I was born missing an ear. What followed was years of well-intentioned violence from a medical system bent on solving the “problem” of my body. In total, I underwent fourteen surgeries to create the appearance of an outer ear. After the first five surgeries in my hometown of Kingston, Ontario, failed, my plastic surgeon referred me to the Hospital for Sick Children in Toronto, where the new plan was to use my own skin and cartilage, as opposed to synthetic implants, to create the simulacrum of an ear.
O ne morning when I was seven years old, my mother stood in the doorway of my bedroom.
“Wake up, Bunny, we’re going up to Toronto today. Operation time.”
I closed my eyes quickly. If I was still asleep, I wouldn’t have to listen to her.
“Kate, come on, time to get up.”
I kept my eyes closed. She had warned me this was going to happen, that one day we’d be going up to Toronto. She never told me my operation dates, because she didn’t want me to spend weeks worrying about them. This kindness also meant the announcement that I was about to have an operation felt unreal, like a bad dream. It had been almost a year since my last surgery. I was getting used to being a kid who didn’t get cut into.
“Kate, come on,” she said, tapping her fingernails on the wood of the door.
I opened my eyes. “But I can’t go today. We’re making candy apples at school.”
“No, Bunny, you’ll have to miss that. Today we’re going up to Toronto.”
“But I told Elena I’d teach her how to make paper frogs at recess today—I have to go, we made plans.”
“Elena will understand. You can play with her when you get home.”
“Does Dad know about this?” I sat up and shouted toward the hall. “Dad?”
Mom sighed. That’s when I knew it was real. “You can bring a toy if you like,” she said.
T he only toy I could think to bring was my Puffalump, Jim: a feather-light stuffed dog made of teal parachute material. He had a large pink gumball nose and kind blue-threaded eyes. His marshmallow arms were much bigger than mine, and he gave the best hugs.
Jim became my comrade for many operations to come—he’d accompany me into every operating room in Toronto and be lying beside me in every recovery room I woke up in.
When I find Jim in my parents’ basement many years later, he’ll be under a pile of old blankets, the weight of which will have flattened and condensed his innards. He’ll look worn out, the parachute material hanging loose and wrinkled. He’ll be smaller than I remembered. His eyes will seem vacant and cartoonish. An outline of translucent brown will stain his right arm and part of his belly. Iodine maybe? Vomit? Blood? His belly will be torn, his left leg attached by mere threads. A medical bracelet, an exact copy of the ones I wore on my wrists in Toronto, will still circle his right arm. The blue writing will have bled into blotches, making the words unreadable.
M om and I always took the train to Toronto. She felt it added a touch of fancy, a nice distraction from what was to come. On the train, with Mom beside me and Jim on my lap, I’d stare at the pattern on the back of the seat in front of me, wishing I could escape into this world of paisley. Slide down slopes of red petals, dance in swirls of orange, skip along scalloped purple edges. In the world of paisley, everything would smell like butterscotch, and when you licked the red petals, they would taste like strawberry suckers. When you twirled in the swirls, you could make yourself disappear completely.
Before signing into the hospital, we’d stop in at Lime Rickey’s in the Eaton Centre for a hot-fudge sundae. The fudge would melt the ice cream into a delicious soup, and for a moment, I would forget the dread filling up in my body. My mom always gave me her cherry.
After the sundae, she’d give me a little present. Once, it was white pajamas with pale pink trim to wear in the hospital. They made me feel light and slippery and important. Another time, it was pink glittery jelly shoes. They blistered my skin, but when I looked down at them, twinkling along the muted grey hospital floor, I felt their magic.
After Lime Rickey’s, we’d head over to University Avenue and walk north toward the blue-and-white sign. “The Hospital for Sick Children.” The name always confused me. I never felt sick going into this place; I only felt sick when I left.
I sat on the hospital bed with Jim, watching my mother pull a sheet over the cot she’d sleep on during my stay. As she slipped her pillow into its case, three men appeared at the door.
