A LIFE THAT MATTERS is a fascinating and profoundly moving new book by a surgeon who has devoted his life to helping the world's most unfortunate children grow up with faces that allow them to know they are part of the human community-assured that they are ordinary in the very best way and fully capable of being loved.
We present ourselves to the world foremost with our faces, Dr. Ken Salyer explains, and the people we meet initially look to our faces to ascertain who, in fact, we are. Dr. Salyer is a fiercely intelligent, energetic, insatiably inquiring, and deeply compassionate man whose life has been one of service. As he writes in his introduction to A LIFE THAT MATTERS, he is "convinced that possessing a face you aren't forced to hide is a fundamental human right-as important to a fully lived life as freedom from fear or want." And in clinics and operating room around the world, today Dr. Salyer continues a groundbreaking forty-year career whose nexus melds cutting-edge medicine with humanitarian aid offered to profoundly unfortunate children.
A LIFE THAT MATTERS focuses on the moving stories of the children whose lives have been transformed and their moving personal testaments to how precious their "normalcy" now is. It is these children who inspired Dr. Salyer to found the World Craniofacial Foundation and establish clinics across the globe that now offer hope for good lives to hundreds of poor children in still-developing countries who otherwise would be shunned, locked away, or abandoned. In a voice that's compelling, eloquent, and always impassioned, he issues a call for a new worldwide understanding of the rights of the terribly disfigured, and he encourages readers to be inspired by the lives of these children and to transform our own challenges into triumphs.
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About the Author
Kenneth E. Salyer, M.D., is an internationally recognized plastic surgeon and pioneer in craniofacial surgery. He is the founder of the Internation craniofacial Institutute and the Cleft Lip and Palate Treatment Center. He received his medical degree from University of Kansas School of Medicine. During his career, Dr. Salyer has contributed 175 peer-reviewed articles and chapters to the scientific literature and authored and co-authored eight books, including the seminal, two-volume Atlas of Craniofacial and Cleft Surgery. Dr. Salyer lives in Dallas, Texas.
Read an Excerpt
A Life That Matters
Transforming Faces, Renewing Lives
By Kenneth E. Salyer
Center StreetCopyright © 2013 Kenneth E. Salyer
All rights reserved.
Sick and Afraid
What I remember most from my childhood is my fear of dying. I had asthma; I wheezed, struggled to breathe, and was constantly weak, spending much of my time in bed. My body was never going to be healthy, it seemed, let alone robust, and if I survived into adulthood, I'd have to make my way with my brain and not my brawn. Yet I wasn't at all sure I would grow up.
I was born in Kansas City, Kansas, on August 18, 1936. My mom and dad and I lived with my grandparents in a house at 711 Sandusky just off Seventh Street, a few blocks from downtown Kansas City. As early as I can remember, a heavy metal oxygen tank stood by my bed, and an oxygen mask attached to it helped me breathe. But breathing—simply breathing—was difficult, and it was frightening.
The Depression still raged, and we were poor. My grandfather Salyer drove a truck and helped support us while my father attended dental school; my mother worked at a five-and-dime on Minnesota Avenue and spent lots of time caring for her mother, my grandmother Warren—a tall, buxom, commanding woman who was a Cherokee and had lived her early years in Indian Territory in Oklahoma.
Mom and Dad were dedicated to each other and showed love and affection throughout their entire marriage. They loved to dance, and my two sisters and I have lasting memories of them smiling and dancing. Our whole family danced together and played music as we were growing up. Both Mom and Dad were great role models when it came to giving back to the community—service to others was always a part of life at home.
One event of these years that may very well have influenced my choice of specialty occurred when, as a teenager, my younger sister, Sandra, was riding in a car with friends when a cherry bomb blew up in the backseat. She was in surgery all night but lost the sight in one eye. That memory and its effect on her as a young person stayed with me. My mother was a strong presence—and distinct from my father, who was a quiet and gentle man. And although I knew he was every bit as concerned about my asthma as my mother was, she seemed to be in a constant state of alarm about whether I would survive the night. I picked up on her fears, of course, and they fed my own, as did hearing the doctor tell my mom and dad late one evening, "He's a trouper, and we're doing everything we can for him, but you've got to be prepared for the possibility that he won't survive."
