Hey y'all I just wanted to take the time to share my story with you. I've shared this on several FB groups and have been encouraged to share it here. So here it goes! It's a long read, although I hope it helps girls as they seek surgeons for FFS.
Introduction
First off and most importantly to know is that Dr. Spiegel operates a clandestine teaching practice. A fact not widely known as his entire practice hides this vital information from all patients unless they happen to inquire. This said, I was never told and never thought to ask so by default, became one of those patients. The result, I was operated on by a student without my permission.
So what does “teaching practice” mean? Well in short it means that a practice is a training ground for up-and-coming students. And if you contract with one of these practices, there’s a more-likely-than-not chance that you'll be operated on by a student not Spiegel. And since he doesn't actually ask for patients permission, you'll never know.
To patients who have used Spiegel, I encourage you to request your Operation Report (OR) report. I was at Boston Medical and it was easy. In most cases it's a free service. When you get the file, look to see if there was another MD listed with Spiegel. If so, this was not a generic “assistant” as his consent forms suggest, but the fellow training under him. This said, ask yourself this; were you ever told he uses fellows or if a student could operate on you?
Hippocratic Oath
I feel a good starting point is to remind folks that the entire modern day medical system has been built by doctors and hospitals to protect doctors and hospitals. Medicine and patient care is second to that foundation. And that’s the underlying narrative I want to share my experience around. Specifically, The Hippocratic Oath.
A hippocratic oath may seem to be just an empty narrative used as a plot point in a Lifetime movie, however it's so much more. Among other things at its core is to, "first do no harm.” Which in short means a commitment to do everything in your power to heal or otherwise make life better for your patient. And no doubt if you ask any doctor about their commitment to their patients, they’ll go on-and-on about the gravity of this oath.
Well what of the doctors who don't? What of the doctors who lose sight of the patient in front of them because they're looking to the next patient and the next cash or insurance payout? How do we as patients discern what a doctor's motive really is?
Safe to say an ER surgeons entire life revolves around one thing; saving lives. But what of the Pediatrician, Dentist and of course Plastic Surgeon? In almost all cases these are not "life or death" situations, so where does a non-triage doctor see themselves within the, "first do no harm” narrative?
Well I had to learn the hard way. For that oath has come to mean a great deal to me since having my FFS with Dr. Spiegel and The Spiegel Center back in March of 2018. As I can testify that, that oath means exactly nothing to Dr. Jeffrey Spiegel.
One would think that if you have your patients best interest in mind you would do everything in your power to provide the highest level of care that today's medicine, technology and technique can provide. You’d remain on top of all things within your practicing field of medicine. Alas with Spiegel this isn’t the case.
Why is anyones guess, be it extended tenure or a runaway ego. All I can tell girls is that a consult with him is akin to listening to a car salesman ensure you that you’re getting, “the best car on the lot.” Only to drive away and realize that the Ferrari you paid for is is actually just a Toyota Camry... or worse.
At first blush one could argue that opening and maintaining a teaching practice is an extension of the hippocratic oath. To which would be completely true if you were being honest in your literature and consultations. Something which The Spiegel Center does their best to conceal from their patients.
Students absolutely need to learn and we need teachers to teach them, however what happens when that teacher simply doesn’t tell patients who will be performing the surgery? Would this be a situation where a doctor has drifted away from his oath?
What would-be patients need to understand is that the Spiegel Center’s Transgender FFS Program is not high end cutting edge medicine, it’s a vocational school.
Dr. Spiegel teaches students a basic in-and-out barebones method. This is why he refuses to invest in technology that could help him build comprehensive individualized surgical plans. His practice simply has no need for them.
As a single example would be sutures. Modern day tech has robotic closing technology which creates hundreds of micro stitches along large entry points. And as one can imagine, "the close" is a major part of the (Type III) forehead conturing procedure.
That incision more than any other, needs to be a clean close with an eye to the aesthetic result. And here is a teacher who could care less about that technology and instead continues with massive traditional 'Frankenstein' hand suturing.
Collectively Spiegel's practice is a confluence of less than ideal realities. From his half-fast laissez faire consultations and clandestine fellowship program to a refusal to employ any technology whatsoever and refusal to take ownership or absorb revision costs, Spiegel has in my opinion, disregarded his hippocratic oath.
My Story
During my initial consult Spiegel poked at my face for all of ten minutes and smiled as his team put together a 57K cash quote for 8 procedures. He never took a single measurement or employed any tech whatsoever.
