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8 Major Milestones in Facial Transplant Surgeries

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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. 

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8 of the Weirdest Gallup Polls
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Born in Jefferson, Iowa on November 18, 1901, George Gallup studied journalism and psychology, focusing on how to measure readers’ interest in newspaper and magazine content. In 1935, he founded the American Institute of Public Opinion to scientifically measure public opinions on topics such as government spending, criminal justice, and presidential candidates. Although he died in 1984, The Gallup Poll continues his legacy of trying to determine and report the will of the people in an unbiased, independent way. To celebrate his day of birth, we compiled a list of some of the weirdest, funniest Gallup polls over the years.

1. THREE IN FOUR AMERICANS BELIEVE IN THE PARANORMAL (2005)

According to this Gallup poll, 75 percent of Americans have at least one paranormal belief. Specifically, 41 percent believe in extrasensory perception (ESP), 37 percent believe in haunted houses, and 21 percent believe in witches. What about channeling spirits, you might ask? Only 9 percent of Americans believe that it’s possible to channel a spirit so that it takes temporary control of one's body. Interestingly, believing in paranormal phenomena was relatively similar across people of different genders, races, ages, and education levels.

2. ONE IN FIVE AMERICANS THINK THE SUN REVOLVES AROUND THE EARTH (1999)

In this poll, Gallup tried to determine the popularity of heliocentric versus geocentric views. While 79 percent of Americans correctly stated that the Earth revolves around the sun, 18 percent think the sun revolves around the Earth. Three percent chose to remain indifferent, saying they had no opinion either way.

3. 22 PERCENT OF AMERICANS ARE HESITANT TO SUPPORT A MORMON (2011)

Gallup first measured anti-Mormon sentiment back in 1967, and it was still an issue in 2011, a year before Mormon Mitt Romney ran for president. Approximately 22 percent of Americans said they would not vote for a Mormon presidential candidate, even if that candidate belonged to their preferred political party. Strangely, Americans’ bias against Mormons has remained stable since the 1960s, despite decreasing bias against African Americans, Catholics, Jews, and women.

4. MISSISSIPPIANS GO TO CHURCH THE MOST; VERMONTERS THE LEAST (2010)

This 2010 poll amusingly confirms the stereotype that southerners are more religious than the rest of the country. Although 42 percent of all Americans attend church regularly (which Gallup defines as weekly or almost weekly), there are large variations based on geography. For example, 63 percent of people in Mississippi attend church regularly, followed by 58 percent in Alabama and 56 percent in South Carolina, Louisiana, and Utah. Rounding out the lowest levels of church attendance, on the other hand, were Vermont, where 23 percent of residents attend church regularly, New Hampshire, at 26 percent, and Maine at 27 percent.

5. ONE IN FOUR AMERICANS DON’T KNOW WHICH COUNTRY AMERICA GAINED INDEPENDENCE FROM (1999)

Although 76 percent of Americans knew that the United States gained independence from Great Britain as a result of the Revolutionary War, 24 percent weren’t so sure. Two percent thought the correct answer was France, 3 percent said a different country (such as Mexico, China, or Russia), and 19 percent had no opinion. Certain groups of people who consider themselves patriotic, including men, older people, and white people (according to Gallup polls), were more likely to know that America gained its independence from Great Britain.

6. ONE THIRD OF AMERICANS BELIEVE IN GHOSTS (2000)

This Halloween-themed Gallup poll asked Americans about their habits and behavior on the last day of October. Predictably, two-thirds of Americans reported that someone in their house planned to give candy to trick-or-treaters and more than three-quarters of parents with kids reported that their kids would wear a costume. More surprisingly, 31 percent of American adults claimed to believe in ghosts, an increase from 1978, when only 11 percent of American adults admitted to a belief in ghosts.

7. 5 PERCENT OF WORKING MILLENNIALS THRIVE IN ALL FIVE ELEMENTS OF WELL-BEING (2016)

This recent Gallup poll is funny in a sad way, as it sheds light on the tragicomic life of a millennial. In this poll, well-being is defined as having purpose, social support, manageable finances, a strong community, and good physical health. Sadly, only 5 percent of working millennials—defined as people born between 1980 and 1996—were thriving in these five indicators of well-being. To counter this lack of well-being, Gallup’s report recommends that managers promote work-life balance and improve their communication with millennial employees.

