8 Major Milestones in Facial Transplant Surgeries

Last year brought a significant milestone in cutting-edge medicine when former firefighter Patrick Hardison received the most extensive face transplant surgery ever performed. Hardison’s operation rounded out nearly a decade since the first face transplant was done in 2005, a period during which a scientific feat that once seemed to belong to the realm of science fiction became possible and moved closer to the mainstream. Not only were technical limitations transcended, but initial moral objections were also overcome. Here is a look at the evolution of this groundbreaking procedure—and the people whose lives were changed by it.

1. THE GIRL WHO GOT HER OWN FACE BACK // 1994

In 1994, 9-year-old Sandeep Kaur was working in a field in India when one of her pigtails was caught in a threshing machine. The machine’s gears pulled in the girl’s hair and peeled her face off in two pieces. Her family brought her to the nearest hospital, which was three hours away. Determining that skin grafts would not work, the doctors made history by performing what was essentially the first face transplant surgery. Technically, though, since it was the victim’s own face that was being replaced, this early operation counts as a face "re-plant" rather than a transplant.

2. THE WOMAN WHO GOT HER MOUTH AND NOSE REPLACED // 2005

Isabelle Dinoire’s partial face transplant made headlines not only for the pioneering science it involved, but for the circumstances surrounding it: Dinoire, apparently in the midst of some emotional distress, had taken some sleeping pills and awoke to discover that her dog had chewed off her lips and nose while she was unconscious.

In November 2005, doctors Bernard Devauchelle and Jean-Michel Dubernard—who led the French team that had done the first-ever modern hand transplant in 1998—performed the world’s first partial face transplant, grafting a triangle of tissue from a brain-dead woman’s mouth and nose onto Dinoire. Dinoire was able to eat and speak within a day and reported satisfaction with the results 18 months later. However, she suffered a series of tissue rejection episodes during that time, pointing to the need for transplant recipients to take immunosuppressant drugs for their entire lives.

3. THE DOMESTIC VIOLENCE VICTIM WHO HAD 80 PERCENT OF HER FACE RECONSTRUCTED // 2008

In 2008, Connie Culp became the first person to receive a partial face transplant in the United States. Culp’s husband had shot her in the face during a domestic dispute, destroying her mouth, nose, cheeks, an eye, and a section of bone and teeth in the center of her face. Her operation was performed at the Cleveland Clinic, the first American clinic to approve the procedure. The extensive, 22-hour operation, involving 80 percent of Culp’s face, required removal of previous makeshift construction of her jaw structure and transplantation of bone, muscle, nerves, blood vessels, and skin to reconstruct the midsection of her face.

4. THE FARMER WHO UNDERWENT 10 ATTEMPTS TO REBUILD HIS FACE // 2010

In 2010, a Spanish farmer who had been horribly disfigured in a gun accident, identified only as Oscar, became the recipient of the world’s first full-face transplant at a Barcelona hospital. Nine early attempts to rebuild Oscar’s face had failed, making him a candidate for the experimental procedure. The 24-hour operation required a team of 30 surgeons, anesthetists, and nurses to replace Oscar’s facial muscles, nose, lips, upper jaw, teeth, cheekbones, palate, tear ducts, and eyelids. Oscar’s surgery was followed just a few months later by the world’s second full face transplant in France.

5. THE BURN VICTIM WHO WAS ABLE TO SPEAK AND SMELL AGAIN  // 2011

Dallas Wiens says he remembers nothing of the November 2008 accident when, while on a cherry picker, his head hit a high-voltage wire, sending electricity coursing through his body and severely burning him from head to toe. The incident blinded him and obliterated his facial features. Improbably, Wiens survived the accident and began to make a recovery, but it was a 2011 full face transplant operation that would return him to life. The operation, carried out at Brigham and Women’s Hospital in Boston, replaced the entirety of his face with that of a donor and returned his ability to speak and smell (though surgeons were not able to bring back his eyesight).

Wiens’s surgery was followed by full face transplants in the United States on Mitch Hunter later in 2011 and a very extensive operation on Richard Lee Norris in 2012.

6. THE CHIMP ATTACK SURVIVOR WHO RECEIVED A NEW FACE—AND HANDS // 2011

While not as much of a milestone in terms of face transplant science, Charla Nash’s story is notable for the extremely bizarre circumstances surrounding it. In 2009, Nash drove to the Connecticut home of her friend and employer Sandra Herold to help her corral her pet chimpanzee Travis, who had gotten out of control that day. Upon her arrival, Travis, a full-grown, 200-pound male, viciously attacked Nash, ripping off her face and hands.

