I love many things about working in the maxillofacial ward but what I love most is the way my patients faces are changed and improved almost immediately (apart from some swelling). Someone who has a cleft lip repair looks beautiful straight away, other repairs take a longer time to heal and swelling to decrease before they look ready to face the world. I’m practiced at looking at faces full of distortion or blown out by a tumour. You learn to look past it to the beauty of the person behind the face. I have learnt a great many things working with these patients, but the attribute that stands out the most is how courageous each of them are.
This last week we had a patient who wasn’t physically deformed from the exterior but his jaw had been locked closed (ankylosis) at the age of 7. His teeth were clenched together and he hadn’t been able to open his mouth at all in 19 years. 19 years. He is now 26 years old and had been unable to chew food in all that time and so he was malnourished and very eager to have it fixed.
When he came for admission it was found that his blood type was very rare and the lab couldn’t find a crew member to match him. In order to complete a safe surgery the team came up with a plan for him to give a blood donation that would be saved for him later if he needed it and in another few weeks he would come back and have his ankylosis release. In the meantime he was disappointed, upset and unable to go home due to distance and earn money for his family.
Eventually the time came for surgery. He was admitted the night before and the surgeon came and discussed the surgery with him. When he came back to the ward post-op he was a bit unsettled after the anaesthetic drugs but he calmed down and slept during the night. When I came in the morning he was sleeping soundly but was woken by the surgeon on ward rounds, shaking his hand. We explained we were going to take the bite block out of his mouth that was holding his jaw wide open and we put a mirror in front of him so he could see how wide his mouth could now open. We aim for two finger widths between the front teeth. Give it a go. Put your index and middle fingers together and put them between your top and bottom front teeth. Most of you would probably be able to put three finger widths in but it’s not actually necessary to open that far.
Well, after we did this with him, he started crying. At first it was silent joyful tears streaming from the corners of his eyes and then came the sobbing. I looked around at the faces surrounding his bed. There was about 6 people on a vision trip from the Netherlands, 2 pharmacists, 2 surgeons, 1 local surgeon, 1 translator, 3 hospital physicians and me, plus the 4 ward nurses, 3 other translators and 1 visitor. I looked around at the faces surrounding him and saw Sandy, our lead pharmacist. Her eyes had pooled in joyful tears which caused my professional façade to break and tears to pool in my own. After this he started sobbing, he started shouting out, “I can’t believe it, I can’t believe it! It’s a miracle!” He was raising his hands in praise to the heavens, high-fiving people, shaking people’s hands, celebrating! The crowd of people around him celebrated with him.
He’d been set free.