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Published September 08, 2012, 11:40 PM

The significance of scars: Marks are physical, emotional

FARGO - Every scar tells a story. Perhaps it’s a tale of daring adventures, a freak accident, illness or simply a life lived. Dan Bertsch of West Fargo has “north of 20 scars.” He earned most between the ages of 3 and 15, he says.

By: Sherri Richards, INFORUM

FARGO - Every scar tells a story. Perhaps it’s a tale of daring adventures, a freak accident, illness or simply a life lived.

Dan Bertsch of West Fargo has “north of 20 scars.” He earned most between the ages of 3 and 15, he says.

“I see them all as evidence I lived life, lived it on a farm, worked like an adult, was never too timid and not very smart,” says Bertsch, now 50. “I’d be embarrassed to have a tattoo, but am proud of most of my scars.”

Fargo native Samantha Johnson says she is finally proud of the scar she received six years ago.

A “funny-looking” mole on the inside of her right leg turned out to be skin cancer. A dermatologist cut a 4-inch long, 1-inch wide incision down to her muscle to see if the cancer had spread. She was 17.

A check of the incised tissue and her lymph nodes came back clear, though for the rest of her life, Johnson will undergo full body checks, blood work and X-rays to make sure the cancer doesn’t return.

At first, she was scared to tell people her story. She didn’t like the pity people expressed when she told them how she got her scar. Now she tells her story with pride.

“I love my scar. It’s who I am. It’s become a part of me, literally and figuratively. It has given me courage to live my life to the fullest, to discover new adventures, and to travel to new countries because I know now how short and precious life is,” says Johnson, who is currently teaching English in South Korea.

Scars affect us both emotionally and physically. Today, through the stories of local residents and words of medical professionals, we explore the impact of scars.

UNDERSTANDING THE PHYSICAL

Why and how our bodies scar is still not well understood despite years of study, says Dr. David Flach, a dermatologist with Sanford Health.

Scarring occurs when there is injury to the dermis, the structural layer of the skin, Flach says. When that injury heals, an excess production of collagen can cause a raised scar. Too little collagen produces an indent.

Basically, a scar is an over-healing process, he says.

Some injuries cause damage to the pigment-producing cells in the epidermis, so they don’t come back, he says. The hair follicles, sweat glands and oil glands also can be affected.

Family history, ethnicity and age all factor into how much we scar. Younger adults and African Americans are more likely to scar, Flach says.

“A scar can be a source of embarrassment,” Flach says. ‘Sometimes they cause functional problems. Sometimes they hurt.”

Treatment of a scar depends on what kind they are – hypertrophic (thick and raised), atrophic (sunken in, commonly produced by acne) or keloid (protrusive and expands beyond the original injury).

Cortisone injection, gels and laser treatments such as vascular or fractional lasers, are all common treatment options, Flach says.

Flach sees a wide range of emotions expressed over scarring. Younger people, especially females, are more sensitive, he says. “It can be a confidence destroyer.”

But for some, “it might be like a trophy,” he says.

UNDERSTANDING THE EMOTIONAL

Terence Barrett, a licensed psychologist and instructor at North Dakota State University, says there are two impacts from any scar: appearance and personal meaning.

The most identifiable impact is how the scar affects the person’s belief of their appearance. A scar can either enhance or detract from appearance, Barrett says.

The personal meaning is the deeper psychological effect of the scar.

“Appearance comes down to our belief in attractiveness,” Barrett says. “So if I’m concerned about appearance, at the same time I’m also concerned about how attractive I am to others. It’s our appearance that attracts people.”

Some people may not realize they are concerned about their appearance until a scar bothers them. How others react to the scar can influence its effect on the individual.

If a person is unconcerned with their appearance, that effect of the scar is lessened, Barrett says. This is especially true if the person has a strong sense of self outside their appearance, and why adolescents – for whom esteem is shaky and appearance is important – can be especially bothered by scars.

“In part, I believe the impact of a scar is determined by where in life we are when it occurs. It is likely that our adolescent years are when a scar will have its greatest impact. The more we develop personally, individually, the stronger we become as an individual. If a scarring occurs at that point in life, it will have less of an impact,” he says.

The personal meaning of the scar is not only a deeper impact, but longer lasting, because our appearance changes over time anyway, Barrett says.

“The personal meaning we give the scar may never change,” he says.

