Extreme Health Care

by: Vicki Mayer / Tulane University

Extreme Makeover

Extreme Makeover examples

Cramming into the middle seat on a hurried morning flight from Sacramento to L.A., I didn’t know I would sit next to a potentially famous TV star — and a first-time flier.

“I’m nervous,” she confessed. Her bag didn’t fit in the overhead. “I’ve never been in a plane before,” she added, continuing, “I’ve never been to L.A.” Peeved and pre-caffeinated, I stared down the SkyMall catalog as she climbed over me to reach the window. I only began to wonder about her mid-take-off, her hand fastened in a death-grip on my armrest, when she revealed, “But it’s already worth it, even if I don’t get picked.”

“Sue Ellen” was a semi-finalist for ABC’s Extreme Makeover. Like its rivals The Swan (Fox) and I Want a Famous Face (MTV), Extreme Makeover‘s website promises to make every woman’s “fairy-tale fantasies come true.”

For Sue Ellen, this was basic health care.

In the age of primary coverage cutbacks, medical mismanagements, and shrinking access to specialists in rural America, Extreme Makeover was her last hope. “I got to do this show now or I’m going to lose them,” she explained. “I don’t want to lose my teeth. I like to smile at people when I meet them and be friendly. I don’t think I could do that without teeth.” Listening, I couldn’t help but glance down from her brown saucer eyes. Sue Ellen’s cracked upper lip didn’t quite cover her incisors. Dry and yellowed, her teeth added a decade to an otherwise youthful 43-year-old’s face.

She always had bad teeth. Diagnosed with a protein deficiency and weak gums, she needed braces early on to prevent the horizontal growth in her mouth, but her parents couldn’t afford it. “They fought about the price,” she lamented. “I was supposed to be a mother not a model.”

Sue Ellen became a mother, and a janitor, but she could never save enough money for the dentist. Her daughter got pneumonia and her husband, a tree climber and pruner, had heart problems. “He had to get a stint in his heart, which was $15,000, so we’re paying that off.” Health insurance did not cover that bill, and she suspected he would need another stint soon. Most recently, he broke his knee cap on the job, making him homebound. Dental surgery, another uncovered procedure, had to wait.

She pushed around the free but inedible airline peanuts on her tray before unwrapping the foil on her own pre-cut sandwich morsels.

Extreme Makeover

Extreme Makeover

“If I don’t get dentures soon, they’ll have to pull everything because my gums won’t hold anything anymore.” She licked her teeth as she talked, an effect of constant air exposure. “I thought you get dentures when you’re old, but now they say I’m almost too old.” Her condition led to frequent infections and several trips to a health clinic where she owed $500 for each of the five root canals she had. Dentures would cost $125,000, more than she could afford even with another mortgage on their home. “But I don’t want to be toothless,” she fretted.

Enter Extreme Makeover: the show that has offered their guests implants, lipo, facial peels, Lasik eyes, and a new tan to boot. Sue Ellen’s daughter sent a postcard to the reality show recruiters. Out of 10,000 applicants from Northern California alone, Sue Ellen was one of six to go to L.A. “They told me one of the doctors saw something they liked, and now they have to shop me around so they can sell me to the other doctors.” Already she found out that, along with the dentures, she would be a likely candidate for a nose and boob job, eye tucks, and a face peel — “the one where they scrub your skin off.” She said she didn’t care about all the rest. “As long as my teeth get done, they can do whatever.”

ABC told her she could get up to $200,000 in free health and beauty care, but she said she already felt like a winner. She was flying. For the next three days, she would ride in a limousine, stay in a Beverly Hills hotel, eat on a $40 per diem, and visit a dozen doctors to assess if her needs were extreme enough. She also hoped she would see the Hollywood sign.

As the plane touched down, she shared her biggest worry about the competition. “They took a video of me already and said I have to elaborate my answers more. But that would mean showing my teeth more and I don’t even smile anymore.”

Dumbly, I smiled.

My middle-class friends grin when they inform me that people who go on make-over shows are superficial and just want celebrity status. The Extreme Makeover website supports this storyline, featuring a fashion tips list as “News You Can Use” and a bevy of plastic surgery propaganda.

Yet the infrequent flier may have been closer to the truth, when she said, “If I had good health insurance, I wouldn’t be doing this.”

Image Credits:
1. Extreme Makeover examples
2. Extreme Makeover

Extreme Makeover
Cosmetic surgery message board
Cosmetic Surgery, Physiognomy, and the Erasure of Visual Differences

Please feel free to comment.


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  • Deborah McIntosh

    Not everyone gets a miracle

    Last summer, I interned at a television station in East Texas where they were in the process of doing their very own version of Extreme Makeover- “East Texas edition”. I had always thought this show was pretentious and unethical, exploiting America’s view of “beauty” and the human body, until I met a woman willing to do anything to feel better about herself again. I got to attend several of the shoots with our contestant, a kind and quiet middle aged house cleaner, who was excited over the facial reconstructive surgery she would receive, as well as Lasik, new teeth, and a completely new hairstyle to top it off. This show was only a small version of what ABC puts out, but the difference it made in this woman’s life was equally as huge.

