- Andy Sandness met Lilly Ross, the widow ho had agreed to donate her high school sweetheart's face to him
- They had a tearful meeting at Mayo Clinic 16 months after Sandness received a face transplant at the hospital
- Sandness and Calen Ross lived full lives before their struggles consumed them, 10 years and 500 miles apart
- Sandness had attempted suicide in 2006, and lived a decade with a face disfigured from a gunshot wound
- Ross killed himself outside his family home in 2016, when his newlywed Lilly was eight months pregnant
- Lilly Ross agreed to donate her husband's face, as well as his lungs, kidneys and other organs to other patients
Published: 02:30 EST, 10 November 2017 | Updated: 07:14 EST, 10 November 2017
Sixteen months after transplant surgery gave a Wyoming man a new face after living a decade without one, he met the woman who had agreed to donate her high school sweetheart's visage to him.
Standing in a stately Mayo Clinic library, Lilly Ross reached out and touched the face of Andy Sandness, prodding the rosy cheeks and eyeing the hairless gap in a chin she once had known so well.
'That's why he always grew it so long, so he could try to mesh it together on the chin,' she told Andy Sandness, as he shut his eyes and braced for the tickle of her touch on new nerve endings in the face that had belonged to her late husband, Calen 'Rudy' Ross.
The two came together last month in a meeting arranged by the Mayo Clinic, the same place where Sandness underwent a 56-hour surgery that was the clinic's first such transplant.
The medical journey came after tragedy hit both Sandess and the Ross family. Sandness put a rifle below his chin in late 2006 in his native Wyoming and pulled the trigger, destroying most of his face. Ross shot himself and died in southwestern Minnesota a decade later.
Lilly Ross, right, feels the beard of face transplant recipient Andy Sandness during their meeting at the Mayo Clinic, Friday, October 27, in Rochester, Minnestota
Sixteen months after surgery gave Sandness the face that once belonged to Calen 'Rudy' Ross, Sandness met the woman who had agreed to donate her high school sweetheart's face to him, who lived nearly a decade without one.
Lilly Ross wipes a tear from her eye as she talks about her deceased husband, Calen 'Rudy' Ross, on October 27 at the Mayo Clinic in Rochester
For Ross, just meeting face transplant recipient Andy Sandness felt like a huge release _ a way to get past a year filled with grieving, funeral planning, childbirth and gut-wrenching decisions about organ donations from her husband
Lilly Ross, left, shows family photos of her and her husband, Calen Ross, to face transplant recipient Sandness after meeting at a library at the Mayo Clinic
Sandness (left) put a rifle below his chin in late 2006 in his native Wyoming and pulled the trigger, destroying most of his face. Ross (right) shot himself and died in southwestern Minnesota a decade later
With her toddler Leonard in tow, Ross strode toward Sandness, tears welling in her eyes as they tightly embraced.
Ross had fretted before the meeting, fearful of the certain reminders of her husband, who took his own life.
But her stress quickly melted away – without Calen's eyes, forehead or strong cheeks, Sandness didn't look like him, she told herself.
Instead, she saw a man whose life had changed through her husband's gift, newly confident after ten years of hiding from mirrors and staring eyes.
'It made me proud,' Ross said of the 32-year-old Sandness. 'The way Rudy saw himself … he didn't see himself like that.'
Sandness and Calen Ross lived lives full of hunting, fishing and exploring the outdoors before their struggles consumed them, ten years and 500 miles apart.
It was two days before Christmas in 2006 when Sandness reached a breaking point. He'd been sad and drinking too much lately. That night after work while 'super, super depressed,' he grabbed a rifle from a closet.
In 2016, 21-year-old Calen Ross shot himself and died in southwestern Minnesota. His wife, Lilly, was eight months pregnant at the time of his deat
Ross already had agreed to donate her husband's lungs, kidneys and other organs to patients. Then LifeSource, a Midwestern nonprofit organization that facilitates organ and tissue donations, broached the idea of a donation for a man awaiting a face transplant at the clinic
Eight months pregnant at the time, she said one reason to go forward was that she wanted the couple's child to one day understand what his father did to help others
Ross (right, with Lilly) and Sandness' ages, blood type, skin color and facial structure were such a near-perfect match that Sandness' surgeon, Dr Samir Mardini, said the two men could have been cousins
He stared at it for a while, then put a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.
