Book summary “Ugly”: summary

Introduction

You often judge people by their appearance before you hear them speak. When a child is born with severe physical deformities, this harsh social instinct creates an immense barrier to connection and happiness. You might wonder how anyone can overcome profound medical challenges and relentless public staring to lead a fulfilling life.

A boy born with massive facial deformities and amputated legs learns that physical appearance matters far less than self-acceptance, family support, and personal resilience.

Robert Hoge shares his remarkable life story in this memoir. The book traces his journey from a harrowing birth and terrifying childhood surgeries to mainstream schooling, competitive sports, independent adulthood, and fatherhood. You will discover how a supportive family and your own determination can transform perceived ugliness into a source of inner strength.

• How do parents survive the initial shock of a severely disabled newborn?
• What drives a child to endure dangerous reconstructive surgeries?
• How do you find acceptance among peers when you look entirely different?

1. Birth and Maternal Rejection

Robert Hoge was born on July 23, 1972, with a massive facial tumour pushing his eyes apart and severely deformed legs. This startling arrival instantly inducted him into the ugly club, a metaphorical collective encompassing anyone whose physical features deviate drastically from societal norms.

Initial shock and grief can lead parents of severely disabled newborns to reject them before a process of gradual psychological adjustment and family consultation takes place.

Faced with a monstrously deformed infant, the author's mother Mary initially refused to see or take him home. Doctors and local clergy advised her to place him in an institution.

Mary had four older children named Michael, Gary, Paula, and Catherine. Her doctor advised her to put the baby into a home because of the family size.

A family breakfast discussion changed everything. The four siblings unanimously voted yes on bringing the baby home. Mary finally decided to bring Robert home on August 28, 1972.

The parents adopted vastly different approaches to public stares and questions. Mary approached encounters with subtle caution and a desire to avoid teaching her son to hold a grudge. Vince tackled questions head-on with brash openness and sharp retorts.

When a child asked inappropriate questions at the Wynnum Wading Pool, Vince would loudly instruct them to go tell their mother she wanted them.

2. Cranio-Facial Surgery and Medical Milestones

When you face severe congenital deformities, medical intervention becomes a desperate gamble between survival and social integration. Doctors proposed a radical cranio-facial operation when Robert was four and a half years old to move his eyes closer together and rebuild his nose using parts of his amputated leg.

Major elective reconstructive surgery on young children requires weighing immense mortality risks against the psychological necessity of social integration.

Vince initially refused to consent because he equated the one-in-four risk of death to rolling dice for a ten, eleven, or twelve. Mary insisted on the necessity of the operation for Robert's future, and Vince eventually signed the papers.

The surgical team utilized revolutionary techniques pioneered by French surgeon Paul Tessier in the 1960s. This approach replaced piecemeal operations with a single comprehensive procedure using pneumatic bone-cutters and precise anaesthetics.

Dr Leigh Atkinson and plastic surgeon Dr Emmett practiced cutting up skulls and planning forty different surgical procedures before performing Australia's first major cranio-facial operation. The resulting procedure lasted twelve hours. Robert held a measured IQ score of 134 prior to surgery.

Post-operative infections pose a persistent danger that can require prolonged hospitalization and additional exploratory operations. After a holiday in Caloundra, Robert developed a severe forehead infection that led to a four-week hospital stay. A hospital scan on 8 November showed a one-centimetre-wide pocket of infection. Dr Emmett performed a two-hour exploratory operation on 20 November to remove un-dissolved wire and silk sutures. Robert spent five months in the hospital following this stubborn post-operative infection.

Despite strict medical association rules prohibiting the naming of doctors at the time, Robert's parents agreed to a feature article by journalist Hugh Lunn. The report gave public recognition to the dedicated Mater hospital staff who performed the complex surgery for a grand total of fifty dollars from the public health system. Hugh Lunn published his feature in the Weekend Australian in May 1977, successfully facing down the AMA disciplinary board and winning a special prize in 1979.

Surgeons performed later interventions during adolescence to prepare facial structures for future major reconstruction using autologous materials. Robert underwent an operation at the Mater Children's Hospital where cartilage was harvested from his right ribs to rebuild his nose. He returned to school seven weeks after the operation for grade six.

3. School, Sports, and Childhood Resilience

Starting school and participating in sports despite a physical disability helps a child overcome avoidance and build lasting peer connections.

Mary requested that Robert be the last to go up and down the school stairs to prevent him from being jostled by other children. On his second day, a boy named David Bandiera met Robert on the stairs, grabbed his hand, and walked him down the rest of the way, beginning a friendship where Robert traded his unwanted school apples for David's help.

