Afterword

I confess that although I have written many forewords, this is my first afterword. Dr. Jeffrey Weinzweig has honored me by
having asked me to provide this epilogue. He has taken a chance because he does not know what an editor, used to having
the last word, might say.
My first comment is that this is a brilliantly conceived and much needed excellent book that admirably fulfills all its
objectives and would have pleased even, or especially, Socrates, whom Dr. Weinzweig cited in his preface to the first edition.
He could have entitled this Everything You Wanted to Know about Plastic Surgery but Didn’t Know or Were Too Afraid to Ask.
One might enter into an abstruse argument about what constitutes “plastic surgery secrets.” Are they facts, as the contents
of this book implies? Pertinent is the observation by Samuel M. Crothers (1857–1927), an American Unitarian Universalist
minister and essayist, who lived in Cambridge, Massachusetts (The Gentle Reader, 1903): “The trouble with facts is that there
are so many of them.” Certainly, after the appearance of this second edition, there are now more facts in plastic surgery than
there are secrets.
Gertrude Stein might have said but did not: “A secret to be a secret must remain a secret.” Advances in medicine and in
the care of the patient depend upon scientists and doctors not withholding information, that is, not keeping secrets, except for
respecting the confidentiality of the patient.
A major benefit of this electronic age has caused the cliché to come true: “Everything is an open book.”
Praise is due to Dr. Weinzweig, the contributors, and the publishers for educating not just medical students and residents,
those who might be asked questions on rounds or on exams, but all plastic surgeons, who can always benefit from more
knowledge; certainly, their patients will.
I must register an obvious caveat: questions with answers, facts and secrets revealed do not guarantee “successful plastic
surgery.” An essential determinant is the personality of the patient and the plastic surgeon. One would hope that the plastic
surgeon would be ethical, psychologically astute, compassionate, competent, judicious, and always committed to placing the
needs of the patient above his or her own, acting according to what is best for the patient and not convenient or remunerative
for the plastic surgeon.
Facts, however, are the necessary equipment of a good doctor–surgeon–plastic surgeon. They constitute the basis of
knowledge but they are not the same as knowledge, which is not the same as wisdom, nor is it the same as a discerning eye
and a responsive soul.
Worn by repetition but valid still is the secret enunciated by the early twentieth century Boston physician, Francis W. Peabody
(1881–1927) (The Care of The Patient, The Journal of The American Medical Association; Vol 88, March 19,1927): “the secret of
the care of the patient is in caring for the patient.”
Too frequently omitted is this equally important quote: “The treatment of a disease may be entirely impersonal; the care of
a patient must be completely personal.”
And that is a fact to remember and a secret to share.
Robert M. Goldwyn, MD
Clinical Professor of Surgery
Harvard Medical School
Boston, Massachusetts

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