Pretty, Chirag would understand, is beside the point. The point is healthy. The point is normal. It makes me feel like a silly little girl that all I can think about is pretty. Even the word sounds silly and small, a shallow and immature concern.
The plastic surgeon’s name is Dr. Boden, and before I can ask him anything, he launches into a grotesque explanation of my surgery, repeating the details my parents explained. Apparently, he’s a really important doctor, one of only a handful of surgeons who can perform this operation.
Finally, I ask, “What did my parents mean when they said we had to do this while the face was still viable?”
“If we wait too long, the donor tissue will die.”
For a second, I consider just letting the clock run out, going on without making a decision at all, until it’s too late and it won’t matter what I choose.
“There is a lot more to this than the procedure itself,” Mom jumps in. “You’ll have to take special sorts of pills for the rest of your life, even after your face heals. And they have all kinds of side effects.”
“Why will I have to take them after I’m healed?”
“To keep your body from rejecting the alien tissue.”
Alien tissue. Do they have to use words that make it sound like I won’t be fully human?
“And if you don’t want to do it,” Mom adds, “that’s fine. There are a lot of risks with this procedure, and no guarantees. They’ve only done a handful of these before. It might be better if we waited until another donor became available, gave your body more time—”
“But you said that could take years, right?”
Dr. Boden nods. “We can move forward with the skin grafts, try that for the next few years. We’ll keep you on the transplant list and wait for another donor.”
I never thought before how strange the notion of a transplant list is. The only lists I’ve ever really given much thought to were grocery lists and to-do lists, lists of homework assignments and lists of clothes I wanted to buy before school started. I never thought there was such a thing as a list of names, people waiting for new faces. People waiting for someone else to die. Maybe there’s a group of doctors who meet in a narrow white room each day, deciding which of us gets which face. Who gets to be pretty, who will have freckles and whose skin will be alabaster smooth, whose nose will have a bump and whose cheeks will have dimples.
So this is what happens to a girl without a face. She’s given a choice: remain faceless (skin grafts), or take someone else’s face instead. But you better do it now, because there’s a long list of people waiting.
I close my eyes and imagine that Chirag is standing beside the bed, holding my hand, his eyes narrowed the way they do when he concentrates. If he were here, he’d probably make a meticulous list of pros and cons, as though there is a correct and incorrect answer, like this decision is as straightforward as a math problem.
I bite my chapped lips and try to imagine the answer we’d find at the end of his list.
Surely we’d conclude that spending the rest of my life with someone else’s face is better than spending it with no face at all.
So I tell them yes.
Everything moves really quickly after I announce my decision. The doctors come in and out and my parents sign what seem like a million consent forms. It gets so I can recognize their signatures from the sound their pens make against the rough paper. My bed is lowered so that it’s flat again, and the nurses prep me for surgery. It takes about a dozen people to move me from this bed onto the one that they’ll wheel into the OR, the bed where I’ll sleep throughout the operation. And all the while, everyone keeps saying the same thing: I’m lucky.
A nurse tells me how lucky I am to have survived my accident. One of the doctors who’ll be scrubbing into the surgery says that I’m lucky to have lost only my nose, cheek, and chin. My lips, mouth, and forehead are still intact. Lucky because there are only a few hospitals in the world where they do this kind of surgery and I’m in one of them.
A psychologist comes in to speak with me as they prepare me for the transplant. I’ve met with her a few times since waking from my coma, though I never guessed that she was evaluating me, like my mother said. I thought it was more like: You’ve lost your face, so we want to make sure you’re not thinking of strangling yourself with your IV tubes, that kind of thing. But it turns out that usually, with a face transplant, candidates—that’s what they call me, a candidate—are evaluated thoroughly, to determine whether they can handle the psychological impact of having another person’s features staring back at them in the mirror. I have to say, I think my dad is right about this: How can they possibly know, before it happens, whether or not I can handle it? But apparently, they’ve been testing me for this procedure all along, making sure my body and my brain are strong enough for it.
