The right to refuse

The town’s people considered it quite a big city. I was not impressed. Nobody seemed to know what a Reconstructive Plastic Surgeon did. But a number of trauma cases required microsurgical expertise. Fortunately the Orthopedician was convinced of my utility. And I needed the job. But the OPDs were boring.

My hopes soared as a young couple walked in. The girl was pretty in a droopy way. The man looked a high testosterone, sullen type. She was pleasantly plumb. Did she require liposuction? A nose job, perhaps? Or may be the man wanted a hair transplant? The front of his scalp was a sparse wasteland.

No. Something was wrong. The girl was weepy. And the man, furious. They were married a few days back.  That was what the man said, as he gruffly introduced him and his wife.

“She was not a virgin. I could tell on the first night. I can tell. I am not a fool. I know these things.” He said calmly. But the words had a malignant finality.

“No…I swear on god…” The girl blurted out. Then she lowered her head and wept.

I hesitantly started on how the hymen can be very delicate in some women and might have broken with exercise or stretching. Or it may  have been, well…not noticeably tough. I paused doubtfully. The man was dismissive.

“I have no doubt. But I am willing to forgive her” He made a magnanimous gesture with his hands. “But I want you to restore her hymen. You have to do a hymenoplasty on her.”

“What!” I couldn’t help exclaiming. My stiff upper lip, the mark of a decent medical man, had gone to pieces.  I put it together with some difficulty.

“Virginity is an idea. I have no objection to you giving such an inflated importance to it. And if she told you that she did not lose it before marriage that should be enough. How can artificially made hymen make up for it? “.  I carefully weighed my words.

Hymenoplasty was a relatively simple procedure. The idea was to make two small mucosal flaps from either side of the vaginal opening and suture them together, leaving a small opening for the menstrual fluid to pass. It was simple- but lucrative.

“I just want to have that satisfaction”.  The man said with the hideous semblance of a smile.

“You won’t get it. At least not through my hands.” I said.

“What do you mean?”

“I won’t do it. That is all. You are free to consult anybody else.” I said.

His eyes bulged. The face took on an incensed reddish hue. I looked on calmly, my hands fending off an imminent attack in my imagination.

He stormed out, and the girl followed him. I walked out and caught Sugunan, the young OPD nursing assistant, staring at their retreating backs.

“I know her. She is Nandini, my neighbour. She is a nice girl. I had attended the wedding.” He had enough sense not to ask what they had come for.

I was surprised to see her alone, waiting in the OPD the next day. Her eyes were swollen and puffy.

“Do the surgery, doctor.” She begged. “Otherwise my life will be ruined.”

This was real agony. This was one of those situations, where the words in the Lord’s Prayer- ‘do not put us to the test’ were designed to abolish. My heart felt as if it was being put through a wringer.

She was crying as she walked out. I had refused to put the knife on her.

Outside, Sugunan was standing. I saw Nandini giving him a weak smile through her tears. Sugunan looked shocked to see her crying face. He looked at me enquiringly.

“Is she a friend?” I asked him. He nodded.

“She is in some trouble. Why don’t you talk to her?” I said on an impulse. Sugunan ran after her.


I came back to the OPD to attend to the next patient. This was a couple. The man looked studious and portly. The young woman was dark and attractive. Swollen eyelids and general demeanour denoted recent crying.

“Here we go again” I thought. I was being inundated with weepy young women. This was definitely not fair, I thought. As many of those afflicted with masculinity, tears especially from women made me distinctly uncomfortable. I have an irresistible urge to run to the next district whenever I see a crying female. But I guess they are as unavoidable as taxes, tables and tiresome males. I had a sudden surge of anger at all the men that made women cry. Why can’t they realise that the women are beautiful, delicate and needs tender handling? Why can’t they be treated with extreme gentleness and care? I conveniently forgot my own transgressions that have sent scores of girls and women associated with me at various periods in my life to weep and cry with unrestrained abandon.

I cornered the man with a hostile eye. “What is the matter? How can I help you?”

The man cleared his throat. “Er…her nose is not alright. She wants a bigger nose.”

I looked at her small straight nose. One could not imagine a more perfect nose. In fact, one could not imagine a more perfect face.