    The sad reality is that, like the woman in the article, these contestants are one out of a million people who not only want, but NEED this makeover. They are in poor health and in poor financial situations, and there’s little they can do to better the two. No one wants an employee who looks unkempt, so jobs available to these individuals are menial, and so they can never afford to better themselves.

    The Extreme Makeover needs to be done on health care costs, so that everyone can afford to smile and feel normal. Until then, I hope that this show stays on the air, so that more people can continue to receive the life changing miracle this show really does give them.

  • Charles Nwachukwu

    Mayer darkly hints at one of the significant problems inherent within the slew of “reality” programming centered around the idea of beauty. As a culture almost entirely underpinned by this notion, by this idea of exhibiting youth and health, it is not at all surprising that our media is so reflective of it; it is not at all surprising that someone devised a show that chronicles the experience of everyday people currently in pursuit of beauty. That is not to say, as Mayer’s experience details, that all of Extreme Makeover’s participants are simply fueled by their own vanity, but rather that the producers of the show should now be met with a new, but valid question: should the program merely be about fulfilling “fairy-tale dreams” or should it be making strong appeals to those with serious and “legitimate” plights in the vein of Mayer’s “Sue Ellen”? Extreme Makeover is not alone in this responsibility. Should our beauty-driven reality programs be used to perpetuate the American ideology (and thus be pitched in that fashion), or should they be used to extend a helping hand to people who are really in need?

  • A reality show that is actually beneficial

    This type of reality programming is great and a blessing to many people. Most reality shows are just for entertainment purposes and this show actually beneficial to people. I love hearing about stories similar to Sue Ellen’s case. As Mayer said this is an age of primary coverage cutbacks, medical mismanagements, and shrinking access to specialists. People who are affected by this now have a chance to gain self confidence. I mean let’s face it, the way someone looks has big affect on how people treat and perceive them. I have seen an episode of ‘The Swan’ and ‘I want a famous face’ and the results just amaze me. I think there should be more opportunities like this for people who need it.

  • christopher rusch

    Is TV in more need of a make-over?

    As Charles stated, Extreme Make-Over may be just another example of reality TV living in a dream world-playing to the crowd in delivering entertaining and perhaps life – changing transformations, while totally ignoring the underpinning issues of vanity, voyeurism, and need for plastic-surgery that always seem lost in the message . We speak highly of television’s ability to push the envelope and go beyond social boundaries that were decades ago considered off limits: sex, violence, feminism, moral and religious critique. Yet for every perturbation that has liberated our society, there lies the radical TV concept that raises controversy from both sides of the field. Plastic surgery is no laughing matter; neither is the growing heath care crisis facing the disregarded middle class. Will reality TV ever truly take notice of these underlying issues, or will we continue to be radiated with the colorful imagery of the glamour-enamored youth reborn?

  • Sarah Lipstate

    Mayer offers some rare insight into the motivation behind one woman’s decision to compete to receive plastic surgery on the reality show “Extreme Makeover”. “Sue Ellen’s” story is a sad one of medical debt with a growing need for expensive dental care that is not covered by insurance. She discloses to Mayer that “If I had good health insurance, I wouldn’t be doing this.” It is refreshing to hear such testimony from a person who might potentially end up as a subject on this television show however, I’m doubtful that many of the other participants on “Extreme Makeover” or similar shows share Ellen’s reasons. Even if they did, it’s unlikely that those motivations would be shared with the audience. The point of these shows are not to help people who can not afford proper health care, it is to satisfy audiences by molding average looking women into some kind of ideal by means of painful and expensive surgery. Furthermore, I don’t think that cases such as Sue Ellen’s make surgery-based reality shows any more palatable or acceptable. According to Mayer, Ellen would likely receive a nose and boob job, eye tucks, and a face peel in addition to much-needed dentures if chosen for the show. Shows like “Extreme Makeover” exploit women such as Sue Ellen who are willing to be cut-open and stuffed full of silicone in exchange for a procedure that they actually need and a limo ride.

  • After the show…

    Make-over shows based on plastic surgery procedures seem to me like Cinderella story told by a butcher. Behind the happy-ending narratives of programs like Extreme Makeover lie horrific tales of social injustice, class and racism. Mayer chance encounter with a contestant says tons about what may drive common people to participate in these humiliating spectacles. Her findings are commonsensical but still striking because they connect with the larger structures of oppression in the ‘classless society’ of the most developed country in the world. Wouldn’t it be nice if Mayer meets the same woman 2 or 3 years later? I’d love to know what will happen to Sue Ellen when she had to go back to her job as janitor.

  • What is the price of self esteem?

