By Victor McConnell

When I relocated from Los Angeles to Denver, some of my physician competitors thought I was foolish. I opened my new clinic in Cherry Creek, fitting out the office with clouded glass, marble floors, hammered copper light fixtures, and every other top-of-the-line finish I could think of. Coming from Beverly Hills gave me a marketing advantage right off the bat—the rich suburbanites and the Cherry Creek locals all wanted to know how things were done out there, who I’d treated, and so on. I became a regular at the Denver bars with the wealthiest clientele and had a standing lunch reservation on Fridays at Hillstone; I even befriended a bartender there who, for a small kickback, would gently recommend that some of his regulars come see me. The divorced women in their forties and fifties were the best targets. My practice grew quickly enough that, within five years, I was in the process of setting up a satellite clinic in Aspen and was making plans to relocate there full-time before my fifty-fifth birthday. Five years there, I figured, then retire by sixty. 

I was thinking about that, the life I’d envisioned in Aspen, midway through my hearing in front of the Colorado Medical Board. I had a feeling they were going to revoke my license even before one of them asked me if I thought my actions were consistent with the Hippocratic Oath. Given that the guy who asked was one of the nine board members without an MD, I wanted to ask him what he knew about taking the oath.  

“Dr. Frenzel. Do you acknowledge that not all problems are medical in nature?” 

The woman who spoke, Dr. Lennard, was older, maybe sixty, and I couldn’t help thinking about how I could improve her look. She wore thick-framed glasses, though not thick enough to hide the wrinkles in the corners of her eyes or the bags beneath them. I’d give her a little dermal filler and some skin resurfacing to start, then a browlift and a blepharoplasty to deal with those sagging eyelids. Looking closer, I thought perhaps she’d done some work on her nose. I bet she would deny it. 

“Dr. Frenzel?” 

“I’m sorry,” I said, nodding. “Yes, of course, I agree with you that not all problems are medical in nature.” 

I didn’t really agree with her, and I mulled over adding a follow-up. I’d tell her that we’re a biological system and therefore all of our problems are biological, are they not? And what is the purpose of medicine if not to address biological problems? She might’ve responded that she was talking about God, implying that certain things are in His hands and His hands alone. Perhaps a half century ago, a 1960s medical board member would’ve said that. I didn’t think she would. She didn’t look particularly godly. Besides, in this day and age, even if she thought that, she wouldn’t say it. Medical boards and the physician community aren’t particularly kind to public acknowledgements of the divine, and my hearing would be public record. If she said that she meant some problems are psychological as opposed to physical, I would’ve just replied that psychological problems are tied to the brain, which is ultimately biology, too. Just a piece of meat that operates our body. She couldn’t refute that, could she? 

But I think what she meant was that some problems are just beyond our capabilities, or beyond the domain of medicine. And I didn’t want to debate morality with her, a half-retired doctor with a practice not half as successful as mine. I’d looked her up—along with the other sixteen board members—and it seemed she’d spent most of her career in surgical oncology, doing lumpectomies and mastectomies. Good for her. Bet she didn’t have a multi-year wait list like I did. 

The first day Suzanne came into my office in Cherry Creek, I knew there was a connection between us. She obviously had concerns about her appearance—why else would she be there—yet she stripped down without my asking and began pointing to different parts of her body, inquiring about various procedures. She wasn’t overweight but did have a little extra fat, like anyone, and I walked her through everything that could be done and how we could sequence it. Abdominoplasty, then liposuction, then a Brazilian butt lift, then a revision on the obviously mediocre breast augmentation someone had done on her three years prior, when she was twenty-nine. She seemed increasingly pleased as I rattled off the treatment protocol. Still naked, she started pointing at her face, and we talked about how to tweak her nose. I showed her my book of before and after rhinoplasty photos. I could tell she was impressed. 

“This woman said the surgery changed her life,” I said, pointing to a brunette whose nose I thought I’d slimmed out perfectly, giving her that angular, Roman look from what had been a bulbous behemoth, a thing simply far too wide for her face. “I fixed her nose and also gave her a perfectly proportional breast augmentation. She was promoted within six months after that. No one wants to acknowledge it, but we all know that physical appearance plays a role in our professional success. Not that I’m trying to take credit for her promotion.” I smiled. “And I’ll keep confidential what she said it did for her sex life.” I was a little past fifty, but I’d taken care of my own teeth and skin, and I knew I could still get a response when I smiled at a woman. 

She smiled back at me, and then our discussion meandered through some technical aspects of the surgeries—how I would approach them, what recovery time would be like. It wasn’t just the technical discussion, though. When we looked at each other, I think we both knew that this was the match we’d been looking for. If I’d been a painter, I would’ve called her my muse.  

