Livensi, our young burn and skin graft patient, was awake when Nan and I visited him this morning.  He was groggy from his pain meds, and he occasionally played with the matchbox cars he was given.  His left arm is fully bandaged and his grafted lip is swollen and has stitches.  When I walked into the room he looked with at me with wide eyes and his face looked almost fearful.  I was clumsy in offering encouragement in a language he doesn't understand.  Nan engaged with him easily and he responded with his wide eyes but an expressionless face.  It’s difficult to know what he is feeling although he is not in obvious pain.  As Nan and I left after our brief visit she gave him a thumbs-up sign and said, “Muy valiente!”  As I followed her out the door I waved to him and he, with his free right arm, enthusiastically waved back. 

Our surgical patients yesterday included a baby with a cleft lip,

_CAC3273

a young man with a facial nerve problem,
  _CAC3269

and Yohan. 
_CAC6941

Yohan is the policeman mentioned a few days ago.  He is a husband and a father of a one year-old boy.  Last year, Yohan was the target of a non-work related assault with “acid of the devil” that essentially melted his face and left his shoulders and arms badly scarred.  There were openings for his eyes but the damage to his eyelids prevented him from blinking.  The opening for his mouth was very small and his lips couldn’t close.

In a 7 hour operation, Dr. Karla Werninghaus, Dr. Bill DeShazo and Dr. Fred Tomlinson grafted skin to his eyelids so they can close to protect, moisten, and cleanse his eyes.  Additional grafts were made around his mouth so it can close and work was done to create a canal for his right ear.

_CAC3230

These changes are more functional than cosmetic.  Unfortunately, there is little that can be done without extensive, expensive work that offers him any possibility of restoring a more normal appearance.

Be Flexible.  Tenga flexibilidad.

Carl Cilker
Photojournalist