Only the Brave

As I sat there in the Cebu, Philippines, pre-operative clinic I almost had to look away from the horribly deformed teenage girl sitting in front of me.

My nineteen years of experience working with severely deformed children could not lessen the discomfort I felt as I looked at her. The beautiful name Maria did not match the face it belonged to, and yet the name was a testament to the love that her mother must have felt for Maria as an infant—even a horribly deformed infant.

For a few moments, the poor girl sitting in front of me was no more than another patient, until I heard someone behind me say, as if to break the silence, “She graduated from high school last week.” The words took a few moments to sink in, and then I realized what I had heard. “Really—she REALLY graduated from high school?” I said. “Yes,” the clinic helper replied, “just last week.”

I turned back again and looked into Maria's face. I suddenly saw the horribly deformed face in a different light. I could only stare for a moment as I caught hold of what I had just heard. Into my mind came a vision of a young girl with severe, bilateral clefts of not only the mouth, but also the nose and eyes, doggedly stepping into the school grounds day after day, year after year, encountering horrified stares, ridicule, and, likely, gasps of fright from other children. Over the ensuing few days I thought many times of Maria - each time gaining more respect for this unusual girl, who, in spite of a face that could barely claim a single normal structure, would persist in attending school through the years, to the point of high school graduation.

Prior to Maria's surgery date, day after day I visited her in her hospital bed. Each time I entered her room she sat up and turned to me as if to remind me that she was there, looking forward to her long-awaited surgery. Maria had gone to other mission groups throughout her school years only to be told that her deformity was too severe for a visiting medical team to help. But one day a couple of months earlier a British expatriate living in Cebu met Maria and said he knew of an organization that would take her case. That organization was ICSF.

On the night before Maria's surgery, as I entered her room, she again sat up as I entered. "Tomorrow is your day," I said. Maria smiled with what little normal facial anatomy she had, which I took to mean, "I'm ready."

The day of Maria's surgery was a Saturday. The ICSF team had voted to give up their day off to do Maria's ten-hour surgery.

As Maria lay there anesthetized, special preparations for the marathon operation were carefully attended to. Special positioning and padding to avoid pressure ulcerations, a catheter to measure urine output, along with the myriad monitoring devices for blood pressure, arterial oxygen saturation, carbon dioxide exchange efficiency, electrocardiogram, breath rate, heart rate, and body temperature. As I approached Maria to make the initial surgical markings, I felt as if I were entering hallowed ground. I felt a guiding hand on my shoulder and a sense of unusual peace and calm as the incision was made. After eight and a half hours of actual operating time Maria was carefully brought out of anesthesia. The ICSF team had performed flawlessly.

As Maria took her first unassisted breath——with her new face—I thought again of her unparalleled courage during the years of ridicule and scorn in the public schools, culminating in her high school graduation. It occurred to me that it was not only school that she had graduated from. She had graduated and passed the test that only the brave can pass. And finally as Maria was wheeled from the operating room, I thought of the people, far away, who had paid for Maria's surgery——ICSF's supporters. As I sat there in the now-vacated operating room, by myself, writing postoperative orders, I realized that it was all meant to come to pass. ICSF, our supporters and Maria, all united forever by the events of that Saturday.

Thank you, to our supporters. Thank you for your part in giving Maria her very fitting graduation present—a reward for her years of bravery, and thank you in advance for helping with her surgeries yet to come. 'Everyone, even Maria, Was Born to Smile'!

Design by Melissa Ventura, Development by Drew Bertola and Walter Martin.