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Feature General Practice

Can GPs do more to help patients with facial disfigurement?

BMJ 2015; 350 doi: (Published 10 March 2015) Cite this as: BMJ 2015;350:h1160
  1. Anne Gulland, journalist, London, UK
  1. annecgulland{at}

Anne Gulland reports on how a practice in Leeds is working with a charity to provide psychological, emotional, and social support to patients

The book Wonder details the travails of a 10 year old boy with a facial disfigurement who tells the reader: “I won’t describe what I look like. Whatever you’re thinking, it’s probably worse.”1 The story was inspired by an encounter the author, R J Palacio, had in a shop with a girl whom she now believes had Treacher Collins syndrome, a rare genetic condition that causes craniofacial abnormalities. Worried about her son’s reaction to the girl Palacio fled the shop, while the words of the girl’s mother echoed behind her: “Okay guys, I think it’s time to go.”

“It was horrible, just horrible. My heart broke for this woman and for this girl, for whom this must happen a million times each day,” Palacio said in a newspaper interview.2

This scenario of extreme social embarrassment is familiar to Carly Bailey, who developed facial paralysis when she was 14, and describes …

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