Plastics, piglets and prejudice...

Changing Faces  is a very special charity.

It supports people who are living with conditions, marks or scars that affect their facial appearance. It works to change attitudes as well as helping those affected to make the best of their appearance--and their lives. (http://www.changingfaces.org.uk)

I was privileged to attend one of their events recently, and moved by a young woman, born with a severe cleft palate, tell of how Changing Faces had changed her life.

But it took me right back to a Maternity Hospital in the 1980s where I was taking the 3-month obstetric course--then a pre-requisite for taking the Health Visitor Course. Early one sunny Sunday morning I went on duty, said good morning to the women on the post-natal ward then made my round to meet the babies born since I went off duty.

As I walked up to one crib by the mother's bed, my immediate reaction was that I felt I was looking at a piglet. The face looked as if it had a snout, and in the split second it took me to come to my senses, I hoped against hope the parents (the father was there, too) had not seen my face.

I immediately pulled myself together (as one does) and asked the baby's name and all the usual things I would talk about. The parents told me their shock at seeing their new baby with such a severe cleft palate, but told me she was going to get specialist treatment. At report, I learned the baby was to be transferred to a plastic surgery unit within the hour. I was to prepare the mother and baby for the journey. To my undying relief, when I went back to the bedside, the father immediately thanked me for treating them so normally and cuddling their baby. He said "you showed absolutely no sign that anything was amiss, you just treated us as a normal couple with a lovely new baby".

Isn't it wonderful--the subtle skills we learn as nurses, without even realising it? Luckily they come to the fore when needed.

This led me to remember a chance meeting with a lovely woman who had been a nurse in WWII. She had worked with Sir Archibald McIndoe. For those too young to remember (!) this surgeon is the father of plastic surgery for burns. He worked with RAF pilots  badly burned after being trapped in the cockpit when their planes were shot down and caught fire. His work was pioneering and amazing, but even so I can remember seeing men with terribly scarred faces in the post-war years.

Apparently Sir Archibald handpicked the most attractive nurses to work on his wards. He was severely criticised--until he said, "For these young men, having to come to terms with such badly disfigured faces, and the loss of their looks and, in their minds, their futures, it is vital that they are treated as completely normal by attractive young women--and that is why I only want the most attractive nurses to nurse them back to health and as normal a life as it is possible for them to have."

I appreciate that this will be anathema in our plotically correct age, but it actually showed great sensitivity in those dark war years where death was literally around the corner and nothing was certain. But I would argue that sensitivity is still key to nursing and never more so than in face-to-disfigured-face contact. McIndoe's patients recognised their role in his pioneering work, and proudly formed 'The Guinea Pig Club' with themselves as founder members.

Another memory for this month links back to my first year night duty (in 1959) on Marie Celeste (I remember that ward - Deborah)! It was a very varied ward. One 4-bedded room was for young women who had had facial plastic surgery to rebuild the depressed bridges of their noses, and reduce the space between their upper teeth. This was caused by congenital syphilis. Shocking now, but it was not until the 1950s that the WR and Kahn blood test was done routinely ante-natally so syphilis could be treated early in the pregnancy.

It never ceases to amaze me to realise all the not-very-exciting but vital developments in medical care within my own lifetime that have made such a crucial difference to so many lives. We take so much for granted--we shouldn't. We have so much to be grateful for but our caring skills are still absolutely necessary for the health of body, mind and spirit of our patients.

Isn't it wonderful--the subtle skills we learn as nurses, without even realising it? Luckily they come to the fore when needed.