Instantly, he knew he'd made a terrible mistake. When the police arrived, an officer who was a friend cradled him in his arms as Sandness begged, 'Please, please don't let me die! I don't want to die!'
He was rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. 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.
When he woke, his mother was holding his hand. She'd always been a strong woman but that day, her face was a portrait of unfathomable pain. The bullet had obliterated his mouth, so he motioned for a pen and paper.
'I'm sorry,' he wrote.
'I love you,' she replied. 'It's OK.' But all Sandness could think about was how he'd hurt his family – and just wonder what was next.
A decade later, 21-year-old Calen Ross shot himself and died in southwestern Minnesota.
By then, Sandness had receded from contact with the outside world, ashamed of his injuries – surgeries to rebuild his face had left him a quarter-sized mouth, and his prosthetic nose frequently fell off.
Follow his suicide attempt, Sandness rushed from his home in eastern Wyoming, treated at two hospitals, then transferred to Mayo Clinic. 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
By the time of the sugery, Sandness had receded from contact with the outside world, ashamed of his injuries – surgeries to rebuild his face had left him a quarter-sized mouth, and his prosthetic nose frequently fell off. Sadness is pictured above shortly after his face transplant
Dr Samir Mardini shaves the face Sandness in July 2016, days after leading a team that performed the first face transplant surgery at the hospital
Hope first came in 2012 when the Mayo Clinic started exploring a face transplant program and again in early 2016 when he was wait-listed for the procedure.
ANDY SANDNESS'S SURGERY TIMELINE
Friday, June 10, 2016
10.16am – Rudy arrives at Mayo Clinic
11.53pm – Surgery starts on Rudy
Saturday, June 11, 2016
12.30am: Surgery starts on Andy
Nerves mapped on both Rudy and Andy
Sunday, June 12, 2016
3.14am: Donated face arrives in Andy’s room
4.30am: Bones plated together
6.00am: Vessels reconnected
9.00am: More plates placed on the mandible (jaw bone)
12pm: Problem detected with vessels, fixed by early afternoon
Evening: Nerves reconnected as well as other structures: salivary gland ducts, incisions made in mouth, skin put back and trimmed, eyelids reconnected to new nose
Monday, June 13, 2016
9.02am: Andy leaves OR
Ross already had agreed to donate her husband's lungs, kidneys and other organs to patients. Then LifeSource, a Midwestern nonprofit organization that facilitates organ and tissue donations, broached the idea of a donation for a man awaiting a face transplant at the clinic.
Ross and Sandness' ages, blood type, skin color and facial structure were such a near-perfect match that Sandness' surgeon, Dr Samir Mardini, said the two men could have been cousins.
Ross consented, despite her hesitation about someday seeing her husband's face on a stranger.
Eight months pregnant at the time, she said one reason to go forward was that she wanted the couple's child to one day understand what his father did to help others.
Lilly said she thought: 'He's a donor, and this is my call – we're going to do it.' Because if we could help countless people, why not? That's pretty much why I did it.
'I've been in contact with the liver recipient, I'm friends with the heart recipient on Facebook. There's one guy who got a kidney and a pancreas, we haven't heard anything from him yet; another lady got a kidney, I believe, and then we've not been in contact with the lung recipient. But I sent everybody letters around the same time, they all got pictures.'
She said: 'I knew what needed to be done and I just did what needed to be done' – adding that the process takes several days, as recipients are identified, and it's not an immediate process as often portrayed on medical television drama.
'The process is a long process, but it's worth it,' she says.
More than a year after a surgery that took a team of more than 60 medical professionals, Sandness is finding a groove in everyday life while still treasuring the simple tasks he lost for ten years, such as chewing a piece of pizza.
He's been promoted in his work as an oilfield electrician and is expanding his world while still prizing the anonymity that comes with a normal face.
Ross had fretted before the meeting, fearful of the certain reminders of her husband, who took his own life. But her stress quickly melted away – without Calen's eyes, forehead or strong cheeks, Sandness didn't look like him, she told herself
Ross said that instead, she saw a man whose life had changed through her husband's gift, newly confident after ten years of hiding from mirrors and staring eyes
The medical team that worked with Sandness (pictured above with Ross) have delighted in seeing their patient and friend open up since the procedure, going out of his way to talk with strangers whose gaze he once hid from
'I wouldn't go out in public. I hated going into bigger cities,' he said. 'And now I'm just really spreading my wings and doing the things I missed out on – going out to restaurants and eating, going dancing.'
