Discover Magazine’s September 2014 cover story, New Hope for Soldiers Disfigured in War, details how Army surgeon Robert Hale is advancing facial reconstruction medicine in response to the wounds of modern warfare. Here, author Liza Gross (bio) shares a few words about her experience working on the story.
How did you come up with the idea to write about facial reconstruction?
It started with an episode of Boardwalk Empire, oddly enough. One of the characters, Richard Harrow, wore a tin mask to cover severe facial injuries he’d sustained in WWI. In those days, newspapers never ran pictures of the men who lost most of their faces in the war. I did a bit of research and realized that the same was true today. We see pictures of men and women who’ve lost limbs, but rarely do we see those with severely disfiguring facial injuries. I wondered why. I thought surely medicine has advanced enough by now to find ways to help repair devastating wounds to the face. I was shocked to find out that surgeons were using many of the same reconstructive techniques that Sir Harold Gillies invented 100 years ago to fix the carnage left in the trenches of WWI. The techniques closed wounds but left the injured with mouths that couldn’t open and eyes that couldn’t shut.
How did you find Robert Hale, one of the Army’s top facial trauma surgeons?
I first heard him speak at AAAS. This is one of those rare cases when a great story came out of a press conference. You tend to think you won’t be able to sell a unique slant on a story when you’re in a room filled with journalists, but this one worked out. Though actually another in-depth feature I did (on bisphenol A) grew out of a press conference, also at AAAS, so I guess I’m less jaded about getting big stories from press conferences than other freelancers I know.
Hale led a press conference that focused on the challenges of facial reconstruction after trauma. Staff Sgt. Todd Nelson, who suffered facial wounds after serving in Afghanistan, was part of the panel, providing what he likes to call the end user’s perspective.
Can you tell us a bit about how you reported this story?
I like to take a historical approach to stories, so I’m always looking at how a field evolved when I start to report a story, even if what I find doesn’t make it into the story. But in this case the history was very much in the present, with surgeons actually consulting textbooks written by Gillies and other Great War surgeons to figure out how to fix these guys, so I knew I wanted to weave the history through the narrative. I immersed myself in old plastic surgery textbooks and journals, much to my husband’s chagrin, and found a biography of Gillies to get a sense of the types of operations he experimented with to try to re-create faces from little more than bloody membranes.
And with so many different fields involved—wound healing, skin restoration, bone regeneration, transplant medicine, immunology, and more!—I spent a lot of time reading papers to familiarize myself with the science. I needed to know enough about the challenges before I spoke to Hale and other scientists about what they were trying to do.
Once I felt like I had some idea of what they were up against, I went to San Antonio to meet with Hale and Nelson and to talk to as many of Hale’s colleagues as I could.
What was your approach? How long did it take from idea to publication?
Well at first, I was so taken by Nelson’s story that I was making him the protagonist but, as my fabulous editor, Siri Carpenter, reminded me, a Discover story needs to focus on the scientist, so that’s what I did. But I felt very strongly that this was a story of two men whose lives became intertwined in a professional and personal way. These men have incredible respect for each other. Hale is the one leading the push to accelerate discoveries to help these horrifically wounded men and women, but it was Todd who set him on this mission. Hale told me, “We’re doing this science because we had such a miserable time trying to help Todd.” He really felt the pain that his patients were going through with endless surgeries that often didn’t work.
As for how long it took, I actually pitched the story in Boston at AAAS, which would have been February 2013, after I heard Hale and Nelson at the press conference. It came out online at the end of July 2014.
What were the major challenges with this story?
There were many! There were so many different fields and technical details that I had to wrap my head around. It took a lot of time to make sure I understood exactly how things worked. Lots of reading, lots of interviews. And I was extremely frustrated by the paywalls I kept running into for medical journals, especially niche journals that covered the latest advances in burn medicine. I think it’s unconscionable that these papers, many the result of taxpayer funded grants, are not easily accessible to the patients who might benefit from them. I was not going to spent $35 each for 20 papers that might not even give me what I needed. I used #icanhazpdf on Twitter to get some of the papers and emailed the corresponding authors on others.
But these were essentially minor irritations. The bigger challenges for me were twofold: my personal feelings about our entry into the wars in Iraq and Afghanistan and my overactive empathy response. I put aside my feelings about these wars because this was at heart a different question: how the traumas of war inspire scientific advances to help wounded veterans reintegrate into a society that sent them to war. And, perhaps most difficult, I channeled my empathic nature to tell Todd’s story with as much respect and sensitivity as I could muster.
What a great, informative article. Thanks, Liza!