Autobiography of a Face

by Lucy Grealy

  At school the gang of boys from last year appeared to have dispersed, and I was free to eat in the lunchroom again. But a new group had formed, and they tracked me down every day between fourth and fifth periods as I went from gym to English class, which were at opposite ends of the school. By the time I reached the staircase near my English classroom, nearly everyone else was already there, leaving me to climb the stairs alone. Alone, that is, until that group of six boys discovered they could find me in this stairwell each day at the same time and took to waiting for me. Their teasing was the most hurtful of all because it wasn't even directed at me but at a boy named Jerry.

  "Hey, look, it's Jerry's girlfriend. Hey, Jerry, go on, ask your girlfriend out." I heard Jerry meekly protest, but I knew that he was as much at their mercy as I was, and I knew that to have me called his girlfriend was just about the most malicious insult the other boys could level at him. I even felt sorry for Jerry, though I never saw him, for I refused to lift my gaze from the floor. What morons, I thought to myself, what misguided morons. Martin Luther King, one of my heroes, had said, "I will not allow my oppressors to dictate to me the means of my resistance." That seemed like a far truer thing, a far deeper thing. I wanted to hate them, but instead I tried to forgive them. I thought that if I could do this, the pain they caused would be extinguished. Though I had genuine glimpses of what charity and transcendence meant, I was shooting for nothing less than sainthood; often, after my daily meeting with them, I only ended up hating myself instead.

  The horses remained my one real source of relief. When I was in their presence, nothing else mattered. Animals were both the lives I took care of and the lives who took care of me. Horses neither disapproved nor approved of what I looked like. All that counted was how I treated them, how my actions weighted themselves in the world. I loved to stand next to them with no other humans in sight and rest my head against their warm flanks, trace the whorls in their hide with the fingers of one hand while the other hand rested on the soft skin of their bellies. All the while, I'd listen to the patient sounds of their stomachs and smell the sweet air from their lungs as attentively as if I were being sent information from another world.

  In the middle of the school year, several months before my fifteenth birthday, I went to see Dr. Conley, the surgeon who had removed my jaw, to discuss plans for reconstructing it. I had known all along that something was going to be done to "fix" my face, but up until this point I don't think I had really believed it.

  Without the threat of chemo or dental work, being in a doctor's office seemed so simple and easy. As Dr. Conley examined me, he held my head in his hands, touching my face as no else had in years. It was only then that I realized how guarded I had become about my face; simply relaxing and allowing him to touch me there was akin to surrender, the closest I ever got to experiencing trust. After the examination, he sat down and spoke to me in the tone of someone speaking to a child, which served to both instantly destroy and strangely build the trust in him I had felt only moments before.

  He explained that the biggest obstacle to reconstruction would come from all the radiation treatments I'd undergone. Irradiated tissue tends not to take grafts too well and presents a higher rate of reabsorption; even if the graft wasn't actually rejected, it might simply be "taken back" by my body and shrink down to nothing. He proposed a technique that required the use of "pedestals," which would require several operations. In the first operation, two parallel incisions would be made in my stomach. The strip of skin between these incisions would be lifted up and rolled into a sort of tube with both ends still attached to my stomach, resembling a kind of handle: this was the pedestal. The two incisions would be sewn together down its side, like a seam. Six weeks later, one end of the handle would be cut from my stomach and attached to my wrist, so that my hand would be sewn to my stomach for six weeks. Then the end of the tube that was still attached to my stomach would be severed and sewn to my face, so that now my hand would be attached to my face. Six weeks after that, my hand would be cut loose and the pedestal, or flap, as they called it, would be nestled completely into the gap created by my missing jaw. This would be only the first pedestal: the whole process would take several, plus additional operations to carve everything into a recognizable shape, over a period of about ten years altogether. Ten years! I was horrified. I would be twenty-five years old in ten years: ancient. Did I have to devote the next ten years of my life to one surgery after another? Ten years—my God.

  I was crushed. It must have shown, because Dr. Conley started explaining that I shouldn't worry about how I looked, how everyone had something they didn't like about their face. Why, he himself had had terrible acne as a teenager, and that had made him feel awful. Acne, was he serious? How could my problem actually be compared to acne. Any hope I'd allowed myself died right then.

  My despair worsened a few days later when I went to the library with my father. While he stayed downstairs and picked among the fiction, I went upstairs to the nonfiction department and secretly looked up books on plastic surgery. In the middle of giant, outdated tomes, I found photographs of the pedestal procedure. The people in the photographs looked like freaks. With their own skin and muscle sewn to disjointed parts of their anatomy, they looked like illustrations of some brilliant medieval torture device. Worst of all, the final outcome made them look exactly like what they were: people with alien bits of flesh sewn to them. To my eye, many of the people used as examples looked even worse afterward. I was so frightened I could not get my breath, and I had to sit down with my head between my legs until the buzzing was gone from my ears. Was this what my life was going to be? I felt utterly without hope, completely alone and without any chance of ever being loved. Feeling as if I had uncovered some horrible secret, I went downstairs to meet my father.