Life with a transplanted face takes work, every day. Sandness is on a daily regimen of anti-rejection medication.
He's constantly working to retrain his nerves to operate in sync with his new face, giving himself facial massages and striving to improve his speech by running through the alphabet while driving or showering.
'I wanted to show you that your gift will not be wasted,' Sandness told Ross.
Mardini and the rest of Sandness' medical team have delighted in seeing their patient and friend open up since the procedure, going out of his way to talk with strangers whose gaze he once hid from.
'It turns out Andy is not as much of an introvert as we thought,' Mardini said. 'He's enjoying these times, where he's missed out on ten years of his life.'
Last year, Ross wrote to Sandness and the five others who received her husband's organs.
She described Ross, her high school sweetheart, as a 'giving person' who loved hunting, trapping and being with his dog, Grit.
Sandness holds 17-month-old Leonard Ross, the son of the man he received a face transplant from, after meeting at the Mayo Clinic, on October 27
Leonard's mother, Lilly, and Sandness say they plan to forge a stronger connection, and Sandness said he'll contribute to a trust fund for Leonard's education
Andy Sandness, left, gets a hug from Dr. Samir Mardini at the Mayo Clinic on October 27. Over the years, the two say they've become as close as brothers
'I am filled with great joy knowing that he was able to give a little of himself to ensure a better quality of life for someone else,' she wrote.
Lilly was given photos of Sandness before and after the transplant. That's when she learned of uncanny similarities between the two men – not just their passion for the outdoors, but the way they stood in their hunting photos.
'It was amazing how good he looked and how well he's doing,' she previously said of Sandness. 'I'm excited for him that he's getting his life back.'
She also noticed one small detail – a small bare patch in the middle of his bearded chin, just as on her husband's face.
Ross and Sandness say they feel like family now. They plan to forge a stronger connection, and Sandness said he'll contribute to a trust fund for Leonard's education.
On the day of their meeting, the boy stared curiously at Sandness at first. But later, he walked over and waved to be picked up. Sandness happily obliged.
For Ross, just meeting Sandness felt like a huge release – a way to get past a year filled with grieving, funeral planning, childbirth and gut-wrenching decisions about organ donations.
'Meeting Andy, it has finally given me closure,' she said, her voice choking as it trailed off. 'Everything happened so fast.'
FACE TRANSPLANTS: STILL RESEARCH, OR REGULAR CARE?
Is replacing a severely disfigured person's face with one from a dead donor ready to be called regular care, something insurers should cover? Mayo Clinic has raised that question by doing the first U.S. face transplant that's not part of research.
Faces, hands, wombs and even a penis have been transplanted in recent years. Unlike liver or heart transplants, these novel procedures are not life-saving but life-enhancing.
Who pays for care that can cost $700,000 or more is a growing concern. Ethics and liability issues also may arise when they're done without the oversight of an institutional review board, a hospital panel that ensures research participants' rights are protected.
The group that runs the nation's organ transplant system, the United Network for Organ Sharing, plans a conference to help guide policy.
'It's time to come together and really ask the question, 'Is this going to become a standard of care?'' said Dr. Scott Levin, a University of Pennsylvania surgeon who heads the UNOS panel on this.
He has done several hand transplants and no longer considers them experimental, though insurers won't pay. Worldwide, about 100 hand, face or other, newer body-part transplants have been done, and 'that's not a lot of cases' to judge safety and effectiveness for some types, he said.
Andy Sandness' operation last June was Mayo's first face transplant. Worldwide, roughly two dozen have been done, about half of them in the U.S. Four recipients have died.
At Mayo, 'we wanted to do it as a clinical program' and felt there was no research question to be answered because the operation uses standard surgical techniques, said the plastic surgeon who led it, Dr. Samir Mardini. Without a transplant, Sandness would have needed 15 other reconstructive procedures and the cost would be 30 to 40 percent higher, Mardini said.
Hospital management and multiple committees reviewed the case, including an ethics panel, a social worker and transplant psychiatrist, to ensure Sandness knew the risks and was giving informed consent.
'It's critically important that he understand what he would be putting himself through,' Mardini said.
Sandness' insurance company would not agree in advance to pay; so, a fund from a donor to start a hand and face transplant center at Mayo paid. Talks on paying for after-care are ongoing.
