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Years after her stepdad shot her in the face, Michigan woman gets a new nose
发布日期:2024-12-19 07:12:05
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July 23, 2023, Lowell, Michigan

Almost 5½ years after a shotgun destroyed half her face and damaged her sight, Amedy Dewey's nose sagged like a glove without a hand, loose and empty.

She wanted a new nose, needed a new nose, just to improve her breathing. So, she was on her way to Ann Arbor for another operation — the 20th since the shooting.

Legally blind, Amedy was riding in a 2007 Mitsubishi Endeavor driven by Rose Haynor, her aunt.

This was one day after the U.S. recorded its 400th mass shooting of the year, the earliest recorded in the last decade according to the Gun Violence Archive; and all of those shootings have ramifications. Even the incidents that are not technically termed "mass shootings" involving four or more people have different versions of Amedy.

They stopped at a Subway restaurant in Lowell about 15 miles east of Grand Rapids.

Amedy made her way to the bathroom, using a cane.

She heard a girl in a stall: “Why doesn't she have an eye?”

A woman replied, and Amedy assumed it was the girl’s grandmother: “Go ahead and ask her.”

“Thank God,” Amedy thought.

Most parents hushed their children around Amedy, embarrassed by the questions and curiosity. Every day, she lives with the consequences of gun violence, but few want to talk about it. It's easier to act like it didn't happen.

The girl came out of the stall, wearing a yellow sundress. She washed her hands and asked Amedy: “Why don’t you have an eye?”

Amedy bent to the girl’s level — Amedy could see about 30% through her right eye on a good day. Her left eye was surgically removed. A skin graft had been pulled tight across her eye socket like a drape over an empty cave. What appeared to be her left cheek was a reconstruction — surgeons moved a flap of muscle from her back to the front of her face to give it contour.

“A very bad man hurt me,” Amedy said, softly. “But he can't hurt anybody else. He's all gone now.” 

Amedy was neither embarrassed nor self-conscious about her scars. She lost her vanity long ago. It was replaced with determination. Amedy wants to tell her story, wants to be a force for change and her message is clear: Look at me. Hear my story. Try to understand what it means to be a survivor of a shooting.

“Move your eye,” the girl said.     

“My right eye?” Amedy asked.

“No, that one,” the girl pointed at the left side of her face.

“Sweetheart, I don't have an eye there,” Amedy said.

The girl giggled: “I’m just kidding.”

Amedy burst out laughing.

“That makes me feel like I am not so much of a freak,” Amedy would say later. “I have family members that are scared of me. When I get little kids that don't know me at all, and they go and do that, it makes me feel like I'm a human being again, not this object that they're staring at.”

Amedy, her Aunt Rose and Josh Snider, a family friend, returned to the car and headed east on Interstate 96 toward Lansing. About 7 miles down the highway, they passed the spot where the shooting happened, where her stepfather used a shotgun to shoot her mother, shoot Amedy in the face and kill himself.

Amedy went silent.

That night, Jan. 6, 2018, never really ended — the darkness never far.

Another surgery in the road to recovery

It's Aug. 24. On the fourth floor at the University of Michigan Health C.S. Mott Children's Hospital in Ann Arbor, in a small pre-op room, Amedy sat in a hospital bed, wearing a blue hospital gown, resting against a pillow. She pulled her legs to her chest, anxious about the upcoming surgery, dreading the pain about to come.

“Good luck with everything,” a nurse said. “You are gonna rock it out, OK?”

Usually funny and confident, seemingly older than her years, Amedy hugged a stuffed animal named Puppy Dog. It was her mother’s and Amedy has taken it with her to 20 surgeries since the shooting.

“OK,” Amedy sighed.

She exhaled hard and blurted: “Ugh!”

“See ya on the other side,” the nurse said.

“On the other side, I’ll look like a pumpkin,” Amedy laughed, thinking about the facial swelling she was certain would follow surgery.

“I don’t mind at all!” she laughed.

Amedy already had this surgery once and understood the basics: Dr. Christian Vercler, a plastic surgeon, planned to cut out a piece of her rib, chisel it down like a piece of wood, and use it to reconstruct her nose, inserting the bone under her skin.