After a year around other children, Robert noticed that many kids had their own unique physical differences, making them feel like members of a special club. Robert observed kids with a harelip, red hair, unusual height, and extreme thinness, realizing everyone had something different about them.

Neighborhood friends adapt quickly to physical differences, allowing for cooperative play, exploration, and entrepreneurial projects. Robert and his neighbor Cassandra built space Lego, searched for UFOs using an AM radio, and tried selling backyard grapefruit for fifty cents each. One customer paid 10 dollars to buy a dozen grapefruit. Dinner time at the Hoge household was usually around 5:30 or 6 pm.

Children often project large-scale historical events onto their immediate local environment to create heroic narratives. When NASA's Skylab was falling to Earth in July 1979, Robert and David planned to be trapped in the Guardian Angels toilet block after impact, using Robert's artificial leg as a battering ram to escape. Skylab was launched in 1973, weighed 77 tonnes, and measured 17 metres in length. The grand church at Guardian Angels opened in 1904, purchased by Archbishop Robert Dunne for £420, and the school opened 10 years later.

Instructor Kerry offered Robert a Ronald McDonald watch if he swam half the length of the pool, motivating him to conquer his fear and swim successfully. The swim lesson had a duration of 30 minutes, and Robert swam 5 metres on his own to earn the watch. Because lower limbs lack functionality and float lower, arms must work harder, but intensive lessons and modifications like specialized flippers can help overcome initial barriers.

Despite Vince's concerns about Robert becoming a spectacle, Mary insisted he run the 100-metre sprint at the Iona College sports carnival, where he fell but finished to cheering crowds. Robert deliberately shook his left stump until his artificial leg fell off in front of his class, causing David to copy him and turning a strict nun's frustration into shared classroom amusement.

Parents and schools must forbid participation in rough team sports like rugby league to prevent accidental blows to delicate facial reconstructions or severe injuries caused by hard artificial limbs hitting other players. When Robert tried to join the under-eight rugby league team, his parents and school intervened, turning him into a sideline ball boy instead after explaining the extreme physical dangers. The Wynnum Manly rugby league team rejoined the Brisbane competition in 1951, and 1979 was the year Robert first brought home a rugby league permission slip alongside a 160 gram cricket ball aimed at players.

During Friday afternoon sports for uncoordinated or injured misfits, team captains methodically select players until only the most deficient remain, and being picked second last rather than last is a patronizing compromise driven by pity or teacher disapproval. Robert routinely experienced the agony of standing in the residual group of misfits on Friday afternoons, waiting to be picked second last by team captains.

4. Names, Words, and Writing

Nicknames and labels carry immense power for a child with disabilities. They act either as affectionate markers or afflictions that reinforce deep-seated insecurities. Schoolyard nicknames often target physical differences and validate your worst fears about yourself.

Childhood nicknames and harsh discipline shape a student's relationship with language, driving them to value the meaning of their words over visual neatness.

Robert accumulated numerous nicknames throughout school. The labels ranged from affectionate ones like Transformer to deeply wounding ones like Toe-Nose, which mocked the surgical origin of his nose.

Analyzing childhood nicknames reveals how specific and unique labels cause significantly more psychological harm than generic ones. Generic insults like four-eyes or ugly-face make you feel part of a shared human experience. Hyper-specific nicknames isolate the individual and make self-defense nearly impossible.

Robert's top ten nicknames included:

• Toothpick-Legs
• Flat-Nose
• Pinocchio
• Jake the Peg
• Ugly-Face
• Retard
• Transformer
• Stumpy
• Cripple
• Toe-Nose

In the 1800s and early 1900s, cripple was frequently used in the medical community. Hasbro brought out the Transformers toys in 1981, and the American Association on Mental Retardation changed its name in 2006.

After receiving a score of one out of ten on a handwriting test and getting caned on his writing hand by Mr Searle, Robert decided that the meaning of his words mattered far more than their visual neatness. Strict standards for running writing and physical punishment for messy results drive you to abandon aesthetic neatness in favor of speed and content.

Teacher Gary Bolton read passages from The Lord of the Rings to the class. This sparked Robert's imagination and encouraged him with the idea that he might write a book someday.

Robert wrote a hasty, unsigned love note to a new student named Michelle da Costa. The note was intercepted and read aloud by other students before Michelle formally rejected his offer.

5. High School Adaptation and Lawn Bowls

Transitioning to a massive high school and finding alternative sports provide new avenues for personal growth and competitive success.

Moving from a small primary school to the Iona campus meant you had to navigate large crowds and one thousand students. You fought for food at the tuckshop and faced the vulnerability of taking off your artificial legs in front of unfamiliar peers.