The long-term medical and psychological effects will be studied as part of formal research, even though the operation itself was not, Mardini said.
'I don't particularly agree with the argument that it's not research,' said bioethicist Arthur Caplan, who advised New York University on its first face transplant, in 2015.
There's a higher bar to ensuring informed consent for research versus a new therapy, and 'questions about competence, experience and even liability are different' when something is called regular care, Caplan said. 'In my view it's still highly experimental.'
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Australia: Scott Morrison saga casts scrutiny on Queen’s representative
In the past fortnight, Australia has been gripped by revelations that former Australian Prime Minister Scott Morrison secretly appointed himself to several additional ministries.
The move has been labelled a “power grab” by his successor as prime minister, and Mr Morrison has been scolded by many – even his own colleagues.
But the scandal has also dragged Australia’s governor-general into the fray – sparking one of the biggest controversies involving the Queen’s representative in Australia in 50 years.
So does Governor-General David Hurley have questions to answer, or is he just collateral damage?
Governors-general have fulfilled the practical duties as Australia’s head of state since the country’s 1901 federation.
Candidates for the role were initially chosen by the monarch but are now recommended by the Australian government.
The job is largely ceremonial – a governor-general in almost every circumstance must act on the advice of the government of the day. But conventions allow them the right to “encourage” and “warn” politicians.
Key duties include signing bills into law, issuing writs for elections, and swearing in ministers.
Mr Hurley has run into trouble on the latter. At Mr Morrison’s request, he swore the prime minister in as joint minister for health in March 2020, in case the existing minister became incapacitated by Covid.
Over the next 14 months, he also signed off Mr Morrison as an additional minister in the finance, treasury, home affairs and resources portfolios.
Mr Morrison already had ministerial powers, so Mr Hurley was basically just giving him authority over extra departments.
It’s a request the governor-general “would not have any kind of power to override or reject”, constitutional law professor Anne Twomey tells the BBC.
“This wasn’t even a meeting between the prime minister and the governor-general, it was just paperwork.”
But Mr Morrison’s appointments were not publicly announced, disclosed to the parliament, or even communicated to most of the ministers he was job-sharing with.
Australia’s solicitor-general found Mr Morrison’s actions were not illegal but had “fundamentally undermined” responsible government.
But the governor-general had done the right thing, the solicitor-general said in his advice this week.
It would have been “a clear breach” for him to refuse the prime minister, regardless of whether he knew the appointments would be kept secret, Stephen Donaghue said.
Critics push for investigation
Ultimately, Mr Hurley had to sign off on Mr Morrison’s requests, but critics say he could have counselled him against it and he could have publicised it himself.
But representatives for the governor-general say these types of appointments – giving ministers the right to administer other departments – are not unusual.
And it falls to the government of the day to decide if they should be announced to the public. They often opt not to.
Mr Hurley himself announcing the appointments would be unprecedented. He had “no reason to believe that appointments would not be communicated”, his spokesperson said.
Emeritus professor Jenny Hocking finds the suggestion Mr Hurley didn’t know the ministries had been kept secret “ridiculous”.
“The last of these bizarre, duplicated ministry appointments… were made more than a year after the first, so clearly by then the governor-general did know that they weren’t being made public,” she says.
“I don’t agree for a moment that the governor-general has a lot of things on his plate and might not have noticed.”
The historian says it’s one of the biggest controversies surrounding a governor-general since John Kerr caused a constitutional crisis by sacking Prime Minister Gough Whitlam in 1975.
Prof Hocking famously fought for transparency around that matter – waging a lengthy and costly legal battle that culminated in the release of Mr Kerr’s correspondence with the Queen.
And she says the same transparency is needed here.
The Australian public need to know whether Mr Hurley counselled the prime minister against the moves, and why he didn’t disclose them
The government has already announced an inquiry into Mr Morrison’s actions, but she wants it to look at the governor-general and his office too.
“If the inquiry is to find out what happened in order to fix what happened, it would be extremely problematic to leave out a key part of that equation.”
Former Prime Minister Malcolm Turnbull – Mr Morrison’s predecessor – has also voiced support for an inquiry.
“Something has gone seriously wrong at Government House,” he told the Australian Broadcasting Corporation.
“It is the passive compliance along the chain… that did undermine our constitution and our democracy… that troubles me the most. This is how tyranny gets under way.”
