It was just two days before Christmas in 2006, when 21-year-old Andy Sandness finally reached his breaking point.
Having been drinking more than normal recently, and feeling “super, super depressed,” Andy was at his very lowest point.
That night after work, he grabbed a rifle from his closet. He stared at it for a long time before putting a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.
Like many survivors of suicide attempts will tell you, the eastern Wyoming man instantly knew he’d made a terrible mistake.
Police arrived on scene, and one of the officers happened to be a friend of Andy’s. He cradled him in his arms as Andy cried out to him, “Please, please don’t let me die! I don’t want to die!”
He was rushed from his home, treated at two hospitals, then transferred to Mayo Clinic. He woke to his mother holding his hand, her face a reflection of unfathomable pain.
Dr. Samir Mardini was the surgeon on call at the Mayo Clinic on that Christmas Eve. In the days that followed, he reassured Andy that he’d do everything he could to fix his face.
“I just need you to be strong and patient,” he said.
The damage could not be fixed overnight. It would take a lot of time and many extensive surgeries.
Andy no longer had a nose or jaw. He’d shot out all but two teeth. His mouth was shattered, his lips almost non-existent. He’d lost some vision in his left eye. At first, he needed breathing and feeding tubes just to survive.
Dr. Mardini and his team removed dead tissue and shattered bones, then connected facial bones with titanium plates and screws. They reconstructed his upper jaw with bone and muscle from the hip; transferred bone and skin from one of his legs to fashion the lower jaw and used wires and sutures to bring together his eyelids, which had been spread apart because of the powerful blast.
After 4½ months and eight surgeries, Andy finally headed home to Newcastle, Wyoming. But his world had completely changed.
When he’d go out in public, he’d avoid making eye contact with anyone—especially children as not to scare them. He’d occasionally hear kids ask their parents why his face looked the way it did.
When people asked him what happened, he’d often lie. “I would tell them it was a hunting accident,” he says.
His social life was nonexistent. He typically kept to himself and spent most of his time in the hills where he could hunt and fish unseen.
Of course he struggled with insecurity—who wouldn’t? But Andy learned to adapt. He tore his food into bits because his mouth was too small to fit a spoon. He wore a prosthetic nose, but it often fell off, and he had to carry glue to reattach it. The nose also discolored, so Andy regularly had to paint it to match his skin.
For the next five years, Andy made annual visits to the Mayo Clinic. In 2012, he received a call that would again change his life.
Dr. Mardini informed Andy that Mayo was launching a face-transplant program, and he might be an ideal patient. The surgeon had already met with various doctors across the globe who had already performed transplant surgeries.
To say Andy was excited was an understatement. He eagerly asked how soon he could undergo the surgery himself, but Dr. Mardini advised him to do as much research as possible. The transformation would not be an easy process for anyone.
“When you look like I looked and you function like I functioned, every little bit of hope that you have, you just jump on it,” he says, “and this was the surgery that was going to take me back to normal.”
Only about two dozen transplants of the like had ever been performed worldwide, and the aftermath of a successful surgery meant a lifelong regimen of anti-rejection drugs.
It would be three more years before Mayo would finally get the face transplant program approved.
In the meantime, Dr. Mardini’s team spent countless hours rehearsing the surgery. They used 3-D imaging and virtual surgery technology to master how they’d perfectly fit a donor’s face to Andy’s.
After undergoing an extensive evaluation to determine whether or not the surgery should be performed on someone who’d attempted suicide, Andy got the okay.
In January of 2016, nine years after the night that first changed it all, Andy’s name was added to the waiting list of the United Network for Organ Sharing.
Doctors expected it would take up to five years to find the right donor: a man with matching blood and tissue types, roughly the same size as Andy, within a 10-year age range and a close skin tone.
But just five months later in June, a donor came.
21-year-old Calen ‘Rudy’ Ross from Fula, Minnesota, had fatally shot himself in the head. He and his 19-year-old wife, Lily, were newly married, and she was eight months pregnant with their child.
Calen had been an organ donor—as indicated on his driver’s license—and being a young and healthy 21-year-old, his heart, lungs, liver and kidneys were donated.
It turned out Calen was also a good match for a suicide survivor awaiting a face transplant.
When approached about the donation, Lily admits she was skeptical at first. “I didn’t want to walk around and all of a sudden see Calen.”
Doctors reassured her that the transplant receiver would not be recognizable as her husband, and extensive tests confirmed that Calen and Andy were a great match.
Dr. Mardini said that doctors were stunned to see how close the two men were in hair and skin color, and just their overall appearance. “It could be his cousin.”
On June 16, 2016, Andy was wheeled into surgery where Dr. Mardini said to him, “We’re looking forward to seeing you with a new face.”
More than 60 surgeons and nurses embarked on what would be a 56-hour marathon surgery, which began around midnight on Friday, and ended early Monday morning.
Reconstruction went far beyond just taking Calen’s face and putting it on Andy. Doctors identified facial nerve branches on both men and made correct transfers so that when Andy tries to smile, the movements actually happen.
Dr. Mardini claims the surgery was a miracle.
Andy was sedated for several days following the marathon surgery, and was not allowed to see himself for almost three weeks. Mirrors in his room and his cell phone were removed.
When he finally did see his face for the first time, it was indescribable, and overwhelmingly emotional.
As Andy sat in his hospital bed, he still couldn’t speak, so he wrote these four words on a notebook: “Far exceeded my expectations.”
Dr. Samir. proudly read the note to everyone there.
“Once you lose something that you’ve had forever, you know what it’s like not to have it,” said Andy. “And once you get a second chance to have it back, you never forget it.”
Andy says it’s a blessing just to have a mouth and nose. “The looks are just a bonus.”
Months before the surgery, both Andy and Lily Ross had expressed interest in learning more about each other. She particularly wanted Andy to know about her husband.
Lily described her high school sweetheart as a “giving person,” who loved hunting, trapping and being with his dog. She explained that she agreed to allow Calen to be the donor for Andy’s face transplant so that she could one day show their son, Leonard, the ways his dad was able to help someone.
Andy and Lily hope to meet each other one day, but until then, Lily was able to see before-and after photos of the man who received her husband’s face.
“It was amazing how good he looked and how well he’s doing,” she says. “I’m excited for him that he’s getting his life back.”
In December, a full decade since he’d had the face he was born with, Andy had a follow-up surgery to tighten skin on his face and neck. His facial muscles are continuing to grow strong, and he’s gone through speech therapy to learn how to properly use his tongue and jaw.
He’s thrilled to smell again, breathe normally and be eating foods that were off-limits for a decade—apples, steak and pizza.
Andy says he knows the exact day he felt “normal” again. He was in an elevator, and a little boy looked up at him without appearing scared, or saying a word to his mother. “I knew then,” he says, “that the surgery was a success.”