Salyer - A Life That Matters: Transforming Faces, Renewing Lives

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Copyright 2013 by Kenneth E. Salyer, MD

Images courtesy of Dr. Kenneth E. Salyer

All rights reserved. In accordance with the U.S. Copyright Act of 1976, the scanning, uploading, and electronic sharing of any part of this book without the permission of the publisher constitute unlawful piracy and theft of the authors intellectual property. If you would like to use material from the book (other than for review purposes), prior written permission must be obtained by contacting the publisher at . Thank you for your support of the authors rights.

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ISBN: 978-1-4555-1513-4

For my family,
my wife, Luci;
my children, Ken and Leigh;
and my grandchildren, Ken III, Hart VI, Ashley, Everett,
Thomas, and Adelle.

I will not die an unlived life.

I will not live in fear

Of falling or catching fire.

I choose to inhabit my days,

To allow my living to open me,

To make me less afraid,

More accessible;

To loosen my heart

Until it becomes a wing,

A torch, a promise.

I choose to risk my significance,

To live so that which came to me as seed

Goes to the next as blossom,

And that which came to me as blossom,

Goes on as fruit.

Dawna Markova

G abriela Morales was beautifulor at least I could imagine how beautiful she could become. Gabriela had been born to a poor Mexican family, and her early life had been terribly compromised by a congenital malformation of her face that led many to turn away from her, cruelly taunt her, even presume she was possessed by evil spirits.

Gabriela, now sixteen, was raised in a shantytown in Tijuana and had been introduced to the staff of the World Craniofacial Foundation, an organization I established in 1989, by an American mission worker. Noting her abnormally wide-set eyes and dramatically malformed nosewhich had been made even more unsightly by a well-meaning but untrained physician soon after she was bornthe missionary imagined that with our help, the very shy girl with big dreams could, in fact, fulfill them one day.

At home in Dallas, when I read reports and saw photographs of Gabi, I was quickly sure that one day she could have a normal facea birthright I believe all the worlds children possess. The foundation raised funds to send her and her parents to Mexico City, where surgeons at an extraordinary reconstructive plastic surgery and teaching centerestablished three decades ago by my dear friend and colleague Dr. Fernando Ortiz Monasteriocould transform Gabis face and set her young life on a very hopeful new course. And when I met dark-eyed and engaging Gabriela in person on a bright April morning in Mexicos capital city, I was certain that she, like thousands of other patients Ive met during my five-decade career, had a bright future indeed.

The Hospital General Dr. Manuel Gea Gonzlez, located in Mexico Citys frenetic Tlalpan district, is surrounded by a high metal-barred fence, its entrances guarded by policemen carrying automatic weapons. On any day, literally thousands of impoverished Mexicans wait patiently for services, often for many hours, yet early every Tuesday morning, the hospitals plastic and reconstructive surgery unit becomes what its recently deceased founder called the most exciting clinic in the world, the only place I want to bea clinic where young patients like Gabi come from throughout the country to be evaluated by a team comprising some of the finest craniofacial surgeons in the world.

In my travels around the globe, performing surgeries and helping establish surgical centers in countries where top-quality medicine is seldom practiced, it is clinics like this one that demonstrate to me that even the very poor can receive excellent medical care at costs that dont bankrupt health-care systems. And with every passing day, I believe more strongly that Gabriela and everyone like her can be offered the basic human right of a normal face.

Consider what life entails for children like Gabi before they are treated; imagine the constant rejection and soul-killing ridicule and the virtual impossibility of succeeding in school, making friends, or one day falling in love. For many centuries, people with facial deformities were locked away, and oftentimes, infants with terrible deformities were simply not allowed to live. And still all too often today, people with shocking facial abnormalities are shunned, hidden, shamed, and tormented.

Ive believed passionately since I was a young surgeon in Dallas in the early 1960s that all the worlds children deserve to lead normal lives, yet for one child in every five hundred, a normal life is impossible without craniofacial surgery. Forty years ago, medicine offered little hope to patients with severe deformities of the skull, jaw, and face, but in pioneering new surgical protocols that once were unimaginable, its been my goaland my lifes great joyto help profoundly change the outlook for these patients and their families. What once was impossible is now a practical reality because of the advancements of modern medical technology and the extraordinarily well-honed skills of a host of professionals.

A craniofacial surgeon never operates alone. He or she serves as both surgeon and impresario, performing incredibly intricate surgical techniques as well as coordinating the work of a highly skilled interdisciplinary team in which each member is absolutely essential to a positive patient outcome. Pediatric neurosurgeons, pediatric anesthesiologists, neuroradiologists, pediatric intensivists, neuro-ophthalmologists, pediatric ophthalmologists, otolaryngologists, orthodontists, speech pathologists, geneticists, anthropologists, pedodontists, pediatric nurses, psychologists, and social workers play vitally important supporting roles, and developing and coordinating a cadre of exceptional professionals can sometimes pose many complexities.

My patient Michael Hatfield, for example, was born with eyes on the sides of his head and without a nose. As a young boy, Michael was shocking to look at, and his mother reported that people assume hes retarded, incapable of interaction or emotion, just one of natures rejects. Without a series of complex surgeries, Michaels life would be effectively over as it began.