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The mirror said everything.

The fair woman she had once been was gone, along by 80 percent of her facial bones. Her strength to speak, to eat without a gastrointestinal tube, the sense of hearing in one ear and the sight in one eye

After seven years of sharpness, in 2004 Suzy Q Karuzzo’s husband held a fire-arm unbecoming her jaw-bone and pulled the trigger. He was convicted of attempted manslaughter and served three years in prison.

Karuzzo got life.

That day at Seattle’s Harborview Medical Center, when she confronted her image in the place of the first time, she couldn’cheek by jowl imagine walking down the public way without horrifying people. The bullet had split her part into two halves.

Karuzzo wanted to die. But Dr. Joseph Gruss believed her face and living beings could be rebuilt.

Gruss, chief of craniofacial, plastic and reconstructive surgery at Seattle Children’s hospital, had throughout established himself as one of medicine’s greatest number esteemed craniofacial surgeons, one whose reputation drew patients from entirely over the world. He pioneered methods of facial reconstruction to repair damage from gunshot wounds and correct cleft palates in children.

When then-3-year-old Muhammed “Hamoody” Jauda was shot in the face by Sunni insurgents in his inbred Iraq, it was Gruss who painstakingly coaxed a human face from scar tissue later the blind boy was brought to Seattle. Hamoody, who has been granted asylum and is live through a Snohomish coupling, now has a future he never would’ve had in Iraq.

As Karuzzo lay in Harborview’s intensive-care unit, Gruss immediately began reconstructive surgery on her face before the scar tissue had a chance to shrivel.

Then he encouraged her to go back to school and look a psychologist to abet her cope. “He reminded me that God had made me perfect,’ Karuzzo said.

From rejected to recruited

Gruss, 63, grew up in Johannesburg, South Africa, and started his healing career in group of genera practice, what one. he loved because it allowed him to follow the development of children and their families conducive to years.

He would later learn that craniofacial surgery requires the same extended contact by patients. “I tell medical students it’sitting the next-best movables” to family practice, Gruss said.

Gruss moved to England in the late 1960s and took a job at London’sitting Great Ormond Street Hospital for Children, known for pioneering research in children’s medical care.

While there he worked with Dr. Paul Tessier, regarded in the same manner with the father of craniofacial surgery, who was famous instead of surgically separating the eye sockets and audacity from the base of the brain-pan by making bone cuts inside the cranium, a technique still used today to fix severe facial deformities.

In 1973, Gruss moved to Toronto and took a job at Sunnybrook Medical Centre at the University of Toronto.

In Canada, viewed like well as in the U.S., it was then becoming threadbare for fire-department medics to correspond to the scene of accidents. As a result, more the many the crowd were surviving accidents that antecedently would have killed them. Yet they were left through horrific facial injuries, and there were few surgeons with the skills to assistance them.

Using Tessier’s still-radical techniques, Gruss did countless surgeries by peeling back all the facial tissue, then splitting the bones and moving them around before repairing the fearful tissue. He likens it to building the structure of a house before putting on the roof.

Gruss also theorized that results could be improved whether or not surgery was executed as with haste as feasible, grafting the patient’s own bone into the damaged area before scar tissue formed.

He was rebuked. Other doctors not only refused to use his techniques but advised those Gruss was teaching not to listen to him. His papers were initially rejected by the medical journals.

“It was wayward to all the textbooks and I got severely criticized,” he said. “I was just a not old doctor and it was very hard on this account that me.”

Inspired by the agency of a German surgeon’s experimental use of tiny metal screws to hold bones together, Gruss became the first North American surgeon to use them in craniofacial surgery. It was some other step toward repairing shattered bones.

In 1991, Seattle Children’session recruited Gruss, who saw the opportunity to shrink a craniofacial program, the first of its kind here. When he and his wife, Eve, arrived he found an endless supply of young patients by horrific birth defects. Their families had been told there was nothing that could be done for them.

“There were hundreds and hundreds of kids who had never been operated on. Kids who were 10 to 12 years old.”

Some had eyes on the side of their head, two noses, a face vapid as a lollipop.

“They had saved all these patients for me,” he said.

He in turn recruited other surgeons, including Dr. Michael Cunningham, now the medical guide for the Craniofacial Center at Children’s.