  As we drove home together, he asked me what was wrong, but I couldn't tell him. At home I went to my room, where I wanted desperately to cry, but even the tears were numbed back. I lay frozen on my bed watching a spider walking back and forth on the ceiling until my mother called me for dinner. For the first time I wished I were dead.

  Relief came in two unexpected ways. The first occurred some months later, toward the end of eighth grade, when Kelly, a girl I had met at the stable, had to move to another state. Unable to take her horse, an ex-racehorse named Sure Swinger, she arranged with my parents to give him to me. I'd never understood just how quickly, how splendidly and suddenly, reality could change, how you could look down at the shoes on your own two feet and wonder if they were real.

  The second form of comfort came in the person of Dr. Daniel Baker, a younger associate of Dr. Conley's. He and some other doctors were working on a reconstruction technique involving microsurgery, a very new field at the time, to graft vascularized free flaps. This "state of the art" surgery involved taking a large chunk of soft tissue, probably from my groin, and sewing the whole thing, veins and all, onto the jaw area. This not only dispensed with the cumbersome, multistage pedestal procedure, but it also offered a greater chance that the graft would survive, because the new tissue would have its own blood supply. Dr. Baker explained that it would be best to wait another year or so, perhaps until I was sixteen, so that I could grow some more first. I would have to have a major operation followed by lesser ones to shape the graft, but Dr. Baker seemed to think there was a good chance of achieving "a near-normal jaw line."

  I can still see my father's reaction as he stood in the corner of Dr. Baker's office, listening to his words and beaming. I had never mentioned my fears concerning my face to my father, and in my solipsism I had never thought that he might share my unhappiness. The halo of joy that surrounded him now was a revelation to me. His joy made me feel better, though it also occurred to me that my face must really be as bad as I feared if he found such relief at the possibility of this surgery.

  Maybe life was going to be all right after all. Maybe this wasn't my actual face at all but the face of some interloper, some ugly intruder, and
my "real" face, the one I was meant to have all along, was within reach. I began to imagine my "original" face, the one free from all deviation, all error. I believed that if none of this had happened to me, I would have been beautiful. I looked in the mirror closely and imagined the lower half of my face filled out, normal. Reaching my hand up, I covered my chin and jaw, and yes, even I could see that the rest of my face really was beautiful. As soon as I took my hand away, the ugliness of the lower half canceled out the beauty of the upper half, but now this didn't matter so much: it was all going to be "fixed."

  What would it be like to walk down the street and be able to trust that no one would say anything nasty to me? My only clues were from Halloween and from the winter, when I could wrap up the lower half of my face in a scarf and talk to people who had no idea that my beauty was a lie, a trick that would be exposed the minute I had to take off the scarf. To feel that confidence without the threat of exposure—how could I possibly want anything more? If they thought I was beautiful, and here I could almost not dare to think such a thing, they might even love me. Me, as an individual, as a person.

  I'd rationalized my own desires for so long that I was genuinely perplexed as to whether this sudden and glorious sense of relief at the prospect of having my face fixed was valid. Was the love that I'd guarded against for so long going to be the reward for my suffering? I had put a great deal of effort into accepting that my life would be without love and beauty In order to be comforted by Love and Beauty. Did my eager willingness to grasp the idea of "fixing" my face somehow invalidate all those years of toil? I did not trust the idea that happiness could be an option.

  For a few months I settled into a routine of living what felt like three separate lives. Days were filled with school, where I tried to be as fiercely intelligent as I could. My armor would be my academic prowess, from which I was developing a superiority complex as earnestly built as it was defensively acquired. In my second life I still lived in a violent fantasy in which I had no choice but to appreciate the life I led in reality, the one in which my face seemed a frivolous thing compared with a land mine or a pogrom. The third life took place after school, and all day during the summer, when I went to my horse, Swinger, with whom I was conducting nothing less than a romantic relationship.

  I knew his whole being. There was not one part of his body I could not touch, not one part of his personality I did not know at least as well as my own. When we went on long rides through the woods, I would tell him everything I knew and then explain why I loved him so much, why he was special, different from other horses, how I would take care of him for the rest of his life, never leave him or let anyone harm him. After the ride I would take him to graze in an empty field. I would lie down on his broad bare back and think I was the luckiest girl alive, his weight shifting beneath me as he moved toward the next bite of grass. Sometimes I took him to the stream and laughed as he pawed at the water, screaming in delight when he tried to lie down in it. Best of all was when I happened to find him lying down in his stall. Carefully, so as not to spook him, I'd creep in and lie down on top of his giant body, his great animal heat and breath rising up to swallow my own smaller hear and less substantial air.

  NINE

  World of Unknowing

  WHEN SCHOOL STARTED AGAIN, MY NINTH-GRADE English class began reading poetry. Our first assignment was Theodore Roethke's "My Papa's Waltz." I read it dutifully the night before class and recognized in the image of the father's dirty hand and the boy's dizzying bewilderment something beautiful and important, something that vaguely had to do with my own family. And as I recognized myself, I also realized the precision of language; I knew that the poem could not have been written in any way except exactly as it had been. The poem's power over me came from the author's unassailable ability to say what felt so right and true. I think I already understood that beauty was somehow related to mystery, but for the first time I saw that mystery was not just a cause but also a natural result of beauty. I tried to say all this in class the next day, but my teacher wanted us to talk about whether or not the boy loved his father. As we spent the forty minutes debating along those lines, what I knew about my love for my own father seemed to grow only more distant and closed off.

