TURIA PITT: 'The never-ending road of surgeries to rebuild my burnt nose.'

This is an edited extract from Selfish by Turia Pitt (RRP $36.99, Penguin Random House Australia). Available on October 7 from retailers, as an eBook and audiobook.

I want to open this chapter by telling you a story about something very specific. My nose.

It was burned when I was burned. The cartilage in our noses give them their shape, but my cartilage was burned off, therefore my nose didn't have a shape.

That also meant it didn't work effectively, so I breathed mainly through my mouth.

In 2014, I had a nose reconstruction. How do surgeons make a nose? Well, mine made it out of some tissue and skin from my forehead – a 'flap' in surgeon speak.

This wasn't straightforward and involved a series of procedures and operations.

The first procedure was what's called a 'delay'. It's called a delay because it involves intentionally delaying the transfer of tissue flap to its new location. For me, my surgeon cut into the flap on my forehead above my left eye.

This cut makes the body go, holy sh**, okay, team, we need to get more blood flowing in the flap. Burned tissue is compromised tissue; it doesn't have the same blood vessels as it used to.

Watch: Addressing needle phobia before surgery. Post continues after video.

It's thinner, not elastic, stiffer and scarred. It's not great material for a surgeon to be working with. After the first operation, my surgeon was worried about blood supply to the flap. Because if the flap didn't have a good strong blood supply, didn't have blood flow, then it would shrivel up, fall off my face and die.

He was so worried about the blood supply to the flap that I had a second delay a couple of weeks later. Like, let's make sure that flap is nice and juicy and bloody.

After the second delay came the big op, where they take the flap – the chunk of tissue and skin from my forehead – and they twist down that chunk, and they stitch it where your nose should be.

So I spent three weeks with my forehead on my nose and it's not an experience I'd like to repeat anytime soon.

Then you have to have another operation in which the surgeon cuts the connection to the forehead, keeps the bit that's there on the nose, then puts the forehead bit back to where it was.

The result is a chunk of tissue on the nose, which came from the forehead. My surgeon calls it 'robbing Peter to pay Paul' – because you can't conjure tissue out of thin air.

It has to come from somewhere.

And for me, they made my nose out of the tissue on my forehead. But you can't replace that bit of tissue on the forehead because, like I said, the tissue has to come from somewhere.

The thinking is that you don't notice someone with a forehead that's a bit thinner on one side, but you sure as f*** notice someone with no nose.

That was four operations in total, and I'll be forever grateful to my surgeon, who had the skills and the willingness to make me a new nose. Since then, I've had a couple more operations to make my nose look better.

I've had fat injected into my face to make it more pliable; I've had rounds of surgery with a CO 2 laser; I've had a bit of my ear taken off to be put into my nose.

And every stage and every operation has resulted in my nose looking better and functioning better. Yay. But. I want it to be even better. I want to be able to breathe better, for sure. But I also want it to look better.

So I've ended up seeing a lot of surgeons about my nose. Most of them tell me something along the lines of… 'Wait, what about blood supply? We won't have blood supply to the flap if we operate!

I don't think I'm the right person for this job. It's not my wheelhouse. What about if you see Dr Nose?'

So I'll book in to see Dr Nose, which will mean several months of waiting, and then I'll see Dr Nose and they'll say, 'This isn't my wheelhouse. Why don't you go see Dr Nostril?'

And so on and so on and so on.

It takes time, money and energy, plus the emotional investment of building myself up before a consult. Smile, be friendly, ask smart questions, look nice, look presentable, be palatable, be f***ing hopeful.

And what normally happens is the surgeon takes a baseball bat and smashes my Hope Palace to the ground. Like the time I saw (yet another) surgeon in Sydney and I hopefully asked if I should make another appointment with him in a year, in case between now and then there were advancements in medical technology, and he threw his hands up and said, 'What for? It can't be done.'

So I cry and sob, and I say to myself, F*** it, that's it. I'm giving up, I'm sick of spending time and money and my energy on these consults and getting my hopes up for nothing.

But then a bit of hope flickers up again. So I do more research, send more emails, make more appointments and the cycle restarts.

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The operation I'm about to tell you about started with me sending another email, in another burst of hope, to a nose reconstruction expert in the US. He was retired. He recommended two doctors. One of them never replied to me, but the other one did.

He was a surgeon working out of the Johns Hopkins Hospital in Baltimore. No, he couldn't do a consult over FaceTime, I'd have to go see him in person.

So I booked the appointment. I booked the consult. It was in three weeks.

Caring for yourself.

What I've believed to be true about self-care, that it's spas and bubble baths, isn't the whole story.

Self-care was first a term used by the medical community in the 1950s as a way to encourage patients to exercise healthy habits. In the 1970s it was adopted by the Black Panther Party in the US, who recognised that taking care of your physical and mental health was essential for survival and resistance.

In the 1980s activist and author Audre Lorde used these words in one of her essays:

'Caring for myself is not self-indulgence, is it self-preservation, and that is an act of political warfare'. I think back to what I learned from my chat with Mirna Valerio. That rest, sleep and stillness are self-preservation, and self-perseveration is self-care.