What a waste all that effort would have been if I’d said no.
“You’re a lucky girl,” the shrink says before she leaves the room.
I can’t help thinking that I would have been luckier not to have gone on a run that morning two months ago. My donor would have been luckier not to have died today. Maybe it’s the doctors who are lucky—they get to perform this once-in-a-lifetime surgery. Someone whispers that fewer than thirty transplants have ever been performed. They seem practically excited.
Dr. Boden says that my donor was killed in a car accident. The family has chosen to remain anonymous. She’s older than I am, and for a second, I kind of hope that she’s much, much older. I hope that she lived a long and happy life before that car slammed into her.
But then I remember that I’m getting her face. What if she has wrinkles and sun spots, like my mom is always complaining about? What a freak I’ll be, a wrinkled, sun-stained teenager with someone else’s skin stapled onto my bones.
Then Dr. Boden says that she’s only a few years older than I am; that’s part of what makes her a suitable donor.
I’m relieved to hear that she was young. I know it’s selfish, but I can’t help it. The doctors continue to chatter: Face transplants aren’t like kidney and heart transplants. We have to share more than a blood type. She also had to have coloring like mine. Someone says that her hair wasn’t quite as red as mine; it was darker, more auburn.
I want to know something else about her. Something that has nothing to do with who she was relative to me.
“Where did she live?” I ask, and Dr. Boden shakes his head.
“I can’t tell you that. Her family has asked for total anonymity.”
Suddenly, even where she lived takes on a whole new significance, and the familiar string of panic weaves its way around my rib cage. “But what if I’m walking down the street one day and someone recognizes their dead daughter’s nose, cheeks, chin?”
Another selfish concern. I thought I wanted to know something about her that had nothing to do with me. But I guess from now on, everything about her will have something to do with me.
Dr. Boden shakes his head. “They wouldn’t be able to recognize her features on your face. And I promise, your donor didn’t live anywhere near here.”
“I thought you couldn’t tell me that.”
He nods. “I can’t. But I do know that a team of my colleagues are on a plane right now to operate on her. If she lived close by, what would they need a plane for?”
“Okay,” I say. Dr. Boden explains that once his colleagues reach my donor, they will begin the work of removing my donor’s face, peeling back the skin like the peel coming off a banana. (I decide I will never eat a banana again.) Next, the face will be placed in a cooler full of ice, just like the kind you might take with you for a day at the beach, and flown to us here in San Francisco.
“By the time the face gets here,” Dr. Boden continues, “we’ll have begun your surgery.” They will expose my nerves and arteries in order to join them with my donor’s. “Like rewiring a lamp,” he says, as though that will make it any clearer to me. He uses phrases I’ve never heard before: words
like microsurgery and craniofacial specialist and immunologist. Apparently, there are more different kinds of doctors than I ever knew existed, and apparently, they’re all going to be working on me today.
My parents take turns kissing my right hand as I’m wheeled past them toward the OR.
“We love you,” my mother says, her voice strained. Just barely inside of my field of vision, I see Dad put his arm around her and she leans into him like she can’t stand up on her own anymore. I’m tempted to close my eyes; I hate seeing how scared they look. But I force my eyes open even wider, just in case. Just in case this is the last time I’m ever going to see them. Just in case I’m going to end up like the boy from the middle of last night, the one who didn’t live, no matter how hard the doctors begged him to.
In the OR, they begin by removing the gauze mask from my face. The lights in this room are blindingly bright if, like me, you can only stare at what’s directly above you. I close my eyes.
“Maisie,” one of the doctors says. The anesthesiologist. “I need you to count backward from one hundred.”
“Why?”
“It’s just part of how we put you to sleep. When you wake up, this will all be over.”
