国家地理 移植的脸如何改变了一名女子的生活(7)（在线收听）

The bullet was a pernicious thief. To get a measure of what it stole from Katie, hold your hands up to your face, palms out, your thumbs touching beneath your chin and your index fingers touching between your eyebrows. Your hands are framing the part of Katie's face she lost. Gone were part of her forehead; her nose and sinuses; her mouth, except for the corners of her lips; and much of her mandible and maxilla, the bones that make up the jaws and front of the face. Her eyes remained, but they were askew and badly damaged.

那颗子弹就像是个恶毒的小偷。要想知道它从凯蒂身上偷了什么东西，把你的手举到脸上，伸出手掌，大拇指按在下巴下面，食指碰触到眉毛之间。你的手就勾勒出凯蒂失去的那张脸。她前额的一部分不见了，失去了鼻子、鼻窦嘴巴（除了嘴角）以及大部分下颌骨和上颌骨，这些骨头组成了她的下颚和脸的前部。她的眼睛还在，但已经歪了，而且严重受损。

This is how Katie arrived more than five weeks later at the clinic, which was founded in Cleveland, Ohio, in 1921 by four doctors, three of whom had served together during World War I and had come home inspired by the military model of teamwork among specialists. In Memphis, Tennessee, where Katie was first operated on, doctors had saved her life against all odds, but their attempt to cover the gaping wound with a tissue graft from her abdomen hadn't worked.

这就是凯蒂受伤5周后来到克利夫兰诊所时的场景。1921年，四名医生在俄亥俄州创立了克利夫兰诊所，其中三人曾在第一次世界大战期间共同服役，并将军队中专家团队合作的模式发扬光大。凯蒂在田纳西州的孟菲斯接受了第一次手术，当时医生们不惜一切代价挽救了她的生命，但他们试图用腹部组织移植来覆盖裂开的伤口时却没有成功。

Brian Gastman, the first clinic doctor to see Katie, lifted her onto a gurney and wondered if she would make it. She was so tiny. Just 105 pounds. Even if she survived, he wasn't sure she would have enough tissue for all the reconstructive work he needed to do. "It was not great," he said. "Her brain was basically exposed, and I mean, we're talking seizures and infections and all kinds of problems. Forget the face transplant; we're talking about just being alive."

布莱恩·加斯特曼是第一个见到凯蒂的诊所医生，他把她抬到轮床上，想知道她是否能活下来。她是如此瘦弱，体重只有50公斤。即使凯蒂活了下来，加斯特曼也不确定她是否有足够的组织来进行需要的所有整形努力。他说：“情况不太好，她的大脑基本上已经暴露出来。我的意思是，可能会出现癫痫、感染和各种各样的问题。忘记换脸手术吧，我们只能确保她活着。”

In his 27 years of training and practice, Gastman said, this was one of the worst face traumas he'd ever encountered. Beyond the wound to her face, she had traumatic brain injury from the bullet's concussive force to her frontal lobe, optic nerve, and pituitary gland. The damage to her pituitary threw her hormones and sodium levels out of whack, which can be deadly. Taking charge of Katie's care, Gastman organized a multidisciplinary team of 15 specialists to address all her issues, from endocrinology to psychiatry.

加斯特曼说，在他27年的培训和实践中，这是他所遇到的最严重的面部创伤之一。除了脸上的伤口，凯蒂的脑外伤也很严重，因为子弹的震荡力量伤及到她的额叶、视神经和脑下垂体。脑下垂体的损伤使她的荷尔蒙和钠含量失衡，这可能是致命的。加斯特曼负责凯蒂的治疗，他组织了一个由15名专家组成的多学科小组来处理她所有的问题，从内分泌到精神病学。