Life as an Extreme Sport

Facing Facial Reconstruction

(Disclosure: I reluctantly took an ambien about an hour ago, being out of the more effective and less hallucinatory lunesta. Should this post devolve into random commentary about the squishy-ness of my keyboard, or the fish floating in the computer screen, just nod your head and go “Right, ambien” and trust I’ll fix the problem the next time I’m chemically sober.)

So, like many people I know who are involved, however peripherally, in medicine, I find Discovery television engrossing, especially (now that I have digital cable) Discovery Health. This eveningmorning, the show “Surgery”, which normally covers 2-3 plastic surgeries, one of which typically done for medical reasons, dedicated the entire show to “the woman without a face.” A victim of domestic violence, her ex-boyfriend had killed her mother, and shot off the vast majority of her face. (He had attempted to kill her by shooting a .44 through her right temple, at an angle, but instead of killing her, sheered her face off.)

The Surgery show focused on the aftermath of surgeries, two years after the initial injury, that were donated by a major hospital in Houston. Over the next 18 months, she had 6 major surgeries and another 3 minor ones, rebuilding her jaw, reconstructing her lower face, shoring up her left (functional) eye and giving her balanced facial features, creating all of the necessary prosthetics. They didn’t promise miracles to her, and she wasn’t given them, but she was given a face that allows her to “pass” at 10 feet without double-takes, and allows her to do things like wear makeup and eat without feeding tubes.

The donated surgeries? They stopped keeping track of the cost after $1million. Which got me thinking about people who could have been helped with that money, is it justifable to spend that much on one person, even though it was donated? The emphasis we place on faces being necessary socially (and they are) means that the sympathy card gets plaid quickly on this case, and I really don’t want to suggest that the woman shouldn’t have had the surgeries – only question what the money/time was drawn away from?

Actually, no, I don’t even want to question that. What I want to wonder about is whether or not facial transplants would have alleviated the number of surgeries and the cost, with a similar acceptable physical result? Was the lack of underlying structure prohbiting a facial transplant (ignoring I suppose the fact that they were not being performed yet), or could you have built the base of the face if you had the tissue to overlay onto it? Yes, she would have to take drugs the rest of her life, but would that be worth it for a socially acceptable face? I suspect everyone asked would say yes.

There’s been a lot of misgivings about face transplants, but this situation seems to illustrate a need for them: to give a person back a face, one that often will look so much better than the best plastic surgery can give, in a less expensive operation that takes less resources from hospitals or patients, and allow for additional donated surgeries.

…I had more to say, but there are fluffy white sparkly glowly moths, and they’re singing to me that I need to go to bed before the keyboard transmagorphs my fingers into the faux fur stone they are, and I become forever augmented by my attachment to my Mac…