At the Tallebudgera Creek school camp, your hollow fibreglass legs clattered loudly on the concrete floor when you took them off in the communal hut. This immediately drew the attention of your peers.

Physical limitations can be reframed into unique advantages through creative adaptation in performance. Having stumps instead of proper legs gave you a lower centre of gravity and extra stability.

At the school camp talent quest, you performed a handstand routine and walked twelve steps across the stage on your hands without your artificial legs. This won first place for your hut.

When mainstream sports are inaccessible due to a disability, alternative sports can provide a welcoming team environment through dedicated coaching and tailored adaptations. Lawn bowls allowed you to participate in a competitive team sport despite your lack of legs. You utilized specialized coaching from Frank Plant and a custom metal stand built by Frank's son to maintain stability.

Frank Plant dedicated hours on Saturday mornings to coach you at the Wynnum Bowls Club across a green five metres wide and thirty metres long. After sixteen months of practice before your first official game, he arranged competitive matches and helped you win your first official third-place singles trophy.

Follow these coaching rules to maintain proper form:

• Keep your head up and your eye on where you want the bowl to end up
• Keep your arm parallel to your leg
• Lock your elbow and bowl from the shoulder
• Release the bowl closer to the ground so it rolls smoother
• Lock your wrist steady like your elbow

Boredom in secondary school classrooms routinely sparks collective, unauthorized manual labor fads among adolescents. Students engaged in a persistent school-wide campaign to sand down their old wooden desks to remove varnish, graffiti, and ink marks. You sanded your classroom desk so extensively that you accidentally wore a hole through the wood. You had to repair it by gluing paper underneath and packing it with sawdust and glue.

Administrative discipline for bullying forces students to recognize the emotional impact of targeted mockery. After you drew a caricature titled Spaceport Ben featuring a classmate's large nose, the deputy principal called you in to explain that the targeted peer was deeply upset.

A lack of lower limbs alters your center of gravity and balance during high-velocity recreational activities. Without the weight of legs to anchor your body against frictional forces, you can easily become top-heavy and flip backwards. While riding a steep toboggan slide at Amazons Water Park that stood three or four storeys high, you flipped backwards and hit your head. You lost consciousness and had to be rescued and revived by a lifeguard.

6. Refusing Surgery and Embracing Identity

Choosing not to alter one's physical appearance through risky major surgery can be a powerful act of self-acceptance for someone with a severe disability.

When you reach age fourteen, doctors recommend a major facial reconstruction surgery. They want to fix your nose, forehead, and eye spacing to make you look more normal. Four years have passed since your previous big operation at age ten.

During a family discussion with Mary, Vince, and Michael, you decide against the operation. The risks are severe, including losing your eyesight or dying. Michael asks a defining question: "What use is looking pretty, if he can't even see himself?" You realize your decision is made for your future rather than your past.

Insecurities about facial appearance and disability can lead adolescents to avoid social interactions and create elaborate deceptions. You feel that your facial scars and disability make you unappealing to girls. At age thirteen, you stop spending time with your childhood female friends and become un-girlfriended.

You adopt coping strategies such as growing a specific fringe to cover your scars. You invent a fake girlfriend named Michelle to appear socially normal at a school fete. Your deception ultimately fails when you pretend to make a call on a payphone without inserting money in front of popular classmate Brook Bishop. Mary gives you five books by Isaac Asimov after your junior certificate.

Confronting physical limitations in nature can force you to fully acknowledge your disability. Mary wins a thirty-day bus trip around Australia on a quiz show. You and Vince visit Ayers Rock, also known as Uluru, and attempt to climb it using metal stakes and chains hammered into the rock in the sixties.

You stop halfway up and sit on the slope because you are overwhelmed by the heat, gradient, and fatigue. You realize that your positive attitude and wit cannot overcome your physical reality.

The sudden illness of a traditionally strong and reliable parent can shatter your sense of security. Vince has always been fit, strong, and healthy despite smoking. At approximately age fifty-five, he wakes up on a Sunday morning after playing poker late and exhibits a slow tapering off of his lips and slurred speech.

A local GP misdiagnoses him with Bell's palsy. Doctors at the hospital later diagnose a series of small strokes caused by smoking, which challenges your perception of his invulnerability.

Transitioning into senior school and taking responsibility for your future can transform academic apathy into high achievement. You face grades eleven and twelve with higher expectations from your parents, your peers, and your own disability. At the start of 1987, Joh Bjelke-Petersen has been premier of Queensland for nineteen years.