8. THE WORLD IS BECOMING SLIGHTLY MORE NEGATIVE (2014)

If you seem to feel more stress, sadness, anxiety, and pain than ever before, Gallup has the proof that it’s not all in your head. According to the company’s worldwide negative experience index, negative feelings such as stress, sadness, and anger have increased since 2007. Unsurprisingly, people living in war-torn, dangerous parts of the word—Iraq, Iran, Egypt, Syria, and Sierra Leone—reported the highest levels of negative emotions.

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11 Times Mickey Mouse Was Banned
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Despite being one of the world’s most recognizable and beloved characters, it hasn’t always been smooth sailing for Mickey Mouse, who turns 89 years old today. A number of countries—and even U.S. states—have banned the cartoon rodent at one time or another for reasons both big and small.

1. In 1930, Ohio banned a cartoon called “The Shindig” because Clarabelle Cow was shown reading Three Weeks by Elinor Glyn, the premier romance novelist of the time. Check it out (1:05) and let us know if you’re scandalized:

2. With movies on 10-foot screen being a relatively new thing in Romania in 1935, the government decided to ban Mickey Mouse, concerned that children would be terrified of a monstrous rodent.

3. In 1929, a German censor banned a Mickey Mouse short called “The Barnyard Battle.” The reason? An army of cats wearing pickelhauben, the pointed helmets worn by German military in the 19th and 20th centuries: "The wearing of German military helmets by an army of cats which oppose a militia of mice is offensive to national dignity. Permission to exhibit this production in Germany is refused.”

4. The German dislike for Mickey Mouse continued into the mid-'30s, with one German newspaper wondering why such a small and dirty animal would be idolized by children across the world: "Mickey Mouse is the most miserable ideal ever revealed ... Healthy emotions tell every independent young man and every honorable youth that the dirty and filth-covered vermin, the greatest bacteria carrier in the animal kingdom, cannot be the ideal type of animal.” Mickey was originally banned from Nazi Germany, but eventually the mouse's popularity won out.

5. In 2014, Iran's Organization for Supporting Manufacturers and Consumers announced a ban on school supplies and stationery products featuring “demoralizing images,” including that of Disney characters such as Mickey Mouse, Winnie the Pooh, Sleeping Beauty, and characters from Toy Story.

6. In 1954, East Germany banned Mickey Mouse comics, claiming that Mickey was an “anti-Red rebel.”

7. In 1937, a Mickey Mouse adventure was so similar to real events in Yugoslavia that the comic strip was banned. State police say the comic strip depicted a “Puritan-like revolt” that was a danger to the “Boy King,” Peter II of Yugoslavia, who was just 14 at the time. A journalist who wrote about the ban was consequently escorted out of the country.

8. Though Mussolini banned many cartoons and American influences from Italy in 1938, Mickey Mouse flew under the radar. It’s been said that Mussolini’s children were such Mickey Mouse fans that they were able to convince him to keep the rodent around.

9. Mickey and his friends were banned from the 1988 Seoul Olympics in a roundabout way. As they do with many major sporting events, including the Super Bowl, Disney had contacted American favorites to win in each event to ask them to say the famous “I’m going to Disneyland!” line if they won. When American swimmer Matt Biondi won the 100-meter freestyle, he dutifully complied with the request. After a complaint from the East Germans, the tape was pulled and given to the International Olympic Committee.

10. In 1993, Mickey was banned from a place he shouldn't have been in the first place: Seattle liquor stores. As a wonderful opening sentence from the Associated Press explained, "Mickey Mouse, the Easter Bunny and teddy bears have no business selling booze, the Washington State Liquor Control Board has decided." A handful of stores had painted Mickey and other characters as part of a promotion. A Disney VP said Mickey was "a nondrinker."

11. Let's end with another strike against The Shindig (see #1) and Clarabelle’s bulging udder. Less than a year after the Shindig ban, the Motion Picture Producers and Directors of America announced that they had received a massive number of complaints about the engorged cow udders in various Mickey Mouse cartoons.

From then on, according to a 1931 article in Time magazine, “Cows in Mickey Mouse ... pictures in the future will have small or invisible udders quite unlike the gargantuan organ whose antics of late have shocked some and convulsed others. In a recent picture the udder, besides flying violently to left and right or stretching far out behind when the cow was in motion, heaved with its panting with the cow stood still.”

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