After several earlier surgeries, Nash eventually received face and hand transplants in May 2011 at Brigham and Women’s Hospital. Both transplants were initially successful, but the hand transplants eventually had to be removed after Nash developed an infection. Nash continues to recover and it is hoped that her progress will inform future operations on veterans returning from war.

7. THE MAN WHO GOT A NEW FACE IN JUST THREE WEEKS // 2013

The first of two face transplants performed in Poland is remarkable mainly because of the extremely short time period within which it was carried out. A male patient, identified only as Grzegorz, received a full face transplant just three weeks after he was injured in a machine accident at work in 2013, losing his nose, upper jaw, and cheeks. The delicate nature of face transplant surgeries usually necessitates months or even years of preparation, making this particular operation the fastest ever performed. Doctors deemed the speed necessary because the accident had left an area of the brain exposed to infection.

8. THE FIREFIGHTER WHO RECEIVED THE BIKE MESSENGER'S FACE // 2015

In 2001, volunteer firefighter Patrick Hardison rushed into a burning home in Senatobia, Mississippi, to rescue a woman he thought was inside. The roof collapsed, knocking his helmet from his head, melting his mask, and searing his skin. The accident left Hardison without ears, nose, lips, or eyelid tissue and with virtually no normal skin left on his entire face and neck. Over 70 surgeries and grafts had left him a patchwork of scars and in constant pain, with limited vision due to lack of functioning eyelids.

In August 2015, surgeon Eduardo Rodriguez performed the most extensive ever face transplant on Hardison at NYU Langone Medical Center, using donated tissue from David Rodebaugh, a Brooklyn bike enthusiast who died following a bike accident. The transplant extends from the back of Hardison’s skull, over the top of his head, and down to his collarbones, and includes eyelids and both ears.

CHALLENGES AHEAD FOR THE PROCEDURE

The relative success of these operations has dispelled many, but not all, of critics’ fears. When face transplants were first proposed, some doubted the transplants would have feeling and functionality, but patients have regained their senses of smell, taste, and touch. Nonetheless, the delicate procedure, requiring years of training, microsurgery techniques, and large teams of specialists, is still in its early stages, and there is much room for improvement. Each face transplant surgery performed so far has followed a slightly different protocol, and the technology is in need of standardization. Surgeons are exploring new ways to match donor and recipient anatomy and improve alignment using CT scans and 3-D printed replicas of the anatomy involved in order to improve planning and speed up the process. The surgeries, too, carry a steep price tag—about $300,000 on average—and American health insurance plans do not cover it, a situation many hope will change.

Then there is the ongoing moral debate over the process. Initial objections revolved around sheer revulsion at the concept and identity-based misgivings. But while some recipients have expressed feelings of responsibility toward the donor’s legacy, few have reported identity crises about wearing a donated face. The current moral debate largely concerns the immunosuppressant drugs that patients must take in order to avoid rejection of the foreign tissue. Such drugs can negatively affect health, increasing risk of cancer, diabetes, and other ailments. Critics argue that the procedure, while life changing, is not life saving, and that it is essentially putting otherwise healthy people at risk of death. 

Finally, while the public may be warming up to face transplants, scientific advances will undoubtedly open new cans of morally questionable worms. Italian surgeon Sergio Canavero has declared that he will perform the first full head transplant in 2017. Most neuroscientists are highly skeptical that's possible, but the future undoubtedly holds stranger things yet. 

nextArticle.image_alt|e
Zach Hyman, HBO
10 Bizarre Sesame Street Fan Theories
Zach Hyman, HBO
Zach Hyman, HBO

Sesame Street has been on the air for almost 50 years, but there’s still so much we don’t know about this beloved children’s show. What kind of bird is Big Bird? What’s the deal with Mr. Noodle? And how do you actually get to Sesame Street? Fans have filled in these gaps with frequently amusing—and sometimes bizarre—theories about how the cheerful neighborhood ticks. Read them at your own risk, because they’ll probably ruin the Count for you.

1. THE THEME SONG CONTAINS SECRET INSTRUCTIONS.

According to a Reddit theory, the Sesame Street theme song isn’t just catchy—it’s code. The lyrics spell out how to get to Sesame Street quite literally, giving listeners clues on how to access this fantasy land. It must be a sunny day (as the repeated line goes), you must bring a broom (“sweeping the clouds away”), and you have to give Oscar the Grouch the password (“everything’s a-ok”) to gain entrance. Make sure to memorize all the steps before you attempt.

