My (Free!) Nose Job

The Accident

It was a crisp October morning in 2007, and I had a very busy day ahead of me. I was biking away from Trader Joe’s, where I’d picked up my lunch for the day, and was headed to campus to study for midterms. On the way home later, I hoped I’d have time to swing by Budget Bikes so they could repair my loose front fender.

Helpful Tip: If you have a loose fender, get it repaired asap.

As I coasted down the long slope on Monroe Street, I was distracted from my to-do list by the fear that always overtook me when biking downhill. I’d never fallen on a hill, but I couldn’t shake the fear of going fast, and I always found myself clutching the brakes to slow down.

Noticing my own white knuckles, I counseled myself: Relax. There’s nothing to be afraid of. Stop riding the brakes. Just enjoy the ride like a normal person!

So I was going a little faster than usual when, at the bottom of the hill, I crossed a patch of potholes that would be repaired the following summer.

The next thing I remember is my face slamming into the pavement.

It hurt. A lot. I lay there in shock, my face throbbing, a rapid explosion of pain overtaking my nose and forehead. I couldn’t move. I let out a low moan: “Ohhh…”

Why couldn’t I move? I was tangled up somehow. What if a car came? Panic rose in me as I realized I was lying in the middle of the road, vulnerable if any cars came by. What was I tangled in?

Disoriented in those first few seconds, I gradually realized that my backpack was still on and had somehow become tangled in my handlebars. I was squirming awkwardly to extract myself from my bike and get off the road. Luckily, it was still morning and no cars were nearby—if they’d been close behind me, I could have been much worse off.

Finally, I managed to free my right arm, which was wrenched and in pain, and crawl to the curb.

Two people were running over to help me: a middle-aged man and a college-aged girl. They were a little dim to me. My eyes were working fine, but the pain in my face made it hard to focus on anything. “Are you okay?” one of them said.

Someone moved my bike off the road.

The man brought out a white handkerchief. “Your nose is bleeding. This is stained, but I swear to God it’s clean, if you want to use it.”

“Thank you,” I said gratefully, reaching up to take the rag. I held it to my nose and tipped my head back.

My helmet was still on. I felt dazed.

The pair talked to me and I slowly regained my awareness. They helped me take off my helmet. I saw drops of bright red blood on the handkerchief. I wasn’t bleeding very much, thankfully, but my nose was throbbing.

My inner martial artist had begun to step up and take over. It had been years since all my kung fu classes, but once upon a time in my teens and twenties, I had been a dedicated student. The training was still there: Keep your energy out; be in control. Even though I was sitting on the curb, part of me was assessing the scene.

“Did you see me fall?” I asked my new friends.

“I heard it,” said the girl.

“Me too,” said the man, “I didn’t see it but I heard it.”

I wish now that I had asked them what my fall sounded like. Did I yell?

A firetruck pulled up—we were just a block from a fire station. Two paramedics got out and stood over me, and I surprised them by bantering with them. There was that old kung fu toughness again.

They asked if I could remember the fall. I said no, but that I didn’t feel disoriented.

“Do you think I might have a concussion?” I wondered, looking up at them over the handkerchief.

“It’s hard to say, but you should go to the hospital to be sure. Do you want an ambulance?”

“No.” Ambulances are expensive. I had health insurance, but I wasn’t sure if this service would be covered.

I asked the girl to call my housemates on my cell phone—they could take me to the hospital. I was still too shaken to make the call myself.

By the time Nickole arrived to pick me up, a police car and ambulance had showed up too. I was surrounded by emergency vehicles. I found myself in the surprising position of reassuring everyone else that I was okay, laughing with them about what a big deal my little accident appeared to be. The firemen told me they’d wheel my bike into their fire station for safekeeping. I thanked them.

“Do you want us to take your helmet too?” one asked. I had taken it off and put it beside me; he picked it up.

“Umm… No; I’ll keep that,” I said.

He handed it back to me. “Your helmet’s cracked,” he pointed out.

I looked at it. There was a tidy crack in the forehead, splitting the front of the helmet in two. A chill came over me. If I hadn’t worn a helmet, that crack could have been in my skull.

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The Hospital

A bit shaky, I stood and climbed into Nickole’s car, thanking my nameless helpers. I later wished I’d gotten their contact information so I could thank them better when I recovered.

