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Making the world understand my face Making the world understand my face
(19 minutes later)
The two sides of Alison's face did not develop in tandem By Dan Bell BBC NewsThe two sides of Alison's face did not develop in tandem By Dan Bell BBC News
On a packed commuter train, passengers rarely give their fellow travellers more than a passing glance. But Alison Rich is not just another face in the crowd - what is the impact of facial deformity on an otherwise normal life? On a packed commuter train, passengers rarely give their fellow travellers more than a passing glance. But Alison Rich is not just another face in the crowd - what is the impact of facial disfigurement on an otherwise normal life?
Every morning on her way to work, Alison Rich is met with sideways glances and furtive second looks. Some people stare openly, others turn away out of embarrassment.Every morning on her way to work, Alison Rich is met with sideways glances and furtive second looks. Some people stare openly, others turn away out of embarrassment.
Alison was born with a condition that impeded the development of the left side of her face and gave her spine a severe scoliosis, curving her back from side to side. From the ages of two to 13, she was strapped into a brace from her waist to her neck. She has had to deal with such reactions all her life.Alison was born with a condition that impeded the development of the left side of her face and gave her spine a severe scoliosis, curving her back from side to side. From the ages of two to 13, she was strapped into a brace from her waist to her neck. She has had to deal with such reactions all her life.
She now works for Changing Faces, a charity that challenges the prejudices surrounding facial disfigurement. Ahead of a public discussion on Thursday at London's Wellcome Institute, Alison invited me to follow her daily commute to witness the reactions of fellow passengers.Don't look is usually the unspoken rule of a crowded commute She now works for Changing Faces, a charity that challenges the prejudices surrounding facial disfigurement. Ahead of a public discussion on Thursday at the Wellcome Collection in London, Alison invited me to follow her daily commute to witness the reactions of fellow passengers.Don't look is usually the unspoken rule of a crowded commute
What for everyone else is a momentary shock, followed by a double-take, for Alison is constant undermining scrutiny.What for everyone else is a momentary shock, followed by a double-take, for Alison is constant undermining scrutiny.
As suited workers file on to the drizzle-stained platform in south London, she is met with a series of second glances. One man stares openly, his mouth slightly open, eyebrows knitted in fascination. A woman looks away, her face full of pity.As suited workers file on to the drizzle-stained platform in south London, she is met with a series of second glances. One man stares openly, his mouth slightly open, eyebrows knitted in fascination. A woman looks away, her face full of pity.
No-one actually says anything, but as passengers crowd onto the train, their eyes dart up from a newspaper, or hastily look away and then back again. One woman stares, her eyes wide in grim fascination.No-one actually says anything, but as passengers crowd onto the train, their eyes dart up from a newspaper, or hastily look away and then back again. One woman stares, her eyes wide in grim fascination.
"Some people we work with, people literally stand back in horror. But for me it's that constant slow drip, drip and you can imagine what that does to someone who is not emotionally equipped.""Some people we work with, people literally stand back in horror. But for me it's that constant slow drip, drip and you can imagine what that does to someone who is not emotionally equipped."
Findings by Changing Faces suggest 542,000 - or one in 111 - people in the UK have a significant facial disfigurement. Alison, 35, says the publicity that comes from events such as the Wellcome Trust debate helps challenge responses to disfigurement, engrained from the playground to the workplace. Findings by Changing Faces suggest 542,000 - or one in 111 - people in the UK have a significant facial disfigurement. Alison, 35, says the publicity that comes from events such as the Wellcome Collection debate helps challenge responses to disfigurement, engrained from the playground to the workplace.
"We don't have to be PC about it. We can't deal with it until people are aware of what they are thinking.""We don't have to be PC about it. We can't deal with it until people are aware of what they are thinking."
Changing Faces aims to change perceptionsChanging Faces aims to change perceptions
While society is more accepting of physical disability, the huge growth in cosmetic surgery suggests beauty is increasingly skin-deep.While society is more accepting of physical disability, the huge growth in cosmetic surgery suggests beauty is increasingly skin-deep.
A 2007 survey by market analysts Mintel predicted people in Britain would spend about £1bn on cosmetic surgery in 2008. They found 577,000 cosmetic treatments were carried out in the UK in 2007, up from 300,000 in 2005.Seeking to improve on natureA 2007 survey by market analysts Mintel predicted people in Britain would spend about £1bn on cosmetic surgery in 2008. They found 577,000 cosmetic treatments were carried out in the UK in 2007, up from 300,000 in 2005.Seeking to improve on nature
Alison believes the trend is leading to a narrower definition of what people find acceptable. Professor Alex Clarke, from the Royal Free Hospital - which has ethical permission to perform the first face transplant in the UK - agrees with her.Alison believes the trend is leading to a narrower definition of what people find acceptable. Professor Alex Clarke, from the Royal Free Hospital - which has ethical permission to perform the first face transplant in the UK - agrees with her.