2. SESAME STREET IS A REHAB CENTER FOR MONSTERS.

Sesame Street is populated with the stuff of nightmares. There’s a gigantic bird, a mean green guy who hides in the trash, and an actual vampire. These things should be scary, and some fans contend that they used to be. But then the creatures moved to Sesame Street, a rehabilitation area for formerly frightening monsters. In this community, monsters can’t roam outside the perimeters (“neighborhood”) as they recover. They must learn to educate children instead of eating them—and find a more harmless snack to fuel their hunger. Hence Cookie Monster’s fixation with baked goods.

3. BIG BIRD IS AN EXTINCT MOA.

Big Bird is a rare breed. He’s eight feet tall and while he can’t really fly, he can rollerskate. So what kind of bird is he? Big Bird’s species has been a matter of contention since Sesame Street began: Big Bird insists he’s a lark, while Oscar thinks he’s more of a homing pigeon. But there’s convincing evidence that Big Bird is an extinct moa. The moa were 10 species of flightless birds who lived in New Zealand. They had long necks and stout torsos, and reached up to 12 feet in height. Scientists claim they died off hundreds of years ago, but could one be living on Sesame Street? It makes sense, especially considering his best friend looks a lot like a woolly mammoth.

4. OSCAR’S TRASH CAN IS A TARDIS.

Oscar’s home doesn’t seem very big. But as The Adventures of Elmo in Grouchland revealed, his trash can holds much more than moldy banana peels. The Grouch has chandeliers and even an interdimensional portal down there! There’s only one logical explanation for this outrageously spacious trash can: It’s a Doctor Who-style TARDIS.

5. IT’S ALL A RIFF ON PLATO.

Dust off your copy of The Republic, because this is about to get philosophical. Plato has a famous allegory about a cave, one that explains enlightenment through actual sunlight. He describes a prisoner who steps out of the cave and into the sun, realizing his entire understanding of the world is wrong. When he returns to the cave to educate his fellow prisoners, they don’t believe him, because the information is too overwhelming and contradictory to what they know. The lesson is that education is a gradual learning process, one where pupils must move through the cave themselves, putting pieces together along the way. And what better guide is there than a merry kids’ show?

According to one Reddit theory, Sesame Street builds on Plato’s teachings by presenting a utopia where all kinds of creatures live together in harmony. There’s no racism or suffocating gender roles, just another sunny (see what they did there?) day in the neighborhood. Sesame Street shows the audience what an enlightened society looks like through simple songs and silly jokes, spoon-feeding Plato’s “cave dwellers” knowledge at an early age.

6. MR. NOODLE IS IN HELL.

Can a grown man really enjoy taking orders from a squeaky red puppet? And why does Mr. Noodle live outside a window in Elmo’s house anyway? According to this hilariously bleak theory, no, Mr. Noodle does not like dancing for Elmo, but he has to, because he’s in hell. Think about it: He’s seemingly trapped in a surreal place where he can’t talk, but he has to do whatever a fuzzy monster named Elmo says. Definitely sounds like hell.

7. ELMO IS ANIMAL’S SON.

Okay, so remember when Animal chases a shrieking woman out of the college auditorium in The Muppets Take Manhattan? (If you don't, see above.) One fan thinks Animal had a fling with this lady, which produced Elmo. While the two might have similar coloring, this theory completely ignores Elmo’s dad Louie, who appears in many Sesame Street episodes. But maybe Animal is a distant cousin.

8. COOKIE MONSTER HAS AN EATING DISORDER.

Cookie Monster loves to cram chocolate chip treats into his mouth. But as eagle-eyed viewers have observed, he doesn’t really eat the cookies so much as chew them into messy crumbs that fly in every direction. This could indicate Cookie Monster has a chewing and spitting eating disorder, meaning he doesn’t actually consume food—he just chews and spits it out. There’s a more detailed (and dark) diagnosis of Cookie Monster’s symptoms here.

9. THE COUNT EATS CHILDREN.

Can a vampire really get his kicks from counting to five? One of the craziest Sesame Street fan theories posits that the Count lures kids to their death with his number games. That’s why the cast of children on Sesame Street changes so frequently—the Count eats them all after teaching them to add. The adult cast, meanwhile, stays pretty much the same, implying the grown-ups are either under a vampiric spell or looking the other way as the Count does his thing.