“Thank you, Dr. Lennard,” said Dr. Michaels. Dr. Michaels was the Chair of the Board and an orthopedist. I thought him to be a kindred spirit. I knew he was twice divorced and had been in litigation with some former partners. I figured that he would see my perspective as a fellow high-powered surgeon who dealt with challenging cases. As the hearing proceeded, however, it became clear to me that he was like most orthopedists, looking down on plastic surgery as a lesser specialty. I wanted to tell him that fixing a bone so that it will work again is far less difficult than fixing a nose so that the world will approve of it. Functionality is, after all, several steps beneath aesthetics. 

“Dr. Frenzel, if you don’t have anything else to say about the first three patients we have covered, I would like to direct the Board’s attention to Patient D.”  

The Board sat in a semi-circle behind a curved mahogany desk. I sat alone about twenty feet from them, behind a smaller rectangular desk with matching wood. A microphone on a slender stand craned over before me. It reminded me of a praying mantis. 

“Dr. Frenzel, according to Patient D’s record, you performed the following procedures on her: abdominoplasty, liposuction, Brazilian butt lift, rhinoplasty, rhytidectomy, blepharoplasty, browlift, genioplasty, otoplasty, breast implant revision, as well as an array of more minor procedures, including Botox injections and dermal fillers, among others. These procedures were performed within a two-year period. Is this correct?” 

“Yes.” 

“Additionally, according to one of your former employees, you entered into a sexual relationship with Patient D during this period. Is this also correct?” 

While I chafed at my relationship with Suzanne being reduced to simply sex, I couldn’t deny it. Julie, my receptionist, recorded Suzanne and I having sex after hours in one of my exam rooms. In retrospect, I should’ve met Julie’s demands for a payoff. I thought her initial ask of $100,000 was a starting point—I didn’t think she’d go straight to the Board after I told her to go fuck herself. She should’ve known I was just playing hardball. And it was especially bad timing given that the Board was already reviewing three other patient complaints—minor ones that probably would’ve been resolved with a few emails and calls, some continuing education, if it weren’t for the situation with Suzanne. 

“Yes, that is also correct.” Before Dr. Michaels could go on, I continued. “However, I would like it noted that my relationship with Suzanne—er, Patient D—was entirely consensual. May I make a statement before you reach a conviction?” I stopped myself from calling their conviction predetermined. 

“Dr. Frenzel, this isn’t a trial. This is a professional hearing. We aren’t convicting you of anything. However, feel free to proceed with your statement if it is germane to the discussion of your treatment of Patient D.” 

“All right,” I said, “Thank you.” I glanced from board member to board member, making eye contact with each, trying to convey warmth, professionalism and charm. “Look, I understand that some of the members of this Board are not physicians. And, of the physicians on the Board, I believe that only one of you is in the plastic surgery business.” I noticed a couple of them look at one another, and I figured that I had impressed them with my level of preparation. “I take my work as seriously as any surgeon. Not only do I consider it an art form, but I believe, truly, that I am acting in the public interest. We all have a body, and we all exist in the world, do we not? And we want to pretend that our body is our own, but that simply isn’t the case. Your body may feel like your own in the sense that you feel as though you are inside of it, yet your experience is as much dependent on how the world interacts with you as it is with what is going on inside. What your body looks like to others is as real as any internal world, and I believe that the internal world cannot be separated from the external one, anyway. And I help patients change the way that the world perceives them, thereby changing the way they experience their body, their existence. My aim with Patient D was no different than any of my other patients—I simply hoped to improve her experience of her own existence. Is that so wrong?” I paused for a moment, letting my question weigh upon them. “And while I apologize for crossing a professional line with Patient D, I would note that when I initially did so she wasn’t under my active care. We were between procedures, and I had no assurance that she would return to me as a patient. It is true that I continued our relationship when she sought additional treatment. Furthermore, in the interest of transparency, I would like to inform the Board that Patient D and I remain in a committed, consensual, monogamous relationship. It may sound like hyperbole, but I worship her—and I believe she feels the same way toward me.” 

I sat down, feeling confident that I’d persuaded them. Dr. Lennard wore a tight smile, and I thought I detected a faint nod from Dr. Michaels. 

In retrospect, I can see that being fully transparent regarding my relationship with Suzanne was probably a mistake. The attorney I’d spoken with before the hearing had advised me as much, but I figured that the Board would understand if I explained myself clearly. I suspect that their decision to revoke my license reflected bias, as much as anything, though I couldn’t find an attorney that agreed with me and would pursue a lawsuit against the Board. 

