Prufrock's picture of twilight as a sort of anesthetic atmosphere, a drugged calm on the cutting edge of night, invites a comparison between the defining malaise of "modernism" and the affective disruptions of modern medicine. The non-sense of dusk as sky set for surgery, and of night, by extension, as darkness riven only by a slicing curve of moon, the confusion, in other words, of ether with ether--of pure, weightless air with sweet, stifling fume--not only records the poem's moment as the modern moment, but also invokes medicine as the definitive metaphor for that moment. In 1905, Einstein's theory of relativity definitively disproved the Victorian idea that the ether was the means of transmission of electromagnetic waves; at the same time, ether supplanted chloroform as surgery's general anesthetic of choice. Writing in 1910, Eliot mixes a metaphor that exposes the modern condition (or at least the condition of modern metaphors) as serious enough to require surgical intervention. To see the sunset as a numbing, as if dusk could be induced to dull the pain of illumination, and to feel that numbing as the necessary precondition of Prufrock's projected "visit," as if poetry's ideal subject were the lack of emotion created by a chemically-induced tranquillity: this is to suggest that aesthetics and anesthetics are somehow the same, that the blunting of sensibilities is not only quintessentially modern, but that it is also symptomatic of a particularly timely art, an overmedicated poetry hovering in the hallucinatory half light of an age about to go under.

I like to imagine that the sky high sky is awaiting plastic surgery, a lift perhaps, to keep it from falling, or a peel to make it clear up--whatever it takes to ensure a sunnier disposition. Such a fantasy is not so far-fetched--by 1915, when "Prufrock" was first published, plastic surgery was well on its way to becoming the fixture of American culture that it is today. As the "featural surgeon" Charles C. Miller wrote in the preface to the 1908 edition of The Correction of Featural Imperfections,

Four or five years ago ethical practitioners laughed or grew hostile when I mentioned my interest in elective surgery of the face for the correction of featural imperfections which were not actual deformities. Two years ago medical publishers refused to consider a manuscript upon the subject. Today I am the happy possessor of cordial and encouraging letters from north, east, south and west, and it is established beyond a doubt that featural surgery is destined to take its place as a recognized specialty. (xxiv)

Writing on the eve of world war, Miller argued for the personal and social benefits of plastic surgery in a peaceful world. During the War, this fantasy of "featural correction" became a reality, as thousands of soldiers underwent reconstructive surgery to restore features that had been damaged or even destroyed by bullets, shrapnel, and fire. The signal mutilations of war supplied the raw material for surgeons such as Harold Delf Gillies and Vilray Papin Blair to refine and perfect their techniques for building noses, chins and cheeks, removing scars and restoring skin. In the process, they helped to materialize Miller's vision of plastic surgery's promise: by the early 1920's, as nose jobs, facelifts, and even breast reductions became matters of routine, plastic surgery began to be seen as a way of life, a practical and philosophical cure for a variety of personal and social ills.

As such, Miller's treatise on what was increasingly coming to be known as "aesthetic" surgery might be read as a kind of practical antidote to the aesthetic pretenses of Eliot's etherized poem. Imagining that "featural correction" would soon take its place among other refined pursuits ("I feel confident that this little book is merely the forerunner of works as pretentious as any we have upon special subjects" [3]), Miller provides step by step directions for everything from the standard nose jobs and eyelifts to "Excision of Scars," "Marginal Tattooing as a means of adding to the apparent width of the lips," removal of "The Scowl," and "Formation of the Dimple" (this last was achieved by inserting a scalpel at the desired location, scooping out a bit of underlying tissue with a hook, and snipping it away so as to ensure a depressed, or dimpled, scar [92]). In so doing, Miller's book both images the science of plastic surgery as the precise art of putting on a pretty, happy face and figures human flesh as the ultimate artistic medium, the endlessly malleable stuff out of which beauty is made. Eliot's poem, by contrast, renders aesthetic surgery itself entirely ethereal: no matter what sort of procedure the sky awaits, it has already undergone a metaphoric operation that situates "ether" as the subject of a beautifully immaterial linguistic transformation. In plastic surgery, anesthesia (usually cocaine, not ether) is a means to a beautiful end ("All the operations described in this book are performed painlessly" [4]); in the poem, ether signals a general anesthesia of language whose dull beauty is a (dead) end in itself. Such a contrast signals the essential difference between the utilitarian aesthetic of plastic surgery and the anesthetic imagery of Eliot's poem. For Eliot, the patient sky is a figure for a deadened life ("I grow old . . . I grow old . . . / I shall wear the bottoms of my trousers rolled"). For surgeons such as Miller, growing old has itself become an outworn figure, a mere "featural imperfection" so insignificant that it can be erased by a simple nip and tuck. "Wrinkles, folds and bags beneath the eyes," for example, those defects that "not only add[] somewhat to the appearance of age, but revolt[] sensitive people," can be "eradicated by the removal of a crescent of skin beneath the eye" (Miller, 40).

I press the unlikely comparison of plastics and Prufrock because I want to insist on the historical and theoretical utility of reading the modernization of aesthetic surgery across the rise of modern art. Historically, the two share a chronology: the period of modernism's consolidation--roughly 1880-1940--is also the period of plastic surgery's coming of age. And theoretically, the two share a mission: plastic surgery, like modern art, saw itself as developing a saving aesthetic, a new approach to beauty that would have far-reaching social effects. Indeed, if one were to write American medicine's modernization as a history of modernism, or, conversely, to write a medical history of American modernism, that narrative would necessarily center on plastic surgery, medicine's answer to the modernist revolution in the plastic arts.

To think plastic surgery through the lens of modernism, and conversely, to reassess modernism through the lens of plastic surgery, is thus to perform a methodological analogue of plastic surgery as it was framed during those years, to suture unlikely materials together so seamlessly that they come to express a new portrait of modern America. Such a manipulation is, moreover, principally licensed by modernism itself. At once a historical period, an aesthetic practice, and a socio-cultural process, "modernism" is, by definition, one of the more indefinite terms in our critical lexicon, a word whose meanings morph by syntax, context, and whim. To understand what "modernism" is, then, one must first understand the defining plasticity of the term: what "modernism" is, in its most basic sense, is plastic. The story of surgical reshaping reshapes the story of American modernism, changing the face of that notoriously plastic category by showing how very materially the modern ideal of plasticity helped plastic surgery to cast itself as the love song of the modern American face.

While modernist art, for all its varied definitions, frequently presented itself as an attempt to diagnose or even cure a general cultural "malaise," "disease," or "syndrome," the medicine practiced by plastic surgeons expressed its healing impulses as an aesthetic inclination: "featural correction" was finally more art than medicine, a clinical procedure whose therapeutic effects were its cosmetic ones. Emerging during the latter years of the nineteenth-century and maturing over the first several decades of the twentieth, plastic surgery became a repository of specifically American innovation, a means of expressing--even molding--the spirit of the age. As such, it both competed with and completed the more traditional forms of modernist expression--painting, writing, and the plastic arts. And in so doing, plastic surgery, like Eliot's poetry, came increasingly to be viewed as a national treasure: the patient etherised upon a table was, more often than not, American, and his rationale for being there was to become a work of art.

Oh, do not ask, 'What is it?'
Let us go and make our visit.

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Part Seven
Part Eight