Injured soldier gets new face — and anonymity

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SAN ANTONIO – His first glimpse in the mirror was largely a blur.

Sgt. Darron Mikeworth had just come out of a drug-induced coma — his mind was still in a fog and he was so weak he could barely stand.

Three weeks before, in Iraq, a suicide bomber had raced up to the right side of his Humvee, igniting a barrel of explosives that tore into the machine gunner's face. He nearly died.

Mikeworth awoke in a hospital bed, thousands of miles away.

He was relieved he still had his arms and legs. He was thrilled, too, that his ears had survived the blast. But he had wounds he could not see, life-changing wounds. His wife, Dea, helped break the news: His face was in bad shape. His left eye was useless.

And there was more.

At first, Mikeworth was too groggy to absorb it all. He was caught up in hallucinations of basketball players shooting hoops in the hospital, of cars on the highway floating in air. He didn't know what was fantasy and what wasn't — until he shuffled into the physical therapy room and stood numbly before a full-length mirror.

"I just had to keep telling myself I'm NOT going to wake up out of this one," he says. "THIS is not a dream. THIS is real."

His head was one giant purple bruise, his eyelids were nearly swollen shut. His left eye had been removed (he'd given his OK from his hospital bed.) His eyelashes and most of his eyebrows were singed off; so, too, was his hair halfway back on his scalp. His nose was mostly gone, just a sliver of cartilage remaining; skeletal-like bones revealed his sinuses. His top right lip was curled into a snarl, making it impossible to close his mouth. His right jaw was torn. His bottom teeth, loosened by the blast, were wired together.

His face — every bone has been shattered — was splattered with pinkish third-degree burns.

"I could have just flipped out," he says, pausing to remember. "But I looked in the mirror and said, all right, there's no changing it. I just have to deal with it. This is me now."

Darron Mikeworth's face was his identity.

So, too, was his life as a soldier.

He was about to embark on a long journey to regain both.

___

Sgt. Mikeworth, the warrior, will tell you he is the same man he was Before The Bomb.

The 32-year-old soldier who served two stints in Iraq (and two more in Kosovo and the Sinai) still wants to take down the bad guys, still thrives on being a cog in the big Army machine.

But Sgt. Mikeworth, the survivor, also knows that no matter how much he heals, he'll forever be defined, in some way, by what happened near Baghdad on April 29, 2005.

"I'm going to be `the blown-up guy' wherever I go," he says. "Anytime I walk into a room, I just know I'm going to be different looking and I'm going to be perceived differently."

Mikeworth knew with the severity of his wounds there was no way doctors could turn back the clock. The smile his wife adored, the laser-like vision he was proud of, the slender face that was uniquely his — they were gone for good. He refused then — as he does now — to dwell on the losses.

"I see guys with injuries five times worse than what I have," he says.

"I have no reason to feel sorry for myself. I could be in a box underground somewhere. Every day above ground is a GOOD day."

But he needed to become himself again, so that he at least would recognize the face in the mirror and so that the people he encountered would see him as a man, not as a victim.

That's where Operation Mend came in.

A one-of-kind partnership between the UCLA Medical Center and Brooke Army Medical Center — the military's main hospital for burn patients — the program provides reconstructive surgery to members of the military who've been severely disfigured in Iraq and Afghanistan. So far, 24 men and women have been treated.

Mikeworth is now nearing the end of his surgeries.

His road to recovery is a war story that has been part medical marvel, part profile in courage — the stalwart soldier who rebuilds his confidence as doctors rebuild his face.

All along, as UCLA surgeons have tucked and trimmed, adding a bit of cartilage here, a flap of skin there, Mikeworth has yearned to return to the simple routines in life, dreaming of the day when he could:

Pick up his two sons without worrying he'd scare their classmates.

Walk around the mall without turning heads.

Be a face, not THE face, in the crowd.

___

"Is your husband a vain man?" the nurse asked Dea Mikeworth.

No, Dea replied. This was a day in May, 2005, and she was still reeling from seeing Darron's bruised, swollen face for the first time. His head was twice its normal size.

"That's good," she was told. "He'll have an easier time adjusting. He's never going to look the same."

Dea knew instantly what would bother Darron most: Half his vision was gone. His features were mangled. People would stare.

She knew, too, how hard that would be for Darron, an introvert who preferred the sidelines to the spotlight, a soldier who'd rather slip into a room, do his job, then slip out quietly.

"I used to like to be able to stand in the back of the crowd and not be noticed," he explains. "I like to be anonymous."

Suddenly, he was the center of attention, and often not in a good way.

Weeks after his release, Mikeworth and his family visited Ripley's Believe It or Not museum. His legs were bandaged, his burned hands in gloves. He wore sunglasses, his nose was just slits.

As he stood, motionless, a young woman apparently thought he was a wax exhibit. When he moved, she was startled. Thinking he was an actor, she blurted: "What are you supposed to be?'"