“Any questions?” the nurse asked.

“I have complete faith in Dr. Vercler,” Amedy said.

Amedy hugged and kissed Becki Hoon, one of her mother’s best friends.

Then, her Aunt Rose.

“See you later, kiddo,” Becki said.

Lauren Zalewski, a nurse, pushed the bed down the hallway, around the corner and into the operating room. Amedy clung to Puppy Dog, as the bed was secured under bright lights. Two nurses rubbed Amedy’s forearms, comforting her, as she was put under anesthesia.

“Breathe deeply,” one said.

By 1:30 p.m., Amedy was lying still, sedated on a table in the middle of the room. She was hooked up to machines. Four black and white photographs of her face, taken at different angles, were taped to the wall for a resource.

Dr. Hannes Prescher, a surgical fellow, studied a CT scan.

Dr. Emily Graham stood next to him. Just out of medical school, Graham was a resident doing a plastic surgery rotation.

Finally, Vercler entered the room. He stood above Amedy, studying her face. He pushed on her skin near her cheek, inspecting what bone structure she had left, trying to come up with a plan.

This kind of surgery — reconstructing a face damaged by a gunshot — would require more improvisation than following a step-by-step, textbook procedure. Vercler and Prescher looked like mechanics in a garage, looking at a car on a hoist, hands on hips, trying to figure out how to fix it.

Prescher pulled back her nose, really just an empty flap of skin, inspecting a scar.

“I don’t think that’s an incision that I made,” Vercler said.

Vercler had operated on Amedy so many times he lost count.

“This is what we did last time,” Vercler said, looking at the CT scan. “Then, she got kneed in the nose, so that’s broken now. I don’t have an X-ray of it broken. You can see, she’s missing large amounts of bone — I mean, all this is missing from the gunshot wound.”

He marveled at the image of her face, moving the mouse, studying different angles.

“All this is pulverized,” he said. “All the teeth.”

The CT scan looked like somebody randomly erased part of her face, leaving jagged fragments of bone.

“I put in a bone graft from her rib on the right side — to the cheek on her left side,” he said, pointing at his own face. “Anyway, that kind of lets us know how much bone is there.”

Vercler had dedicated his life to craniofacial surgery. He trained at Harvard, at a time when surgeons there were pioneering face transplant techniques on people with devastating facial injuries. Some were victims of gunshots, according to Vercler.

“I have thought for a long time that I should write a piece called, 'The face of gun violence in America,' ” Vercler said. “I have so many stories of this kind of thing, and it's usually acts of passion or something, just irrational stuff, and then devastating consequences.”

Amedy has been living with those consequences ever since.

The origins of reconstructive surgery

After scrubbing his hands, Vercler returned to the operating room, his hands dripping wet. He dried off with a green towel and put on a pair of glasses with a small bright light and magnifying glass. Two nurses helped him into his surgical gown ― it looked like a well-choregraphed dance.

Prescher planned to perform most of the rib operation, and Graham stood on the other side of the table to assist. “We are going to do an H,” Vercler said standing by her head, motioning his hands. He looked like a coach, talking to his team, giving instructions. He loved this part of the job, teaching young doctors, sharing his wisdom. In many ways, it’s the foundation of how surgeons are taught. One surgeon passes on knowledge to the next generation.

The underlying surgical principle that Vercler would use in this operation — using healthy bone from Amedy’s ribs to make a new nose — dated to World War I. The technique was created by a surgeon named Dr. Harold Gillies, the father of modern plastic surgery.

“He's pretty famous for pioneering a lot of facial reconstruction techniques,” Vercler said. “You can imagine, in World War I, with the trench warfare, a lot of these guys, if they didn't get killed from a blast to their faces, as they came up over the trench, they were devastated. And so they would ship them all back from (the) eastern front to England, and Gillies would make up ways to reconstruct their faces.”

Gillies performed more than 11,000 operations on more than 5,000 veterans during World War I.