I sat down in the passenger seat and looked at Nickole, who said, “Are you okay?”

In answer, I burst into tears.

“Oh, honey, your nose is broken,” Nickole said matter-of-factly.

“Really?” I blubbered. Now that I was safe, my inner martial artist had vanished.

Nickole said she could see that my nose was offset, pushed toward one side of my face. My shoulder ached. I could barely use my right arm.

“What happened?” she asked as we drove. Through my tears, I explained that my front fender had been loose. I couldn’t remember the accident, but I remembered hitting potholes. I guessed that the bumpy road made the fender detach and get caught in the wheel, stopping the bike suddenly and throwing me over the handlebars. (A look at my bike later confirmed this was probably the case.)

Nickole had to go to class, so I trudged into the Emergency Room alone, carrying my backpack and bike helmet. Still in a daze, I wandered to the check-in counter and was told to wait. As I lowered myself into a seat, I was conscious of how awful I looked, with my bloody nose and scrapes on my face.

A middle-aged black woman appraised me shrewdly from a few seats away. Leaning over, she spoke frankly. “Who did this to you?”

“Oh, no,” I admonished. “It was just a bike accident.” I gave a little reassuring smile but was disturbed to think of the implications of her question. She must have known others for whom such accidents were not accidents.

I waited several hours, and the pain gradually subsided.

While I waited, I called family and friends. Ron wasn’t home, so I called his roommate Josh, who was also a good friend of mine. When I started crying on the phone, Josh said, “Katie, hang on—I’ll be there in ten minutes.”

He sat with me for hours while I waited to be seen.

A CT scan revealed that I had no concussion. My loss of memory was a common reaction to a traumatic event, I learned: often, in an accident, you lose the memory of the last moments before impact. Perhaps that was why I could remember only the impact itself—not the fall, but the very moment of my face hitting the pavement.

I wished that memory had been erased as well. I vividly remembered seeing the pavement rush up in fast motion to meet my face, and the crunch and pain as I hit. The pavement had been so…unyielding.

The scan also confirmed that my nose was broken. And the doctor suspected a torn ligament in my right shoulder; I would need physical therapy.

That evening, I curled up in Ron’s arms and sobbed. He and I weren’t dating at the time—we were on one of the off-again periods of our off-and-on relationship. But the thought of my cracked helmet sobered us both.

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The Otorhinolaryngologist

Everyone was sympathetic over the next couple of weeks. My broken nose meant twin black eyes, which I learned are a trademark of a broken nose. Too scared to bike, I took to walking to campus.

I noticed how, upon seeing my face, many people’s eyes would widen and then slide quickly away in embarrassment. Occasionally, someone would leave their gaze on me and give me the most tender, sympathetic smile, which always made me smile back with raised spirits. Professors and fellow students often gathered around my desk to hear my story. I felt an outpouring of love and support from everyone around me.

After a week or so, it became obvious that I still couldn’t breathe through one side of my nose. And that realization gave me an idea.

You see, I suspected this was not the first time my nose had been broken. When I was eleven or so, I’d been sitting on my knees on a skateboard, happily scooting myself along, when I encountered an unexpectedly uneven place in the sidewalk. With a jolt, the skateboard stopped cold but I didn’t, and the momentum propelled me face-first into the pavement.

(You’d think that experience would have taught me about the dangers of traveling on uneven pavement, but apparently the lesson had been forgotten by the time I biked down Monroe Street.)

I had run shrieking inside in pain, but there wasn’t much Mom could do except give me ice. Looking in the mirror, I was appalled to see a new bump on my previously straight nose. As a vain preteen, this bump represented imperfection. I hated it every day I looked in the mirror.

Even as an adult, the bump on my nose was still the Thing I Liked Least when looking at my reflection. Everyone’s got something, I guess, and that bump was mine.

I thought my nose had been broken other times, as well. As a martial artist, I took blows to the nose now and then. I also came face-to-pavement once more, misjudging the bottom of a swimming pool and hearing and feeling an unwelcome crunch through the water.

So by the time I fell off my bike, it seemed that every time I’d had an accident, my poor, misshapen nose had taken the brunt of the force. It was almost as if each time I broke it, the bump got a little bigger and thus more prone to being broken the next time.

My idea was this: If I couldn’t breathe because of this accident, could my health insurance pay to fix my nose?

