An article today on the BBC news website covered a dramatic meeting between facial transplant patient Richard Norris and Rebekah Aversano, the sister of the man whose face he now wears.

Richard Norris was severely injured in a shotgun accident some 15 years ago. In 2012 he received a transplant from a motor accident victim; a whole new face. The transplant was one of the most extensive ever attempted and extended from his hairline down to his throat. The operation replaced Norris’s jaw, tongue and nose.

Because the tissue came from a donor, Norris will now live with a lifetime risk of rejection. He will have to take daily immunosuppressants which opens him up to infections and disease.

Tough choices

Reading about Richard Norris’ story got me thinking about the choices he, and others like him have to make. It’s hard to imagine living with a life altering disfigurement. There must be some really complicated head stuff going on, that’s for sure.

What if it was a hand? Lacking a hand makes life difficult, granted, but many amputees live perfectly normal lives, coping with prostheses. I’m sure all of them would agree if there was no downside, but why would someone be willing to live with a reduced immune system, risk of systemic disease such as diabetes, and probably a reduced lifespan in exchange for a partially functional limb?

Should a donor hand be rejected though, there’s always the option to remove it as in the case of the first successful hand transplant in 1998. The recipient of the hand, Clint Hallam, failed to bond with it psychologically, and eventually stopped taking his medication to force doctors to amputate the donor limb in 2001.

Norris has no such option to change his mind and if his body rejects his new face, he will die. There isn’t enough left of his own body to form viable structures and his old face is gone forever.

How much harder then must the decision be to choose a facial transplant? There aren’t many options for prostheses, but reconstructive surgery using the patient’s own tissues can do amazing things to restore functionality. With a facial transplant, on top of all the lifelong health impacts of other transplants, the constant threat of rejection carries with it a certain death sentence. How could anyone live with that hanging over them?

Worse than Death?

Perhaps acceptance of such risks is similar to the mentality which drives people with such afflictions to suicide. There must come a point where living with a disfigurement seems worse than death.

As a healthy, whole person, I struggle to comprehend what that point feels like. I simply have no experience or frame of reference. The closest I can come is to try and imagine life without some aspect or faculty of my body.

What frightens me most is the loss of my sight. There are very few things I do in my daily life that wouldn’t be affected. For one, how would I write? My thought processes are highly visual and without being able to write and read notes I couldn’t organise my thoughts. I would become cut off from the passions which motivate me in life. Without them, would I feel life was still worth living? I’d like to think I would adapt eventually, but I’m not sure I could.

If I lost my sight, and a transplant could restore it, at the cost of my health, would I do it? I think perhaps I would. I would certainly give it serious consideration.

Would you consider transplant surgery for something other than a life threatening condition? What would justify the health risks for you?


 

If you’re interested in reading more about Richard Norris try these links:

University of Maryland Face Transplant

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