“I think the nose is perfect. It is very difficult to improve upon this. What exactly is the problem with it?” I enquired cautiously. I was always very guarded with rhinoplasties. One had to be, especially when the complaints were vague and the deformity small or non-existent. It was an urban legend among our professional community that till date, seven cosmetic Surgeons have been murdered by dissatisfied nose-job patients. I didn’t want to be the eighth.

“Ok. Leave it. Can you do anything about the chin? Make it longer for instance. Is it too small?”

I stared at the man. He quickly corrected himself:

“Smaller, I mean. Don’t you think a smaller chin will give more balance to her face?”

I am afraid I sort of lost my temper at that point.

“Why are you the one who wants all these? Why doesn’t she speak? Did you make her come to me? For what?” I almost shouted.

“No doctor. I want it.” The girl spoke up for the first time.

“What is it that you want?”

“My face is all wrong.” She replied.

“I have to know exactly what is bothering you about your face. Otherwise I can’t help you.”

“My eyes, eyebrows, nose and chin-everything is wrong. The length of my face- I don’t like it. I want a more moon-like face. The nose and chin also has to be changed.” She had a desperate look.

Some psychiatric conditions like this were known. But why did the young man collude with this? Suddenly it struck me, like I had removed my too dark sunglass.

“You want people not to recognise you- and change your appearance. Why?” I asked.

I had caught them out. I was rewarded with a remarkable story.

Mary had a dying father. She had a brother who wanted to go to college. Prostitution was a way out. She got many high-paying clients over one year. That was when Sunil came to her. It was his first time. Sunil fell in love with her and wanted to marry her. He was a driver. But many of Sunil’s friends and fellow townsmen knew her. Some too intimately well. She was trapped in her shady reputation. She was ready for any sacrifice to marry Sunil. Sunil loved her, but how will he handle the humiliation? That was the gist of this pair’s dilemma. They thought that I was the perfect plan.

“I can’t help you through surgery. But let me see”

I took my mobile and dialled Sandy. Sandeep was a classmate from medical school. Now he had a chain of clinics all across Dubai and Abu Dhabi. He was one of my closest friends.

“Hello sandy, this is jimmy. Yes, it’s been a long time. Do you need a driver for one of your ambulances?”


One year later when I went to visit Sandeep in Dubai, I was an honoured guest at Sunil’s house. They had a small but neat apartment. A small one month baby lay in the crib, rosy eyelids tightly shut. It smiled in her sleep.

“That was quick work” I winked at Sunil. I thought about the desperation that made Mary and Sunil to come to me. Mary was willing to get disfigured through surgery to achieve her dream of living with him. Now Sunil was employed with my friend Sandeep in Dubai, far away from the tight constricting morals of their hometown.

“The way you solved our problem was also quick.” Sunil said. “Somebody else is coming to meet you. It is a surprise.”

The doorbell clanged and Sugunan, the Nursing Assistant walked in. I knew he had left India six months back. He had taken a letter from me to Sandeep, for possible employment. So I was not surprised to see him.

But I was really surprised to see Nandini standing by his side. I remembered her well because of the strange hymenoplsty request. He had an arm around her.

“We ran away” He explained. “She has filed for divorce.”

On the way back, I reflected on the strange way the world was put together. Virgins, former prostitutes. On the men and their different attitudes. On coincidences and outcomes. And the mysterious ways of providence.

The day I rejoined the hospital, Puneeth, the hospital administrator, came to meet me.

“We know you are good, doctor. But the conversion rate is not all that good.” He said.

The ‘conversion rate’ was a term used in Hospital Finance. It was the percentage of patients seeing a Surgeon that gets converted to revenue generating procedures.

I replied:

“A liposuction- Ruppees fifty thousand for the hospital.” He looked at me enquiringly.

“A rhinoplasty- Sixty thousand Ruppees.” I paused for effect.

“The right way of refusing a wrong procedure- Priceless.”(Jimmy Mathew)

Dr Jimmy

I am a Doctor, Writer and Science Communicator. I am a member of Info- Clinic, and have written a few books. This site features my blog posts and stories. Thank you for visiting. ഞാൻ എഴുതാൻ ഇഷ്ടമുള്ള ഉള്ള ഒരു ഡോക്ടർ ആണ് . നിങ്ങളുടെ താത്പര്യത്തിന് നന്ദി .