“It's all about understanding the anatomy and how you can move parts,” Vercler said. “That's sort of been a principle that's been around for a long time.”

Gilles taught his techniques to surgeons, who taught the next wave of surgeons.

“Many plastic surgeons currently trained with someone who knew him or was trained by someone who knew him,” Vercler said.

Techniques from World War I were about to help a young woman with a stuffed animal named Puppy Dog — this is the state of gun violence in America.

Prescher made an incision across Amedy’s rib cage.

Vercler stood close, watching intently, offering suggestions and advice.

“If we get a piece 4 centimeters, that would be more than enough,” Vercler said.

The surgery was expected to last around three hours, if everything went perfectly.

But working on a gunshot victim was always tricky — Vercler explained — because the parts were never in the right place. No patient is the same. The trick is the improvisation.

But removing the rib went quick and flawlessly.

Vercler snipped out a chunk and put it on the tray.

“What’s the length?” he asked.

It was 6 centimeters.

“Nice,” he said.

Vercler and Prescher returned to the computer monitor to review the CT scan of Amedy’s face.

Vercler loved the challenge of facial reconstruction. It required precision and technical excellence, with a dash of creativity. It’s an endless series of decisions and complications, always interesting, always technically challenging.

“The CT scan is before she broke her nose,” Vercler said. “The bone is not where it is in real life.”

Finally, they came up with a plan but Vercler saw a problem.

“There’s a lot of scar tissue here,” Vercler said.

Before Vercler could put the rib bone in her nose, before he could give shape to her face again, he had to clean scar tissue from the area.

So, he started to do just that, looking like somebody working in a garden bed overgrown with weeds.

It was a slow, deliberate process.

Vercler spent nearly 2½ hours working on the scar cartilage — far longer than he had anticipated. It was the most challenging part of this surgery, requiring the most skill. Most of the scar tissue was from the shotgun blast, but some originated from the different surgeries.

New bone can’t lay on top of those scars. It’s an unstable bed and scar tissue always moves and twists.

So he had to delicately cut into the scars, freeing them up, removing them up off of the lining of her nose and returning them to the normal position.

'I think she'll like that part'

At 4:01 p.m., after the scar tissue was removed, it was finally time to give Amedy a new nose.

Vercler picked up a chunk of her rib and put it against her face, measuring how long it should be. The rib looked like a beef short rib with an edge with a slight curve. Vercler studied that curve and planned to use it to give her nose some shape.

“Can I get a ruler?” Vercler asked, wanting to measure the chunk of rib.

Prescher took a blue marker and drew a line across the rib, looking like a carpenter marking a line on a piece of wood before trimming it: Measure twice, cut once.

The two surgeons went to a table on the other side of the room, taking the rib piece with them.

“All right,” said Vercler, who held a chisel on the rib, wanting to trim it across the blue line.

“Tap! Tap!” Vercler said softly, as Prescher tapped the top of the chisel with a mallet. It sounded like a hammer hitting a nail.

After about 10 minutes of chiseling, they took the rib back to Amedy and inserted it under her skin, but something wasn't right. The bone didn’t fit perfectly, so Vercler took it out and started trimming it at the operating table, using a tool that looked like it was straight from a toolbox, a simple, hand-held grinder and it sounded like a dentist drilling a cavity. 

They repeated the process several times, putting the bone under her skin, discovering where it didn’t look quite right and then pulling it out and trimming it again — the true art of the operation.

“Yeah, that’s good,” Vercler said, sensing progress.

Vercler delicately shoved the rib into the flap of skin and studied the new nose.

“I guess we need to carve it down more,” he said.

So, they grinded it some more.

After several attempts, the rib bone finally fit perfectly, the nose taking shape, like a hand going into an empty glove.

Vercler bent down and studied the new nose from the side, trying to make it perfect.

 “Yeah, yeah,” he said, studying the bridge. “I think she’ll like that part.”

He took a deep breath, going down on his knee, looking from the side. “It’s so flimsy,” he said.

Amedy’s nose looked full and complete.

A step toward being whole again.

But they still weren’t done.