“Hello, Katharine!” one of the men said. “How are ya?”
“Fine,” I said, feeling suddenly shy. He said my name like we were friends, but none of my real friends called me Katharine.
“Welcome to Sick Kids.”
I didn’t know yet that this was the nickname for the hospital, so his words hit me more like a warning than a welcoming.
“Not much of a talker, are you?” he said when I didn’t respond. “I’m going to be your surgeon. Remember? I’ll be making you the ear.”
I did have a vague memory of meeting him the year before, after the plastic ear was removed, but I’d met so many doctors that their faces all blurred together.
He came in closer, pulled out his hand for me to shake. “Put ’er there, kid.” I placed a limp hand in his, and he squeezed it, jiggled it, and let go. My hand fell to my side like a dead squid.
“Not much of a grip there, eh?” He laughed, and I noticed the deep half-moon lines carved under his eyes and around his mouth. I noticed the three puffs of hair sticking out from the top of his head. He looked a little like a barefaced clown. He was a small man, but there was something big about him. An energy. Like people should clap after he spoke.
“So, let’s take a look at things.” The surgeon pulled my hair back and pushed into the side of my head like it was a hard lump of clay. I looked to my mom. She was leaning against the metal dresser, where my nightgowns now rested. Her arms were crossed tightly. She nodded at me as if to say everything would be okay.
It didn’t feel okay.
“Stay still, dear,” he said as I tried to pull my head away from him. He turned to the other men. “She’s already had synthetic implants, but they were rejected.”
The men nodded. I mulled over the word synthetic.
“So, first we’re going to insert a tissue expander here to stretch out the skin for a couple of months.” He reached into his front pocket, took out a pen with the cap still on, and made invisible roads on the side of my head. I could tell by how the pen scraped my skin that the cap had been lightly chewed.
“And then”—he brought his pen down to my lower chest—“we’ll take cartilage from the rib cage. Here, feel, the ribs are pretty soft.”
He pulled up my shirt and motioned to his men to come closer. They each took turns pushing into my bottom ribs. I could feel the cartilage bend to their touch. I could feel the bone curve into my guts. I wanted to curl into myself, turn into a ball like an armadillo.
My surgeon continued to talk, explaining his plans to his men. They nodded and wrote things down on clipboards. When he was finished, he patted me softly on the back. “We’ll see you tomorrow, kid.”
The group of men straightened and walked to the door. My surgeon turned back. “Oh, and just so you know, my patients call me Uncle Louie.” He winked and slipped the pen back into his front pocket, its roads still blazing on my skin.
I would get to know this man well in the years that followed. He was a man who could twist my stomach into knots just by entering the room, a man who tried his best to relate to me through bad jokes and kid jargon. A man of good intentions, who wanted only to build me the best ear he could. A man who, despite his efforts at kindness, was still the man who sliced into me while I was asleep.
With Uncle Louie, I became two bodies: the one I experienced and the one he measured. The one I experienced flushed pink when excited, nerve endings shining. It knew the interplay of skin and sun. The warmth, the tingling. The one he measured was skin that split easily. It was trails of sewn flesh mapping the damaged bits. The one I experienced made puppets of its fingers, mouths of its knees. It hummed songs it didn’t quite know the lyrics to, feeling the purr in its face. The one he measured was arms and legs flailing and stiffening. The thump on the examination table. The slack of the upper lip in the operating room.
T he man at my back pushed the stretcher forward. The wheels rumbled and screeched below me. I held Jim tight, making his head bulge with stuffing. My mom had explained that Uncle Louie and his team were going to be inserting a balloon in the side of my head. She’d tried to make it sound fun, like a birthday balloon. I knew it wasn’t going to be like that.
We reached the elevator, and my mom started talking to the man at my back. Her voice was squeaky and weird, like she was a cartoon. She asked him if he’d had a busy day, and he said yes, lots of surgeries today. The elevator dropped down and down, and it felt like there was a marble rolling around in my guts. The elevator doors opened. The hallway was white but dark, like the shadows in the corners were bleeding. I looked to my mother. I wanted to tell her not to leave, even though I knew she couldn’t stay with me for much longer. The man kept pushing me forward, and the doors at the end of the hall came at me too fast. After these doors would be other doors. Then the green people, the masks, the needles, the rubber hands, the machines, the wires.