Lacking any of todays insight I would come back months later with insurance and commit to surgery with him. Due to that insurance dynamic, I couldn't get 8 procedures done, instead I could only get 4. Learning post-op that my insurance was charged 56K for half of the work, (36K going directly to Spiegel himself) and I scheduled my surgery date. Making perfectly clear that,
I WAS NEVER TOLD HE OPERATED A TEACHING PRACTICE AND NEVER ASKED IF A STUDENT COULD OPERATE ON ME.
So on March 15, 2018 I went under the knife. I had Type III forehead with scalp advancement and brow lift. An open Rhinoplasty. Chin Implant and Tracheal shave. I was under for less than 4 hours. Type III's alone take most surgeons 4-6 hours.
As the first days post-op wore on I knew something wasn't right. I had a massive (Xtra-Large) potato size implant in my once narrow jawline which scared me to death. It has masculinized my lower face.
I had what appeared to be a lifted forehead, only to watch the incision open up and turn to massive scarring, skin wrinkling, lumpiness and my brows flatline. Hair would fall out and never return and my hairline was only advanced on one side. Lastly I now had this dent/trench between my eyebrows. Visible when I smile.
Meanwhile my nose was, (and remains) a mess. I struggle to breath due to collapsed nasal passages, came away with a deviated septum, it runs off center and the bridge looks like it was ignored completely. In short it looks like I've been in a fight. Lastly my tracheal shave seemed meh at best with a lumpy pimple like scar emerged.
I was a mess and reached out to Spiegel's office. They were all manner of supportive. Verbally anyway. So was Spiegel. The marching orders were and remained for months, "ya have to let it heal" and "don't worry we will do whatever it takes to make you happy."
Well it healed alright. And so emerged a complete botch job top to bottom. And that promise to make me happy? Well that was nothing more than a can they were kicking down the road for 6 months. And when the time finally came, it came with a 7K price-tag. I balked. They took absolutely no ownership and ignored me. So I walked away. My head spinning I fell apart.
In the years since I’ve done some extensive research and have a new understanding and appreciation of just how fellowship programs are administered. As such have come to the conclusion that Dr Spiegel never even touched me. It was his then fellow, Dr. Laura Garcia Rodriguez. And if Spiegel did operate, he was obviously rushing with another patient in mind. Remember I was under for less than 4 hours for a series of surgeries that normally take twice as much.
All told I have suffered beyond words. My face post FFS is a disgusting dysphoric mess. I mean take a look below. This is what $56,000 worth of Dr. Spiegel’s time looks like.
Mind you I am petite, look, sound and act very feminine. And without my hair and makeup to hind behind, I can dress as a man and never be mis-gendered. And even then, I'm constantly clocked and horribly scarred, cannot breath, and now have a more masculine lower face because of this massive implant.
In so many ways I represent the perfect storm of how transgender medicine goes wrong. I'm the victim of an arrogant, profit seeking, dishonest and yes... negligent doctor. And I will testify under oath to that end.
Closing & Suggestions
So what happens when an established plastic surgeon has an ego that far exceeds his talents? One who employs antiquated and honestly outdated processes, while also doubling as a teacher to aspiring students? Is he doing no-harm? Or is he actually causing it?
Spiegel end-rounds informed consent because he knows that nobody is ever going to agree to having a student operate on them when they came to the self proclaimed, ”best in the world" for their surgery. So by that omission alone, what’s the hippocratic oath worth when your doctor doesn't care about you the patient, but rather how much he can charge for a bare minimum amount of time and investment?
I suggest that:
We deserve to know who’s operating on us. Our surgeons should be compelled to disclose that they and they alone are performing the work that we’re paying for. Or obtain a patients informed consent if they seek to utilize a student in the surgery. And that this informed consent is asked for and obtained verbally and in writing before surgery and again verbally and in writing at the day-of surgery.
We deserve to have a surgeon who doesn’t just offer modern technology, but demands it be used in their practice. From basic things like X-Rays and CT-Scans to computer software that the doctor can use to help us create a custom surgical plan. If they don’t, find a surgeon who does.
Obtain an in-writing guarantee that should any revisions be needed, that all associated costs will be absorbed by the doctor and practice without exception.
Lastly, (where I was never asked) I’ve heard the newest thing is that some doctors/practices are asking patients to sign a non-disclosure agreements. I cannot stress enough how sketch and unethical these demands are.
I’ll go on record and suggest that these are born from loud patients like myself who have publicly called their doctors practice and ethics into question. Refuse to sign them, and if they balk, report them to the BBB and the medical review boards of your state.
Thanks again for reading and remember to research and educate yourself before seeking a surgeon. So that when you do, you can choose one that has your best interest in mind. Remembering that if you’re paying for the Ferrari, be sure you’re going to drive away in one.
Pics on my profile page:
Peace
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