國家地理:移植的臉如何改變了一名女子的生活(7)

The bullet was a pernicious thief. To get a measure of what it stole from Katie, hold your hands up to your face, palms out, your thumbs touching beneath your chin and your index fingers touching between your eyebrows. Your hands are framing the part of Katie's face she lost. Gone were part of her forehead; her nose and sinuses; her mouth, except for the corners of her lips; and much of her mandible and maxilla, the bones that make up the jaws and front of the face. Her eyes remained, but they were askew and badly damaged.

那顆子彈就像是個惡毒的小偷。要想知道它從凱蒂身上偷了什么東西，把你的手舉到臉上，伸出手掌，大拇指按在下巴下面，食指碰觸到眉毛之間。你的手就勾勒出凱蒂失去的那張臉。她前額的一部分不見了，失去了鼻子、鼻竇嘴巴（除了嘴角）以及大部分下頜骨和上頜骨，這些骨頭組成了她的下顎和臉的前部。她的眼睛還在，但已經(jīng)歪了，而且嚴(yán)重受損。

This is how Katie arrived more than five weeks later at the clinic, which was founded in Cleveland, Ohio, in 1921 by four doctors, three of whom had served together during World War I and had come home inspired by the military model of teamwork among specialists. In Memphis, Tennessee, where Katie was first operated on, doctors had saved her life against all odds, but their attempt to cover the gaping wound with a tissue graft from her abdomen hadn't worked.

這就是凱蒂受傷5周后來到克利夫蘭診所時的場景。1921年，四名醫(yī)生在俄亥俄州創(chuàng)立了克利夫蘭診所，其中三人曾在第一次世界大戰(zhàn)期間共同服役，并將軍隊(duì)中專家團(tuán)隊(duì)合作的模式發(fā)揚(yáng)光大。凱蒂在田納西州的孟菲斯接受了第一次手術(shù)，當(dāng)時醫(yī)生們不惜一切代價挽救了她的生命，但他們試圖用腹部組織移植來覆蓋裂開的傷口時卻沒有成功。

Brian Gastman, the first clinic doctor to see Katie, lifted her onto a gurney and wondered if she would make it. She was so tiny. Just 105 pounds. Even if she survived, he wasn't sure she would have enough tissue for all the reconstructive work he needed to do. "It was not great," he said. "Her brain was basically exposed, and I mean, we're talking seizures and infections and all kinds of problems. Forget the face transplant; we're talking about just being alive."

布萊恩·加斯特曼是第一個見到凱蒂的診所醫(yī)生，他把她抬到輪床上，想知道她是否能活下來。她是如此瘦弱，體重只有50公斤。即使凱蒂活了下來，加斯特曼也不確定她是否有足夠的組織來進(jìn)行需要的所有整形努力。他說：“情況不太好，她的大腦基本上已經(jīng)暴露出來。我的意思是，可能會出現(xiàn)癲癇、感染和各種各樣的問題。忘記換臉手術(shù)吧，我們只能確保她活著?！?/p>

In his 27 years of training and practice, Gastman said, this was one of the worst face traumas he'd ever encountered. Beyond the wound to her face, she had traumatic brain injury from the bullet's concussive force to her frontal lobe, optic nerve, and pituitary gland. The damage to her pituitary threw her hormones and sodium levels out of whack, which can be deadly. Taking charge of Katie's care, Gastman organized a multidisciplinary team of 15 specialists to address all her issues, from endocrinology to psychiatry.

加斯特曼說，在他27年的培訓(xùn)和實(shí)踐中，這是他所遇到的最嚴(yán)重的面部創(chuàng)傷之一。除了臉上的傷口，凱蒂的腦外傷也很嚴(yán)重，因?yàn)樽訌椀恼鹗幜α總暗剿念~葉、視神經(jīng)和腦下垂體。腦下垂體的損傷使她的荷爾蒙和鈉含量失衡，這可能是致命的。加斯特曼負(fù)責(zé)凱蒂的治療，他組織了一個由15名專家組成的多學(xué)科小組來處理她所有的問題，從內(nèi)分泌到精神病學(xué)。