A Patient's Story of Cosmetic Surgery and the General Medical Council (GMC)
1. In September 2000 I entered the Priory Hospital North London under the treatment of Dr David Veale for body dysmorphic disorder. He lured me into treatment with the promise of inviting a rhinoplasty ('nose job') surgeon to see me at the hospital, though making it clear that he thought I shouldn't get the operation as he believed my real problem was due to a distorted internal body image.
2. I found the hospital treatment poor and after three days walked out - before the surgeon had seen me at the hospital. Dr Veale then sent me a referral letter to the surgeon instead. Although advising against surgery in the letter, he also used it to recommend the surgeon.
3. I soon had a cosmetic rhinoplasty with the surgeon in his private office on Harley Street, a Mr N A Nasser.
4. This resulted in extensive external surgical incisions all over my nose. I found this hard to handle and, dropping out of university, set off backpacking on a round-the-world ticket.
5. The incisions had by now turned into oddly distinctive and badly healed surgical scars. (The incisions were very badly stitched closed - with one side different levels - because the twilight anaesthesia quickly began to wear off mid-operation and for some reason the anaesthetist couldn't give me any more anaesthetic; so Nasser had to rush to finish as I gripped the operating couch in strong pain. The scars remain easily visible at a conversational distance.) I consulted with several leading rhinoplasty surgeons in the US and then several in London, UK. I began discovering that the incisions are unique to Mr Nasser and clinically pointless. Mr Nasser lied to Dr Veale in a pre-operative letter that it was the "only" way to perform the operation; described it as a "new technique" to me; and I later learnt from his secretary that he had lied to her that he got it from a renowned surgeon in Chicago - who vigorously denied ever having seen it before. (He also agreed with me that it was a game of pretence by Nasser, and has met him a few times.) Mr Nasser described the area of these incisions as "aesthetic shadow lines" in his operative report; and a few months after the operation he told me that the painter "Raphael did it", in a bizarre reference to the pattern created by the surgical scars. The clinically pointless incisions that made these scars may indicate a criminal matter. Nasser has refused to even try to prove otherwise.
6. I had a relatively successful revision with the leading Chicago surgeon in February 2002. However, the scars in-question were untouched and are permanent.
7. In the summer of 2002 I complained to the General Medical Council (GMC) about Mr Nasser and Dr Veale. The screeners rejected my complaint without an investigation. I accept that Dr Veale's flawed recommendation/referral isn't really an issue for the GMC and that he shouldn't be struck off in this case. However, I maintain that Mr Nasser ought to be if my claims are true. I have strong reason to believe that he presents a potential threat to his patients - including those at his Harley Street, Princess Grace Hospital and Charing Cross Hospital clinics. It is evident that the screeners rejected my Nasser complaint through prejudice over my mental state as a BDD sufferer, ignorance over the technicalities of rhinoplasty and an unjust bias towards the surgeon.
8. In the summer of 2004 Mr Nasser's insurers payed me an out-of-court settlement for 30 000 pounds (after I had commenced a legal claim two years earlier, around the same time as the GMC complaint), albeit without an explanation or apology. Although I wanted to take the case to court in order to prove an assault I was compelled to accept the substantial settlement as I was on Legal Aid funding. My expert-witness surgeon then wrote to the GMC stating that the incisions "served no medical, cosmetic or functional purpose", and that: "if Mr Nasser continues to practise in this manner, many of his patients would be at serious risk of being harmed." This letter was received by the GMC within two years of my complaint being dismissed, before the new GMC rules came into effect on 1st November 2004. It ought to have caused the GMC to reopen my case, in accordance with rule 14 of the GMC's old rules, on the basis of it being serious new information. But the GMC dismissed my expert-witness surgeon's letter out of hand. So I enlisted the help of my MP, who requested that the GMC reconsider in light of the new evidence. The GMC then agreed to reconsider my expert-witness surgeon's letter. I commissioned an independent report from my expert-witness surgeon and the GMC agreed to extend their review of his letter to include his report when it was ready, which was submitted in the summer of 2005. The GMC again refused to investigate. The final stages in my pursuit of this matter are documented on the Home page.
9. I attempted to obtain a refund for the two thousand pounds my brief Priory treatment cost, considering that the Priory Hospital and Dr Veale created the opportunity for me to be a victim of negligence and possibly a criminal assault. I eventually managed to arrange a meeting with the Priory Healthcare Chief Executive, Dr Chai Patel, in the summer of 2004. He denied all responsibility for Priory, but offered a refund. However, this refund included a gagging clause and I objected to this in principle; it seems likely that they were effectively trying to buy-off my silence concerning their ill treatment of me. As a result, I took my Priory complaint to the Independent Healthcare Forum at the start of 2005. Their "Independent Adjudicator" (Lionel Campuzano) claimed no jurisdiction due to its supposed complexity, although he did make a summary of events which was basically slanted in Priory's favour.
He also copied Chai Patel in on his letters to me, but didn't copy me in on his letters to Chai Patel; and Priory's representation was kept secret from me. Lionel Campuzano is a chairman of various quasi-judicial bodies, yet his actions in this case hardly display a predilection for fairness. When I tried to obtain a copy of Priory's secret representation, the IHF (Sally Taber and Tim Elsigood; now called the Independent Healthcare Advisory Service/IHAS) played petty bureaucratic games and lied to the Healthcare Commission over its existence. I then telephoned Tim Elsigood who told me ('computer says no' style) "you have had all you are going to get" and hung up, a man of true integrity. I tried the Information Commissioner's Office, but they were quite stunningly incompetent and simply accepted the IHF's claim that all records containing my personal data had been supplied - unlikely considering that Priory's secret representation concerned my health - without asking to see, or even for a description of, the documents being withheld. I could have taken it to the county court, but it just wasn't worth the effort; so I didn't get to see Priory's secret letter about me. I did, however, get to see a (heavily censored) record of Lionel Campuzano's IHF judgements. Out of about the twenty complaints that had been heard over the past year or so, and the considerable amount (5000 pounds maximum per complainant) that could, and probably should, have been awarded, only around two thousand pounds in total had been awarded. Some independent complaints procedure; I should have known it would be a waste of time.
10. Following the IHF response, Priory offered the refund contract again through Professor Chris Thompson but still with a gagging clause. Professor Thompson refused to answer four basic and reasonable questions about the terms - specifically the gagging clause - and the offer of a refund appeared to be withdrawn as he refused further contact with me on behalf of Priory Healthcare.
