Ann Curry Reports   |  June 29, 2013

A Face in the Crowd, Part 2

Richard meets Dr. Eduardo Rodriguez, a surgeon in Baltimore who develops a plan to perform the most extensive face transplant ever. But first Richard needs a donor.

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This content comes from Closed Captioning that was broadcast along with this program.

>>> after an accidental shotgun blast left richard norris ' face extremely disfigured, he spent years living in isolation. multiple surgeries failed to correct his injuries, and he felt his future was hopeless. it was dr. eduardo rodriguez who changed everything.

>> the first time he came into our clinical appointment, he barely spoke. he was so embarrassed of his appearance, of the way he looked.

>> dr. rodriguez is a surgeon at the shock trauma center in baltimore , party of the university of maryland medical system . son of miami immigrants from cuba who made sacrifices for their children's education, rodriguez studied hard. he has specialties in plastic and reconstructive surgery , cranial facial surgery , oral surgery as well as micro surgery which meant he was uniquely qualified to treat richard 's injuries.

>> when you're missing the upper and lower lip it's a difficult area to recreate. we could have done surgery on him forever but he never would have looked or functioned normal.

>> dr. rodriguez realized he needed something that had never been done before, a full facial transplant. the doctor heard about a partial face transplant carried out in france in 2005 , and at the same time the department of defense was funding research to advance the treatment of severely injured u.s. troops returning from the wars in afghanistan and iraq. rodriguez secured that research funding which would be used to treat richard . what was it about richard 's injuries that made him perfect for trying to create the kind of science needed?

>> that was the same type of injury that our soldiers were experiencing in iraq. they would see these injuries as a result of the ied blast coming from the ground up, so we could treat this problem in a civilian patient, it would be ideal to treat the military patients. that our first goal.

>> but 2009 the surgeon set his sights on a goal that was unprecedented. he would attempt the most extensive face transplant ever performed with the goal of leaving few visible scars.

>> it was the only way that a person could become normal and walk in a room and no one would know that they had a face transplant .

>> you wanted that for richard ?

>> of course, 100%.

>> but the extent of the surgery he planned for richard was a first in medical history . the idea, to transplant all the bone structure below richard 's eye sockets, including jaws and teeth, and his tongue, then after connecting critical muscles and nerves for facial expression and some sensation he planned to graft an entire new face on to richard 's head from below the collar bone to above the hairline to hide most of the scars. that it had never been done before must have given you some pause despite all your experience and training?

>> of course, but it was the only way that we could treat the deformity.

>> still, there was one huge obstacle, finding a face donor. rodriguez calculated the likelihood of finding a donor matching richard 's blood type , immune system and face size at just 14%. and there was another big catch . the same surgery that might change richard 's life was so extreme there was a strong chance it could kill him. you as a doctor have to come to grips with failing to keep somebody alive when they didn't have to die.

>> that is correct. ultimately it's my responsibility.

>> over the next two years dr. rodriguez worked to advance his skills for the surgery with a life-threatening risks remained. then, in march 2011 when richard came to baltimore , rodriguez finally presented him with the plan and introduced richard to a key member of his team.

>> he took the mask off and saw the deformity, and i just felt so badly for him.

>> almost immediately cynthia schaffer, the director of dr. rodriguez 's clinical research could see richard 's emotional suffering.

>> it just broke my heart.

>> in that moment?

>> in that moment.

>> before joining rodriguez cynthia had spent five years on the university of maryland science and ethics board that reviews and approves research with human volunteers. she knew better than most how to navigate the pros and cons of such extreme surgery. so what did you tell him?

>> i said you know this is experimental, and even dr. rodriguez said i wish i could tell you that we've done ten of these very successfully but we haven't done one. you could die on the table. you could come out of this worse off than you were before.

>> from the beginning cynthia wanted to protect richard . why do you think you were open to that compassion so quickly?

>> this is something i don't think i even told richard . i actually because of an accident almost burned my face off in college.

>> in her accident, cynthia said, she fired up a propane grill , and the gas blew up in her face.

>> and i literally just went like this, and i must have turned because like the back of my hair was singed so when i saw richard and how he lived, it really drove it home, that could have been how different my life could have been.

>> that experience also helped cynthia identify with the choice that richard had to make.

>> if my life had changed because of that grill accident and i had burned my face off, i would have signed up for anything. you could tell me that i'd have five normal years and i would have said i'll take it.

>> but, still, cynthia would often drive six hours to richard 's home in virginia to advise him to take his time deciding because even if he survived the surgery, there were further risks. the anti-rejection drugs he might need to take for the rest of his life would make it harder for his body to fight off diseases like cancer, she told him.

>> i needed to know that richard understood what he was getting into.

>> in june 2011 , 14 years after the shotgun accident, richard made his decision. despite all the risks he would go ahead with the face transplant surgery.

>> richard was the right patient. he was committed to doing absolutely everything, and he always wanted to move forward. he wanted to help the wounded warriors.

>> the shock trauma center documented its research and even interviewed richard at the time about his decision to be a human experiment for those wounded in war.

>> gave them a chance to give hope, not give up, keep hoping and keep fighting.

>> he was willing to risk the possibility of dying and the hope that he might --

>> of regaining a face.

>> for altruistic reasons.

>> right.

>> a medical non-profit called angel flight shuttled richard to and from baltimore where dr. rodriguez , his team and cynthia made meticulous preparations. they went so far as to practice the surgery 15 times, once with a brain dead donor knowing they might have only a single chance to get richard 's face transplant surgery right.

>> there have been many moments where i had to turn away to sort of wipe a tear from my eye. it's amazing to think that someone would be courageous enough to do this, selfless enough to do this, knowing that this could fail, miserably.

>> that courage was about to be put to the test, and another family with a son would have to find the courage to make a choice no parent should ever have to. it is one thing to donate your child's organs, but it's an entirely different thing to donate your child's face. e, and you're