Some scars, but a miracle too

THE HEADING on the obituary for Mr Bernard O’Brien _ `Medical world mourns leading Australian micro-surgeon’ (`The Age’, Monday) _ seemed strangely inadequate. It was not just the medical world that mourned the passing of Bernard McCarthy O’Brien. I mourned, too.

Mr O’Brien, steely haired, with poor eye sight in latter years due to the constant peering through microscopes, won world acclaim for his work as a plastic and reconstructive surgeon and microsurgeon, but he was less known for his work with lymphoedema patients like me. It was through his genius and dedication that I gained greater mobility and confidence, and in doing so, made the painful journey from denial of my physical abnormality to acceptance.

I was 18 when I first met him, and had learnt to live with a congenital abnormality that left me with no lymph gland in my right leg and, consequently, a leg vastly bigger than the other. I wore long dresses and apart from a recurring nightmare that like Alice in Wonderland, I would not only outgrow my shoes, but my house, I could walk and run as well as anybody. But the prognosis was not good. As the lymph gathered, my leg got bigger and I faced the prospect of reduced mobility.

As a child, I had been under the care and observation of the Royal Children’s Hospital, but then there was no known treatment for such abnormalities. I did not know that my mother over the years had made persistent inquiries, and eventually was referred to Mr O’Brien.

I had seen enough before and after newspaper and magazine reports to believe that plastic surgeons were like disciples of Christ: turning ugly into pretty at the stroke of a scalpel. But Mr O’Brien was brutal in his assessment: “You will never have a normal leg, but I may be able to help you. We may be able to reduce it a bit, but there will be scars,” he said.

As I left his office, I wept tears of gratitude and disappointment. So there would be no miracles after all. Everything has a price, my mother would say.

Now the scars that had been on the inside would be visible on the outside. But millions of people had scars. Yes, I would gladly exchange my “big leg” for the relative normality of scars.

His first task was to determine the extent of the lymphatic system and to do a bypass operation to see if the lymph could be redirected through the blood vessels in the groin.

But it didn’t work. My condition was simply too advanced.

But Mr O’Brien was a lateral thinker. If he couldn’t take the lymph out, perhaps he could stop it getting in by reducing the area that it could escape to?

By experimenting on dogs, which have similar lymphatic systems, he found that by cutting away the lymph and then reducing the expanse of skin and regrafting it back on the limb, an enormous reduction could be achieved.

I had four operations in eight years, the last during the Ash Wednesday bushfires. During that time, I was both grateful and furious. I still wanted miracles, not crutches, ramps, and bandages.

“You must elevate the limb,” he would chide. But at 20, I wanted to kick my heels up, not put my legs up.

But Mr O’Brien was no Dr Kildare. He was more interested in surgically reconstructing his patients hands than in holding them, and seemed more comfortable talking into his hand-held tape recorder about me, than to me.

In his rooms in Victoria Parade, he had devised a complex system of colored and flashing lights to tell him which patient was waiting for what treatment, which was impersonal and disconcerting to say the least.

Despite all my visits, throughout the years he remained stern and preoccupied and, although I now have my own before and after pictures, he never knew what he really did for me.

I had what he promised: a greatly reduced leg and many scars. But I had my miracle, too. Through the physical challenge of the surgery he masterminded, I was forced to confront the emotional challenge of dealing with difference.

I threw away my long dresses, but in my haste to run out the door, I forgot to say goodbye or thank you.

It’s been 10 years since my last operation, and lymphoedema can now be treated with special massage techniques pioneered in Germany and available in clinics in Adelaide and Melbourne.

But my days of sitting in waiting rooms hoping for miracles are over _ thanks to Mr O’Brien.

For more about Mr Bernard McCarthy O’Brien:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4292103/