Waking in what seemed like the middle of the night, I drew back the curtains to be greeted by a thick blanket of snow covering the car park of my East Midlands hotel. After a quick breakfast with Olive, my co-researcher, we took a taxi to the airport. We planned to travel to Poland on RyanAir alongside a small group of ‘cosmetic surgery tourists’ (CSTs). The airport was predictably chaotic – lots of rumors of cancellations, no actual information. Navigating the airport via texts with the Surrey-based agent who had arranged our trip and those of the other travelers, we finally met a patient, Janet, in the café. Janet was visibly nervous, monosyllabic and profoundly impervious to our best early morning efforts at charm. Her surgery – a facelift – was scheduled with Dr. J the day after tomorrow. She shook us off and headed for the bar.
In the queue we bumped into three more of our party. Two had been offered a taxi to Stansted (they had the VIP package) while a third, Lisa, was off to visit her partner Jason, whose surgery had not gone according to plan. Jason had experienced what the agent, on her Facebook page, was calling a ‘little bleed’ after a ‘tummy tuck’. It later transpired that he needed blood transfusions after his wound failed to heal.
We left the airport to search for any remaining public transport to Liverpool, meeting Janet on the way out. Her surgery had been cancelled, as arriving a day late would leave no time for pre-surgery tests. When we finally met him, Dr. J explained that these tests were vital as his patients from the UK often had undiagnosed underlying health problems such as high blood pressure or diabetes and couldn’t bring their medical records with them.
Janet was already transformed from her earlier meeting: friendly, immensely relieved, a little bit drunk but determined to re-book her surgery at a later date. It was now 7.30 am. After another night in a different airport hotel and a flight with Lisa at 6 am we arrived in Poland to be collected by Jack, our convivial English speaking driver. Clearly Jack excelled in putting nervous patients at ease and lightened our anxious ride to the hospital to drop Lisa. We met Jason for the first time, outside the main entrance, in a hospital gown, cheerfully smoking a cigarette in the snow.
It is easy to think about CST as a transaction between patient and doctor, but it is in fact a series of complex networks, incorporating: medical staff based in a clinic or hospital – permanently, or having flown in temporarily to work in rented hospital space; intermediaries (or agents) who are usually former patients, trailblazers who realize their intrepid surgical journeys can be capitalized by showing others the way; drivers or translators whose primary task is the emotional labor of making patients feel cared for in hospitals, hotels and apartments where recoveries are completed. Hoteliers and landlords, as well as airlines, local tourist attractions and shopping malls also benefit from these (albeit budget) surgical packages offered to CSTs.
Our patient-consumers are not rich, footloose, cosmopolitan global citizens, as some studies have suggested, but are ordinary people on modest incomes – taxi drivers, receptionists, sales assistants, hotel porters, nurses, prison officers – who cannot afford surgery in the private sector back home. They travel for facelifts, tummy tucks, breast augmentations and uplifts, body recontouring, liposuction, hair transplants and dental veneers.
They research surgeons and destinations thoroughly, a difficult task since surgeons’ qualifications can be baffling even to the initiated, and there is no independent register of how many times or how well a surgeon has performed a particular procedure. Patients are very aware of the ways in which websites can be manipulated, with rival clinics posting negative reviews for example (as per Trip Advisor).
The ‘clinical trails’ of CST patient consumers are onerous rites of passage in unfamiliar liminal spaces. Their transformations are anything but trite.