There is now pressure not just from celebrity culture, but in what is expected from day-to-day life as well.There is now pressure not just from celebrity culture, but in what is expected from day-to-day life as well.
"It's more the sort of presentation of highly attractive people in everyday contexts. It's the sitcoms like Friends or Neighbours, or very good-looking newsreaders. That's the subliminal message," she says."It's more the sort of presentation of highly attractive people in everyday contexts. It's the sitcoms like Friends or Neighbours, or very good-looking newsreaders. That's the subliminal message," she says.
And this airbrushed ideal is emerging at an early age. For someone going through puberty with disfigurement, the anxiety and insecurity can be particularly distressing.And this airbrushed ideal is emerging at an early age. For someone going through puberty with disfigurement, the anxiety and insecurity can be particularly distressing.
"Because it is coming at you from all angles, from the TV, from the internet, it's very difficult to stand back from this and say do I agree with this? Am I happy to look the way I am?""Because it is coming at you from all angles, from the TV, from the internet, it's very difficult to stand back from this and say do I agree with this? Am I happy to look the way I am?"
Alison is not opposed to plastic surgery - she has had 15 operations on her face. The decision whether to go under the knife, she says, should come down to individual choice.Alison is not opposed to plastic surgery - she has had 15 operations on her face. The decision whether to go under the knife, she says, should come down to individual choice.
And medical advances such as face transplants can raise false hopes of what can be done for people with disfiguring conditions.Isabelle Dinoire, who received the first partial face transplantAnd medical advances such as face transplants can raise false hopes of what can be done for people with disfiguring conditions.Isabelle Dinoire, who received the first partial face transplant
"You look at somebody with a pan-facial scar from a Spitfire, for example, or at somebody with a pan-facial scar from a road accident, the cosmetic result really isn't much different," says Prof Clarke."You look at somebody with a pan-facial scar from a Spitfire, for example, or at somebody with a pan-facial scar from a road accident, the cosmetic result really isn't much different," says Prof Clarke.
It's a point that Alison feels strongly about too.It's a point that Alison feels strongly about too.
"The first thing is that they are only available to a very small number of people with particular injuries, so everyone is not going to be suddenly walking out with a face transplant."The first thing is that they are only available to a very small number of people with particular injuries, so everyone is not going to be suddenly walking out with a face transplant.
"The way the media has presented face transplants is it sets them out as a great white hope and plays into this stereotype that it's absolutely impossible to lead a decent life if you have a disfigurement, and that just isn't true.""The way the media has presented face transplants is it sets them out as a great white hope and plays into this stereotype that it's absolutely impossible to lead a decent life if you have a disfigurement, and that just isn't true."
Coping strategyCoping strategy
Ultimately Alison has dealt with her disfigurement through inner strength.Ultimately Alison has dealt with her disfigurement through inner strength.
At school, girls would be friendly outside the gates, but shun her in the classroom. At discos boys would stand in front of Alison before turning to her friends and refusing to dance with her. I don't look in the mirror in the morning and say 'oh God, look at my face'At school, girls would be friendly outside the gates, but shun her in the classroom. At discos boys would stand in front of Alison before turning to her friends and refusing to dance with her. I don't look in the mirror in the morning and say 'oh God, look at my face'
It was one of the cruellest reactions that transformed how she dealt with her disfigurement.It was one of the cruellest reactions that transformed how she dealt with her disfigurement.
"I was in the student union and this guy came up to me and threw me against the wall and said: 'You are the ugliest thing I have ever seen, I'd kill myself if I looked like you'. I just didn't go out for a few days, I was quite bruised by it."I was in the student union and this guy came up to me and threw me against the wall and said: 'You are the ugliest thing I have ever seen, I'd kill myself if I looked like you'. I just didn't go out for a few days, I was quite bruised by it.
"But it also made me realise how I was going to handle myself and that I had to get strong inside. And I think even more importantly I needed to learn how to deal with these things.""But it also made me realise how I was going to handle myself and that I had to get strong inside. And I think even more importantly I needed to learn how to deal with these things."
In a way, she says, he did her a favour. She now has a number of strategies she recommends to anyone concerned about their disfigurement: Look someone in the eye, have a short explanation ready, move the conversation on, and seek expert support.In a way, she says, he did her a favour. She now has a number of strategies she recommends to anyone concerned about their disfigurement: Look someone in the eye, have a short explanation ready, move the conversation on, and seek expert support.
But she still has bad days.But she still has bad days.
A young man who had been talking to her suddenly turned round and said: "you'd be really lovely if you weren't so ugly"; and before her wedding a shop assistant told her: "Oh gosh, I didn't think that someone who looked like you could get married."A young man who had been talking to her suddenly turned round and said: "you'd be really lovely if you weren't so ugly"; and before her wedding a shop assistant told her: "Oh gosh, I didn't think that someone who looked like you could get married."
Alison is always aware of how those around are reacting.Alison is always aware of how those around are reacting.
