CLEVELAND — When Connie Culp heard a little kid call her a
monster because of the shotgun blast that left her face horribly
disfigured, she pulled out her driver's license to show the child what
she used to look like. Years later, as the nation's first face
transplant recipient, she's stepped forward to show the rest of the
world what she looks like now.
Her expressions are still a bit
wooden, but she can talk, smile, smell and taste her food again. Her
speech is at times a little tough to understand. Her face is bloated
and squarish. Her skin droops in big folds that doctors plan to pare
away as her circulation improves and her nerves grow, animating her new
muscles.
But Culp had nothing but praise for those who made her new face possible.
"I
guess I'm the one you came to see today," the 46-year-old Ohio woman
said at a news conference at the Cleveland Clinic, where the
groundbreaking operation was performed. But "I think it's more
important that you focus on the donor family that made it so I could
have this person's face."
Until Tuesday, Culp's identity and how she came to be disfigured were a secret.
Culp's
husband, Thomas, shot her in 2004, then turned the gun on himself. He
went to prison for seven years. His wife was left clinging to life. The
blast shattered her nose, cheeks, the roof of her mouth and an eye.
Hundreds of fragments of shotgun pellet and bone splinters were
embedded in her face. She needed a tube into her windpipe to breathe.
Only her upper eyelids, forehead, lower lip and chin were left.
A
plastic surgeon at the Cleveland Clinic, Dr. Risal Djohan, got a look
at her injuries two months later. "He told me he didn't think, he
wasn't sure, if he could fix me, but he'd try," Culp recalled.
She
endured 30 operations to try to fix her face. Doctors took parts of her
ribs to make cheekbones and fashioned an upper jaw from one of her leg
bones. She had countless skin grafts from her thighs. Still, she was
left unable to eat solid food, breathe on her own, or smell.
Then,
on Dec. 10, in a 22-hour operation, Dr. Maria Siemionow led a team of
doctors who replaced 80 percent of Culp's face with bone, muscles,
nerves, skin and blood vessels from another woman who had just died. It
was the fourth face transplant in the world, though the others were not
as extensive.
"Here I am, five years later. He did what he said — I got me my nose," Culp said of Djohan, laughing.
In
January, she was able to eat pizza, chicken and hamburgers for the
first time in years. She loves to have cookies with a cup of coffee,
Siemionow said.
No information has been released about the donor
or how she died, but her family members were moved when they saw
before-and-after pictures of Culp, Siemionow said.
Culp said she wants to help foster acceptance of those who have suffered burns and other disfiguring injuries.
"When
somebody has a disfigurement and don't look as pretty as you do, don't
judge them, because you never know what happened to them," she said.
"Don't judge people who don't look the same as you do. Because you
never know. One day it might be all taken away."
It's a role she has already practiced, said clinic psychiatrist Dr. Kathy Coffman.
Once
while shopping, she heard a little kid say, 'You said there were no
real monsters, Mommy, and there's one right there,'" Coffman said. Culp
stopped and said, "I'm not a monster. I'm a person who was shot," and
pulled out her driver's license to show the child what she used to look
like, the psychiatrist said.
Culp, who is from the small town of
Unionport, near the Pennsylvania line, told her doctors she just wants
to blend back into society. She has a son and a daughter who live near
her, and two preschooler grandsons. Before she was shot, she and her
husband ran a painting and contracting business, and she did everything
from hanging drywall to a little plumbing, Coffman said.
Culp
left the hospital Feb. 5 and has returned for periodic follow-up care.
She has suffered only one mild rejection episode that was controlled
with a single dose of steroid medicines, her doctors said. She must
take immune-suppressing drugs for the rest of her life, but her dosage
has been greatly reduced and she needs only a few pills a day.
The
clinic expects to absorb the cost of the transplant because it was
experimental, doctors said. Siemionow estimated it at $250,000 to
$300,000. That is less than the $1 million that other surgeons estimate
it costs them to treat other severely disfigured people through dozens
of separate operations, she said.
Also at the Cleveland Clinic is
Charla Nash of Stamford, Conn., who was attacked by a friend's
chimpanzee in February. She lost her hands, nose, lips and eyelids, and
will be blind, doctors said. Clinic officials said it is premature to
discuss the possibility of a face transplant for her.
In April,
doctors at Harvard-affiliated Brigham and Women's Hospital in Boston
performed the nation's second face transplant, on a man disfigured in a
freak accident. It was the world's seventh such operation. The first,
in 2005, was performed in France on Isabelle Dinoire, a woman who had
been mauled by her dog.