Virginia Woolf's famous statement--that "on or about December 1910, human character changed"--thus finds a peculiar precursor in the logic of plastic surgery, which, from 1887 onward, operated according to the belief that personality was as malleable as a person's flesh. Writing in 1924, Woolf's idea was, of course, that the abstract art exhibited at the first Post-Impressionist exhibition marked a change in human sensibilities: "All human relations have shifted--those between masters and servants, husbands and wives, parents and children. And when human relations change there is at the same time a change in religion, conduct, politics, and literature. Let us agree to place one of these changes about the year 1910" (96-97). Woolf goes on to explain the importance of this shift to fiction. Changing human relations necessitates corresponding changes in how those relations are narrated; more particularly, a novelist's approach to the delineation of character must reflect the new reality, as older conventions of realism (exemplified by Arnold Bennett) are no longer adequate to represent the realities of modern character (embodied in Mrs. Brown). But we might well back up a bit, and question Woolf's smooth elision of avant-garde art (as implicitly exhibited by the painting and sculpture of "Manet and the Post -Impressionists") and modernist narration (as explicitly exhibited in her own prose). For just as it is not inherently obvious how changes in a non-narrative medium are metaphors--not to say mandates--for analogous changes in narrative form, neither is it so very clear that the exhibition marks a "change" at all, so much as a formal recognition or consummation of a process whose origins and conditions of possibility lie in the very century, and the very aesthetic traditions, Woolf wants to relegate definitively to the past.

Woolf herself acknowledges that December 1910 is not only an arbitrary date, but that dating cultural shifts is itself an arbitrary, and hence purely symbolic, endeavor: "I am not saying that one went out, as one might into a garden, and there saw that a rose had flowered, or that a hen had laid an egg. The change was not sudden and definite like that. But a change there was, nevertheless; and, since one must be arbitrary, let us date it about the year 1910" (96). In so doing, she stresses that "history" is as much a narrative construct as narrative itself: her philosophical need for rupture, for complete discontinuity between the Victorian, and even Edwardian, world and the modern one, is served by this openly "arbitrary" approach to dates. At the same time, her acknowledgement that history does not work the way she asks it to (indeed, her insinuation that to talk of time in this way is to lay a methodological egg) invites--even demands--alternative, even competing, accounts of this shift in human relations. One such account might be refracted through the history of plastic surgery, which, even more literally than postimpressionist art, signified the advent of an entirely new era of "expression." Since one must be arbitrary, let us date the shift Woolf describes two decades earlier and say that on or about June 1887, human character changed.

For the change in human character embodied in the doctored nose was the result of an aesthetic movement no less revolutionary than that registered in Fry's exhibition, or, for that matter, in Woolf's essay: from the first, plastic surgeons saw themselves as pioneering artists. Roe, for example, wrote that in order to ensure surgical success, rhinoplasty and other plastic operations must be approached "from an artistic point of view" (quote in Rogers, 85):

In the correction of all facial defects the surgeon must be not only an artist but also more or less of a sculptor, with perception of symmetry as related to the different features. How often do we see persons who in infancy had been operated on for harelip and fissured jaw, according to the principles most accurately laid down in surgical works, and who nevertheless present a most disfigured appearance, because of the entire disregard of the principles of proportion of symmetry. (quoted in Rogers, 73)

Roe's image of the surgeon as sculptor quickly became a dominant motif in both medical and popular writing about plastic surgery. In 1928, the New York surgeon J. Howard Crum declared himself to be "an artist rather than a surgeon. I model in human flesh" (quoted in Haiken, 80). Jacques Maliniak titled his 1932 book on plastic surgery Sculpture in the Living and included in it a testimonial from a patient averring that Maliniak was "a consummate artist whose work should bear his signature as any sculptor's in marble does" (quoted in Haiken, 63). In 1936, the New York surgeon Maxwell Maltz wrote that "The plastic surgeon must be more accurate than the sculptor, but he cannot work successfully without the sculptor's vision." In 1938, the Philadelphia surgeon Henry Schireson wrote that "The esthetic surgeon . . . is not only a sculptor, but he must have a complete knowledge of form." And in 1951, the surgeon Murray Berger explained that "The well-informed plastic surgeon--essentially a sculptor--studies the proportions of his patient's facial features . . . . he has a sculptor's concept of the features that form the particular face under study and consequently can obtain a gratifying surgical result . . . to himself and patient alike" (quoted in Haiken, 221). Representing their medical capabilities as somehow secondary to--or the same as--their qualifications as artists, plastic surgeons consistently portrayed their expertise as a productive blend of aesthetics and therapeutics.