Personal meaning reflects what the scar represents or symbolizes to the person with the scar, and how they perceive the event that caused the scar.

People may take pride in their scar, or the scar could trigger a sense of victimization, shame or guilt, Barrett says.

“If I want people to see the scar, it’s likely because I’ve been affected by the event in a positive way. If I’m trying to hide the scar or I don’t want them to see it, in essence, I don’t want people to ask about it."

The two components can intermingle. It’s possible someone may take pride in their scar, but try to diminish its appearance anyway because they feel it detracts from their attractiveness to others.

For people who are struggling with scars emotionally, Barrett says he explains that the scar represents survival and resilience – that they were able to bounce back and move forward from the event.

“I can feel positive about my part in the event, and the scar is a reminder of the event,” Barrett says. “The scar represents more my ability to experience things and move forward than be stopped by them and stuck.”

A DREAM REALIZED

For Neal Barringer, the faint scar on his left hand tells the story of a lifelong dream realized.

The 48-year-old Fargo man grew up a half mile from a Bismarck racetrack. “Every Sunday night, we’d hear the noise from the track,” he says.

It was his dream to race cars.

When Barringer was 19, he says he drug a 1973 Chevrolet Chevelle Malibu to that track. He didn’t do well, but he finished the race and received cheers from the crowd.

As Barringer put his hand out the window to wave to the racing fans, he scraped it against a bare piece of metal, and ripped off some of the skin.

Every time he sees the scar, he’s reminded of the four seasons he spent racing. He won the feature in his last season.

Today, he still follows races, but doesn’t go to the track. It’s too much temptation to go buy a car, he says.

LESSONS LEARNED

For Julie Bietz of West Fargo, the scar on her 5-year-old son Gavin’s head is a lesson she shares with other parents.

Gavin, then 2½, was fussy and cried being buckled into the seat of a clothing store’s shopping cart, so Julie put him in the large basket part of the cart.

“As we were strolling along shopping, Gavin went to sit on the edge of the cart,” Julie says. He misjudged the height of the basket’s side, lost his balance and went backward out the end of the cart, landing on the concrete floor.

She immediately scooped him up – “which I shouldn’t have done, in case he had a neck injury,” she says – and put her hand on his head. “When I pulled my hand away, it was covered in blood.”

Gavin had a 3-inch laceration on the crown of his head, just to the left of his cowlick, she says. He had five staples put in his scalp to close the wound. The emergency room physician had to remove hair follicles when he was cleaning out the wound, so Gavin will never grow hair on the scar, Julie says.

“It was by far one of the scariest experiences in my life, but a valuable learning experience for me as well,” she says.

To this day, Julie stops parents who allow their children to sit or stand in the back of the cart, turns Gavin around and shows both the parents and kids his scar.

“If I can get one parent to buckle their child in after seeing Gavin’s scar, I feel like Gavin’s scar isn’t in vain,” she says.

HEALTHY REMINDER

The scars on Cindy Eggl’s face and body whisper reminders of health scares and vigilance to protect her wellbeing.

There are scars from her youth, on her abdomen from hernia surgeries and the cigar-burn shaped scar on her shoulder, resulting from a last-ditch attempt to make sure she was vaccinated for school.

When Eggl was in her mid-40s, basal cell carcinoma was removed from the left side of her nose, leaving a gaping hole down to the cartilage. It took three surgeries to rebuild her nose over a 2-year period.

The scar has faded though she often sees it in the rearview mirror of her car. The light hits it just right as she leaves the office for the day.

“Taking photos was traumatic for a number of years, but I have learned to be grateful for the scar that serves as a constant reminder to schedule and complete my annual dermatology appointment,” Eggl says.

She battled cancer again – Stage 2 breast cancer – last year. Surgeries to remove two lumps from her left breast and nine lymph nodes from underneath her left arm left more scars, as well as the implant of a port in her chest for chemotherapy treatments. Her most recent scar resulted from the removal of a blue ink tattoo near her left collarbone. The small dot tattoo, used to align her for 33 daily radiation treatments, had spread to the size of a pencil eraser, she says.

“My prognosis following my breast cancer battle is positive … my newest scars remind me of my breast cancer journey and keep me focused,” Eggl says.

“Each of my scars has left me with a feeling that I am a better person for having them on my body,” she says. “They have been character builders and remind me to be grateful and to thank God for his blessings every day.”

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