"I just looked at her and said, 'I'm a blown-up soldier.'"

Dea says they can laugh now but back then, she was filled with anger and pain, knowing how much that experience hurt her husband, who grew even more reluctant to go out.

When he did, there were more awkward moments.

Mikeworth quickly aborted a Christmas Eve shopping trip at a crowded mall when he noticed people doing double takes. He encountered strangers who'd burst into tears or try to press money into his hands.

Dea recalls one store cashier who leaned over and asked, "What happened to him? What's his name?" even though Darron was standing right there. People thought because "his face was messed up, something was wrong with him," she says.

Mikeworth was understanding, even empathetic.

"I was pretty gruesome in the beginning," he says. "I looked like I came out of some Halloween horror movie. I know that. Sometimes if I was having a bad day, I'd get mad at the situation I found myself in, but I would never get angry at the people."

At home, Dea says, her husband sometimes hid in the bedroom, even when her friends visited. He wouldn't go to their son's kindergarten, fearing Ryan's classmates would tease the boy.

If someone new was coming over, he'd ask Dea to give them a heads-up, saying: "Did you warn her kids that I look kind of funny — just so I wouldn't scare them." She complied.

Even simple pleasures became haunting reminders.

"I can remember nights sitting on the couch watching TV looking at people," he says, "thinking they have TWO eyes. I'm never going to look like that again."

None of that seemed to faze his sons, Ryan, now 7, and Connor, 6.

When the boys were about to come home after a two-month stay with Dea's parents in Illinois, she tried to prepare them by sending them photos of their injured father. Connor, then 3, studied Darron's obliterated nose and drooping left eye socket, then blithely announced: "Yep, that's my daddy. Where's my mom?"

Once everyone was reunited, the boys brought laughter into the home.

When Mikeworth had to wear round plastic devices called nasal trumpets — they act like fake nostrils — they dubbed it his Pig Nose.

When he got a latex wider-than-normal prosthetic nose attached with glue, they dubbed it his Big Nose. One day the glue wore away and the nose fell off while Mikeworth was napping. Their cat, Anastasia, snatched it, with Connor, Ryan and Dea in hot pursuit.

Mikeworth found ways to poke fun at himself, too. When a photographer for a medical journal assured him his privacy would be maintained, the sergeant replied: "Doesn't matter either way. No skin off my nose." Pun intended, most definitely.

But humor was just a temporary distraction.

"When you're without a nose, with burns on your skin, without an eye, it's a hard thing to swallow," says Lisa Gustafson, his former case manager and the Operation Mend coordinator at Brooke. "You've got a family. You're afraid you're going to lose your wife. People in the community are staring at you. You don't know if you have a future, if you have a paycheck. That's pretty scary for a young man. He had a lot of heck of a lot of weight on his shoulders."

Dea tried using tough love. Early on, when Mikeworth confided he felt "useless" and feared he'd never drive again and be able to support his family, she was blunt.

Remember, she said, my father is blind in one eye, he worked all his life, he even played softball with me.

"I was kind of rough on him," she says. "I'm not a person big on self-pity. He needed to hear what I had to say. But he had every right to grieve for what he lost before I kicked him in the butt. I was just too early."

But Dea, Gustafson says, has been "a perfect wife," always at her husband's side.

"We were kids together," Dea explains. "One eye, two eyes, one hand, two hands. It doesn't matter what he looks like. He's Darron."

They met at age 15 when Mikeworth's father retired from the Army, settling in the tiny farming town of Robinson, Ill. From high school to life partners, they are a study in contrasts.

Dea is animated and talkative; Darron is shy and sparing with his words. She doesn't consider much off limits. He zealously guards his privacy. And yet, this ordeal has, not surprisingly, unified them.

"We're both pretty pragmatic people," she says. "Yeah, this sucks. But we need to deal with it and move forward."

___

At Brooke, Mikeworth endured about 16 surgeries, many on the lower right arm that he almost lost in the blast.

He had skin grafted from his thighs for arm and knee burns. A bone graft from his skull for his cheek. And titanium pins inserted around his eyes and cheekbones.

Within three months, he asked to return to his unit, the 603rd Transportation Co., even though he could barely walk. "I think that was kind of denial," Dea says. "He wanted it to be over, he wanted to be a regular soldier again."

The Army later recommended he retire — he's classified having an 80 percent disability — but Mikeworth was insistent. His attitude, Gustafson says, was "I'm staying in the military with or without a nose, with or without an eye."

But reconstructive facial surgery at Brooke proved to be slow going.

"It felt like my entire life and career were on hold," Mikeworth says. "It just seemed ... I'd always be a patient."

Gustafson tried to boost his spirits with daily phone calls.

"You are a soldier," she'd tell him. "You are NOT going to give up. You're going to continue to fight." She reminded him of what he'd been through. "You WILL get over it," she said.

