Ghastly crime, a new face

Updated: 2013-11-10 07:58

By Abby Goodnough(The New York Times)

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THETFORD, Vermont - Carmen Tarleton left her rural home here and drove through the frigid dark on February 14 to Brigham and Women's Hospital in Boston. Her doctor had called with the news she had been waiting for: a suitable donor had been found. She would get a new face.

Almost six years had passed since her estranged husband broke into her house, beat her and soaked her with industrial lye. The attack nearly blinded Ms. Tarleton, a nurse and mother of two. She lost her eyelids, upper lip and left ear. Her face and much of her body was a knobby patchwork of scar tissue and skin grafts, painful to look at and far more painful to live with.

Now she was ready to receive someone else's features. After 15 hours of transplant surgery, Ms. Tarleton, 45, emerged from the operating room with what looked to her mother, Joan Van Norden, like a puffy, surreal mask. At first she wanted to faint as she stared at the new face, smooth and freckled, stitched to her daughter's pale scalp. But when Ms. Tarleton started talking in her old familiar voice, Mrs. Van Norden relaxed.

"I said, 'This is who Carmen is now,' and it really looked beautiful," she recalled. "Although it didn't look anything like her, it was her face."

Face transplants are still an experimental procedure, the first having taken place just eight years ago in France. Some two dozen full or partial transplants have been completed worldwide, including five at Brigham and Women's. Arteries, veins, nerves and muscles from the donor face must be painstakingly connected to the recipient's.

Ghastly crime, a new face

Ms. Tarleton's appearance is still evolving: her scalp was so badly burned that hair will never return to parts of her head, but her donor's hair is growing around her forehead and temples. Her right eye remains closed, and her left droops. Her face is sometimes masklike, betraying little emotion, because the muscles are still reconnecting. And that mask looks like neither her nor the woman who donated it.

But eight months after the operation, there was evidence that Ms. Tarleton's new face was more than just donated tissue, and was becoming part of who she is.

"When someone at work asks me, 'How's Carmen?' the picture that comes up in my mind more and more is that face,' " said her sister, Kesstan Blandin.

For Ms. Tarleton, the process of acceptance has been trickier. For one thing, her poor vision keeps her from seeing herself clearly unless she holds a mirror up close. "I don't yet feel it is 'my face'," she wrote in a recent blog post. "I feel like I am still borrowing it."

Ms. Tarleton's former husband, Herbert Rodgers, 58, pleaded guilty to a charge of maiming and is serving a prison sentence of at least 30 years.

After the attack, Ms. Tarleton underwent a number of reconstructive surgeries, with little success. When Dr. Bohdan Pomahac called in May 2011 to propose a face transplant, Ms. Tarleton's mind first leapt to a "Twilight Zone" episode that had jarred her as a child, about a man who could change his appearance to look like other people.

"Initially I felt that it was very sci-fi," she said. But after weighing the pros and cons - for one thing, she is likely to be on immunosuppressant drugs for the rest of her life, raising her risk of infection and cancer - Ms. Tarleton decided to forge ahead.

After a number of trips to Boston for physical and psychological screening to determine if she was a good candidate, she got on the donor list that fall. "It was like a big surprise, a big gift," she said. "I'd already accepted my disfigurement, fine. But I accepted it believing there wasn't an alternative."

The things Ms. Tarleton wanted from a new face were more pragmatic than aesthetic. Tight bands of scars ringed her neck, causing debilitating pain. She drooled constantly and could not blink, jeopardizing a synthetic cornea in her left eye. And with her face frozen from scarring, it was hard for others to read her emotions.

For a time, she was devastated that she could not see "the old me," as she put it. But she moved on, writing a book about her physical and emotional recovery from the attack and speaking publicly about her experience. She seemed mostly unconcerned about her appearance while waiting for a donor.

But in December 2012, she gained a desire for a new face. She had started taking piano lessons at a local music shop not far from her home. Her teacher was Sheldon Stein, an earthy soft-spoken musician with whom she felt an instant affinity. The feeling, it turned out, was mutual. The two say they are in love.

Ghastly crime, a new face

"I kept looking in the mirror all of a sudden when I met Sheldon," she said. "I wasn't insecure before. But now - now you have feelings for somebody and now you have something to lose, when before, one of the reasons I did so well is I had nothing to lose anymore."

After the operation, she went through a harrowing three weeks when her immune system rejected the face. But medications helped her accept the new tissue. And some of the improvements she had hoped for came shortly after. Soon her neck pain disappeared, and her left eyelid, immobile for years, began to blink again. Her drooling diminished.

The transplant did not make Ms. Tarleton look like her donor, Cheryl Denelli Righter of North Adams, Massachusetts, who died at 56 after a stroke. That is a typical outcome for face transplant recipients, partly because bone structures differ.

Ms. Tarleton has undergone nearly 60 operations. And a speech therapist is helping her learn to move her new lips.

"One of these days in the near future," Ms. Tarleton said, "when I start to cry or I laugh, you're going to be able to tell by looking at me how I feel."

The New York Times

 Ghastly crime, a new face

After she was disfigured in an attack by her estranged husband, Carmen Tarleton received a face transplant. Leslye Davis / The New York Times

(China Daily 11/10/2013 page9)