10. THE COUNT IS ALSO A PIMP.

Alright, this is just a Dave Chappelle joke. But the Count does have a cape.

nextArticle.image_alt|e
iStock
17 Things to Know About René Descartes
iStock
iStock

The French polymath René Descartes (1596-1650) lived after the Renaissance, but he personified that age's interest in mathematics, philosophy, art, and the nature of humanity. He made numerous discoveries and argued for ideas that people continue to grapple with. (His dualist distinction between mind and the brain, for example, continues to be debated by psychologists.) Get to know him better!

1. NOBODY CALLED HIM RENÉ.

Descartes went by a nickname and often introduced himself as “Poitevin” and signed letters as “du Perron.” Sometimes, he went so far to call himself the “Lord of Perron.” That’s because he had inherited a farm from his mother’s family in Poitou, in western France.

2. SCHOOL MADE HIM FEEL DUMBER.

From the age of 11 to 18, Descartes attended one of the best schools in Europe, the Jesuit College of Henry IV in La Flèche, France. In his later work Discourse on the Method, Descartes wrote that, upon leaving school, “I found myself involved in so many doubts and errors, that I was convinced I had advanced no farther in all my attempts at learning, than the discovery at every turn of my own ignorance."

3. HIS DAD WANTED HIM TO BE A LAWYER.

Descartes’s family was chock-full of lawyers, and the budding intellectual was expected to join them. He studied law at the University of Poitiers and even came home with a law degree in 1616. But he never entered the practice. In 1618, a 22-year-old Descartes enlisted as a mercenary in the Dutch States Army instead. There, he would study military engineering and become fascinated with math and physics.

4. HE CHANGED CAREER PATHS THANKS TO A SERIES OF DREAMS.

In 1618, the Emperor of the Holy Roman Empire, Ferdinand II, attempted to impose Catholicism on anybody living within his domain. The result of this policy would be the Thirty Years' War. It would also prompt Descartes, a Catholic, to switch allegiances to a Bavarian army fighting for the Catholic side. But on his travels, he stopped in the town of Ulm. There, on the night of November 10, he had three dreams that convinced him to change his life’s path. “Descartes took from them the message that he should set out to reform all knowledge,” philosopher Gary Hatfield writes in the Stanford Encyclopedia of Philosophy.

5. HE COULD BE EASILY DISTRACTED BY BRIGHT AND SHINY OBJECTS.

In 1628, Descartes moved to the Netherlands and spent nine months doggedly working on a theory of metaphysics. Then he got distracted. In 1629, a number of false suns—called parhelia, or “sun dogs”—were seen near Rome. Descartes put his beloved metaphysics treatise on the back burner and devoted his time to explaining the phenomenon. It was a lucky distraction: It led to his work The World, or Treatise on Light.

6. HE LAID THE GROUNDWORK FOR ANALYTIC GEOMETRY ...

In 1637, Descartes published his groundbreaking Discourse on the Method, where he took the revolutionary step of describing lines through mathematical equations. According to Hatfield, “[Descartes] considered his algebraic techniques to provide a powerful alternative to actual compass-and-ruler constructions when the latter became too intricate.” You might have encountered his system in high school algebra: They’re called Cartesian coordinates.

7. ... AND THE REST OF WESTERN PHILOSOPHY.

Everybody knows Descartes for his phrase Cogito, ergo sum (which originally appeared in French as "Je pense, donc je suis"), or "I think, therefore I am." The concept appeared in many of his texts. To understand what it means, some context is helpful: At the time, many philosophers claimed that truth was acquired through sense impressions. Descartes disagreed. He argued that our senses are unreliable. An ill person can hallucinate. An amputee can feel phantom limb pain. People are regularly deceived by their own eyes, dreams, and imaginations. Descartes, however, realized that his argument opened a door for "radical doubt": That is, what was stopping people from doubting the existence of, well, everything? The cogito argument is his remedy: Even if you doubt the existence of everything, you cannot doubt the existence of your own mind—because doubting indicates thinking, and thinking indicates existing. Descartes argued that self-evident truths like this—and not the senses—must be the foundation of philosophical investigations.

8. HE'S THE REASON YOUR MATH TEACHER MAKES YOU CHECK YOUR WORK.

Descartes was obsessed with certainty. In his book Rules for the Direction of the Mind, “he sought to generalize the methods of mathematics so as to provide a route to clear knowledge of everything that human beings can know,” Hatfield writes. His advice included this classic chestnut: To solve a big problem, break it up into small, easy-to-understand parts—and check each step often.

