Scars

Very few people know that if you cut the skin of a baby early enough before birth, amazingly, he/she can often heal without a scar. Wouldn’t you like to have that kind of ability, to heal your wounds without scars! Many other things actually are also very exciting and novel about the baby scars and healing before birth. Two are just shocking.

First, huge holes in the heart exist normally to facilitate blood flows, for the baby during the fetal period, but they magically close and seal after the baby is born, in the immediate newborn period. Just like scar healing, without scars. Among hundreds of other huge changes in the body, blood flows after birth suddenly become totally different, and dramatically change directions, pressures and volumes: astonishingly, there are then no more holes in the heart. All healed.

Second, embryonic stem cells, sort of the baby of baby cells, have the super-magical ability to form all kinds of new cells in the body, with totally different functions. They are now touted as a dramatic inspiration for “adult stem cells,” adult cells being made to “revert” to be like these baby cells, in order to use them to heal many diseases, by their creation of specific fresh new tissues to replace diseased ones. Poetically, like healing without scars, without a trace.

Personally, I have spent my academic life in the events surrounding early life, and I am in awe of the amazing abilities of so-called “immature” organs to totally outperform so-called “mature” organs! Most people call early-life organs as “immature,” but I like to teach my medical students and residents that actually they should be described as “perfect” for the stage of life that they are in, simply developing in different ways at different stages of life.

Photos 1 & 2: I like little scars, enough to remind me of the beauty and artistry of healing, but not enough to scar me for life.

Indeed, we all know the amazing ability of young children to pick up fluently all kinds of languages, much, much better than adults, even as we call their brain as “developing immature brain.” Just watch the new immigrant’s young child pick up the local English language fluently in one year, compared to the impossibility of their adult parents to ever speak as fluently. And the child might be able to speak 3 or more languages fluently if the parents and grandparents have other different native languages, and they just talk naturally to the child; it “just happens.”

To be provocative, I could even legitimately say that many functions and capabilities of our organs actually may go downhill after the fetal, baby or childhood phases! Like the smooth, seamless, painless healing function of a fetal scar, healing completely without a trace, an ability that is seemingly lost later. I like to say the newborn baby skin can be even considered some form of idealized “reference standard,” essentially closer even to “perfection.” For example, wouldn’t it be wonderful if we had all that kind of perfect unscarred skin, all our lives!

In the rest of life, scars can indeed be ugly. We understand instinctively why people always like to cover up their scars, even if they are not wearing bikinis. I have personally had enough scars in my life, from accidents and surgeries. I had a scar above my left eyebrow from a fall in childhood, but I bore that scar proudly as a young man, in a macho kind of way. Boys will be boys, and scars proved it, I figured.

I had an appendix operation scar however which I did not like, because there were so many ugly needle holes in the rather unsightly scar. However, in both my forehead and my appendix scars, I noticed that, over half a century later, they actually very gradually started fading, and now, at my late age, I can only vaguely see the scars, to my surprise! Then I realized my wife’s surgical scars from her 2 ovarian cancer operations, step-by-step very slowly also fading, an unexpected blessing of long advancing years, I suppose! I don’t remember being taught that scars actually being diminished, given lots of time, but we are quite happy about that.

However, I feel sorry for the person who develops keloids, which are the truly unsightly overproduction of scars. The bothersome problem is that surgery to remove the scars can produce worse keloid scars. And sometimes these keloids can really look rather angry.

The average doctor actually doesn’t tell you much of what happens to your wounds and scars. You just have to deal with those so-called “minor secondary issues” yourself. My wife had a relatively “simple operation” to place a “port” in her large vein system to give her cancer chemotherapy. It wasn’t explained that the scar would be quite large, could get tangled up with fibrous tissue, and removing the port was not simple, sometimes even requiring a “minor” operation. Indeed, for her, removal was painful, and left a bad puckered scar for years. Scars usually are just not pleasant.

I remember vividly being trained in surgery by very careful surgeons at the eminent Queen Mary Hospital, of the University of Hong Kong School of Medicine, at a time when I was focused on a career in surgery. These “artistic” surgeons liked to close their wounds with very fine thin sutures, basically under the skin, with no skin needle holes needed. There were practically no visible signs of the sutures at all, and the wounds closed themselves gently with minimal scarring.