Like many Americans in that era, most of my ancestors were immigrants from Europe. Three Salyer brothers came to the United States from France before the Civil War—two settled in New England, and the third became a slave-owning farmer in Kentucky. A village near his farm became known as Salyersville—and I was made its honorary mayor on my only visit decades later.
Eventually, my great-grandfather James Clinton Salyer made his way to Kansas, where he worked as a circuit-riding judge, as Lincoln had done. But the man evidently was no Lincoln; he was a hard drinker and terrible family man, and my grandfather B. A. Salyer was forced to go to work to support the family when he was only in the fourth grade. My grandfather labored in the fields for less than a dollar a day, never received any more education, and worked hard every day of his life, starting a canning company, selling pickles and wholesale fruits and vegetables. Granddad would wake up at two or three in the morning, hitch up his horse and buggy, go down to the local market, load up his goods, and peddle to stores in the area surrounding Topeka, Kansas. By the late 1910s, he had built a multimillion-dollar business, complete with a fleet of tractor-trailer trucks and several warehouses, and dozens of people worked for him.
He was a classic go-getter, and building his business and wealth were accomplishments he and his family were very proud of. But in the crash of 1929, he and the family lost everything—everything except the single truck in which he subsequently made endless trips to Denver, where he would buy a load of vegetables and fruit he would sell to grocery stores along the route back home to eastern Kansas.
My maternal grandfather, George Warren, worked for the Union Pacific Railroad; I remember that sometimes he wore a pistol strapped to his hip, and I got to hunt with him a few times when I was well enough. I loved being around both men, as well as my two grandmothers. I felt very close to them and spent a lot of time with all four of them, particularly in the early years when my dad was consumed with the challenges and pressures of dental school and my mom was working full-time.
When my father graduated, he became the first professional in either the Salyer or the Warren family, and everyone took pride in his accomplishment. I attended the graduation ceremony as a two-year-old, I'm told, and my first memories of my dad are of someone everyone looked up to. He was a kind and always caring man, and people felt comfortable going to him for their dental work.
One of my dad's closest friends was a physician named Louis Gloyne; he was the fellow who delivered me, in fact, and his office was near my father's in a building in downtown Kansas City. Dr. Gloyne was both a family friend and the family physician, and beginning early in my life he was determined to see what he could do to improve my asthma and make me healthy. He treated me with sulfa drugs, tested me for every allergy under the sun, suggested particular diets, and recommended that I be kept indoors—and I know it troubled him that he couldn't simply cure me.
Kansas has four distinct seasons, including winters with plenty of snow, and hot summers when every weed imaginable grows wildly, and neither the doctor nor my parents could be sure ultimately whether I was terribly allergic to the mold that grew in the damp recesses of our house, or to ragweed or other summer pollens, or whether something else was at the root of my problems. They did accurately ascertain that I was violently allergic to cats—I still am—but simply keeping me away from cats wasn't enough to keep my bronchial airway open. With an overprotective mother looking after me, buttressed by a physician who was eager, too, to ensure that my condition didn't worsen, playing outdoors with other kids was simply out of the question.
It wasn't until the United States entered World War II and my father became an army dentist stationed at Fort Bliss in El Paso, Texas, that my sequestered life began to broaden. I certainly fared better in the dry desert air on the US-Mexico border; I had energy I'd never had before, and little by little, my parents allowed me to spend time outdoors. For the first time in my life, I began to play with other kids, to run and jump and swing, and I loved it. I'd reached the third grade, and suddenly dying didn't seem a certainty. Maybe I could grow up; maybe I could be normal.
My dad had been a tennis champion in his youth in Topeka, and he began to teach me the game during the eighteen months we spent in El Paso—something that would have been unthinkable just a year or so before. The rest of the world was consumed by a terrible war, but for me, that time in the desert was a glimpse of a life I'd feared I'd never have. In Texas, I wasn't forced to think of myself as being sick; for the first time, I thought of myself as alive.
