Scar stories

By Renata Braudy, PhD, PT, MA, CLT, Empowered Wellness and Recovery 

20 years ago, Susan came to my clinic a few years after completing breast cancer treatment with chronic, idiopathic shoulder pain. The pain hadn’t stopped when the treatment did, despite medical clearance to return to regular activities and seeing her oncology team plus two physical therapists prior to our visit. 

I performed the standard shoulder exam: range of motion, strength, flexibility, and function. Then I handed her a gown and stepped out of the room. When I stepped back in, she had tears in her eyes. “I’m not crying because of the cancer or the mastectomy,” she said. “I’m crying because you’re the third physical therapist I’ve seen and the first to look at my scars.” 

I didn’t know what to say. If I’d evaluated a post-surgical knee and failed to assess scar mobility, the surgeon would have questioned my competence on the spot. Restricted scar tissue limits surrounding tissue mobility, affecting joint biomechanics and function. The scar is a significant clinical finding. And no one had looked. 

This patient encounter changed my practice forever. 

Susan taught me that looking at the scar and asking directly about functional limitations was an act of respect. It tells a patient; I see what happened to you. I see all of it. The scars are still there. The question is whether we look. 

Here are a few tips for all healthcare professionals about acknowledging and respecting all parts of a patient’s body so you can truly see their full history and story: 

1. Start by looking.

Visual inspection can yield important functional and diagnostic clues you may miss through history alone. When appropriate and with consent, inspect surgical sites, scars, skin changes, prostheses, stomas, or other visible signs of past procedures or disease. Explain why you want to examine a site, obtain permission, use gowns/drapes, and offer a chaperone when appropriate. Respect for bodily autonomy builds trust and reduces trauma. 

2. Attend to equity and trauma history.

Be aware that past medical trauma, cultural norms, and power dynamics affect how comfortable people are exposing parts of the body. Offer culturally sensitive care and extra support for survivors of abuse or those with marginalized identities. 

3. Ask explicitly and sensitively.

Use simple, direct questions: “Can I look at the area where you had surgery?” “How does that scar feel?” “Does that part of your body limit anything you do?” Normalize the question to reduce embarrassment and invite honest answers. 

4. Consider the whole-person context.

A scar may have physical, emotional, and social impacts. Ask about pain, body image, activity limitations, and roles at home and/or work. Screen for distress and refer to psychosocial resources when needed. 

5. Examine your assumptions and language.

Avoid minimizing phrases, like “it’s all cosmetic.” Acknowledge the patient’s experience and the significance of bodily changes. 

6. Follow up.

If you identify an issue or begin a conversation about a scar or body change, arrange follow-up to monitor progress, response to interventions, and psychosocial adjustment. 

Seeing and acknowledging every part of a patient’s body is more than a physical exam maneuver—it’s a message: “I see what happened to you and I’ll try to help.” This simple recognition can help restore dignity to patients whose stories have been partially unseen. 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.