"I never have a day off. But I don't look in the mirror in the morning and say 'oh God, look at my face'. I think I'm looking pretty tired today, or shall I pick up some lipstick, or 'hey, you're looking pretty good'.""I never have a day off. But I don't look in the mirror in the morning and say 'oh God, look at my face'. I think I'm looking pretty tired today, or shall I pick up some lipstick, or 'hey, you're looking pretty good'."


Add your comments on this story, using the form below.Add your comments on this story, using the form below.
Sadly, some of these comments don't surprise me. People are just so shallow it's disgusting - I've had random strangers comment on my size in the middle of the street (I'm short and quite overweight) and I've had people look down their noses at me when commuting into work, as though they resent having to share their space with a less-than-perfect being. Alison is such an inspiration for us all to be more accepting of ourselves, even those of us who look "different" and to ignore the rules pushed on us by society of how we should look.Sharon, London, UKSadly, some of these comments don't surprise me. People are just so shallow it's disgusting - I've had random strangers comment on my size in the middle of the street (I'm short and quite overweight) and I've had people look down their noses at me when commuting into work, as though they resent having to share their space with a less-than-perfect being. Alison is such an inspiration for us all to be more accepting of ourselves, even those of us who look "different" and to ignore the rules pushed on us by society of how we should look.Sharon, London, UK
The ugliest thing in this article is the ignorance and bad manners of some of the people who made comments to Alison. Not Alison's face.Kate, LondonThe ugliest thing in this article is the ignorance and bad manners of some of the people who made comments to Alison. Not Alison's face.Kate, London
I can easily imagine myself giving an involuntary second glance and then looking away with pity. But the question begged, and is not answered by an otherwise fascinating article, is what reaction on the part of others would Alison consider kindest and most considerate of her feelings? How would she prefer people react?Bill Gribble, Gloucester, UKI can easily imagine myself giving an involuntary second glance and then looking away with pity. But the question begged, and is not answered by an otherwise fascinating article, is what reaction on the part of others would Alison consider kindest and most considerate of her feelings? How would she prefer people react?Bill Gribble, Gloucester, UK
I have a pretty big birthmark on the side of my head, face and neck so I understand where Alison is coming from about getting sideways glances and stares from lots of people. But my attitude has always been to just get on with it; if people want to have a look and stare then it's up to them, I just rise above it and get on with my life.David Gore, Liverpool, UKI have a pretty big birthmark on the side of my head, face and neck so I understand where Alison is coming from about getting sideways glances and stares from lots of people. But my attitude has always been to just get on with it; if people want to have a look and stare then it's up to them, I just rise above it and get on with my life.David Gore, Liverpool, UK
She is totally right about the definition of acceptable being narrowed. Of course, the worst thing is that the image of "beauty" presented by celebrities and the media is nothing of the sort. Even "normal" is no longer normal, and it's time the pretence that these people's looks are totally natural and fairly easily attainable was put to a stop. Not that the BBC has any moral high ground, as Moira Stewart and others could vouch for.Doug Daniel, Glasgow, ScotlandShe is totally right about the definition of acceptable being narrowed. Of course, the worst thing is that the image of "beauty" presented by celebrities and the media is nothing of the sort. Even "normal" is no longer normal, and it's time the pretence that these people's looks are totally natural and fairly easily attainable was put to a stop. Not that the BBC has any moral high ground, as Moira Stewart and others could vouch for.Doug Daniel, Glasgow, Scotland
Parents - if your child points out the obvious, don't tell it to be quiet. They're being truthful, and talking about such things encourages acceptance.James, ParisParents - if your child points out the obvious, don't tell it to be quiet. They're being truthful, and talking about such things encourages acceptance.James, Paris
I don't know why we are so obsessed with beauty. Big Brother is a joke, but is in fact one of the only programmes to feature disabled people. Why are there no disabled/disfigured people in soaps? Why are there no disabled/disfigured people on X Factor? If the faces of the media were not so selected, then they wouldn't be considered freaks - they would be normal people, which is what they are.Dawn, BedfordI don't know why we are so obsessed with beauty. Big Brother is a joke, but is in fact one of the only programmes to feature disabled people. Why are there no disabled/disfigured people in soaps? Why are there no disabled/disfigured people on X Factor? If the faces of the media were not so selected, then they wouldn't be considered freaks - they would be normal people, which is what they are.Dawn, Bedford
People's capacity for unkindness is truly shocking.Gerry, Exeter, EnglandPeople's capacity for unkindness is truly shocking.Gerry, Exeter, England
Perhaps it could help to try to stop being so aware of how people around you are reacting. You are looking for things that often are not there. How often does someone glance at a person and look away for many different reasons that facial disfigurement? Many of us are a bit "unusual" or "interesting" to another person in some way.Judy, Bromley, UKPerhaps it could help to try to stop being so aware of how people around you are reacting. You are looking for things that often are not there. How often does someone glance at a person and look away for many different reasons that facial disfigurement? Many of us are a bit "unusual" or "interesting" to another person in some way.Judy, Bromley, UK
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