Plastic surgeons aren’t held in particularly high regard—by the public or our fellow physicians. At least those of us who do elective procedures that our patients choose for aesthetic purposes. There are those out there who rebuild faces after accidents or treat children born with deformities. Those are the only plastic docs that people really respect. And I don’t begrudge them their status. I do, however, question who gets to define normalcy. When is facial surgery “necessary” to allow a patient to exist normally in society, and when is it an unnecessary modification driven by vanity? Aren’t both driven by vanity?  

And then the public—and other doctors—have their bias deepened by high profile disaster cases. Like the idiot in Florida who tried to perform a Brazilian butt lift but didn’t know what he was doing and killed his patient. Or the lady who livestreamed her operations online and was shocked when something went wrong and she was accused of being distracted during the procedure. Those folks lost their licenses, which I agree with. But I don’t see why I should be lumped in with them. Frankly, I think the women on the Board just disapproved of my relationship with a woman two decades younger, and the men were just jealous. People are petty. 

As for the three other patient complaints—as I said, they were minor. One was dissatisfied with the level of my post-op attention, and the two others both claimed that I had cajoled them into procedures that they were on the fence about and were now unhappy with. Honestly, I think those three would’ve blown over if it weren’t for the tape of Suzanne and me having sex. A part of me hoped that they would play the tape during the Board hearing—I hadn’t seen it but was confident that Suzanne and I would come off well, though I was concerned about the angle, as I didn’t know exactly where my receptionist had hidden the camera. 

They did wind up playing the tape at my trial a year or so later. We looked pretty good, I thought. I tried to discreetly glance around the courtroom to see how the women were reacting. The camera angle was from the side, with Suzanne leaning forward over the exam table and me behind her. I was glad I’d kept my shirt on, as from the side my stomach appears bigger than it really is. The courtroom was quiet after they played it. The prosecuting attorney moved on fairly quickly afterward, simply saying that the tape spoke for itself and represented incontrovertible evidence of me abusing my power as a physician. I figured he was probably prudish, or maybe I made him feel inadequate. He was explaining why I’d lost my license and was trying to paint me as a disgrace to the profession. It was true that losing my license had been a blow, yet while I didn’t want to say it during the trial, the surprising fact was that the year after I lost my license was one of the best times of my life, even if it eventually ended badly. 

Shortly after the Board ruled against me, I converted the mother-in-law suite above my garage to a small, private operating room. I had a former nurse, Nadine, who believed in what I was doing and was willing to help part-time as my assistant. She was a former patient, too—and, like most of my patients, I think she was happy with her outcome. And I knew she had feelings for me, but I didn’t know that she wouldn’t be able to handle rejection. After all, when she started assisting with procedures at my house, she was aware that I was in a relationship with Suzanne, and she also knew that Suzanne was to be my primary patient. I still gave Nadine regular Botox treatments and other minor procedures, of course, but Suzanne was the body I was working to perfect. Which is what Suzanne wanted—it was a mutual pursuit of perfection, really. 

I’ve never been naïve about the risks associated with unhappy patients. That is something that the public doesn’t fully appreciate, and I wish I’d mentioned it at my Board hearing. Like the plastic surgeon in Illinois who was killed in the 1990s by someone who wasn’t even a former patient. Just a crazy who was against the industry, believed it contributed to the downfall of the Aryan race or something. He apparently found the plastic surgeon with the biggest ad in the yellow pages and that was that. Or there was the murder/suicide a couple of decades ago in Seattle, a lady who had a facelift and wasn’t happy with it. A few months later, she killed her doctor and then went home and killed herself. I read a news article about it in the L.A. Times. The reporter interviewed her husband, who said he found her body and was haunted by the image of it, of her with part of her head blown off. I wondered what it was like to be the mortician, to try and prepare a wound like that if someone wants an open casket—probably a bit like plastic surgery. Maybe I should’ve gone that route after I lost my license. I thought about the disgruntled patients I’d had over the years, and I wanted to call the reporter and tell him that he should’ve interviewed some other plastic surgeons, because a story like that haunts all of us.  

Sculptors refine their work almost endlessly, do they not? Make it a little better and a little better until it is as close to perfection as they can get? That is what I told Nadine, Suzanne, and the handful of other people I treated during that period between losing my license and my trial. I testified that Suzanne once told me she might’ve killed herself without the surgeries I’d performed. I knew they’d critique me for inadequate psychological screening, so I tried to explain how thoroughly I’d interviewed her, how I’d been able to see that my skills were precisely what she needed. And if I stopped her from killing herself, how am I not helping, I asked, how did I not save a life? During trial prep, I also schooled my attorney on the false demonization of so-called elective plastic surgery in America. Half the women in South Korea have plastic surgery in their twenties, and the rates are about as high in Venezuela and Argentina. Doesn’t that show that this isn’t some American thing, and could it really be the case that half the women in these countries are wrong? And what about this whole notion of elective? Who gets to decide that? The attorney told me that he didn’t think the judge would wade into a debate about free will. I asked why not and he told me we should stick to discussing the facts of the case. I thought it was cowardly on his part, or perhaps the sign of a weak intellect, to be unwilling to venture into those philosophical grounds; if we hadn’t been so close to the trial, I would’ve gotten a new lawyer. 