These doctors cared not only for the “primary” surgery, the main organs they were treating, but also for the “secondary” appearance and well-being of the patient. I wish all surgeons were trained like that, skins would be a lot more beautiful! Indeed, I have a feeling that scars were meant to heal well, even beautifully, if we just learn to be more delicate and deliberate, and surgeons had more time and patience.

After all, the healing process itself is indeed amazingly complex and artistically beautiful. It is definitely not just stitching up a wound with lots of sutures. Thousands of actions have to take place in a highly organized, even artistic, concert of movements, chemicals, and electrical functions. That these “natural” responses could happen without any human guidance is just another one of those things we take for granted and easily forget about. Without these complex, truly creative, functions that occur “naturally,” frankly there would not be any healing of wounds. Oddly enough, the outward scar is just one small part of the healing, like a visible signature of what is happening invisibly underneath the skin.

I am immensely touched and impressed by cosmetic surgeons who work on burn patients, so gently and so expertly. Scars related to burns are among the most awful kinds of scars for anyone to face, for patients, family, and even nurses and doctors. We once came to know a child well, from Chongqing, China, who traveled thousands of miles to Cincinnati to be treated at the world-famous Shriners Burns Hospital, and who required ultimately dozens of surgeries in order to treat the extensive burns over nearly all her body. It was amazing to see her grow up as a relatively “normal child,” who did not have to hide herself from society, to basically live a new life in Cincinnati. Her God-loving new family who tenderly cared for her throughout her many operations, and fully adopted her, completed the scar healing process to a remarkable degree. A touching love story for those who were privileged to know them, including many pediatric scholars from China.

Most people are only familiar with plastic surgeons or cosmetic surgeons who make rich people look pretty, but there are also many who are involved in the beautiful work of correcting congenital deformities and disfiguring face and skin conditions. As a baby doctor, I had the chance to see what great creative skills it took, to allow some less fortunate babies to have a chance to look normal and pretty, to avoid a life of misery and discrimination. These are some of the best doctors who try to leave minimal scars, even those related to their own surgery! They truly have to take meticulous pains and care, to make sure each action, each stitch, at the right location is accurately and precisely made, for the best and most beautiful result.

And, just as physical scars seem to get better after long periods, even emotional scars might sometimes get better, over long periods. I just heard the horrible story of a twin Jewish girl who suffered cruelly in Auschwitz, as an experiment in the evil hands of the notorious Doctor Mengle. To her own surprise, in her very old age she was ultimately able to forgive her tormentors. Corrie Ten Boom, whom I have written about, (see Reggiestales.org), traveled extensively to speak about God’s love, in spite of experiencing hell on earth in Nazi concentration camps. In a dramatic moment of meeting her former camp guard face to face, she suddenly felt God filling her with His love, to forgive even a cruel Nazi tormentor. Deep scars need deep healing.

Photos 3 & 4: Ahh the baby, whose skin is perfect, unscarred and beautiful. We wish we all had her skin. By permission of Eliana Joy, Ben and Olivia Waters.

I suspect most people dream of an idealized place with no scars at all, where everybody looks pretty, where all skin features are smooth, not dimpled, not rough, and certainly without a single scar anywhere. Actually, as we started this story, the newborn baby exhibits many of these dream situations that we would like to have. The skin of a newborn baby is just that beautiful, and if you carefully touch the skin, you will be shocked how soft, smooth, and gentle it feels. Even baby hair has such a great gentle texture to it. That’s a lot to do with why grandparents, unwittingly, fall head over heels in love with their brand-new grandchild!

As a newborn baby doctor, I can attest full-heartedly that the baby, especially her skin, is indeed such a joy to behold, and I feel, a great hint of what a fully restored human being could be like, in that final land of innocence and no scars! After all, the greatest Teacher even said famously, to enter into the kingdom of heaven, you have to be “like a child,” to have a “new birth.” Words that make a newborn baby specialist beam with pleasure and satisfaction!

But wait, there is one individual in all of history whose dramatic scars have radically made history, changed history, and impacted the personal history of one third of the world’s population. That person was scarred from beatings, tortures, and a crown of thorns. His wounds and scars are depicted in pictures and paintings over the world, as signature of his supreme love for all. Enabling all to be healed of deep scars, presently and in that place of no scars.

Photo 5: The scars that removed our scars. According to medical journals the nail was likely in the wrist, and not the palm of the hand, to not tear through it.

Sources

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