Lorde's quote was written in the context of her social justice work, where burnout is prevalent, and for her self-care was used as way of defiance and resistance, particularly for marginalised groups. I find the history of self-care so f***ing powerful.

That's what it's been about all along. Why don't more people know this?

Maybe because self-care has been adopted by capitalism. Because when I think self-care, I honestly think of the website Goop. Gwyneth Paltrow and her team are obviously extremely good marketers.

I jump onto Goop to see what it has to say about self-care. Deep in their catalogue, I see there's a Skyview Wellness Table Lamp on sale for US$999.

I click on it and read the product description. By the time I get to the end of the description I'm convinced that this lamp could help me. After all, it cycles through lighting modes designed to provide optimal circadian stimulus.

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I remember I can get this same effect by having my morning coffee on the balcony in the sun.

There's also a product called a Rainbow Mat for $1999. It's filled with precious gemstones that slowly heat up as you lie on it. In the photos it looks like… a rainbow-coloured yoga mat.

It's like rampant consumerism has wrapped itself in a self-care cloak, telling you that yes we can help you to self-care; first, please give us your credit card details.

Though this brand of self-care was what I believed to be what self-care was, it doesn't make me feel whole. It feels exhausting; it feels ludicrously expensive; it feels like another item to do; it feels like another way I don't measure up… to who?

To no one in particular; I just feel like I'm inadequate. As well as cooking our family nourishing meals and clothing them and dropping them off at sports, do we now have to complete an eight-step skincare system (self-care!), meditate daily (self-care!), and do five gym sessions (self-care!)?

I love exercise. I love moving my body and sweating, and all the feelings that come with it – pride, strength, belief in my capabilities. What I don't like is how exercise has been tainted by diet culture and beauty culture, and is another way to make us feel bad about ourselves.

I also don't like how unattainable some forms of self-care can seem. Especially if our idea of self-care comes from Goop, or TikTok, where we see 20-year-olds taking two hours to do their morning routine.

And I remember an influencer's post in which she talked about how amazing it was having a spa day and getting treatment after treatment; how good it was to do self-care like that. This influencer got roasted.

People said that they'd also like a spa day, but they were busy working to pay the mortgage, and they had no support, so even if they could afford a spa day, there was no one they could ask to look after their kids anyway.

I think maybe suggesting people self-care could be like throwing a glass of water on a house fire. I'm sure giving people a liveable wage, making childcare free, having more support at home would help more than putting on a face mask.

Having said all of that, I also know that there are things we can do to take care of ourselves. Because ultimately that's what self-care is, right? Taking care of ourselves.

Drink more water. Drink less alcohol. Spend time in nature. Leave your phone at home, move your body, spend time with people whose company you enjoy, eat a home-cooked meal. Walk in a park. Deep breathing.

I've had operations before, so at the hospital the following day I kind of know what's going to happen. The doctors will come in, they'll look at my arms and be puzzled because they won't be able to see a vein because of my scarring.

I'll ask them to get an ultrasound, and also some nitrous oxide, because I always find the process of getting a canular in so traumatic, it's honestly the worst part of the operation for me – even writing this I can feel my heart beating faster.

I'll be crying by the time I'm on the operating bed, silent tears, but everyone in the operating room will know what's wrong, they'll know I'm just scared, and someone will come and hold my hand. I'll be seized by a desire to scream 'DO YOU KNOW WHAT YOU'RE DOING? Do you know I'm a mum to two of the most incredible boys to ever have been born?

Do you know I'm a busy person, and I love bushwalking, and writing, and I have a spunky partner, and I used to be an engineer and I'm not just a patient, I'm Turia?'

But I know I'm in a room of professionals, and this is their job, and they do know what they're doing. The anaesthetist will tell me that they're putting me to sleep now, and I'll try to count to ten, but will be knocked out before I get to six.

I'll wake up in recovery and my face and body will hurt. I'll be tired and sore. The nurses will have a little plastic cup of apple juice for me. It will be hard keeping my eyes open so I'll fall asleep again.

One of the medical team will ask me how I'm feeling and how much pain I'm in from one to ten. (I always say seven for some reason.) I'll ask for water and they'll sit me up and they'll ask if I want some of the juice and I'll nod my head but I'll throw up after taking a tiny sip and I'll fall asleep again.

I'll continue this pattern for hours. So thirsty but when I take a sip of water I throw up.

I'll have a hospital meal, probably cold scrambled eggs with a packet of cornflakes and a small milk. Everything's in packets in hospital.

Like aeroplane food. I'll look outthe window at the sun filtering in and I know it will be night-time back home. I'll grab my phone and text my love. 'SUCCESS!' I will say. He will write back, 'No way! So proud of you darl. Everything all good at home. We love you. I'll speak to you in the morning.'

And that's exactly what happens.

Selfish by Turia Pitt. Image: Supplied.

Feature Image: Supplied.