Tuesday, February 7, 2012

The Beauty That is Hidden

It must have seemed so uncomplicated at first. A patient’s kidneys are failing, let’s give him a new one. The first human organ transplant was performed at Boston’s Peter Bent Brigham Hospital in 1954, a kidney donated by one identical twin to another, to minimize tissue rejection.

I remember hearing about the first human heart transplant performed by the South African surgeon Christiaan Barnard thirteen years later and thinking, Creepy but cool. Are you the same person with another person’s heart in you? The question lingers for me 45 years later.

Now comes an awe-inspiring article in this week’s New Yorker about Dallas Wiens, the first American to be given a face transplant. (The photo on this post is from his web site, of Wiens and his daughter.)
Written by Raffi Khatchadourian, it is one of those articles that the New Yorker is famous for, the long, detailed story of how Wiens had his face burned off by contact with a high-tension electrical line; how his family was told he would not survive, and he did survive; and— But let Wiens’s own web site pick up the story for a paragraph:

Spurred on by the desire to hold his two-year-old daughter Scarlette again, he learned to speak without the use of lips or teeth, threw aside his wheel chair despite being told he would not walk again, and opted for pushups and workouts in his hospital room during his free time instead of resting. Three months later, Dallas was out of the hospital and well on his way to returning to life before the accident. However, he was not satisfied.

 
Khatchadourian’s article continues with a blow-by-blow history of organ transplantation and the gripping description of Wiens’s own complex procedure, performed at Brigham and Women’s in Boston (the successor to Peter Bent Brigham) and the first performed in the United States. But for all the medical and surgical wizardry catalogued in the article, the remarkable story is not scientific but human. What was Dallas’s Wiens’s experience? I sped through the procedural details of Khatchadourian’s article to see what he might add. He adds a lot.

When Wiens awoke with his new face, he had no pain, only a sense of “heaviness.” A nurse put sterile gloves on him and he explored his face. It had lips! “It was incredible,” Wiens told the journalist, who adds, “The eyelashes in particular moved him. There was something about their intrinsic delicacy that seemed human, impossible to face. 

Several days after the surgery, he was brought a tray of hospital lasagna and realized that he could smell it. The taste took on a three-dimensional aspect that had been gone since he lost his nose, more than two years before. The rush of sensation surprised him. He later told me, “Smelling is awesome.”
Later, Wiens commented, “It is an amazing experience to be able to just feel a kiss again after two and a half years of having no feeling whatever.” Even more remarkable, later in the article, is Wiens’s report of crying and realizing that he was crying real tears, through tear ducts that had been given to him.

Today, according to the article, Dallas Wiens is learning meditation, Japanese, Braille. He speaks at churches And though he is blind and still cannot see his face, “himself” in the mirror, his inner attitude is exemplary. The article ends this way: 

These days, the face that he encounters in his dreams is more often a version of the transplant. He does not know what it looks like, but his unconscious has been struggling to visualize it. “I have never seen it clearly—more as a profile,” he told me, his voice slow an dsoft over the phone. “It is kind of clouded, so it is difficult to tell, and even if I see it clearly I don’t remember it clearly when I wake up. But it’s pleasant.” He paused, and added, “Mostly becuase my attitude about life is pleasant.”

While it takes thousands and thousands of words to tell the scientific story, Khatchadourian summarizes the drama of the first human face transplant with a single striking sentence: “If a face transplant demonstrates anything about what it means to be human, it may be that we are less superficial than we imagine.”

Tonight, out to dinner with Katie, I couldn’t help noticing another couple behind us. The man was about my age; the woman had her back turned but her blond hair and energy suggested she might be his daughter. Wife? Girlfriend? I couldn’t tell.

When they finally got up, I gestured toward them and asked Katie what she thought. Her eyes followed them out of the restaurant, and then she pronounced a woman’s verdict and certainly the right one: “His wife. Wearing a wedding ring—and she’s had a lot of work done. I mean a lot.”

When the woman climbed into the passenger seat of their car just outside the restaurant window, the dome light illumined her face: tight-stretched and eerie in that overhead glare. I thought, She could do worse than spend a few minutes with Dallas Wiens. 

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