Leitura para o feriado: a nova cara de Richard Norris

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The New Face of Richard Norris

For fifteen years, Richard Norris had a face too hideous to show. Then, one day, a maverick doctor gave him a miracle too fantastic to believe. Richard got a face transplant, a new life, and a new set of burdens too strange to predict. What’s it like to live with a face that wasn’t yours—and that may never quite be?

Before we bring him in, maybe we can open the floor to some questions. This will be your first time meeting him. He’s very comfortable with people evaluating him. Because right now he’s being looked at almost as an experiment. Which he is. He’s a human-subjects experiment.

Richard Norris was 22 when he shot himself in the face. This was back in 1997. He doesn’t remember how or why it happened, but his mom, who was three feet away, said it was an accident. She remembers pieces of Richard’s face showering her body. This was in the living room. The gunshot had blown off his nose, cheekbones, lips, tongue, teeth, jaw, and chin, leaving just his wide brown eyes and a swirl of nameless twisted flesh.

The miracle that would come to define Richard’s life begins with these tragic details. Like most miracles, with each retelling, the edges of the story sharpen, the colors become more vibrant, and the shadows disappear. Ashamed of his appearance, Richard became a hermit, living for nearly a decade on a foggy mountaintop in rural Virginia with his parents. They covered the mirrors in the house so Richard wouldn’t have to look at his hideous face. He stayed in his room even to eat, wore a black mask on the rare occasions he came out. According to legend, one time the cops stopped him at gunpoint, mistaking him for a robber.

Then one day, searching on the Internet, his mom found Eduardo Rodriguez, a Baltimore reconstructive facial surgeon. He promised Richard he would make him normal. Over the next few years, Rodriguez performed dozens of surgeries using Richard’s own flesh, fashioning a nose-shaped appendage out of tissue from his forearm and a small chin out of flesh from his legs, but these crude approximations failed to make Richard normal. Meantime, Rodriguez had a grander idea in mind. He was driven to achieve perfection. He had been practicing face transplants on cadavers. What he envisioned for Richard was the most extensive transplant any surgeon had ever attempted: He would give Richard a whole new face.

“It’s showtime,” Rodriguez said one day.

“You’re my godsend,” Richard’s mom said.

“Let’s do this thing,” Richard said.

The surgery started at dawn on March 19, 2012. The face of a recently deceased 21-year-old man came off as one solid flap, skin, muscle, bone, nerves, blood vessels, tongue—everything as one piece. Rodriguez removed what was left of Richard’s disfigured face, dissected down to the skull. He attached the new face midway back on Richard’s scalp. He stabilized it with screws, tapped the jaw together, and finally draped the skin and sewed it down like a patch on a coat or a pair of jeans.

You can see the junction; the incision actually goes here in the coronal, extends in front of the ear, and goes posteriorly all the way down, uh, to the neck.

Rodriguez and his team worked nonstop for thirty-six hours, and when they were finished, Richard’s mom looked at her son and felt like he was somehow resurrected. “We have Richard back!” she said on the phone to Richard’s dad, who had not had much of anything to say for many years.

With his new face, Richard, now 39, became a media sensation for a time, the story of the miracle told many times over until it hardened even in Richard’s mind into a kind of precious jewel.

···Maybe we can scroll through some of the clinical photographs while we’re talking. I feel very happy about the bony union here. That’s the donor palate. And that’s the donor floor mouth. The donor hair, it’s a little darker than his. His is a little bit more salt-and-pepper.

Most of the thirty or so people gathered in the conference room are wearing white coats or lanyards or both, and they sit visibly captivated by the photographs Rodriguez is describing. The mood is electric, scrambled, like a show on opening night. The pictures show Richard, who’s waiting in an adjacent room for his cue to enter. The expectation lends an extra edge of drama to the presentation. He’s flown up here to New York from the foggy mountaintop where he still lives, so that the assembled doctors and other clinicians at NYU Langone Medical Center can meet him.

Rodriguez is an imposing figure, tall and broad, with a big dimple on his giant chin, wide pinstripes, cuff links, and unbuckled galoshes affecting a disheveled nonchalance. In the wake of his world-famous work on Richard, he was just named NYU’s chair of plastic surgery, a substantial professional promotion (“like I’ve just been handed the keys to the starship Enterprise,” he told me). In part, he’s been hired to get NYU into the face-transplant business, and today, as the hospital begins the process for its first one, he’s brought his star patient before his new colleagues.

One of the things you’ll notice is he has a couple of these scratches. He tends to pick and scratch a bit.

Since the first face transplant, in 2005, only three American hospitals have performed the procedure. Many of the twenty-eight transplants were partial, sections of the face transplanted from deceased donors. Richard’s transplant was a full face and is said to be the most ambitious ever. Rodriguez likens the medically complex procedure to the Apollo moon landing.

Surgical difficulty aside, the fact that Richard didn’t need a new face to survive raised an ethically grim question: Is a “life-enhancing” surgery worth the risk? There was a good chance he’d die—either on the operating table or later, if his body rejected the face. Of course, for people disfigured like Richard, the breakthrough represents something far beyond a mere enhancement. Here was new hope for millions of people disfigured by trauma, burns, disease, or birth defects. Wounded warriors suffering ballistic facial injuries would now have a surgical option that would go light-years beyond the currently available treatments. No more Band-Aid cosmetic surgeries. No more skin grafts that might only complicate your appearance. Now you could get rid of that face and replace it whole. “We’ve gone beyond the boundary of what we thought was even possible,” Rodriguez tells me.

One by one, some of the specialists in the conference room who had a chance to evaluate Richard earlier today stand up to speak of their findings. Concerns emerge, principally about Richard’s state of mind. Has he become too emotionally attached to Rodriguez, the medical attention, the fame? What will happen to him now that Rodriguez has moved on to a new hospital, new face transplants, new miracles?

We were both struck by how good he looks and the really excellent aesthetic result.

He reported to me no chewing or swallowing problems.

I was having trouble understanding him.

I asked: Do people understand you? Are you mostly intelligible?

He hasn’t done any exercises.

He said he just wants to move on, do his own thing.

I think he’s maybe overwhelmed, like you said.

He is not in any kind of psychotherapy.

He seems to have somewhat habituated to all the media attention.

He’s sort of had this Mick Jagger status.

He feels there’s a sense of abandonment.

I did not get the sense that he was open to therapy at this time.

In terms of any concerns about suicidality or low mood, severe depression, I would say that he denies it. I don’t know fully if that’s exactly accurate. I would want to speak with him again.

When Rodriguez gives the nod, the door flies open and Richard saunters in, dressed in a bright purple Baltimore Ravens hat and jacket. He’s been living with his new face for two years now, and he’s undeniably attractive—clean-shaven, youthful, the kind of guy you would hire to run the front office. He takes a seat facing the crowd, arms splayed out, cool as Justin Bieber on a late-night talk show. Everyone stares at him, and some cock their heads. He’s used to this; sometimes people applaud. Is he smiling? His new face doesn’t move a lot. Does it move at all? He might be smiling, or it might just be the will of the room. His eyes, the one part of his original face still intact, dart like anyone’s eyes, and I find myself chasing them, the only reliable clue as to what might really be going on in there.

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