Wednesday — January 28, 2004

Saving Face

Commentary by JoEllen Collins

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In a nightmare scenario, a traffic accident fatality who has signed an unspecific donor card is "farmed" for several organs. A young girl regains sight through his eyes, a middle-aged mother is given a new lease on life through his liver, and most of his other body parts benefit others. However, in a brand-new procedure, his face is transplanted onto the wrecked face of a burn victim. Several months later the donor’s widow collapses when she sees the image of her late husband coming down the street.

Surely this is the stuff of science fiction, of movies like "Face/Off" where Nicholas Cage and John Travolta exchange faces. According to a research team of British surgeons, however, the procedure is almost perfected. And while countless scarred, burned and disfigured people can perhaps anticipate new faces that won’t repulse onlookers, the surgery opens up many moral and esthetic issues.

When I mentioned the impending likelihood of facial transplants to some friends, the first reaction was overwhelmingly one of disgust and shock. Somehow I don’t think most of us have thought about the possibility of having our faces live on in other bodies. It is a creepy prospect.

Just as in my generation, when we thought in vitro fertilization was impossible and we couldn’t even grasp the concept of cloning, this new advance is frightening. Many new discoveries are scary, of course, partly because we are afraid of possible perverted uses. The mad-scientist version of face transplantation is one. Can we imagine someone, out of vanity, "reserving" the face of a model or movie star in the event of his or her early demise?

Atomic energy was thought a boon to civilization until the development of atomic weapons, so massive in their destructive abilities that most peaceful uses of atomic energy have been sidelined. The one thing I have learned as a product of the 20th Century is that most of the fantastic can become real. We must expect the unexpected.

So what is so terrifying about this particular development? Most of us agree that the dead don’t "feel," and so removing organs will not cause pain. Why do detractors of the procedure claim that people will stop designating themselves as organ donors because they shudder at the use of facial features post mortem?

For one thing, the very essence of individuality is inherent in the face, the one part of a body that most uniquely represents its bearer. No two faces, like snowflakes, are alike. Most of us fall in love with a smile, a look, a face.

The soul is reflected, many believe, in the face. In Thailand, the higher the body part, the more honored it is. Thus one doesn’t touch another’s face or head casually, and pointing feet at someone is an insult. It is no accident that pride in Asian societies is wrapped up with "saving face." In addition, the memories we have of loved ones almost always focus on their faces, the images of them in photographs, the occasional visual reinforcement of the remembrance of someone’s eyes or lips. Finally, I believe, it is easier to make more impersonal the removal of interior organs after death to benefit others. We don’t see our kidneys every day: We aren’t particularly attached to our insides except when they don’t function. But we do look at our faces all the time. The fact that I almost wrote ourselves instead of our faces shows how the concept of the self is inextricably associated with facial appearance. It is often said that the aged get the faces they deserve, as though being a good and loving person will insure a graceful old age, or that being a nasty one will mean certain ugliness in the retirement home. I don’t agree. Lots of other factors than wickedness are etched on people’s faces. I remember when my mother lost her brother and sister within a year of each other (both were in their early 40s) and the resultant emergence of new lines in her face. I cherished them, as I did everything about her visage, as a part of the person she was. There is certainly a sense of violation about peeling away someone’s face and applying it to another’s. That is understandable. The other side of the coin, however, is from the vantage point of the horribly disfigured. What a difference might it make to be able to wear a face that generates welcome instead of rejection? In spite of my disgust with our society’s emphasis on physical beauty, and the increasing demand for ever more youthful looks on those wearing older faces, I accept the reality that we are often judged by first impressions. No one can contest the truth that the attractive often have an easier time than those less blessed with beauty. It must be very lonely to be hideously ugly or to live with the negative reactions of others on a daily basis to a ravaged face.

It may not be inconceivable that this most precious manifestation of our individuality can indeed be salvaged to ease the pain of another if we but open our minds. Surgeons needn’t generate monstrous uses of life-saving procedures, nor do we, perhaps, have to fear this ultimate assault on our vanity. There must be a way, as in all medical breakthroughs, to insure the ethical uses of such knowledge.

 

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