The Possibility of Cosmetic Surgery for the Soul

What would Cyrano de Bergerac say? That was the question that came to mind after reading an article on "Cosmetic Neurology" published last week in Neurology.

I suspect he would read the title of the article, take note of the subtitle, "The controversy over enhancing movement, mentation and mood," raise his eyebrows, put his hand on the hilt of his rapier and exclaim, "What?" or, if you want to be picky, "Quoi?" Cyrano himself is not around, of course, so I had to contact the author of the article myself to ask about the title.

The substance of the article is clear. Dr. Anjan Chatterjee, of the department of neurology and the Center for Cognitive Neuroscience at the University of Pennsylvania, discussed the many ways that exist and are emerging to tinker with emotions, intellect, memory and other aspects of ourselves by choice. Beyond therapy for mental or physical illness, he said, neurologists in particular will be in the middle of societal demands for drugs to improve attention and mood simply because people want them.

Genetic engineering and the use of stem cells may also become techniques for elective enhancements of some sort. Neurologists will be involved, he said, in anything involving the brain and nervous system, he said, so they had better be ready.

Fair enough. But why "cosmetic"? Dr. Chatterjee said he coined the term to have an easy, memorable label for the issues he was addressing, and to spark some thought about what is cosmetic and what isn't.

He said that the Greek roots of the word had to do with order and arrangement and went back to the cosmos itself, which solved a long-term puzzle for me - the connection between cosmetology and cosmology. Both involve "skilled arrangements," as Dr. Chatterjee put it.

I myself am not a neurologist. In fact, I'm not a doctor of any sort, as my friends and family often point out in order to make me pipe down. And neither was Cyrano, although he did indulge in the odd spur-of-the-moment dissection.

So I really latched on to the word "cosmetic." Despite Dr. Chatterjee's venture into etymology, the common definition of cosmetic has to do with appearances. And the changes he talks about go deeper than appearance. How can you compare a nose job to a change in intellect?

Cyrano, of course, is the swashbuckling poet and soldier who is afflicted with a nose that he describes as a "vile protuberance," which nobody else is allowed to mention. There was a real Cyrano, but the one we all know is the character in a play by Edmond Rostand.

He is ugly on the outside but beautiful on the inside. Because of his appearance he cannot bring himself to declare his love for his cousin Roxanne, a great beauty and a fellow lover of wit and poetry. But he does find a way to convey his feelings to her. Roxanne falls for a young, handsome soldier, Christian, who, although she doesn't know it, does not have inner beauty to match his exterior. Cyrano, through some plot twists, ends up as his speechwriter, composing letters and declamations for him that are irresistibly passionate and witty.

Roxanne swoons under the influence of the words. She needs to be wooed with rhyme, meter and metaphor, with lyric extravagance. On his own, all Christian can say to improve on "I love you," is "I love you very much." So he relies on Cyrano. As Roxanne falls deeper and deeper in love, the question that drives the drama is whether her love is for external or internal beauty - Christian or Cyrano.

Now imagine Cyrano reincarnated in the Age of Rhinoplasty, watching "The Swan" and reading Neurology. He would be shocked at cosmetic surgery, but I think he would have been first in line for a nip and tuck. He was desperate. His nose afflicted him.

A greater shock would be cosmetic neurology, the possibility of altering passion, intelligence, memory, verbal panache - qualities that Cyrano and Roxanne held to be part of a person's soul. Fine, get the nose fixed. But what if Christian were able to take a poet pill? Alas, poor Cyrano, poor Roxanne, poor Rostand, for there would be no play at all.

These are, of course, some of the very issues that Dr. Chatterjee takes on in his article. He wishes to provoke thought. But he might have provoked more in Cyrano, who was a master of the sword as well as the pen, and quick to respond to any challenge. I can see him brandishing his epee.

"Mais non!" he would shout as he ran his sword through the latest issue of Neurology. "Elective neurology, perhaps. Voluntary neurosurgery, maybe. Even out-of-network, nonessential personality change. But cosmetic? Never!"

Touché.