He makes it sound so simple. They said this would be a long surgery, but I didn’t think to ask just how long it would be. Six hours? Ten? Twenty-four? I guess it’s too late to ask now.
“Okay,” I say, taking a deep breath as though I’m about to dive underwater. I pretend that Chirag is here with me, holding my right hand. I imagine him leaning down to kiss my undamaged right knuckles. “One hundred, ninety-nine, ninety-eight …”
Then nothing.
Waking up from my surgery isn’t all that different from waking up from a coma. Voices float around the room above me. I swim up from sleep once more, trying to make out what they’re saying. I begin to open my eyes, but I can’t see anything.
Oh my god, the surgery went terribly, terribly wrong. I’m blind. They blinded me.
The string of panic twists its way around my rib cage, tighter than it’s ever been before, until I think it’s going to pull me apart. I can’t seem to articulate any of the questions flying around in my head so instead I say, “Give me back my eyes.” My voice comes out sounding like I’m about one hundred years old. My throat feels like it’s on fire.
“Give me back my eyes,” I repeat, growing desperate. “Please,” I plead. “I need my eyes.” I try to lift my good arm—my right arm—from the bed to touch the place where my eyes used to be. But it’s stuck beneath a tightly tucked sheet. I’m covered in blankets from the neck down.
A voice I recognize says, “Maisie, sweetheart. We need you to calm down. You’re going to hurt yourself.” It’s one of the nurses who called me lucky before the surgery.
“Give me back my eyes,” I say again.
“Should we sedate her?” the nurse asks as though I can’t hear her.
A male voice answers, “No.” He folds back the covers and pulls my right arm out, placing my hand between his. “Maisie,” he says calmly, “it’s Dr. Boden. Do you remember me?”
“Yes,” I croak. “You’re my plastic surgeon.”
“That’s right.” He sounds pleased. “What’s the last thing you remember?”
Who cares what the last thing I remember is? “What went wrong?” I ask, my tongue feeling paper-dry and thick in my mouth.
“Nothing went wrong,” Dr. Boden answers calmly.
Nothing went wrong? Nothing went wrong? When they wheeled me into surgery, I could still see. I’m sure of it. I remember my parents’ faces, their tight-set mouths, the tears brimming in their eyes.
“Maisie,” Dr. Boden prompts. “The last thing you remember?”
“Ninety-eight,” I answer, though I don’t see why it matters. Mom was right. This surgery was tempting fate. We used up all of our luck when I survived the fire; there wasn’t enough left over to get me through the surgery unscathed.
“Seriously, doctor,” I beg. “What went wrong? What happened to my eyes?”
“Your eyes?” He sounds confused. Oh god, he doesn’t even know that he blinded me?
“I can’t see!” I try to shout, but my throat is too dry.
“Your eyes are just covered with some gauze. You can’t feel it—your face is still numb. Here—” he says, and I hear the sound of a chair squeaking against the linoleum floor as he stands and leans over me. He gently unwraps one eye, and then the other. I blink as my eyes adjust to the light. He stands over me, where I can see him. He’s smiling warmly. His honey-colored skin is just a little bit lighter than Chirag’s.
“That’s better, isn’t it?”
I can’t nod, but I take a deep breath. Yes. That’s much, much better.
Dr. Boden offers me some water and I sip it through a straw carefully. “Where are my parents?”
“They’re just outside. You’re in the recovery room, and we wanted to wait until you’d woken up before letting them visit.”
“I’m awake.”
“I know. But I thought you and I might talk for a few minutes before they came in, if that’s okay with you.”
I like it that Dr. Boden is treating me like an adult, acknowledging that I’m old enough to ask questions without my parents by my side.
“How did the surgery go?”
He squeezes my hand between his. His palms are cool and his grip is firm. I guess he has to have good hands, to be a surgeon.
“It went wonderfully, Maisie. We’re all so pleased with the results.”
