Born without a right pectoral muscle due to Poland syndrome, John Trumbo has always felt defective, but then he discovers a possible solution.
John Trumbo is a senior healthcare writer with a bachelor’s in communications and a concentration in journalism from James Madison University. He also holds a master’s in nonfiction writing from the Johns Hopkins University. Specialty areas of study included Crafting Nonfiction Voice, the Literature of Science, Essay and Memoir, Review and Opinion Writing, Teaching Writing and more. Professionally, John writes about transforming the care experience with the help of innovative health IT solutions that put patients first. follow him @JohnMTrumbo.
This story originally aired on Nov. 2, 2018, in an episode titled “Bodies”.
Story Transcript
I come from a family of baseball players. My father was a pitcher and he tried to get me interested in the game by throwing balls to me in the front yard, but it never really worked. I sucked, actually, at anything having to do with upper body strength or coordination. I actually played on a few Little League teams but anytime I tried to return a ball hit into the outfield it barely reached the baseline.
It turns out there was a good reason for my lack of performance and enthusiasm. On an annual physical in third grade, our family doctor diagnosed me as the M&M Man, which stood for Missing Muscle Man. That’s because I was born without a right pectoral muscle thanks to a congenital disorder called Poland Syndrome. Poland Syndrome affects about two out of every 100,000 newborns and is three times more likely in boys than girls. The usual manifestation is a lack of a chest muscle, but other symptoms include webbed fingers or toes. No one seems to really know what causes Poland syndrome but researchers theorize that somewhere around the 46th day of pregnancy there is a disruption of blood to embryonic tissues that help build the chest wall.
All I knew at the time was I was different from my male friends and classmates. As we grew older, their shirts filled out more fully and completely while mine kind of sagged awkwardly down the right side.
I also began to realize that I was gay, which added to my level of anxiety. My parents never really talked to us about sex or sexual attraction but we were devout Southern Baptists and I soon figured out, or so I believed at the time, that God really wasn’t cool with two men lying with each other. But that’s what I believed at the time.
Nevertheless, I knew I had this attraction to men and the male body. I remember the old Charles Atlas ads in the back of my comic books where the big muscle dude comes up to the skinny, wimpy guy on the beach and kicks sand in his face next to his girl and his girl is like, “What?” But the more I began to realize that I wouldn’t have that perfect male body that I sought after.
That is until I discovered science and reconstructive surgery. In 1992, when I was 27, in the back pages of a pre-Google research device called the phone book, I found a nearby plastic surgeon whose office was located in a somewhat seedy strip mall and most of the literature in the waiting room was geared at women seeking boob jobs. The doctor said he had heard of my condition, but my insurance company denied my claim because they considered it just plastic surgery.
But I kept searching and, nine years later, in 2001, thanks to the internet and a real surgeon at a major university hospital, my new insurance carrier approved my request for chest wall reconstruction with CPT 19340.
My parents were supportive when I told them of my decision but, frankly, I don't think they had ever thought about my missing muscle since my diagnosis. Like a lot of things, we just never talked about it. Nevertheless, my father agreed to drive me to the surgery.
On that morning of the surgery, he and I sat facing each other in the hospital exam room while I waited for my doctor. I had my shirt off, which is a little uncomfortable. It had been years since I'd had my shirt off in front of my father. And he could clearly see the bright sun tattoo that I have on my upper arm now.
Now, I was uncomfortable revealing the tattoo to him because, as a freshman in college, I got my ear pierced. Now that’s not such a big deal, but my parents hated it. They really hated it. My mom reminded me something what the Bible said about men not acting feminine. But what was worse is that my dad didn’t or couldn’t speak to me for quite a while.
The surgery itself went fine. it was over in an instant, from my perspective. As I slept someone had indeed slipped a new muscle into my chest but, instead of a soft cushiony implant, it felt more like a boulder someone had put in there.
A little while later in a private recovery room, my father knocked on the door, poked his head in and said, “How did everything go?”
And I said, “Fine, I think. Come on in.”
He proceeded to tell me about everyone that he had met while he waited for me in the cafeteria. A nice couple from Richmond, a man from a small town where he used to teach school. My dad didn’t talk much about his feelings or emotions, but he had this amazing ability to engage you in small talk until it felt like you had known him all your life.
Later, when I was released from the hospital, he cradled my right arm against my chest as we walked out to the car. My pain medication was wearing off and we still had a 90-minute drive home and I just wanted to get home. But my father, being the good southerner that he is, suggested that we stop and get something to eat. He sees food actually as the great healer and this was his way of wanting to help me feel better.
But I cringed as we pulled into the parking lot of an all-you-can-eat family restaurant with a line of tour buses circling the parking lot. My father got us a table and offered to get me a tray of food, but I said I think I can probably manage myself. But when I came back to the table holding just a bowl of chicken soup and some biscuits, he looked at me with this look of betrayal.
“What?” I said. “I told you I’m not hungry and my pain medication is wearing off.”
Again, I know he wanted to help me, but he looked helpless, unable and not sure how to reach out to his aching son.
Once again we filled the time with small talk, missing yet another opportunity to come clean with each other and, more importantly, for me to explain to him why this surgery had been so important to me, something I thought I wanted for thirty-six years.
Eventually, I discovered that I was missing more than a muscle in my chest, something that an expensive silicone implant with CPT Code 19340 couldn’t fix. It couldn’t fix this feeling of feeling a little defective or not exactly who or what I thought I was supposed to be.
Today, I’m out to most people in my life and that’s generally not an issue, but I never came out to my parents before they both passed away. I always looked for the right opportunity about as many times as I prayed that God would heal my chest, but I knew what they believed about homosexuality and, frankly, I was afraid to risk losing my relationship with them. But having never revealed my true whole self to them while I had the chance was the real deformity that I'll never be able to fix, fill in or repair. Thank you.