This is Medicine

I've seen this industry change over my lifetime. Tonight, after dinner, I nursed a brandy and reflected on that fact, and on my day. It occurred to me that today, a typical day actually, was oddly illustrative of the changes I'd seen in my lifetime.

Another man might have been alarmed by those changes, but I'm not the sort to spook easily. In fact, I find the presence, or the prospect, of large sums of money to be distinctly soothing.

I arrived at work by seven o'clock sharp. I always have a briefing with my assistant, Sage, to run through my schedule. She also brings me my coffee.

At eight a.m. my first consultation begins: a young woman wanting a nose job. After this, I have a breast augmentation which takes a few hours, and then, right before lunch, another consult, this time for a facelift. These patients are typical of the ones I had in my early years as a doctor. All women, all more than able to pay me for my services. All white, actually, if you must know. Insecure. Self critical. Terrified of aging.

Oh, if only I could get rid of my flabby belly! My chin juts too much, my breasts sag, my thighs rub together, I have back fat, etc etc etc.

In the afternoon, I see younger patients. Some have similar concerns to their aged counterparts. Just as many, or more, aren't even concerned with aging yet. They seem to fighting a more fundamental battle.

There is an extraordinarily good sandwich shop on the high street. Sage knows my order. I eat at my desk, glancing through my emails. After lunch, I have my first paediatric surgery of the day.

She's exactly like my earlier patients, but a good bit younger. There is hardly any lipo to suction, but I do my part. If she is satisfied, it'll be me she books her boob job with in a few short years.

Then my afternoon consults begin.

The first one is a pale, skinny young person with red hair and heavily bitten fingernails. This youngster doesn't seem to have the faintest clue what they want, besides not this. It is as if they believe on some level that their dissatisfaction is a tumor that can be excised.

It strikes me a doctor of the mind would have been a better option, but I didn't make money with that attitude. I squash the thought, and marshal a reassuring smile on to my face.

The mother is here as well, which is a good thing, because she steers the conversation in the direction she is determined for it to go. All I need do to make the sale, is nothing at all. I let her take the reins, and talk them both into whatever treatments she imagines her offspring needs. I congratulate her on her wisdom, and how supportive she is. She sweeps out of my office beaming, the child under her wing looking less sure than ever.

Another consult, this time for a small boy who wants legs like a cheetah. His parents are very keen for him to grow up to be an athlete, and he is very excited about being able to run so fast. I give him a sticker before he leaves. It has cheetah spots on it. He can't stop grinning.

Next, my final surgery of the day: an icthyoplasty. The girl is nine. We've already had multiple consults about what accommodations she'll need after the surgery. She's only having the bottom surgery, so she will still be able to breathe normally. She will need constant access to water she can submerge her lower body in, so that the scales on her tail don't dry out. She also has to spend a minimum amount of time with the tail submerged, which is a tall order for most little girls.

This is the most difficult operation of the day. I only do one or two of these a year. It takes a long time, but ultimately it's a success. She will need lots of follow up appointments, and a life time of medication. Knowing this has me humming cheerfully as she is wheeled away to recovery. I don't go with her, and I'm not there when she comes to and looks down at her tail.

Sage has typed up notes for today, based on the shorthand I've left for her. I read through it to make sure all is present and correct, and then I head home to a hot dinner and a pretty, young wife.