9. HE LIKED TO HIDE.

Descartes had a motto, which he took from Ovid: “Who lives well hidden, lives well.” When he moved to the Netherlands, he regularly changed apartments and deliberately kept his address a secret. Some say it's because he simply desired privacy for his philosophical work, or that he was avoiding his disapproving family. In his book titled Descartes, philosopher A. C. Grayling makes another suggestion: "Descartes was a spy."

10. HE WASN'T AFRAID OF CRITICS. IN FACT, HE RE-PUBLISHED THEM.

When Descartes was revising his Meditations on First Philosophy [PDF], he planned to send the manuscript to “the 20 or 30 most learned theologians” for criticism—a sort of proto-peer review. He collected seven objections and published them in the work. (Descartes, of course, had the last word: He responded to each criticism.)

11. HE COULD THROW SHADE WITH THE BEST OF THEM.

In the 1640s, Descartes’s pupil and friend Henricus Regius published a broadsheet that distorted Descartes’s theory of the mind. (Which, put briefly, posits that the material body and immaterial mind are separate and distinct.) The two men had a falling out, and Descartes wrote a rebuttal with a barbed title that refused to even acknowledge Regius’s manifesto by name: It was simply called “Comments on a Certain Broadsheet.”

12. HE NEVER BELIEVED MONKEYS COULD TALK.

There’s a “fun fact” parading around that suggests Descartes believed monkeys and apes could talk. He believed no such thing. According to the Stanford Encyclopedia of Philosophy, Descartes denied that animals were even conscious, let alone capable of speech. The factoid comes from a misreading of a letter Descartes had written in 1646, in which he attributed the belief to “savages.”

13. HE TOTALLY HAD THE HOTS FOR CROSS-EYED WOMEN.

In a letter to Queen Christina of Sweden, Descartes explained that he had a cross-eyed playmate as a child. “I loved a girl of my own age ... who was slightly cross-eyed; by which means, the impression made in my brain when I looked at her wandering eyes was joined so much to that which also occurred when the passion of love moved me, that for a long time afterward, in seeing cross-eyed women, I felt more inclined to love them than others.”

14. WHEN HE MET BLAISE PASCAL, THEY GOT INTO AN ARGUMENT ... ABOUT VACUUMS.

In 1647, a 51-year-old Descartes visited the 24-year-old prodigy and physicist Blaise Pascal. Their meeting quickly devolved into a heated argument over the concept of a vacuum—that is, the idea that air pressure could ever be reduced to zero. (Descartes said it was impossible; Pascal disagreed.) Later, Descartes wrote a letter that, depending on your translation, said that Pascal had “too much vacuum in his head.”

15. HIS WORK WAS BANNED BY THE CATHOLIC CHURCH.

Back in the late 1630s, the theologian Gisbert Voetius had convinced the academic senate of the University of Utrecht to condemn the philosopher’s work. (Descartes was Catholic, but his suggestion that the universe began as a “chaotic soup of particles in motion,” in Hatfield's words, was contrary to orthodox theology.) In the 1660s, his works were placed on the church’s Index of Prohibited Books.

16. HE REGULARLY SLEPT UNTIL NOON (AND TRYING TO BREAK THE HABIT MIGHT HAVE KILLED HIM).

Descartes was not a morning person. He often snoozed 12 hours a night, from midnight until lunchtime. In fact, he worked in bed. (Sleep, he wisely wrote, was a time of “nourishment for the brain.”) But according to the Journal of Historical Neuroscience, he may have had a sleep disorder that helped end his life. A year before his death, Descartes had moved to Stockholm to take a job tutoring Queen Christina, a devoted early-riser who forced Descartes to change his sleep schedule. Some believe the resulting sleep deprivation weakened his immune system and eventually killed him.

17. HIS SKELETON HAS TRAVELED FAR AND WIDE.

Descartes died in Stockholm in 1650 and was buried outside the city. Sixteen years later, his corpse was exhumed and taken to Paris. During the French Revolution, his bones were moved to an Egyptian sarcophagus at the Museum of French Monuments. Decades later, when plans were made to rebury Descartes in an abbey, officials discovered that most of his bones—including his skull—were missing. Shortly after, a Swedish scientist discovered a newspaper advertisement attempting to sell the polymath’s noggin [PDF]. Today, his head is in a collection at the Musée de l’Homme in Paris.

SECTIONS

arrow
LIVE SMARTER
More from mental floss studios