You knuckle down in subjects like maths in society, also known as veggie maths. You achieve a ninety-two percent score on your first-term biology test compared to a forty-seven percent score on your first maths test. You achieve equal top grade in your class for maths in society, score high across all senior subjects, and successfully apply to study a competitive journalism degree at the University of Queensland.

7. University, Career, and Adulthood

Academic success, university freedom, and early professional opportunities pave the way for lasting independence and romantic relationships.

You receive a tertiary entrance score of 915, placing you in the top 8.5 per cent of students in Queensland. This secures your admission into the arts and journalism degree at the University of Queensland.

Moving from high school to the University of Queensland offers freedom of dress, study, and association. You form close friendships with peers like Malcolm Cole, Damon Cavalchini, and John Back, with whom you collaborate to start an advertising-supported campus newspaper.

John Back recommends you to take over desktop publishing for the Department of Education's newspaper Education Views. You work six or seven days per fortnight for the casual desktop publishing role, and editor Greg Jackson puts you through rigorous newsroom questioning about interview facts and story completeness.

You follow professional lessons closely:

• Listen to everything everyone says in a newsroom environment.
• Listen to other journalists during phone interviews to learn question types and information-gathering techniques.
• Listen to what the chief of staff asks for to find the best story direction.

After years of friendship, you decide to ask Cassandra out by writing a sixteen-line poem in verse. You give her the poem while eating Kentucky Fried Chicken at the Myer Centre in Brisbane, and her subsequent visit and kiss confirm mutual romantic feelings.

You also meet Sue through a social group playing pool and visiting a Brisbane pub. You become regulars at the Britannia Inn on Thursday nights for drinks and karaoke, eventually leading to you proposing marriage when you are twenty-two years old.

With financial assistance offered by an anonymous donor after a newspaper article, you contribute funds to help your sister Catherine purchase a house in Hemmant. You and Vince spend three days painting the interior of Catherine's new house and hauling soil and grass clumps from an old farm to build up the yard by five centimetres.

8. Legacy, Fatherhood, and Self-Acceptance

Confronting personal grief over a parent's passing and facing the anxieties of prospective fatherhood complete a lifelong journey of self-discovery.

Everyone notices flaws when truly looking in a mirror. Ugliness challenges societal superficiality, but no one else has the right to define what is ugly for another person.

When you were twelve years old on holiday in Sydney, two middle-aged ladies stared at your face in a hotel elevator and remarked on how terrible it was that kids were allowed to play football, assuming your appearance was sports-related damage.

Despite missing legs, which severely impacts mobility and is objectively a greater physical hindrance than facial deformities, you would still choose to fix your face if given a hypothetical choice between the two.

Discovering that Sue was pregnant brought immense joy, but also sparked deep anxiety about whether your congenital disabilities would be passed down. Vince asked you over lunch if you had talked to doctors about potential issues with the baby, suggesting it would be tough bringing another child with problems like yours into the world. Ten weeks into pregnancy at Christmas, you and Sue had told her parents, and Vince already had thirteen grandchildren.

The due date landed on 23 July, which was your birthday. Following Vince's comments, you endured the agony of waiting for the first scan for two weeks.

First-trimester scans occur within the normal window of eleven and thirteen weeks. During the scan at the Mater Hospital, the technician confirmed that the heartbeat, size, and due date were completely fine, causing you to let out a massive sigh of relief.

At twenty weeks, Sue had her second scan to check development and learn the sex. Before knowing the sex, you used the combined placeholder name Imax based on your chosen names, Max and Imogen. The technician asked if you wanted to know the sex and subsequently announced you were having a healthy little baby girl named Imogen.

On 21 July, Sue started experiencing abdominal pain, and Catherine drove you and Sue to the Mater Hospital. Sue underwent a caesarean section, and you finally held your newborn daughter Imogen, counting her ten fingers and ten toes.

10 Key Ideas

1. Initial shock and grief can lead parents of severely disabled newborns to reject them before a process of gradual psychological adjustment and family consultation takes place.
2. Major elective reconstructive surgery on young children requires weighing immense mortality risks against the psychological necessity of social integration.
3. Starting school and participating in sports despite a physical disability helps a child overcome avoidance and build lasting peer connections.
4. Childhood nicknames and harsh discipline shape a student's relationship with language, driving them to value the meaning of their words over visual neatness.
5. Transitioning to a massive high school and finding alternative sports provide new avenues for personal growth and competitive success.
6. Choosing not to alter one's physical appearance through risky major surgery can be a powerful act of self-acceptance for someone with a severe disability.
7. Academic success, university freedom, and early professional opportunities pave the way for lasting independence and romantic relationships.
8. Confronting personal grief over a parent's passing and facing the anxieties of prospective fatherhood complete a lifelong journey of self-discovery.