"The Young and the Desperate" by TheFittest

All,

We spend a lot of time on this forum discussing very technical issues regarding HT. That’s as it should be. However, there is another aspect to HT that is rarely discussed, and urgently requires discussion – namely – whether or not a given person is *psychologically* a good candidate for HT. Many recent posts have convinced me that some of the people who most desperately want HT are exactly those who should be most strenuously discouraged from HT.

While *unrealistic expectations* of the final results of HT surgery are the hallmark of the bad candidate, often these ill-informed patients can be cured of their delusions simply by seeing actual HT results in-person. They then realize that what has been so tiresomely repeated is true: HT’s on the street very rarely look as good as they do in pictures online. However, the need to see patients in-person is not my main point today, although it remains the First Commandment of the prospective HT patient.

Instead I’d like to begin a discussion about some of the features that render a patient a *bad candidate* for HT on purely psychological grounds. Because there are some problems, mainly emotional problems, that may continue no matter how many finished patients are seen.

We all read the posts from the *desperate* patient. By definition, the desperate patient is in the worst possible position to make rational choices about his future. He is “sick” of his hairloss; and one sympathizes. He requires an “immediate solution” to the all-encompassing problem of hairloss, and he “just can’t wait.” He is at his “wits end;” drugs are not doing enough; he wants action. Yesterday! He wanders miserably onto the Surgical section of this site. He vaguely asks for others’ opinions, but, of course, he is already decided. He will get HT. Period. No one can tell him differently, or even qualify the *wonders* that will inevitably result from his planned HT; if someone does question or qualify, that person is a “naysayer;” heck, if the desperate poster is particularly creative and dramatic – the person advising caution may stand revealed as a *doom-sayer.* And it’s all in good fun until someone loses a *life* to an ill-advised HT. It has happened, and is happening even now, despite the “best modern techniques.” These techniques, however improved, only treat the scalp. They cannot treat the *real* problem. The desperation.

The desperate patient is almost always young and traumatized by the first few years of hairloss. He believes with all his heart that life is over; things will never improve, in any way, unless he “gets his hair back.” He is now ugly; the thrill of going out, the even greater thrill of getting ready to go out, is gone, gone, gone. Then on Monday the florescent lights at his office. In a word: hell.

We all know this hell intimately, and sometimes, even though it’s obvious that the patient is desperate and therefore by definition a bad candidate for HT – we *indulge* him with talk of graft estimates, FUE vs. strip, and can he wear it gelled when he gets it back?

This is wrong. The problem for people trying to advise the desperate patient is this: how, knowing what he is going through – indeed, knowing it all too well – can one possibly deny him the hope he so desperately needs? How not to come off as the condescending elder, the know it all, the terrible, well-intentioned friend or parent who all tell him the same shitty thing, which seems to be: *get over it.* How does one avoid that?

One doesn’t. There is no way to avoid telling the desperate patient what they don’t want to hear. They have to be told that they are NOT a good candidate for HT; no; they are a *bad* candidate. Young and desperate is *never* the condition in which to make a decision about something as serious, complex, costly, and life-altering as HT. Never.

TheFittest