By Maher M. Anous, M.D. Pp. 256. Self-published (available at: http://stores.lulu.com/zinjanous). 2009. Price: $40.24.
Appropriately recognized as one of the “top 10” plastic surgeons of the twentieth century,1 Paul Tessier then and now can only be described with superlatives. He created virtually de novo an entire field of plastic surgery,2 indeed deserving the appellation of “father of craniofacial surgery.” Dr. Anous, as author and publisher, has pieced together his reminiscences of “Paul,” purposely omitting the surname not with disrespect but instead for emphasis of an individual most would agree was a brilliant, dedicated, and tenacious personality.3
Part biography and a lot autobiography, this journey begins with a young general surgery resident who, like most of us, has taken a meandering path without direction in search of a professional goal. Stirred onward by an opportunity to learn the basic principles of plastic surgery in, of all places, Allentown, Pennsylvania, then smitten by the complexities of craniofacial surgery in a nearby big city, it was at a chance seminar during a fellowship in Houston, Texas, that he not only had the privilege of listening to the master in person but also caught his attention by asking questions in perfect French, a characteristic not typically American. The author's multilingual fluency and obviously superb writing skills enabled him to eventually obtain, via a circuitous pathway and with help from Tessier's secretary and confidant, a fellowship, but without, of course, monetary compensation. Long hours were spent in the operating room, primarily as a retractor grande; car rides home, chauffeured by none other than Tessier himself, allowed plenty of time for conversations that revealed Tessier was an authority on many other subjects, including Africa and big game hunting, politics, history, food, wine, and perhaps women.
Apparently unknown to Tessier, notes on every encounter were meticulously maintained by the author so that he could later regurgitate the events without the need to rely on an unreliable memory, if ever an historical record were to be produced. It now has been, and as evidenced by several letters to many authorities included as a postscript, Tessier himself reviewed the manuscript on several occasions, admiring the pomp and circumstance but reviling any suggestions that he was hard-headed, temperamental, or what today we would call disruptive. Perhaps out of respect or fear of retribution, the author waited more than 15 years to publish the book now, following Tessier's death in 2008.
The book portrays mainly details of interactions within the operating room among Tessier, his team, and his young fellow. Those few glimpses of the outside world are quickly glossed over, perhaps indeed rare moments typical in the life of a busy surgeon.
A prologue attempts a psychoanalysis of how a person such as Tessier was able to not just find the innate genius present in each of us but also avoid hiding it and allow it to flourish to the extreme. Words such as loner, artist, innovator, introvert, unemotional, and insensitive hit hard with negative connotations, in contradistinction to his conventional aura that portrayed a “genuine tenderness and concern for his patients.”3 Yet in reality these traits may be intertwined.
All good things must come to an end, and after this opportunity of a lifetime, the author returned to the anonymity of his private aesthetic practice. This short book, a small and unilateral experience by a very junior colleague, is accompanied by personal letters from many giants of craniofacial surgery. Some pictures, but not enough, whet the true plastic surgeon's appetite. Obscure points are highlighted by too many footnotes.
Nevertheless, once started, it is hard to put this book down. This introspective touches the very innards of every plastic surgeon, and sheds light on our greatest fear of being analyzed by a knowledgeable insider, to see our shadows and prove we are all human, are we not? Yes, it was so easy to take this all personally. Will our behaviors as a specialty change? Probably not. Wait for the movie!
Geoffrey G. Hallock, M.D.
1. Hallock GG. The plastic surgeon of the 20th century. Plast Reconstr Surg.
2. Wolfe SA. Paul Louis Tessier, M.D., 1917 to 2008. Plast Reconstr Surg.
3. Jones BM. Paul Louis Tessier. Plast Reconstr Surg.
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