I went first to an ear-nose-throat doctor, or in medical terms, an otorhinolaryngologist. (His delightful title was translated just as delightfully into Spanish on the office door: Otorrinolaringólogo.)

He was a tall, 40-something man with an unflappable smile and large hands. He sat down in front of me and worked his magic: one gentle touch of my face and he knew my whole history. “Oh yes, your nose has been broken multiple times.”

“Really!” I was impressed that this was so obvious to him from just one light touch. And I felt a bit smug to hear I’d been right all these years—my nose really had taken a beating.

He offered to reset my nose. This should happen right away, he said, before the swelling had gone all the way down. It would be painful, and it wasn’t sure to work—there was only a 70% chance that I’d be able to fully breathe afterwards. But it could be done today.

Whether or not we tried resetting, the otorhinolaryngologist went on, he’d be happy to refer me to a surgeon. And all of this would be paid for by my insurance.

My nose was still in pain from the accident. The thought of someone yanking it back into place today made me shudder. But it seemed worth a try, and if it didn’t work then I could still try surgery. I sucked up my courage and gave him the go-ahead.

A nurse led me into a little room, sat me in a chair, and began laying out implements that would be needed for the resetting. She explained that the first part of the process was to numb my nose by sticking stakes up it that were tipped with medication.

The stakes were laid neatly on the table before me now, each several inches long. Staring at them and feeling the pain in my nose, my chin began to quiver in fear.

The otorhinolaryngologist walked in at that moment. He took one look at my face, stopped in his tracks, then bent down in front of me.

“You know what, Katie?” he said seriously. “You’re not ready for this procedure. I’m looking at your face, and I can see that you’re not emotionally ready for it. So I’m going to call it off, okay?”

I nodded, tears of relief streaming down my cheeks. With compassion, he sent me off, smiling and saying I should go next to the surgeon.

(Brief tangent: As fate would have it, Ron broke his own nose playing basketball a year and a half later. Not wanting surgery, he opted to have it reset—he was braver than I. He lay back in a chair and endured the cocaine-tipped stakes being shoved slowly up, tears of pain involuntarily streaming out of his eyes. A nurse came in every few minutes to push the stakes up a few millimeters farther. He then struggled to breathe as the doctor and nurse muscled his nose into place over the course of several minutes. He said it was the most excruciatingly painful experience of his life.)

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Transformations

The nose surgeon worked on the outskirts of town in a glassy black building labeled “Transformations.”

The waiting area was accented with brochures about plastic surgery: all the ways I might enhance my appearance, improve my lifestyle, and boost my happiness. Everyone working here was good-looking. The surgeon was a young, dark-haired, dapper man named Dr. Marcus.

All of his assistants appeared to adore Dr. Marcus. From the secretaries to the specialists, every new woman I talked to seemed to echo the others. “You’re so lucky to have him. He is so wonderful.” And he was, indeed, a very nice and capable man.

Dr. Marcus told me it was good that I hadn’t had my nose reset. “It wouldn’t have done you any good,” he said. “Your nose has been broken too many times. I think you’re right that it was broken when you were a kid; I can tell by the way the bones are that it was broken a long time ago and has actually grown a little crooked.”

He said I was an excellent candidate for surgery.

“So,” he said with a touch of coyness. “You know, while I’m working on your nose to fix your breathing, I could also change how your nose looks if you wanted.”

I couldn’t help smiling. Actually, funny you mention that, I said. I told him about my hatred of my unnatural bump. I didn’t want to look like a different person, of course… But if he could get rid of the bump and make me look how I was supposed to look… Well, I wouldn’t be opposed!

Dr. Marcus happily agreed.

I brought in old childhood photos of me from before the skateboard accident. He used a special computer program to attach various potential noses to my picture, and we settled on a nose that might have been mine if my nose had never been broken.

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Surgery

A few months later, in February of 2008, my mom and stepdad Lanny flew to Madison to help me recover from the surgery. They took me to Transformations, bade me farewell as I was wheeled into the surgery room, and were there when I awoke.

I came to in a cozy little room. I found myself reclining in a chair, wearing the surgery robe, with Mom and Lanny seated cheerfully on a bench to my right. A nurse was standing over me and talking to them while she monitored me.

“Oh, hi,” I murmured. It seemed as though the surgery had happened in the blink of an eye. “I’m awake.”