  Earlier in my childhood, when my father came home late at night, he would shout greetings to everybody as he came through the door, and Sarah and the dogs and I would go running to greet him. But as we got older we were less interested in this ritual, and eventually only the dogs would get up to greet him, while Sarah and I tossed off distracted greetings from our seats in front of the television set. One evening I had a terrible premonition of the time, after Sarah and I had grown up and moved out and the dogs were long dead, when he would come home and there would be only his own voice echoing emptily up the stairs. I felt a strange chill, a hollow and unspeakably sad chill, almost as if I had seen a ghost. From that day on I made a point, even when I didn't particularly feel like it, of greeting him at the top of the stairs. I saw this in terms of my future absence from his life; it never occurred to me that he would ever be absent from mine.

  Just seven or eight months after that premonition, I had my first experience of death. Only four months after I received him, Swinger developed an infection in his hoof. I watched carefully as Gene, one of the few regular adult employees of the stable, gave Swinger the prescribed penicillin injection in his neck. Then I went down to the tack room to put something away. After finishing my chore, I turned back to the ring, where Gene was leading Swinger. I was about to crack a joke like, "What do you think you're doing with my horse?" when I realized something was terribly wrong. Swinger was falling down and trying to get back up, only to fall down again. Finally he could not get back up at all.

  A crowd had gathered and everyone was yelling and shouting and trying to rouse him, but his legs were sticking almost straight out and trembling and his eyes were rolling into the back of his head. Gene shouted at me to run and get a blanket from the barn. I tore away and fumbled to get the blanket off its rack. With it in hand, I ran back to the ring, but as I got closer I saw that everyone was just standing there, not shouting anymore. Gene reached the gate before me. With one arm, he held it shut and wouldn't let me back in. I looked at him, dropped the blanket, and burst into tears, all the while strangely aware of the melodrama of it all, as if I were remembering this scene from a movie I'd seen. The shot was of Gene's strong and hairy arm barring my way, of everyone standing so silent, of Swinger's huge dark body on the ground. Although I had never liked Gene very much, I allowed him to hold me as I sobbed. I smelled the sweat on his clothes and looked toward Swinger and saw the slow line of urine seeping into the lightly colored dust. I had read that you peed and defecated when you died, and now I knew it true.

  I couldn't bring myself to call my mother to tell her what had happened — I asked someone else to call for me. When she came to pick me up, for some reason I was frightened by the prospect of her reaction: would she be mad? Naturally she was very sympathetic, but I couldn't shake the feeling of shame. When we got home I went wordlessly down to my room and watched television in a stupor of grief. Finally I heard my father come home, shout his usual greeting, and walk up the stairs into the kitchen, which was above my room. I could hear my parents' footsteps above me, and I knew she was telling him. I listened as he walked down the stairs then silently over the thick rug toward my room. I felt the same sense of shame I'd experienced with my mother, not unlike the times he'd visited me in the hospital. He offered his condolences and kissed my ears, which tickled and annoyed me so that I pushed him away, and then left.

  My mourning was so untouchable that I had no clue as to what to do with it. Perhaps Swinger had died because I loved him too much: what other reason could there be? Why else would God allow the being I loved more than any other living thing in the world, including myself, to die like that? If this had some kind of meaning, if I was supposed to learn some lesson, I didn't care. Ever since the moment when Gene st
opped me at the gate, I had been unable to stop observing everything from an untraceable distance. Even as I felt the worst pain I could ever remember feeling, a sense of the drama of my situation crept in, and there, in front of my private audience, I played my role of the hapless and ill-fated lover once again.

  I was stricken over Swinger's death for several months, but time eventually did perform its healing task, and gradually I became excited at the prospect of getting another horse, promised by my parents. I knew that money was still an issue and that this new horse might not materialize straight away, but I knew they would not go back on their word. But sometime after Christmas my mother received a phone call from my dad's boss, explaining that he had gone to the hospital because of stomach pains. My first reaction was that this would put a wrench in my new-horse plans. My mother was certain he was only being a hypochondriac, that it was nothing at all. Maybe it was his ulcer acting up again and he was just overreacting. But he was still in the hospital the next day—they were keeping him for tests—and he was there the day after that and the next day, too. My mother started visiting him every day, yet the rest of us stayed behind, assuming he would be out the very next day.

  The weeks turned into months, and each day we received a new report on my father's health. He had pancreatitis: no one would say if he would get better or not. One day toward the end of March, my mother came home and told us they'd put my father on oxygen. Inwardly I shuddered. Everything I knew about hospitals told me that this was a bad thing. My father was going to die, and as bad as this knowledge was, it was made worse by my notion that I was the only one who understood it. My family was not the sort to openly discuss things. Though we all must have been hurting, we did not speak of my father except with a forced optimism.