    I have watched the Swan on occassion and I hardly see women who want nothing more than to be famous. Each woman on the show comes with a story. One woman may have had five kids, and as hard as she works out, she still has a stomach that would make her husband turn away. These makeover shows don’t offer fame, they offer self esteem. Yes it is a sad time and a question of parenting and how our society portrays beauty when we need it physically to believe it emotionally. But that’s how we are raised. And no matter how perfect someone may look on the outside, deep down there is turmoil and trouble. If a woman feels terrible about herself and unattractive to her husband, I think that’s a legitimate reason to be on one of these shows. I always look at famous people and say “I could be that pretty if I had that much money too.” And its true. So this is the answer. Not every woman in America will have the chance to prove that, but for the women who do, its priceless. Its not about being famous, its about being proud of who you are. Sometimes it takes a little work on the inside to really blossom on the inside. That is shallow, but thats the way America and its obsession with model-like looks has made us all.

  • Jenny Alvarado

    I totally agree with the author is implying. I do like to see the process of the “extreme make over” on the show. I do not see the contestants as mere no bodies that would do anything for a chance to be on TV and gain notoriety. In fact, for anyone to believe that is the contestants objective is ignorant. When one actually sits down and sees the situation and cases of each individual contestant, their reasoning goes beyond the scope of fame. They are rather, a victim of a superficial society, if anything. The demands of society on individuals to be, what is considered and accepted as attractive, are a stressful requirement. To further their strain, many of the contestants cannot afford to have any type of surgery done, be it superficial and unnecessary or necessary. As a last resort, they turn to “cheesy” and “distasteful” programs such as extreme make over. Yes, the producers use the contestant and elaborate the truth to add some kind of over-dramatic element to the program. This is not the contestants’ doing, but they are obligated to carry out these tasks in order to receive free treatment and surgery. I cannot begin to fathom the embarrassment one must feel exposing themselves on network television for all to see in order to have the procedure done.

  • Chasity Colomb

    In my opinion, the show Extreme Makeover is an excellent source for underprivileged women who want to look beautiful. Many of the women who appear on the show, receive medical treatment that otherwise they wouldn’t be able to afford. In today’s society, a woman’s beauty is everything. Alot of these women just want to feel beautiful at any cost. I don’t think its about fame or wanting to be something that they’re not. Most of those women have conditions that can’t be fixed without medical attention. On MTV’s I Want A Famous Face, is a totally different aspect. Most of those people are obsessed with celebrities who they never ending up looking like anyway. Most of them have perfectly fine bodies, but are unsatisfied with being themselves. Extreme Makeover is a blessing to many people who can’t afford expensive medical necessities.

  • A road less traveled

    As discussed by others, the idea of beautification is an entirely subjective. Although I feel for this woman, who does not want to lose her smile, and for the many other that feel they are on the verge of losing their very own identity, the idea of beauty should not be a completely visual concept. Perhaps if we were in the days of radio, contestants would be given diction and articulation lessons. The fact that television is so completely focused on this idea of visual beauty disturbs me. As young women continue to subject themselves to breast augmentation and tummy tucks before even being able to put such surgery to good use at a bar (yes that was a dig at the young age in which MTV’s Famous Face participants go through life altering surgery) I feel that we are down spiraling into a cross-culturally standardized mindset of beauty. Is it so bad to just be yourself? I can understand if someone was in need of surgery in order to alleviate a health problem, but these types of shows generally encourage a singular notion of beauty. More-so since these transformations typically involve surgery, there is no effort or true “work” put into changing one’s self. We are truly moving to decadent times, where the individualized self is no longer of value, hard work and determination become foreign concepts, and unfortunately we rely on television networks to provide us with healthcare.

  • Mark Andrejevic

    extreme retirement pension?

    Thanks for highlighting the exploitative character of reality TV. Perhaps somewhere in the greedy back corridors of Los Angels, producers are gloating over the current dismantling of the social safety net. Imagine the possibilities! Retirees undergoing public humiliation to compete for a shot at a pension. Parents exposing their private lives in order to win college funding for their kids. There’s a certain affinity between the reality TV era and personal retirement accounts (that offload corporate risk onto members of the public): privatization and lottery logic go hand in hand. The ownership society meets the Lottery of Babylon.

  • A Response

    I want to thank everyone for putting in the time and reflecting on what is a real class dilemma in reality TV. Heather S. and Chasity have me thinking that if TV is so great, we should all just stop paying those high deductibles and let TV pick up the bill! But really, Mark, you’ve hit the nail when you see the neoliberal bent taken to the next level. In Argentina, there was a game show for people to compete over getting a job (think of The Apprentice for telemarketers and grocery bagging). Let’s hope we don’t get to the point where all of our basic rights become TV contest-docs.

  • Wow it is amazing how extreme surgical procedure can achieve such transformation to someone, I guess the risks must be also high considering that most of these surgeries are considered invasive. Thank you for sharing anyways.

  • Thank you very much for telling me about the surgical procedure…

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