I reached for my mom’s hand and squeezed it, hoping to squeeze out a little more time. The stretcher stopped. All right then, Bunny, we’ll see you very soon, she said. Her smile was too big, like it’d been drawn with a fat red crayon. I wanted to say no. I wanted to say it very loud. But I didn’t. A snap, she said, it’ll be over in a snap. She always said that. I didn’t let go of her hand. Okay, Bunny. She pulled her hand away. Okay, she said one more time and then turned around. I watched the back of her as she walked to the elevator. She moved away quickly and didn’t look back.
“I t wasn’t like that,” my mother says when, years after the surgeries end, I ask her why she was always cheery when walking me down to the operating room. “I was so scared and I didn’t want to make you scared. I wanted to make it feel okay.”
“It didn’t feel okay,” I say.
“I know. It didn’t feel okay for me either. After I’d leave you, I’d run to the closest bathroom, turn on the tap, and cry.”
“I didn’t know that.”
I picture her in a grey-toned bathroom, collapsing over a sink. I picture her tears mingling with the tap water—salt with fresh—and I realize something: These surgeries happened to her too.
O ne time, between operations, my friend Lindsey and I played “hospital.” Since I was older, I got to be the doctor and she had to be the patient. The game was fun at first. I pretended to listen to her heart and she mimicked a heartbeat that sounded more like a frog. We laughed. I took her temperature with a popsicle stick.
“Yes, you are very sick,” I said. “You need an operation.”
I put her on the operating table (a towel on my bedroom floor). She giggled.
“No moving!” I said.
She started swaying her arms.
“I mean it, you have to be very still, or I’ll have to give you a needle.”
This made her laugh, and suddenly I was furious. Didn’t she know she wasn’t supposed to move in an operating room? Operating rooms were not funny. I stormed out of my bedroom and down the hall to the kitchen, where I found a syringe in the drawer where we kept old keys and elastics. It wasn’t a syringe with a needle on the end; it was a hollow tube that was given to me once to measure out liquid medicine after an operation. I held it under the tap and pulled back the plunger to fill the syringe with water. It looked enough like a real needle that I knew Lindsey wouldn’t know the difference. It was important that she understood the seriousness of an operation.
I marched back to my room. Lindsey was still on the operating table but had grabbed two My Little Ponies that were now galloping across her stomach.
I showed her the syringe. “I’m sorry, Lindsey, I’m going to have to give you a needle to put you to sleep.”
As I’d predicted, she didn’t notice that there was no needle attached. Her smile dropped and her bottom lip quivered. “No, I don’t want a needle!”
“I’m sorry, you have to have it. You don’t have a choice.”
She scrambled to stand up. I could see the tears rolling down her pink cheeks.
“Don’t be a baby!” I yelled as she bolted out of my bedroom, down the hall, and out the front door.
T he wound was closed with vertical mattress prolene sutures and topical antibiotic applied. The patient was then resuscitated and taken to the recovery room. It’s the word resuscitated that stops my breath years later when I read my medical records. General anaesthetization, I later learn, is akin to a medically induced coma. Patients are unable to breathe on their own or regulate their own heart rate. Brain activity drops significantly.
It never felt like sleep, more like a blinking in and out of existence. No dreams, just blank.
“Every time you have a general anesthetic,” writes Kate Cole-Adams in her book Anesthesia, “you take a trip towards death and back.”
In the operating room, I was nowhere. Only a body remained. There are stories it knows that I never will.
Excerpted with permission from It Must Be Beautiful to Be Finished: A Memoir of My Body by Kate Gies, published by Scribner Canada, an imprint of Simon and Schuster Canada. Copyright © 2025. All rights reserved.