In the fall of 2007, Gustafson heard about a pilot program at UCLA called "Operation Mend." Mikeworth seemed an ideal candidate.

He flew to California to be evaluated.

"They said they were going to fix me up," he says. "It was a golden opportunity and I knew it."

___

One of the first people Mikeworth met was Dr. Timothy Miller, UCLA's chief of reconstructive and plastic surgery. Miller knows about the sacrifices of war firsthand.

He earned a Bronze Star in Vietnam and has been known to wear a camouflage hat from those days in the operating room.

When talking about Operation Mend, Miller often recalls a quotation he saw etched above a church door, decades ago, when he was teaching in Italy. It said: "It is the divine right of man to look human."

Once when Miller was giving a speech about the UCLA program, Darron Mikeworth heard him use that phrase — and something just clicked.

"It's a lesson so plain no one thinks about it," he says. "Everyone wants to look like a human being. You don't know what it is to have your nose there, then it's gone and you have two slits in your face. Complete strangers are wondering things and thinking things about you and you haven't even gotten to a handshake."

Once Mikeworth became an Operation Mend patient, doctors took photos, made measurements and developed a stage-by-stage reconstruction plan.

Starting in January 2008, they began operating about once a month.

For his nose, doctors used a small piece of cartilage grafted from his ear, then tucked it under a flap of skin on the right side of his forehead above his eyebrow. They stored it there — Mikeworth says it was like stubby little horns — for about four weeks.

Doctors partially elevated the flap before pivoting it clockwise down to his nose. It remained attached so it looked like an elephant trunk for a time while they made sure there was proper blood flow. Then they shaped and thinned it.

The lower left side of his nose that had been worked on at Brooke was a bulbous mass (Mikeworth's boys dubbed it his "bubble gum" nose). Surgeons removed thick cartilage that made it hard to breathe, inserted new cartilage and thinned it out.

For his left eye, they created a new lower dam-like eyelid (he lost his in the blast), using forehead skin and a piece of tissue from the roof of Mikeworth's mouth. It's strong enough to hold a prosthetic eye, which will come later.

"It's amazing what they can do," Mikeworth says. "They just take parts of you from everywhere and rearrange them."

For his mouth, they removed scarred skin on his upper lip that had exposed his teeth and created a snarl — Dea jokingly called it his Elvis snarl. A skin graft made the lip full again. Doctors still plan a tattooed line to mask the scars and make the lip look more balanced.

"Getting him to look like he did before is totally unrealistic," says Dr. Christopher Crisera, his chief surgeon. "My goal is to try and get them to a point where they're happy the way they look."

He already is.

Each time Mikeworth returned from a major surgery, friends noticed progress. "I was seeing it, too," he says. "It kept improving and I was happy and smiling about it the whole time."

Gustafson, his former caseworker, says Mikeworth no longer speaks in a monotone, staring at the floor. He no longer has to be tracked down in the smoke shack; Gustafson says he initiates visits, and has a lot more to say.

"He's more motivated, excited about life, excited about who he is," she says. "He walks around with his head up. Now he's feeling so much better about himself."

When she recently asked to see the progress of his eye, he lifted his sunglasses. "He was just so proud," she says. "I just popped him in the chest and said, 'I've got to hug you. We did it.' It would be easy to take no for answer and say, `I'll disabled for the rest of my life.'"

Last summer, Darron returned home to escort his sister, Amanda, down the aisle at her wedding. He started walking, then noticed he still was wearing sunglasses. He yanked them off.

His reason: "I just wanted to be me."

___

Sgt. Mikeworth hopes to join an Army unit by summer.

He's on medical hold while he looks for a suitable slot where the Army can use him. He's thinking about military intelligence or becoming an instructor.

"I don't want to be put on a shelf or a back burner, or left in a corner anywhere," he says. "If they give me half an opportunity, I can demonstrate I can do the job."

Gustafson understands.

"Will he be 70 in some VA home talking about this war?" she asks. "He's not that type. He's not someone denying this has happened to him. He's not out for revenge. He just wants to be a soldier. So many want to go back to the war for revenge. He just wants to do his job."

Still, some scars will never disappear.

"It's not something 20 years from now he's going to pull out of the box and show his kids," Dea says. "It has completely changed our lives."

At school, she says, the boys are the sons of the guy who got hurt. Among friends, she's the wife of the injured soldier. "Wherever we move, whatever unit he's in," she says, "there's still that little tag on you that identifies you."

But Dea is elated to see Darron's transformation.

They no longer limit family outings to dark movie theaters. He goes on errands alone and last year attended a parent-teacher conference — an unimaginable thought, not long ago.

"I used to be afraid to go pick up the kids at the bus stop because I was afraid I looked like a monster," he says. "Now I pop on my sunglasses and just walk down the street and unless somebody walks up and gets into my face and starts talking to me, they have no clue.

"It is," he says, "a pretty good feeling."
 
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