The prosecuting attorney and the judge both seemed to think I felt no remorse for what happened. They clearly hadn’t understood that I truly loved Suzanne, even though I emphasized that when I was on the stand. 

We were doing a little liposuction touch-up, nothing major. To this day, I believe Nadine made the error, maybe even on purpose. She was always so jealous of my relationship with Suzanne. Anyway, after the surgery, Suzanne got a fat embolism—a complication none of my patients had ever had. We couldn’t avoid taking her to the hospital, and Nadine told them what happened. That is, she told them where the operation had occurred, that it was performed in a room above my garage. I wasn’t there when she said it. I’d gone back to my house in Cherry Creek for the night—it had been a long day, after all. 

When the police knocked on my door in the morning, I was confused. Suzanne was in serious condition, and I was worried about her, mostly. I don’t think I was in a state to speak with them, and I told them that she loved me and that she begged for me to do the procedures. One of the cops held up a warrant, so I didn’t even have a chance to destroy the video we’d made of the operation. 

I was lucky that she didn’t die, I guess. I don’t think the hospital treated her competently, but I know they would’ve blamed me if she hadn’t made it. While she was in critical condition, the police told me I was facing manslaughter. I would’ve thought that qualified as coercion, that it would mean my confession was given under duress and could be thrown out. My attorney said that wasn’t the case. 

Suzanne did pull through, but by then it was too late. They had the video, my confession, and Nadine’s testimony. They didn’t even make Suzanne testify. For months, I knew nothing about how she was doing—her family forced her to cut off contact with me. I’m sure that was as hard on her as it was on me. 

The judge gave me eighteen months, which is the maximum penalty in Colorado for practicing medicine without a license. The prison was minimum security, so I was surprised to find that they still used solitary confinement as punishment. I told the guard that solitary is considered torture and he told me to shut the fuck up if I knew what was good for me. 

A week in solitary for giving tattoos. I found it amusing. Not being in solitary, of course, which was grueling, but what I was being punished for. I could see that most of the prisoners around me had tattoos, and I didn’t see any of them being punished. Yet there I was, filling a need, a desire, improving people’s relationship with their bodies, helping them navigate their immediate environment, and I was the one in the wrong. I couldn’t help but see the parallel to my prior career. I tried to point out the irony to my fellow inmates after I’d gotten out of solitary. They didn’t seem to understand the insight. One of them just asked me about the biggest tits I’d ever put on a woman—a question I found quite offensive. 

Suzanne visited me once, about a month into my sentence. She didn’t seem happy to see me and immediately pointed at her face. 

“David, the lift you gave me, it’s wearing out.” 

I told her she still looked beautiful. I was a little peeved, to be honest, as she seemed to be doubting the quality of my work. I had told her it would last for at least five years and it had only been three. 

“Suzanne,” I said, “don’t worry. I’ll be out of here in eighteen months and I can help you then.” 

She shook her head. “I just wanted to tell you in person, David. I met with another plastic surgeon this week, and he says he can help me. If I wait for you to get out, it will be ruined.” 

“Suzanne,” I said, “what about us?” 

She looked a little confused. “David, we had something good there for a while, we did. But it’s over. You can’t help me anymore.” 

The visitation room felt like a bus terminal. Fluorescent lights, rows of plastic chairs attached to metal frames, fixed to the floor. The linoleum tile was startlingly clean, and if you stripped out the chairs and brought in some better lighting, it could be an operating room. Suzanne was already standing up, signaling the end of our visit. I wondered about her new plastic surgeon. I imagined her undressing before him, him inspecting her body, pinching and examining all the work I’d done on her. I expected he would be impressed, maybe even intimidated, trying to follow in my footsteps. 

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Victor McConnell grew up in a small town in Texas and graduated from Dartmouth’s creative writing program in 2004. After a year in a wheelchair in 2005 and a long, mostly dormant period from 2010-2019, he resumed writing fiction and poetry in 2020. His work has been nominated for a Pushcart Prize and has appeared in a variety of literary journals, such as the Los Angeles Review, New Ohio Review, Dogwood Literary Journal, and Driftwood Press, among others. His first book, a collection of short stories titled WHEN EVEN THE BONES HAVE THINNED, is scheduled for publication in 2026 with Hidden River Press. He has a 14-year-old son and lives in Golden, Colorado. More of his work can be found at https://www.victormcconnellauthor.com/.