At 6:04 p.m., Vercler asked Graham to line up the nose, to make it perfect. She delicately adjusted the nose with her fingers, trying to make it straight.

But how should he secure it?

Vercler was afraid that if he put a screw into the new bone that it might crack. So, he decided to wire her nose into place.

Vercler held her nose, as Prescher used a tool that looked like a drill. He pushed the sharp bit through her skin, into the rib bone, through the old bone and anchored it. As he slid the drill bit out, like a needle coming out of skin, a thin K-wire stayed attached.

He did the same thing again, using a new wire, slightly offset for stability.

When they finished, the surgery was essentially complete.

At 6:49 p.m., Vercler walked away from the table and took off his gown. The stress and focus seemed to drain out of him as he took a deep breath. He rinsed off Amedy’s hair, trying to get the disinfectant off her face and any goop out of her hair. As Amedy was taken to recovery, Vercler went into a small meeting room to meet with Amedy’s friends and family.

“Everything went really well, you know, challenging as always,” he said. "Everything's great. We are all done.”

He described the surgery.

“I think you'll see a big difference,” he said. “Now, of course, everything's pretty swollen. We're at the absolute limit of how far I can push it.”

He slumped into a chair. The adrenaline was wearing off.

“She really hated the way it was,” he said. “I always wish things would look better and more perfect, but it's as good as we possibly could get today, given the limits. We pushed right up to the edge of what we could accomplish today.”

A reason to cry

Amedy inched close to a mirror to look at her new nose.

“I think it's big, but nobody else does,” she said a couple of weeks after the surgery. “It’s just a me thing. I haven't hadn't had a nose in five years.”

She was in a great place mentally, as well as emotionally.

Living in Ludington with her grandmother, Patti Dewey, Amedy was busy raising a new puppy, Lola, an 8-month-old black lab. Amedy was taking classes at a community college, getting all A’s. Eventually, she hopes to go to Western Michigan to become a trauma therapist.

Barbara Forgue, her therapist, said this is a healthy step: “I've talked to her about advocacy, motivational speaking, writing a book. I've talked to her about the counseling she wants to do. There's so many different avenues she could take.”    

“I am a survivor,” she said. “What I went through, I don't want people to go through that. And especially you know, teenagers and young women who feel like they don't have a voice.”

She just hoped that by sharing her story, maybe somebody will see something similar in their own life, and prevent a horrible tragedy. “People need to realize that he was showing signs before any of this even happened,” she said. “I want people to see this and hear this and be like, holy crap, I'm in a similar situation.”

Now, looking back, Amedy can remember moments when her stepfather lost his temper and immediately turned to his gun in the midst of his rage.

In the spring of 2014, Amedy’s dog Chance, a boxer, was in the garage. “She clawed the hell out of the whole side of his truck,” Amedy said.

David freaked out. "He glanced at his truck, grabbed his gun and said, 'I'm going to shoot him,' ” Amedy said. “I bawled and literally begged and pleaded on my knees; and my mom was behind me, ‘Oh my God, Dave, put the gun away. You can buff it out.’

“She was trying to like de-escalate but at the same time, she was yelling at him."

Another time, when Amedy was a freshman in high school, she got into a confrontation with her boyfriend. “David went back in the garage, grabbed his 12-guage, walked in the house and said, if I don't break up with him, he's going to shoot him,” Amedy said. “He just snapped. That terrified me to my core. I truly felt he would do it.”

Now, Amedy wants to share these stories, hoping it might help others. Hoping somebody might say: I’m living through the same thing.

Before it’s too late.

Six-year anniversary

Amedy had more than a new nose.

She had become a new person.

Before the shooting, Amedy was a competitive cheerleader.

“I was a very selfish, very vain, I only cared about my looks,” she said. “Now, I just want to help people. I'm a completely different person.”

The scars are part of who she is, and she desperately wants to use her story to help others.

“She's saying this could happen to anybody. And I want you to understand things about this. She's just embraced herself, which is really healthy. Like, she told me one time in counseling, 'I’m proud of my scars. Because I survived.' It also gives a purpose to the whole thing.

