Thirteen years after attempting to take his own life only to survive without the bottom half of his face, a reflective and candid Andy Sandness, recipient of the first face transplant ever conducted by Mayo Clinic, opened up about his life before a hushed ballroom on Thursday, Sept. 26, sharing the human story behind his remarkable medical journey.
"I sometimes think I haven't found my purpose yet," Sandness offered with quiet humility early in the hour, just one of many bracing admissions that would garner the young Wyoming electrician a standing ovation from the 400 professionals listening to his story on the last day the annual Mayo innovation conference known as Transform.
The question had been put to him what he thought when he realized he had survived his attempt on his life in an impulsive moment of isolation following the Christmas holiday in 2006. "I thought thank God I survived," he said without a moment's pause. "I said please don't let me die."
"I have since told myself you survived for a reason," Sandness said of the second chance he'd been granted, a long and grueling path. "I believe there's a reason I am here."
Exploring his story alongside two of his clinicians and the moderator and former Minnesota Public Radio host Tom Weber, Sandness's interactions with transplant surgeon Dr, Samir Mardini and psychiatrist Dr. Sheila Jowsey-Gregoire suggest the trio now share mutual admiration and even something of bond, a familiarity transcending the provider-patient standard.
Before Sandness could become one of only 35 face transplant patients in the world, he had to learn to to live with himself, rebuilding his confidence as a person missing a face. After becoming stabilized at Mayo he was sent home without any discussion of transplant,owing to his doctors' deep respect for the enormity of that step.
"You think your problems are bad," Sandness said, "then you survive the injury and you have to go home. I'm from a town of 3,000 people. Everybody knows me."Tired of the stares, he said, "for a while I was a hermit."
But he rebuilt his life without a face. He grew so close to his niece and nephew that when he went to get a transplant, they didn't understand why he needed surgery. In the meantime his doctors had studied what would be required, hoping only to help Sandness achieve health as a person. "We had to make sure we approached it as a team," said Mardini. "Everyone had to say he was ready, his psychiatrist, his social worker, everyone in his life. We made sure the surgeon wasn't driving it."
"I wasn't in it for looks," says Sandness, who says he jumped at the chance to undergo the complex uncertain procedure. "I wanted function. I wanted a real nose, real mouth, real lips with teeth." At the time, he had lived for six years with a plastic nose, he said, one that he cleaned at night with a toothbrush.
"I wanted to kiss my girlfriend. I wanted to go swimming." For a man who once did not want to live, he now wanted it all.
In Rochester, Mardini and a team spent 50 Saturdays over three years training on cadavers. As Sandness travelled back and forth to the Clinic during this time, they set about mapping the nerves in his face, noting which ones carried the message to smile, frown and form shapes with his lips and cheeks.
He developed the skills of resilience including "good coping strategies, the ability to be flexible, optimism and being a good problem solver," according to Jowsey-Gregoire. On the day of his surgery, Sandness said, "I remember laying down on the bed. I said a little prayer for myself, and for my doctors. I also prayed for the donor family. They had been through so much and gave me so much. I feel like a burden sometimes when I think about it."
The surgery required 24 hours to prepare Sandness' face and to simultaneously remove the donor's face. When Sandness awoke, his care team had covered all the mirrors in his room. It would be three weeks before he could see his new face. His doctors wanted him to have a good first impression.
He said it was all that he could have hoped for. Today, the young man who once hid out at home is prone to striking up conversations with strangers in elevators and cashiers at convenience stores. He says he just finds people interesting.
"I was nervous about this today," he said toward the end of the hour. "If I could tell something to anyone who is feeling the way that I felt, it's that you have to find these feelings and identify them, and face them for what they are. If you are feeling these thoughts, you have to talk to someone, and it can be anyone. I built a wall. I let nobody in. I regret that now, even though I don't like the word regret.
"If my story could help just one person reach out to somebody, just to talk, then I would feel like that was my purpose now."