Why She’s Not Putting on a Shirt, and Why We’re Walking With Her

This is the story of how Kim Bowles, an introverted, but bold, scientist and mother of two toddlers, ended up protesting topless on a sidewalk in Cleveland. This is why you should walk with us on September 8, 2018. (Author: Amanda Newill)

While chemotherapy ravaged her body and she was waiting for her mastectomy, Kim researched her cosmetic options. Many women choose breast reconstruction, but Kim decided to forgo reconstruction and “go flat.” This would allow her to have a single surgery and would minimize recovery time, so she would not miss any more of her babies’ little years. During a long consultation with Dr. Steven Bernard, the plastic surgeon recommended by her breast surgeon, Kim shared pictures of her desired cosmetic result.

what i asked for what I got

She remembers Dr. Bernard saying, “I will make you flat,” and he noted in her record that she wanted “a smooth, flat result.” She believed she was in good hands.

Kim tells of the day she had her mastectomies. “Can you picture this? I’m on the operating table—bald from chemotherapy, with the IV in my arm—and I heard him say, ‘I’ll just leave a little extra in case you change your mind.’ And I said, ‘No! Make it flat! I just want to keep my range of motion….’ And then I conked out….”


At first, everyone tried to reassure her that she had obtained the result that she wanted, which made her question her own eyes—and her mind. Does she look flat to you?


Kim knew it was too late for her. She would have to find a way to live with this result, which she felt was intolerable; or she would have to take more time away from her family (as well as take on more risk and more expense) to have further surgery.

Kim pleaded with Dr. Bernard’s hospital, Cleveland Clinic, to address her concerns, acknowledge what happened, and discipline Dr. Bernard. She reached out to the hospital ombudsman, CEO, chief experience officer, plastic surgery department head, and medical ethics department, and then the state medical board, the Society of Plastic Surgeons, and a malpractice attorney who told her, “The jury will just hear a woman complaining about a cosmetic result, when the doctor saved your life.” [Dr. Bernard, in fact, did not perform any of the lifesaving cancer removal; that was the breast surgeon, who did a fine job. Dr. Bernard’s only job was to make Kim’s chest smooth and flat. And, the core issue of her complaint is patient consent and her right to bodily autonomy, not aesthetics.]

When she couldn’t get results after making countless phone calls and sending myriad letters and emails, Kim protested topless—by herself!—at the CEO’s office at Cleveland Clinic. She took her shirt off again for an entire day on the sidewalk outside of the hospital. From those efforts grew her organization, Not Putting on a Shirt.

Kim’s determination to have her wrong righted—by acknowledgment, apology, and formal change in hospital procedures— continues to grow as she hears story after story of similar things happening to other mastectomy patients, many of them in poor health, due to cancer. Often, they are in their sixties and seventies. Some don’t even live long enough to have a chance to stand up for themselves.

For all of these women, for Kim, and for every mastectomy patient in the future who decides that breast reconstruction isn’t for her, we will walk. Men and women who have never had a personal experience with cancer will walk with women with scarred chests, some of them bare.

You are invited to walk with us on September 8, 2018. The Not Putting on a Shirt main walk and lunch event is in Cleveland, and, with our help, you can coordinate a walk in your town or city.

Pictured: Walkers will get Not Putting on a Shirt t-shirts in a variety of colors. Shirts are also available for mail delivery. Note: Website is not up and running, yet.

We will stand together so that awareness will grow; so that women will get the best information and support possible, before and after surgery; so that medical professionals and institutions will be held accountable when bodily autonomy is violated; and so that patients and surgeons will share decision-making in a way that helps surgeons provide the best care available for each patient.

I’ll finish with Kim’s words: “We have strength in numbers on this. It’s easy to dismiss one woman standing on the street with a sign. It’s much harder to dismiss a group of people supporting each other, walking together. I know we all have very busy lives. My two- and five-year-olds would certainly rather I stay home with them so they can climb on me and scream at me… And I appreciate any time that any of you are willing to give towards this cause. I spoke to a woman last week who had this bait-and-switch happen to her, and she will never be able to get it fixed, because she is stage 4 (terminal) and too weak from ongoing chemotherapy to survive another surgery. Can you imagine? This s*** has to stop.”

Find Kim and Not Putting on a Shirt on Facebook or contact her at NotPuttingonaShirt@gmail.com.

Published by Not Putting on a Shirt

Founder of Not Putting on a Shirt, a mastectomy patients' rights organization that advocates for optimal surgical outcomes for patients going flat.

3 thoughts on “Why She’s Not Putting on a Shirt, and Why We’re Walking With Her

  1. Thank you, Amanda, for putting Kim’s story in such a great narrative! You expressed the issues very clearly and concisely. I appreciate your effort on her behalf, and for all the women (and anyone) who have had a similar or, often worse, surgical outcome.
    Kim was so adamant and clear in her desire (long discussions and actual photos) with Dr. Bernard, that I was, and am still, astounded at the ensuing result. I will never forget her devastation – waking to find she’d had her decision ignored and would have to risk the dangers of a second surgery if she was to have any hope of a truly flat scar! After all she’d been through dealing with her cancer, and her efforts to minimize her future health risks, well…, the photos show how “not flat” her scarring is.
    I am sorry she was forced to join the group of women(mostly) that have a surgical outcome so contrary to their express wishes. I am sorry that anyone has become a part of that group. My hope is that these efforts lead to surgeons accepting the concept that the patient’s decision is primary, not the surgeon’s, when it comes to aesthetics, and it is on the surgeon to have a thorough discussion with the patient if the surgeon has doubts as to wisdom of the patient’s choice. Assumptions and arrogance have no place here – they have proven detrimental to outcomes for Kim and other patients, who are now paying the heavy price for surgeon’s attitudes!
    Thanks again to you and all the crew behind this movement. I will see you in Cleveland!!!!

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