Although my parents certainly celebrated my improvement, remaining in the desert Southwest wasn't an option when the war ended in 1945. Our extended family remained in and around Kansas City—and living near family was important to us—so we returned, and so did my wheezing and coughing and fighting for every breath. Yet by then I'd had a taste of life, of what it meant to venture outside the house, to play and interact with other kids and challenge myself physically. I still didn't have much confidence—and I was shaken by the dramatic return of my asthma—but I was different somehow.
I returned to Kansas with a newfound determination to be as normal as I could be. I spent lots of time by myself—listening to The Green Hornet and The Lone Ranger on the radio—but little by little, I developed friendships and grew physically stronger. And I spent far more time outdoors in Kansas than I ever had before, playing cowboys and Indians and other games with a growing circle of friends.
You would think that my long isolation and nearly constant solitude might have resulted in my becoming an excellent student—but that sadly wasn't the case. I was never a voracious reader; I didn't discover the world via books, and although I wasn't the worst student in school, As and Bs weren't my most common grades. I was a tall, skinny, awkward kid, and easy to make fun of—and more than a few bullies found taunting me irresistible. That might have been part of the reason school was never a place I was eager to be, but more than anything else, I know I was preoccupied with a fear of dying that somehow I couldn't shake.
Even well into junior high school, if I tried to shovel the sidewalk in front of our house, my airway would tighten, I'd begin to wheeze and fight for air, and I would panic. In the summer, the same thing repeatedly happened when I'd try to mow the lawn. I just couldn't do it—and I would have loved to. You can't imagine how great it would have felt—and how proud I would have been—if I'd simply been able to cut the grass. It was hard to envision ever being productive, ever lending a hand, ever being strong and capable. The bullies were right, I decided: I wasn't worth much. I was often in tearful despair.
By the time I reached high school, I'd grown stronger, at least a bit, and I'd begun to be a better student. I still struggled with writing, literature, and languages, but I discovered an interest in science and math—even some real aptitude in those areas. I didn't have any idea yet where those skills might lead me, but at least they were an aspect of me I could feel good about. Then, in a vocational studies class in my sophomore year, the teacher assigned us to write a report on a profession that interested us.
By that time, I'd become a bit of a regular at my dad's dental office—just hanging out at first, then doing a variety of jobs he trained me to do in his lab—and I remember that I loved to tag along when Dad and his good friend Dr. Gloyne got together, the two men letting me join them for a malted milk shake at the neighborhood drugstore often enough that I felt kind of like a colleague.
I'd been a regular patient of Dr. Gloyne's all my life, of course, and I thought I had a good sense of what it was like to be a family practitioner. So it made sense to write my assigned report about the life of a dentist or a physician. For some reason, I chose medicine—maybe because I worried that my teacher would think it was too easy if I chose to write about my father's profession.
Each of us in the class had to read our report aloud, and I doubt that mine was particularly impressive. Yet I brought an unmistakable enthusiasm to the subject; I made it sound as if being a doctor was a terrific thing, and that was the day my classmates nicknamed me Doc, a sobriquet that stuck with me throughout my high school career. I kind of liked the name, to be honest, and at least privately, I began directing myself toward the possibility that one day I would be a doctor.
Although it was perhaps remote, the possibility that I had the stuff to become a doctor really motivated me to overcome my physical challenges as best I could and gain a bit of the self-confidence I'd never had. With the help of a few teachers who assured me that I could achieve whatever I set my mind to, I finally became the student I'd never been before. I couldn't play football or basketball—the sports that "mattered," as far as most of the kids in the school were concerned—but I worked hard at tennis, lettering in the sport in my junior and senior years, and I became a key member of a team that once won thirty-one straight matches. Because of my asthma, I always had trouble running up to the net, but my forehand and backhand strokes were sound, I had a good serve, and I pushed myself as hard as I could.