“I thought maybe something was wrong with my eyes,” I say. The words come out slowly; it’s as difficult to talk as it was when I first came out of the coma. My face feels completely immobile; I can move my lips, but not my chin or my cheeks.
“I’m sorry we scared you.” He pauses. “Maisie, I’m a plastic surgeon. Other types of surgeons, they make you better by taking things away. Dr. Cohen, he had to remove all that charred muscle and bone two months ago.” I shudder, trying not to imagine Dr. Cohen hacking away at my face. “But I make my patients better by putting things back. I would never have taken your eyes away.”
He sounds like he’s some kind of superhero, and I kind of hope he is. He continues, “We were able to completely replace your nose, cheeks and chin.” How strange to think of body parts as interchangeable like that.
“Will they cremate her?” I ask suddenly.
Dr. Boden looks confused, like he thinks maybe I’m still a little stoned from all the anesthesia. “Who?”
“My donor.”
“I don’t know what the family is planning.”
“I don’t want them to have to see what’s left of her.” Maybe I am still foggy from the drugs. What a strange thing to say about people I’ve never met.
Dr. Boden smiles, his dark eyes narrowing warmly. “Don’t worry,” he tells me. “We’re actually creating a replica of her face in case they opt for an open-casket funeral.”
Wow, you’ve thought of everything. “You can do that?”
He nods. “We use silicone,” he says. I don’t know what’s more grotesque—me wearing this woman’s face for the rest of my life or the fact that she’ll be buried wearing a mask of it, forever.
“Can I see it? The replica?”
Dr. Boden shakes his head. “I’m afraid not, Maisie. That would only confuse you.”
I’m plenty confused already, but I don’t think telling him that would help my case.
“Was I your first face transplant?”
He doesn’t hesitate before answering, which makes me like him even more. “The truth is, only a very few of these surgeries have ever been done. But I was the number two surgeon on a full face transplant a few years ago. A thirty-hour surgery.”
“The number two guy?”
“You never work alone on a procedure like this. I was one of three plastic surgeons in here with you today. We had a team of about twenty doctors.”
“A team, huh?” Like this is a game
or something. I wonder what the score would be. What inning we’d be in. When the shot clock ran out. “How did you all fit around my face?” I say, and Dr. Boden laughs. “The thirty-hour guy—did his face burn off, like mine?”
Dr. Boden shakes his head. Show-off. “Gunshot victim,” he says matter-of-factly, like it’s not a big deal that a bullet literally blew some guy’s face off. “And I’ve led surgeries replacing noses, cheeks, or chins before.”
“Just never all at once?”
“Right.”
“Well, let’s hope you had beginner’s luck with me,” I say, and Dr. Boden laughs again.
The nurse must have brought my parents in, because the next thing I hear is Mom’s voice asking, “What’s so funny?”
“An inside joke between Maisie and me,” the doctor replies, squeezing my hand one last time before releasing it so that my mother can hold it instead. Unlike the doctor’s hands, hers are hot and clammy, like she’s been wringing them nonstop since my surgery began. Her face floats into my field of vision.
“How long was my surgery?”
“Sixteen hours,” Dad’s voice answers. I wouldn’t be surprised if he had a stopwatch running the whole time, just so he could keep track. Sixteen hours sounds so short compared to the thirty of Dr. Boden’s other transplant.
Mom offers me more water. “Look, sweetie,” she says, “it’s a bendy straw. You love bendy straws.”
“Yeah, when I was five years old.” All the straws in the hospital are bendy straws. I’ve been drinking from bendy straws for so long I can’t remember what it’s like to actually put my lips on a glass. I’m sick and tired of bendy straws.
“Can I have my mirror?” I ask, and my mother looks positively panic-stricken.
My father says, “It’s in your room. They’ll transfer you back there in a few hours. They want to keep a close eye on you here in the recovery room for a little while first.”
I twist my right hand from my mother’s grasp.
“Maisie, stop!” my mother gasps.
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