“There's a lot of self-acceptance there,” Forgue explained. “She's embraced who she is today. It's also about advocacy. She's not doing, ‘Poor me.’ She's really turned the corner."

Passing the six-year anniversary of the shooting, the shock waves continue every time there is another shooting in America. Amedy just hopes laws can be changed, so no one else has to go through this — the years of incredible loss and pain and surgeries and haunting dreams and frightening nightmares and guilt and fear.

Here’s the tragic part of this entire case: Amedy’s story is not unique.

Almost two-thirds of intimate partner homicides in the U.S. involve a gun, according to Everytown for Gun Safety Support Fund, an organization focused on curbing gun violence.

Last month, legislation to temporarily ban those with domestic violence convictions from possessing and purchasing firearms and ammunition in Michigan went into effect. But that legislation wouldn’t have helped in this situation. David was never convicted of assaulting Amedy’s mother.

Another new law will allow a judge, if petitioned, to temporarily remove guns from a person who poses an imminent threat to themselves or others. Michigan Gov. Gretchen Whitmer has approved several other laws aimed at reducing gun violence: expanding background checks to all firearm purchases and establishing new requirements for gun owners to store their firearms in a locked container or use a locking device if they have a child in the house.

Amedy supports all of these steps.

She is pro-gun, and she supports the Second Amendment. She shot her first deer with a shotgun. The same shotgun that her stepfather used to destroy her face and kill her mother.

But something has to be done, right?

"Red flag laws," she says. She hopes the ones passed recently in Michigan will help.

And then, there's another shooting the next day, the next week, an endless cycle that never seems to end.

Sending more victims into an endless cycle of surgeries.

Vercler has another patient who suffered even more facial damage from a gunshot than Amedy and has performed dozens of operations on the patient.

“It’s like one step forward, two steps back,” Vercler said. “It’s a continuous fight with the blood supply, a constant challenge to open the patient up and move things around and add tissue or rearrange it.”

When will the surgeries end?

For most of Vercler’s patients, it ends when they can’t take the pain that comes after a surgery.

“I know someone is done when they say, ‘I just can’t take it anymore, Doc,’ ” Vercler said.

Amedy has yet to reach that stage.

She wants more.

Amedy needs her tear ducts fixed — she hasn’t shed a tear since the shooting destroyed half of her face.

“My new eye doctor is going to go in and either try and unclog that one tear duct or she's going to make a whole new one,” Amedy said. “She doesn't quite know yet because she has to go in and see how everything healed.”

On Dec. 12, Amedy returned to Ann Arbor to meet with a new eye surgeon.

“This surgery is to help drain my tear ducts,” she said in 2023. “Because all the goop I get in it, that can cause a severe infection. And so they're going to make a new passageway put in the tubes that I had before and hopefully it works.”

She had the procedure Jan. 4, although there has been minimal change.

She took three classes in the fall semester at West Shore Community College: Intro to Literature; Intro to Philosophy and Intro to Psychology.

“It was amazing,” Amedy said. “My professors were absolutely amazing, extremely accommodating. I had no issues. They worked with me and with my doctor appointments; and whenever I had any type of issue, they were on it. They would do anything to help me succeed. And it was a very good semester for me.”

The psychology class, in particular, was helpful, helping her understand some of her issues.

“I was a kid in a candy store in that class,” she said. “Woo-hoo. Oh my gosh, I learned so much about my brain ... why I am the way I am.”

What is she now, after passing the six-year anniversary of the shooting, after all the surgeries and therapies?

She is a survivor — the "toughest human being I've ever met," according to the detective who picked up pieces of her face from a highway the night she was shot.

She is an advocate, wanting to help others.

She is pure determination — someone who refused to die, refused to let him win.

She is fearless, willing to share her story. She is determined, wanting to reclaim what was taken from her.

And she has a new nose.

But she is still waiting to cry.

This is the last chapter of a five-part series in which Detroit Free Press columnist Jeff Seidel shares the story of a Michigan survivor of gun violence. Contact Jeff Seidel: [email protected] or follow him @seideljeff.

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