On and off the court, asthma still limited me—but by the time I turned sixteen it was a limitation rather than a disability, and I'd become normal enough in my junior year that I even managed to have developed a relationship with a girl, something that would have been unimaginable just a year or two before. Even when I contracted mononucleosis from her, I gamely endured the illness and my slow recovery as proof that I'd become a regular guy.
I was so thoroughly and proudly a Kansan that when it came time to decide where I would go to college, there really wasn't any decision to make. I attended the University of Kansas at nearby Lawrence with the hope that I would be accepted into the university's medical school as soon as I completed the institution's undergraduate science prerequisites. I was certain I wanted to be a doctor by now and was eager to get under way. But the medical school wanted its students to have a well-rounded undergraduate education, and each time I applied I was rejected—and told to complete my bachelor of science degree, then to apply.
I wasn't happy with having to wait, particularly because in addition to imagining a lifelong career as a physician, my college girlfriend, Shaaron Steeby, and I had made the decision to marry during my junior year at Lawrence. It was 1957 and neither of us had turned twenty-one yet; in retrospect, we were probably far too young to marry and begin to create a family, but we were in love. And there was something else, I'm sure: I wanted to leave the long and difficult years of my childhood behind me; I wanted to dive into adulthood, and no doubt I imagined that marriage and children—and medical school—would be fast-track tickets out of my isolated and sickly life and into a world in which I was a full participant.
Because the University of Kansas School of Medicine turned me down, and perhaps a little impulsively, I decided to apply to the dental school at the University of Missouri–Kansas City instead. My father had led a successful and satisfying life as a dentist, after all, and the dental school was at home in Kansas City, and my parents and Shaaron were supportive. I was accepted, and my grades placed me in the top ten percent of my class at the end of my first year, but something was wrong. I couldn't escape the growing realization that dentistry wasn't right for me. It simply wasn't going to be challenging enough, I finally admitted to myself. It wasn't going to satisfy my increasing desire to do something really special with my life, if I possibly could. I didn't yet know what aspect of medicine I wanted to be part of, but now, at least, I knew absolutely that I wanted to be a physician.
I had completed four years of college by that point and had done well, and this time the admissions department at the University of Kansas School of Medicine welcomed me. I was delighted. The medical school was still in Lawrence in those days, but Shaaron was working in Kansas City and we were at home there, so during my first year I lived in a dorm in Lawrence and drove the forty miles home on weekends. It wasn't an ideal situation, but it was acceptable, and right from the outset I knew I'd made the best decision.
Few people who have attended medical school remember it as anything other than a blur—a time during which you're alternately fascinated and overwhelmed, excited and humbled, inspired and exhausted—and for me it was all those things. It was a time, too, when my future in medicine began to take clear shape, yet also a time when I remained uncertain about the physician I wanted to be. I hadn't received lots of hands-on experience at the University of Kansas medical school, and for that reason, as I was about to graduate, I looked for an excellent rotating internship in which I'd really dive into obstetrics, pediatrics, internal medicine, surgery, and a host of specialties. I felt certain that I'd discover an area of medicine that seemed exactly right for me at a big public hospital that was part of a university system, and when I was accepted into a residency at Dallas's Parkland Memorial Hospital, which was affiliated with the University of Texas's Southwestern Medical School, I was thrilled. Moving to Texas meant moving away from my extended family, of course, but I presumed I'd return to Kansas at some point, and by this time I was ready for the life and career adventure I'd never had before.
Excerpted from A Life That Matters by Kenneth E. Salyer. Copyright © 2013 Kenneth E. Salyer. Excerpted by permission of Center Street.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Table of Contents
Introduction A Life That Matters 1
1 Sick and Afraid 13
2 Choosing Plastic Surgery 35
3 Building a Dream 68
4 Two Faces 95
5 The Dogaru Girls 120
6 Petero 147
7 A Normal Face to Love 174
8 Conjoined 208
9 Face to Face 229
10 Change, Reflection, Resolve 254
11 Beautiful Faces 286
Afterword Seed, Blossom, and Fruit 323
About the Author 339