Merriam-Webster defines a scar as a mark remaining on the skin after injuries have healed. I can spend days explaining the pathophysiology of wound healing. How after a wound happens platelets aggregate and activate a cytokine response that lead to the formation of a fibrin plug that later changes to metalloproteases which in turn forms a mesh of endothelial cells and collagen ultimately leading to the formation of new skin. I can also explain how this new skin’s characteristics and basic cellular composition differs from normal skin, hence we get the visible scar. But we’ll skip that for today.
As a surgeon, I spend most of my working hours either looking at scars or making new ones. I am trained to know exactly what type of surgery the patient underwent without them knowing. All from the way and placement of scars on their body. I can tell of they had an appendectomy or a colectomy. I can tell if they had a coronary bypass using a saphenous vein graft or an internal mammary graft. I can tell if they had a caesarean delivery or had their uterus removed. All from these scars. As a mentor once told me “You can guess eighty percent of your diagnosis from afar”.
And with these scars come the stories. The story of the worrying mother with the kid who has appendicitis. The story of the son whose father has colon cancer. The story of the newly married woman who found a breast lump. The story of the college student who was robbed and stabbed on the way back home. All these stories will ultimately lead to a scar of some sort. Sometimes unlike the kid with appendicitis, whose issue is solved soon after surgery, the stories persist long after that scar has been made. Like the woman who had a mastectomy and now walks around without the thing that used to define her as a person. Or the one who had to undergo months of chemotherapy after their surgery. Or the kid who now has a hernia where he was stabbed which reminds him of that dreadful night. Any one of these scars is a proof of misery and despair ever so brief. Thus, they require our attention, our compassion, our empathy and respect.
But have you ever been sitting in a café on the street or walking around and see that person that looks weird? The one who acts in a bizarre way? The homeless who looks young and capable but decides to remain sleeping in the cold wet roads? Have you seen that one person who just can’t have fun who always has a blank face? Or those who cannot get into a relationship?
What do most say of them? That they’re crazy? Out of their minds? They’re addicts and deserve this? That they are boring and emotionless? That it is better to stay away from them? Not to mingle among these people?
But have you ever sat down and thought why they’re like this? That they may have been suffering like everyone else? Maybe the bizarre actions are autism? Or the homeless person cannot mute the voices of schizophrenia without the drugs he spends everything he owns on? Or the blank face is due to depression and has blunted all forms of emotion? Or that they cannot be in a relationship because of the sexual abuse they got from their uncle?
Why do these people get any less attention, compassion or empathy? Why do we not respect them like we respect the others? Is it because their scars are hidden? That unless we see it we cannot believe it?
Or maybe I guess we can wait for the hidden scars to turn into cuts on wrist or bullet holes in the skull or maybe ligature marks on the neck? Maybe then they can get or attention?
But wouldn’t that be a little too late?