“Hi, Katie,” the nurse said.

“How did the surgery go?” I asked. I’d been nervous about being put under.

“It went fine, Katie,” she said soothingly, with just a touch of condescension, as if talking to a child.

“How long was I under?”

“You were out for maybe an hour,” she said in that same tone. “But you know, Katie, you’ve asked me that question about five times now, and I don’t think you’re going to remember the answer.”

Huh?

“I have?”

“Yes, Katie. You’ve been talking now for about thirty minutes.”

“Really?” I laughed. “I don’t remember that at all.”

“Yep, you have,” Mom confirmed from the bench.

It took me a few minutes to convince them that I really was awake now. I asked what I had been like when I was talking. They said I was very nice, grateful to everyone, and had lots of questions about the surgery. I felt like an old person with Alzheimer’s, completely unable to remember conversations from a few minutes before. Well, at least I’d been pleasant!

Now that the surgery was over, I had stints up my nose to prop it open as it healed. These would stay in for a week, then I’d come in again and have them removed. Because of the stints, I couldn’t breathe through my nose, which meant that my throat and mouth were already very dry.

I also couldn’t wear contacts or glasses for the first few days. Since I’m blind as a bat, that meant no reading and no TV. I had set up various podcasts on my computer for Mom to play for me, but I was also heavily medicated and exhausted, and I didn’t feel like doing much of anything.

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Mom, Lanny, and my housemates nursed me for the next few days. The hardest part was sleeping. I had to sleep sitting up, and my dry mouth was so painful that I couldn’t sleep more than 45 minutes at a time. After 45 minutes, I’d awake from the searing pain in my cracked lips, needing to feebly lick them and reach for a water bottle. Even my tongue was dry and swollen. I was miserable.

(Watching me go through this was part of the reason Ron opted to have his own nose reset a year later. “After seeing what the surgery’s like, all I know is, I do not want nose surgery,” he would say.)

After a few days, Mom and Lanny flew back to Portland and I could put my contacts back in. The swelling was going down slightly and I was starting to be able to breathe through my nose again, giving my tortured mouth some relief.

Looking in a mirror, though, I was appalled: my nose was so swollen that my nostrils tilted forward like a pig’s nose. I had a moment of panic. What if the surgery had been botched and I’d be cursed to look like this for the rest of my life?

But Dr. Marcus said this was normal and not to worry.

I began going back to class at the end of that week, with the stints still in my nose and a bandage over it. Once again, I had two black eyes. Once again, I was walking around campus and drawing many awkward look-aways and a few sympathetic stares.

When I walked into one class, a girl named Jenny did a doubletake: “Oh my God, Katie, not again?!”

I laughed. “No, no—same injury!” I reassured her. “This is from the surgery to recover from when I broke my nose.”

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Getting the stints out turned out to be one of the most painful experiences of my life. It’s just no fun to have things all the way up your nose, especially when your nose is already swollen and in pain.

A nurse numbed my nose and pulled the stints down and out, causing pain to shoot all the way up into my sinuses as I clutched the handles of my chair. But then it was over.

I had imagined the stints to be wooden stakes; I was surprised to see what they actually looked like. They were clear plastic squares with rounded corners. Each square was about 2 inches to a side, and each had been rolled into a stiff tube. The tubes had held my nose open in the shapes of nostrils, so that my nose would set itself properly as the swelling went down.

I could breathe out of both sides of my nose again. The surgery had worked.

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Blessings

As the pain and trauma of the accident and surgery passed, I came to see this ordeal as a blessing in disguise. Breaking my nose on my bike had meant I could have my nose fixed. That was something I’d wanted all my life, but I would never have ordered a nose job for myself without an excuse. I always told myself I wasn’t that vain.

But truth be told, I’m just as vain as anyone—I’d been bothered for years by a bump on my nose. I was just too self-conscious to admit how much it had bothered me, and my self-consciousness was like another kind of vanity.

Looking in the mirror now after the swelling went down, I was overjoyed that the bump was gone. I no longer had that feeling of frustration when looking in the mirror. There was nothing left that I really disliked about my own face. And, of course, I could breathe!

A month or two after the surgery, I received a letter from my health insurance company regarding the surgery. It had cost around $7000. They hadn’t charged me a dime.