Wounding By Choice: Lessons from a Simple Surgery
“The unending paradox is that we do learn through pain.” —Madeleine L’Engle
This morning, lying in bed in a dream state, the wound on my face started hurting again after weeks of feeling fine. I asked why it was hurting and it said, “Because I want you to write about me and I know you’re thinking my experience is not important enough to write about it.”
When I promised that I would write about what had happened, the wound immediately stopped hurting.
On June 17, 1991, I had an appointment with an 80-year-old surgeon to have a large birthmark (technically, just a large raised mole) removed from my face. It wasn’t that I feared it was cancerous, nor was I particularly vain about having an “imperfection” on my face.
Rather, I’d simply had a strange sense for many months that I was supposed to have it removed. I didn’t understand why until the minor surgery was all over.
In 1989, childhood sexual abuse memories began to surface unexpectedly. Since that started happening, I’d been taking a break from working with male doctors. However, my longtime companion, John, knew a surgeon who had been his personal physician for more than 15 years. John trusted this man as a doctor and as a friend. Since I trust John, I made an appointment with the surgeon.
The doctor said he would need to make a three-quarter inch incision in my cheek in order to cut out the mole. He said the incision site would be red for a year and that there would be a scar. I’d seen the scars on John’s face from similar mole removals and they looked fine, so I agreed to the surgery. John assured me that it didn’t hurt and that he’d felt nothing more than a tugging sensation during the procedure.
The surgeon took about 20 minutes to make the necessary preparations. During that time, he didn’t say anything to me. When he was ready to begin, he gently touched me on the side of my face and said the next part would hurt. Then he gave me a shot in the cheek to numb the area. After the drug took effect, he started cutting. Still he didn’t say a word to me.
John sat at the opposite end of the operating table, holding my feet and squeezing them reassuringly. The surgeon kept cutting, stopping repeatedly to dab the blood away. Whenever I opened my eyes, I saw him taking gauze after gauze away from my face, each one full of bright red blood. I felt a little queasy. Also, the cutting actually hurt quite a bit, so I was wincing.
I noticed that I was concerned about being the “good patient.” I didn’t want the doctor to feel bad about hurting me, because John had told me that his surgeon-friend hated to hurt people. While one part of me was concerned about the doctor’s feelings, another part of me couldn’t believe I was worried about him. At some point, the pain brought me to my senses, and I told the doctor that it hurt too much. He gave me another shot of painkiller.
Now there was only a tugging sensation and the sound of flesh being dug out of my cheek as the surgeon cut away the mole’s “root” tissue beneath the surface of the skin. There was no more pain, although the sound made me feel rather nauseated. I’ve had major surgery twice on my abdomen, and other surgeries along the way, but those times I was knocked out. In those cases, I heard nothing, saw nothing, and felt nothing until it was all over.
The face surgery was intense simply because I was fully conscious during the procedure. After the doctor finished cutting out the mole, he started sewing up the hole in my face. It felt like he was going to pull my cheek off! I was truly impressed to realize my human skin was much tougher than I thought.
At one point, I freaked out from the blood, the sound, the cutting, and the digging. I went into shock. Something beyond the surgery was apparently restimulated, and I suddenly felt desperate. I wanted to cry and scream and tell him to stop!
At the same time, I was worried about being a wimp. Besides, I was scared to move or make a sound because I didn’t want him to slip with the knife or the needle. I felt totally at his mercy. Yet ironically, I realized this whole thing was happening by my own choice.
When I went into shock, I promised myself that I would do everything possible later—on my own—to feel and express all the emotions I was repressing during the surgery. Then I endured the rest of the procedure.
The doctor put a bandage on my face that covered half my cheek. He handed me two days’ worth of painkillers and told me to come back in a week to get the stitches out. I didn’t even get to see what he’d done to my face. I imagined a Frankenstein-style scar emblazoned in red across my cheek.
I threw out the doctor’s painkillers and went to a store in Seattle called “The Herbalist.” I wanted one of their tinctures called “Painless.” I knew this particular tincture had herbs that would not only help to alleviate the pain, but would also help to heal the nerve and tissue damage caused by the surgery. I started taking the tincture as directed.
The next day, I could literally feel the nerves in my cheek “reweaving” themselves. In less than 12 hours, the pain stopped completely. While at the Herbalist, I also purchased some calendula-comfrey salve to smooth onto the wound once the bandage came off. When the bandage did come off later, I was incredulous to see the doctor’s handiwork. John was right—the surgeon was really good.
In the two days following the procedure, I was flooded with information about the deeper “reasons” I had the mole removed. First of all, I realized that the surgery had symbolically extracted more of my “father stuff.” The birthmark was on my right cheek (the “father side” of the body according to various schools of thought), and my father had always been hyper-critical about issues relating to appearance.
On one hand, he thought I was attractive and complimented me openly. On the other hand, he was very strict regarding clothing, critical about the way I moved and spoke, and extremely controlling around dating and sexuality issues.
