Jess Row - Your Face in Mine

Deep background, as the reporters say? He laughs. Well, Kelly, I have a deep-background question of my own. I’ve been waiting a long time to ask you this, and I can hardly stop myself.

Go ahead. Why wait?

Did you ever find out what the miao character means?

I look down at the binder, which I’ve placed under the table, between my legs, as if the answer is hidden somewhere in there. And then, without wanting to or meaning to, I begin to laugh: a deep, froggish belly laugh, rising up from my diaphragm, a sound I don’t think I’ve ever made before. A group of businessmen stooped over bowls of noodles at the next table look up at me with wary curiosity.

It’s publicly available, you know, Silpa says.

Only if you have access to the right database.

That part was very simple. That’s what assistants are for.

I can’t stop myself from laughing; I wipe the tears away with my sleeve. Dr. Silpa—

Just Silpa. Everyone calls me Silpa.

What could you possibly want out of my dissertation?

He gives me another of his bland, detached smiles.

Homo faber, he says. We are what we make, right? We are what we produce. Look in that binder and you will find me. How do I come to know a person — a writer, a scholar? How else? You think I’m interested in you as a hired hand, an employee. I’m not, really. That’s just circumstantial. Do you know what the Buddha says about karma? If you brush by a person on the street, that’s because you knew them in five hundred previous lifetimes. You think you just met Martin out of nowhere, for no reason, in some parking lot in Baltimore? Life doesn’t work that way. You present yourself to us. We present ourselves to you. It’s an opportunity, not an accident. So the question is, what next?

You make it sound like a conspiracy, I say.

And as soon as the words are out of my mouth, I realize that that’s exactly what it is. For a moment I feel the sour taste of Phran’s fruit under my tongue again; to squelch it, recklessly, I take a forkful of ground-pork salad, dotted with red onion and tiny green chilis. Why not? I’m thinking, as the white heat shoots up into my nose, my sinuses, my eyes leaking tears. If I’m going to get burned, I’m thinking, without quite knowing why, let me be completely burned. Nothing left.

Silpa rummages in his briefcase and hands me a packet of Hello Kitty tissues.

No, he says, still smiling. The laws of the universe aren’t a conspiracy. But they are laws.

In the morning, after ten hours of dreamless sleep, I stay in my room, reading, till eleven. Phran brings me a thermos of chamomile tea and half a loaf of milk bread, still in its wrapper from a Chinese bakery. For your stomach, he says, tapping the thermos. Julie-nah made.

It’s been a cloudy morning, with intermittent bursts of sunlight; now a soft rain is falling. The beginning of the monsoon season, I guess. I set the binder down on the writing desk, open my laptop, let myself down into the swivel chair, and switch on the light.

CLINICAL REFERRAL

Patient: Martin Lipkin

Evaluated by: Jorge Lopez, M.D.

Assistant Professor of Plastic and Reconstructive Surgery, Johns Hopkins Medical Center

Gender and Reconstructive Surgery Clinic

April 24, 2001

Dear Dr. Silpasuvan,

I’m writing to refer the above-named patient, Martin Lipkin, to you for evaluation at Mr. Lipkin’s request. Mr. Lipkin contacted me at the GRS clinic because he was unable to find any other surgeon in the United States who was willing to do a consultation on his condition.

Mr. Lipkin is a twenty-eight y.o. male of Ashkenazi Jewish (p) and unknown-other Caucasian (m) descent. At my request, previous to our consultation, he was evaluated by the GRS clinic psychiatrist, Dr. Tomasi, and found to be suffering from mild but detectable clinical depression but otherwise free from psychological factors that would constitute comorbidity. He is not suffering from any physical complaints other than occasional insomnia and anxiety that he describes as “not debilitating.” He is a recreational user of marijuana but almost never drinks alcohol and does not use tobacco. His family medical history is almost entirely unknown. His mother and father separated when Mr. Lipkin was an infant. He is not in contact with his mother. His father (according to Mr. Lipkin) died of AIDS-related septicemia in 1995 at age fifty-two and left no extant medical records.

Mr. Lipkin believes himself to be suffering from what he himself has titled “Racial Identity Dysphoria Syndrome.” That is, he believes that he was born into a physical identity of the wrong race. He states that for as long as he can remember he has had a vivid but obviously repressed sense that he is living in the wrong body and has recently realized that he is, in fact, internally, African American. He wishes to seek out options for surgical reassignment so that he can appear physically African American.

To my knowledge (and as I informed Mr. Lipkin) there is a) no such diagnosis, and b) no surgeon in the world who would perform any procedure based on such a diagnosis. When he inquired whether it would be possible to pay for cosmetic surgeries that do exist, I told him (as I believe to be true) that the standards of care in plastic/reconstructive surgery would make it nearly impossible to find a surgeon to provide reliable care under these conditions. Mr. Lipkin is a very well informed patient and a very persistent self-advocate and that is how he brought your name to my attention.

It is my understanding that since leaving U of R (where you doubtless knew my former mentor, Martin Trumbull) you established a clinic in Bangkok for radical psychosomatomic disorders. I was not able to locate any recent publications of yours on the subject, but Mr. Lipkin showed me your website, and since I know that you had excellent training, I am recommending Mr. Lipkin to your care with the strongest possible reservations. I refuse to believe that any such syndrome can exist. Notwithstanding Mr. Lipkin’s evaluation, I believe he is suffering from some kind of intellectual or cognitive (if not technically psychiatric) delusion. I do not believe that Mr. Lipkin is a good candidate for surgery of any kind.

Yours sincerely,

J. Lopez

Preliminary treatment plan

Patient: Martin Lipkin (Goal Identity: Martin Wilkinson)

Lead physician: Binpheloung Silpasuvan, M.D.

Agreed to and witnessed March 2, 2001

Mr. Lipkin (hereafter Mr. Wilkinson) has agreed to the following surgical procedures in order to achieve his stated goal of a new identity, “Martin Wilkinson,” an African American male, appearance determined through MorphTech software and certified as the final version by himself and Dr. Silpasuvan.

Mr. Wilkinson will receive subcutaneous injections of melanotomanine (afamelanotide sulfate) three times daily for one month, together with daily UV exposure sessions, to stimulate melanin production, beginning immediately.

Mr. Wilkinson will be scheduled for initial facial surgery in six weeks, assuming no contraindications from the above treatment. This surgery will involve alteration of the palatine and vomer bone structures and the addition of muscle mass to the orbicularis oris (upper and lower lips), as well as ordinary rhinoplasty with nostril augmentation. Recovery time from surgery is estimated to be one month.

Following successful recovery from facial surgery, Mr. Wilkinson will proceed with the “Real-Life” transitioning plan agreed to with Dr. Silpasuvan. This transition period may take up to four months.