M.D.
Britain Nicholson, M.D.
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