The only time my father ever exploded in anger at me in my entire life was when I was a young teen and he screamed: “All men will ever want from you is sex!” It didn’t help that I was eating a meal at the time.
Years later, as one of my therapy assignments, I spoke with my father about enduring 15-plus years of eating disorders. He listened and then looked at me sadly and said, “Oh, I would rather you’d have been a street-walker than have starved yourself.” As if those were my only two choices!
Of course, those experiences are just two of countless “dances” my father and I shared. As such, they do not convey the full repertoire of our long and complicated journey together, both loving and shaming. However, the point is that when I had the “imperfection” on my face removed by the surgeon, I felt like I was somehow affirming to myself that it was safe to be attractive.
I was affirming that no one was going to control me or take advantage of me sexually just because of the way I looked—or if someone tried to, I could now stand up for myself and say NO. Obviously, the mole removal didn’t cause me to feel this way; it was more like an acknowledgment of how far I’d come.
Another reason my intuition led me to this surgery was so I could experience one particular moment on the operating table. It was the moment when I realized I was consciously choosing to endure a painful and scary procedure even before I fully understood why. This turned out to be a gift, because it explained something that had bewildered me for years.
The metaphysical idea that people “choose” their life experiences appealed to me in some ways, yet there was something about it that bothered me. I could never figure out why people would want to live out an experience if they already knew in advance what they were going to learn. That seemed rather academic, at best, or masochistic, at worst.
Besides, the whole notion of “choosing” one’s life experiences sounds suspiciously like another manifestation of a need for control disguised as “free will.” Apart from my personal objections to the underlying motivation for this metaphysical tenet, I nonetheless wondered why I or anyone would choose to experience trauma or abuse of any kind.
The analogy that occurred to me following the surgery is that choosing to have a particular life experience is more like choosing to take a class in mathematics. When you sign up for a math class, you don’t know what’s in store. You do your research, select a school and a teacher and a time that works for you, and then you live into whatever lessons the experience may bring.
As it turns out, maybe the teacher will remind you of your mother and you’ll have the opportunity to do more work on your maternal relationship by interacting with the instructor. Maybe you’ll fall in love with someone in the class, run off to Africa for a romantic adventure, and forget about math entirely. Maybe you’ll find out that you hate math and transfer into ornithology. Who knows?
All you do is sign up for the class, and then you see what happens. In other words, my minor surgical procedure showed me that even if I have a particular outcome in mind, the journey will always be an adventure. In addition, the outcome itself may turn out to be quite different from what I expected.
The third and final lesson from the surgery was to show me how much I’ve learned about accessing and releasing old pain. A couple of weeks after the surgery, I could tell that the fear and pain I had repressed during the surgery was ready to move and shift. I called one of my friends, Tim, with whom I’d long traded breath-coaching support.
I asked Tim if he’d act as my witness for a breathing session. He was happy to oblige. Since Tim and I were old friends as well as veteran breath coaches, I knew I could trust him not to interfere with my process no matter what came up.
Once I had settled into some deep “circular” breathing (with no gaps between the inhale and the exhale), I realized I was stuck. As if on cue, Tim touched the wound on my cheek and said he would do Reiki on it while I breathed. I thanked him and also asked him to push gently on the wound to restimulate the experience I’d had during surgery.
That did it. I suddenly went into shock, only this time I let the feelings pour out. I cried and cried. My legs extended down and outward repeatedly, as if trying to push something away from me. I noticed that even though I was sobbing and gasping for air, I did not tell Tim to stop. Then I heard myself say, “If only he would talk to me! He just keeps hurting me and he won’t tell me what he’s doing! How come he’s hurting me and won’t tell me why?”
In the same moment, Tim and I both recognized that I was reexperiencing something other than the surgery. At that point, I grabbed Tim’s hand and said, “Stop it! Stop hurting me!”
Please understand that Tim was not actually hurting me. This was old stuff and I was “talking” to someone from my past. Tim stopped immediately when I cried out, and he was glad that I had stood up for myself. After that, I wept with relief until all the shock, grief, and fear subsided. It was a powerful gift.
Ram Dass would call this “suffering as grace.” I don’t know what you would call it, or what this story means for you. However, I do know that I had to write about this experience. During the many hours it took to complete this article, the scar on my face became noticeably less visible.
When I finally finished writing, I came out from my office at home and showed my cheek to John. He was as amazed as I was by the rapid shift in healing that occurred while writing this article. Everything is so interconnected and mysterious. You never know what’s going to happen when you make a choice and act.
This article was adapted from an article originally published by The New Times (September 1991) and updated in April 2024.
Cat Saunders, Ph.D., is a longtime counselor, death doula, and nonsectarian minister. She is the author of "Dr. Cat's Helping Handbook: A Compassionate Guide for Being Human" and more than 200 articles and interviews, which have been reprinted around the world.