“He operated for years on children who were much older,” Cunningham before-mentioned. “He got a lot of heedfulness in the common.”

And because his surgical techniques were, at the time, more radical than was commonly practiced, other physicians anew questioned his judgment.

“New ideas are hard to get accepted in the therapeutic common,” he said. “I’ve always tried to look for solutions and take on things others don’t want to take on.”

Gruss’ pattern of “cutting the face in half and bringing it together” was very new, Cunningham said.

It’s risky and complex, but it’s now a indifferent technique taught to other surgeons who rehearse Gruss has changed the path of their medicinal careers.

“Dr. Gruss is an amazing combination of surgical wisdom, melting mood, and courage. There are few craniofacial problems that he will not tackle and fewer nevertheless that he cannot correct,” Cunningham said.

“He is a much mentor,” related Dr. Richard Hopper, director of craniofacial surgery at the hospital. Under Gruss’s guidance, the craniofacial unit began to incorporate 13 other specialties, including ear, nose and throat specialists, opthalmalogical surgeons, speech therapists, neurologists and psychologists.

In the mid-1990s, Gruss again fought the national medical establishment when he challenged the augment in cranial surgeries performed in infants following the American Academy of Pediatrics advisory that babies were safer from Sudden Infant Death Syndrome if they slept on their backs.

But babies that slept on their backs ended up with heads flattened in the back and often that was misdiagnosed as craniosynostosis, a serious state in which the bones of the skull coalesce prematurely, limiting brain growth. It resulted in countless unnecessary surgeries, Gruss said.

Gruss and his colleagues published an award-winning essay that ended the practice.

“Our group stopped it. We showed what people were operating on wasn’t legitimate,” he said.

A boy’s life-threatening tumor

In a small town north of Milan, Italy, a large extended family of aunts and uncles waited for the birth of a infant. boy. When Edoardo Borleri came into the world, his mother and father knew immediately something was wrong. On the infant’s neck was a tumefaction. Even though it was benign, it threatened to block the baby’s ability to breathe.

Surgeons in Italy could move part of it but not all, said his aunt Guiseppina Ferraro. The only hope of saving the baby’s life, doctors told them, was to send him to Gruss in Seattle. Edoardo’session five aunts and three uncles, grandparents and their town raised the money.

“The surgery itself is extremely challenging and potentially dangerous,” Gruss said. The tumor had wrapped itself around all the having life structures in the face, neck and chest such as the carotid artery; the facial fortitude that is responsible for movement; and the great vessels in the upper case.

“If these structures are inadvertently damaged on the operating table, the bantling could die.”

Gruss had to dissect the tumor from the face and facial nerve and areas in the neck where it was threatening to block Edoardo’s breathing. Then Gruss had to uphold the nerves and arteries until he relocated them to the place they were supposed to have existence.

After 12 hours of surgery, the Boleri family got their wish. Today, Edoardo is 2, rides his bike, plays with his sister and loves visiting his grandparents. Only a scar remains to tell of his ordeal. In early October, while he was lecturing in Italy, Gruss was a guest at a Boleri family dinner.

As Ferraro said: “Because he makes a miracle in opposition to us, he’s a special person.”

At a medical conference in Chicago not long ago, Gruss tackled his latest concern

With effective body armor, those who survive wounds often have injuries to their limbs or faces. Restoring soldiers to normal coming is easiest if they receive craniofacial surgery immediately, Gruss said. As it is, soldiers are stabilized in Iraq and valuable time passes before they are sent on to a stateside hospital where craniofacial surgery can begin.

“Unfortunately, level though I have published these techniques and have lectured totality over the world about these techniques notwithstanding additional than 25 years, it is still common to delay the renewal of facial gunshot injuries,” he said.

He points to Karuzzo by recompense.

Many surgeries later, she looks close to normal, he said.

Karuzzo, now 32, admires Gruss “not only similar to a doctor but in the same proportion that a human being,” she said.

“My impudence determination none be the same, but it is a blessing to be assured of that in that place are clan who don’confidentially give up when helping others less fortunate,” she said.

Karuzzo now has the life she never supposition she would following she was projectile and left for dead. She is remarried, to a man she met at church, and lives in a quiet rural community to which place she’s a billing clerk. They are expecting their first child.

She and her husband have a special first remembrance in memory: Joseph, after the attendant who gave Karuzzo a new face and a new life.