I don’t normally review non-fiction that I haven’t chosen for myself, but when I had a query as to whether I’d be interested in reviewing Am I Ugly?, a memoir from Michelle Elman, a body positive influencer who goes by the handle @scarrednotscared on Instagram, I signed up because I’ve got a few scars of my own and I wanted to see how Michelle’s experience related to my own.
I was nine when I was run over and the accident left me with a fractured skull, broken nose, a badly broken leg and, the jewel in the crown, a full thickness degloving crush injury to my left foot. If you don’t know what that is, don’t google it. I will not accept responsibility for any damage caused to keyboards by you losing your breakfast, regardless of how long it’s been since you ate it. So, in short, a life time of experience with some none too subtle scars and a few prolonged hospital stays.
Michelle Elman’s scarring is a result of multiple surgeries to treat hydrocephalus, and the complications that stemmed from earlier surgeries. Her memoir starts with an account of her health rapidly deteriorating at boarding school and the emergency surgeries that soon followed. While the memoir is billed as an account of one woman’s journey to body positivity, and while I’m sure that it was intended as such, for me, the book wasn’t really about the scars as a profound childhood trauma that the author was left to manage without any sort of adequate support. I’d really recommend it to anyone trying to understand how a child might experience a long hospital stay and traumatic illness.
Elman has changed a lot of names in the book, including the name of her school (which can be viewed on her LinkedIn profile so isn’t a hugely effective smoke screen) presumably for legal reasons in light of the allegations she makes about her teacher’s failure to safeguard her during her illness and the diet that her house mistress puts her on. Basically, if you were toying with the idea of spending £15,000 per term to outsource your child’s education and wellbeing to an external agency, then this would put you off.
The names that she can’t change, however, are those of her parents, and it does leave you wondering what they were thinking sending a young child with such a dangerous condition to boarding school without proper oversight. Rather than rush her immediately to a hospital when realising how ill her daughter has become at boarding school in the UK, her mother makes her feign wellness to fly to a hospital in LA which has previously treated her “because they have her notes”, risking her daughter’s health on the outbound flight. Following a series of surgeries in the US, she is then in hospital in an intensive care unit where she receives limited psychological support and the medical professionals discuss her condition in front of her in a way that seems designed to increase trauma. As soon as she is well enough, she’s shipped off back to boarding school in the UK, where her peer group has dispersed, finding herself isolated from her family who are in Hong Kong, without friends, and mistrustful of the teachers who have previously neglected her wellbeing.
Once back at boarding school, the author finds herself gaining weight from her inactivity while in hospital and is soon locked in a cycle of feeling awful about her scars and her weight, wondering whether she will ever be able to have a relationship with a man because of the scars. This all comes to a head at university, where she is forced to confront that she is still suffering from the trauma of her ICU stay in America. And it’s hardly surprising. I really felt for the poor girl. To go through all of that in a secure and supportive environment is hard enough…
I think a lot of how my recovery post-accident was dealt with made a big difference to our experiences and possibly our various perceptions of our scarring. I was carted off to a psychologist to talk about my PTSD pretty much as soon as I was out of hospital, suffering nightmares and squeaking in distress every time I was taken across a road (bit of a low point that).
I don’t ever recall feeling especially self-conscious about mine, my frustration with my foot has always been the ongoing pain that it causes and the things that it’s stopped me doing. If I had the option of having my scars disappear, I’d probably keep them because they are a big part of who I am and I probably wouldn’t feel right without them (the underlying bone issues and my ongoing fear of cars though, they can f*** right off…).
What I do relate to though is the being told how brave you must be (as if there was a choice but to cope as best you can?) and the expectation that this sets up that you will keep being brave. And that this becomes a role that you have to play. I remember after one of my surgeries the nurse coming to see if I needed painkillers and still feeling okay because the local anaesthetic was still working and my grandmother telling me that it was okay to ask for the painkillers if I needed them, saying, “You don’t have to be brave.” And I fell to pieces, because it upset this whole identity that had been constructed for me in the hospital about being a “brave girl” and a “good patient”. It’s been interesting to see about how Michelle went on to experiment with different kinds of therapy to address her PTSD, and that is something I’d like to learn more about as I’m vaguely aware that’s a journey that I’m still on.
I understand that this is intended as a book about physical scars and the bravery that it’s taken to embrace those, but for me, what’s impressive about this book is the emotional and psychological scars that the author has addressed and the strength that it takes to confront those so publicly. Michelle is still so young, so to tackle the issue of undiagnosed PTSD head on is a brave move, and will hopefully raise awareness for the carers of other young people in similar situations.