LITMIR.BIZ

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did I come?” he wondered aloud, in a manner that suggested depth. “Did I expect this would make me handsome?”

      “It’s the way we’ve been socialized,” I said.

      “It’s not like I have a deviated septum or anything. It’s not like my insurance is going to pick up the tab.”

      Vanitas vanitatum: elective surgery, in other words.

      He asked for my professional opinion. I said, “There’s no turning back once we do this, so take some time and think it over. There’s no rush. I don’t like to play God. I’m only an intern doing a rotation here.”

      “But you must see a lot of noses in life, on the street, and you must have an artistic opinion,” said Ray.

      “If it were I, I wouldn’t,” I said for reasons that had nothing to do with aesthetics and everything to do with the nauseating sound of bones cracking under mallets in the OR.

      “Really? You think the one I have is okay?”

      “May I ask why you want to do this now, Mr. Russo?” I asked, glancing at the chart that told me he’d turn forty in a month.

      “Let’s be honest: Women like handsome men,” he said, voice wistful, eyes downcast.

      What could I say except a polite “And you don’t think you’re handsome enough? Do you think women judge you by the dimensions of your nose?”

      Next to me he smiled. The camera mounted above the monitor played it back. He had good teeth.

      “I haven’t been very lucky in love,” he added. “I’m forty-five and I don’t have a girlfriend.”

      “Is your date of birth wrong?” I asked, pointing to the clipboard.

      “Oh, that,” he said. “I knock five years off when I’m filling out a job application because of age discrimination, even at forty-five. Bad habit. I forgot you should always tell the truth on medical forms.”

      “And what is your field?”

      “I’m in business, self-employed.”

      I asked what field.

      “Concessions. Which puts me before the public. Wouldn’t you think that if everything was okay in the looks department, I’d have met someone by now?”

      I hated this part—the psychiatry, the talking. So instead of asserting what is hard to practice and even harder to preach in my chosen field—that beauty’s only skin deep and vastly overrated—I pecked at some keys and moved the mouse. We were back to Ray’s original face, bones jutting, cartilage flaring, nose upstaging, a face that my less scrupulous attending physicians would have loved to pin to their drawing boards. If it sounds as if I saw something there, some goodness, some quality of mercy or masculinity that overrode the physical, I didn’t. I was flattering him to serve my own principles, my own anti – plastic surgery animus. Ray Russo thought my silence meant I wouldn’t change a hair.

      “Vows” would reconstruct our consultation, with Ray remembering, “I heard something in her voice. Not that there was a single unprofessional moment between us, but I had an inkling she may have been saying ‘No, don’t fix it’ in order to terminate our doctor-patient relationship and embark on a personal one.”

      Reading between the lines, and knowing the outcome, you’d think something was ignited in that consultation, a spark between us, but I wasn’t one of those attractive doctors with a stethoscope draped around her shoulders and a red silk blouse under her lab coat. I was an unhappy intern, plain and no-nonsense at best, and hoping to perform only noble procedures once I’d finished my residency, my fellowship, my board certification—to reconstruct the soft tissue of poor people, to correct their birth defects, their cleft lips and palates, their cranial deformities, their burns, their mastectomies, to stitch up their torn flesh in emergency rooms so that no scar would force them to relive their horrible accidents. I’d hand off to my less idealistic and more affluent associates the nose jobs, the liposuctions, the face-lifts, the eye and tummy tucks, the breast augmentations, and all cosmetic procedures that make the marginally attractive beautiful.

      Ray Russo should have consulted someone who would graduate from the program and set up a suite of sleek offices in a big city. I wished him well and sent him home with the four-color brochure that covers the gruesome steps of rhinoplasty.

      Why did I take his phone call six months later? Because I didn’t remember him. He dropped the name of my chairman, which made me think he was a friend of that august family—as if he’d sensed I was worried about my standing in the department and my ambivalence toward my then chosen field. Of course, I am summarizing for narrative convenience. Why go into detail about our history, our motivation, our sweet moments, if I’m going to break your heart soon enough? I could add that I have a mother who worries about me, a mother whose motto is “Go for a cup of coffee. It doesn’t mean you have to marry him,” but I’m not blaming her. This is about the weak link in my own character—wishful thinking—and a husband of short duration with a history of bad deeds.

      If I sound bitter, I apologize. “Vows” should revisit their brides and grooms a year later, or five or ten. I’d enjoy that on a Sunday morning—scanning the wedding announcements stenciled with updates: NOT SPEAKING. DIVORCED. SEPARATED. ANNULLED. CHEATING ON HIM WITH THE POOL-MAINTENANCE GUY. GAVE BIRTH 5 MONTHS LATER. IN COUNSELING. CAME OUT OF THE CLOSET—any number of interesting developments that reveal the truth about brides and grooms. Ray’s and mine could have multiple stamps, like an expired passport. It could say DIDN’T LAST THE HONEYMOON OR SHOULD HAVE KNOWN BETTER. Or, across his conniving forehead, above that hideous nose, succinctly and aptly, LIAR.

       2 Later Classified as Our First Date

      RAYMOND RUSSO’S SELF-IMPROVEMENT campaign began with a stroke of Las Vegas luck: He won a free teeth-bleaching, upper and lower arches, in a dentist’s lottery. It explained his too-easy grin and his drinking coffee through a straw during what would later be classified as our first date. We were side by side, on stools at the Friendly’s in the lobby of my hospital. Conversation was stalled on my medical degree, which evoked something close to reverence, expressed in boyish, gee-whiz fashion, as if he’d never encountered such a miraculous career trajectory. Was it not flattering? Was I not psychologically pummeled every day? Insulted by evaluations that described my performance as workmanlike and my people skills as hypothermic? Was I not ready for someone, anyone, to utter words of admiration?

      “I can’t be the only woman doctor you’ve ever met,” I said. “You must have gone to college with women who went on to medical school.”

      “Believe it or not, I didn’t.”

      “There are thousands of us,” I said. “Maybe millions. A third of my medical school class were women.”

      “Well, keep it coming,” he said. “I know I was happy when you walked into the examining room. It helped me more than some guy saying, ‘Your nose is fine the way it is.’ I might have thought he wanted to keep me homely—you know—to reduce the competition.”

      I hoped he was joking, but humor comprehension was never my strong suit. I asked, “Did I take measurements that day, or a history?”

      Still smiling, he said, “You don’t remember me at all, do you?”

      I said, “It’s coming back to me. Definitely.” Studying his nose in profile, I added, “I’m not a plastic surgeon. I just happened to be in the wrong place at the wrong time.”

      “Just the opposite! Thanks to you, I’m going to live with this nose of mine and see how it goes. I know a couple of guys who had nose jobs—I’m not saying they were done upstairs—but I think they look pretty fake.”

      I stated for the record—should anyone more senior be listening—“We have some true artists

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