The most immediate rationale for surgery's paradoxically aestheticist imagery--an imagery that even more paradoxically believed itself not to be imagery at all--was a pragmatic one. Plastic surgery's status at the turn of the century was dubious to say the least--there was considerable doubt among doctors and laypeople alike about the viability of a clinical specialty whose genuine power to heal consistently blurred into its potential to become an expensive arm of a burgeoning, and professionally suspect, beauty industry. In order to establish themselves as respectable professionals, surgeons had to distinguish their considerable skills from the more mundane accomplishments of run-of-the-mill "beauty doctors." Sculpture proved to be the rubric through which the new class of plastic surgeons reconciled the prerogatives of medicine (do no harm) with those of the market (supply and demand). Too commercial to be strictly therapeutic, too aesthetic to be purely scientific, plastic surgery turned to the familiar idiom of high art to claim its place as an elite branch of medicine.

We don't have far to look to find the impetus for the sculptural idiom. The idea of the surgeon as a sculptor was more than mere analogy--the tools and techniques of plastic surgery were so similar to those of sculpture that at times the one was indistinguishable from the other. George Monks and Tait Mackenzie were as famous for their sculpture as they were for their surgery. Vilray Blair insisted that learning to model in clay was necessary training for any plastic surgeon. And Robert Weir explicitly promoted the advantages of sculptural tools over scalpels: "I would remark here that I have since twice removed [nasal] humps by incisions conducted . . . by getting beneath the skin from the nasal passages, and, with properly shaped knives, or chisels, which I like better, have cut off sundry portions of the projecting mass" (89). His case reports bore out this preference for artist's tools, describing his methods for "chiseling . . . sunken nasal bones" (86), making "beveled incisions" that allowed for the "careful chipping off of the offending cartilage by means of a fine engraver's chisel" (89), using "a fine awl" to pierce holes in cartilage and flesh (88), and even erecting the surgical equivalent of scaffolding to support fragile internal structures. Chipping and chiseling cartilage and bone into lasting forms defined by their graceful lines, plastic surgery was not like sculpture, it was sculpture, a time-honored art form trying its hand at a brand new medium--human flesh. Indeed, it was arguably the most authentic form of sculpture to date. As one physician put it, "The surgeon of this specialty now uses the human body as source of supply for all manner of living materials. Swiftly and painlessly, he shifts bone, tendon, fascia, nerves, muscles and skin, reshaping the transplant to any desired contour far more accurately than a sculptor works with clay" (Schireson, 242).

In "Pictures" (1925), Woolf argued that the modern era is under the "dominion" of painting--so much so that "Were all modern paintings to be destroyed, a critic of the twenty-fifth century would be able to deduce from the works of Proust alone the existence of Matisse, Cezanne, Derain, and Picasso; he would be able to say with those books before him that painters of the highest originality and power must be covering canvas after canvas, squeezing tube after tube, in the room next door." For Woolf, plastic art is synonymous with painting, and painting is synonymous with all that is revolutionary in modern art, the means by which "human nature" was being "changed," and the medium with which all other artistic forms had to contend. For surgeons, it was sculpture--not just any sculpture but sculpture practiced on people's faces--that offered a glimpse of a brave, new, beautiful world. At times surgeons compared their work to painting--da Vinci's "Mona Lisa" was a favorite point of reference. But comparing plastic surgery to painting could only represent the one as a poor imitation of the other. The best such an analogy could do was to make plastic surgery look like it was trying--and failing--to be like painting (to continue Woolf's conceit, a critic of the twenty-fifth century would never be able to deduce the existence of painting from plastic surgery). But comparing plastic surgery to sculpting made it possible to locate plastic surgery squarely within the sculptural tradition. As a peculiarly accurate image for how plastic surgeons worked with flesh, sculpture could be read as no image at all; as such it allowed medicine to convert image into actuality, to depart entirely from the field of comparison. When physicians described plastic surgery as a particularly modern, especially technical form of sculpture, they cast their specialty as the culmination of centuries upon centuries of plastic art (a critic of the twenty-fifth century would deduce not only the existence of sculpture from plastic surgery, but would deduce that plastic surgery was the thing sculpture was meant to be).

In the room the women come and go
Talking of Michelangelo.

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