PM defends governor-general
Prof Twomey says the criticism of Mr Hurley is unfair – there’s was no “conspiracy” on his part to keep things secret.
“I don’t think it’s reasonable for anyone to expect that he could have guessed that the prime minister was keeping things secret from his own ministers, for example.
“Nobody really thought that was a possibility until about two weeks ago.”
Even if he had taken the unprecedented step to publicise the appointments or to reject Mr Morrison’s request, he’d have been criticised, she says.
“There’d be even more people saying ‘how outrageous!'” she says. “The role of governor-general is awkward because people are going to attack you either way.”
Prime Minister Anthony Albanese has also defended Mr Hurley, saying he was just doing his job.
“I have no intention of undertaking any criticism of [him].”
A role fit for purpose?
Prof Hocking says it’s a timely moment to look at the role of the governor-general more broadly.
She points out it’s possible the Queen may have been informed about Mr Morrison’s extra ministries when Australia’s parliament and people were not.
“It does raise questions about whether this is fit for purpose, as we have for decades been a fully independent nation, but we still have… ‘the relics of colonialism’ alive and well.”
Momentum for a fresh referendum on an Australian republic has been growing and advocates have seized on the controversy.
“The idea that the Queen and her representative can be relied upon to uphold our system of government has been debunked once and for all,” the Australian Republic Movement’s Sandy Biar says.
“It’s time we had an Australian head of state, chosen by Australians and accountable to them to safeguard and uphold Australia’s constitution.”
But Prof Twomey says republicans are “clutching at straws” – under their proposals, the head of state would also have been bound to follow the prime minister’s advice.
“It wouldn’t result in any changes that would have made one iota of difference.”
Australia election: PM Morrison’s security team in car crash in Tasmania
A car carrying the Australian prime minister’s security team has crashed in Tasmania during an election campaign visit.
Four police officers were taken to hospital with “non-life threatening injuries” after the car and another vehicle collided, authorities said.
Prime Minister Scott Morrison was not in the car, but the accident prompted him to cancel the rest of his campaign events on Thursday.
The other driver involved was not hurt.
Tasmania Police said initial investigations suggested the second car had “collided with the rear of the police vehicle, while attempting to merge”. It caused the unmarked security vehicle to roll off the road.
The two Tasmania Police officers and two Australian Federal Police officers were conscious when taken to hospital for medical assessment, the prime minister’s office said.
“Family members of the officers have been contacted and are being kept informed of their condition,” a statement said.
“The PM is always extremely grateful for the protection provided by his security team and extends his best wishes for their recovery and to their families.”
Australians go to the polls on 21 May. Mr Morrison – prime minister since 2018 – is hoping to win his conservative coalition’s fourth term in office.
Polls suggest the opposition Labor Party, led by Anthony Albanese, is favoured to win. However, Mr Morrison defied similar polling to claim victory at the last election in 2019.
Mr Morrison’s Liberal-National coalition holds 76 seats in the House of Representatives – the minimum needed to retain power.
Political observers say the cost of living, climate change, trust in political leaders, and national security will be among key issues in the campaign.
In recent weeks, the prime minister has faced accusations of being a bully and once sabotaging a rival’s career by suggesting the man’s Lebanese heritage made him less electable. Mr Morrison has denied the allegations.
Mr Albanese stumbled into his own controversy this week when he failed to recall the nation’s unemployment or interest rates.
Sydney airport warns delays could last weeks on third day of travel chaos
Long queues at Sydney airport’s domestic terminals have continued for a third day, with some passengers missing international connections, as the airport warns delays resulting from a surge in travellers and a shortfall in security staff could continue for weeks.
Chaotic scenes were reported in the departure halls as early as 4.30am on Saturday, with some frustrated travellers, many of whom heeded the pleas of airport chiefs to arrive at least two hours before their domestic flight was due to take off, claiming only one security line was operating.
While the queues that formed early on Saturday are understood to have cleared later in the morning, the airport apologised to affected travellers.
“Traffic numbers are picking up and the close contact rules are making it hard to fill shifts and staff the airport. We appreciate your patience,” Sydney airport said on its Twitter account.
A wave of families travelling as the term two school holidays begin this weekend, combined with close contact rules that are understood to be taking out about 20% of security shifts in any given day, are driving the problem.
Certis, the company that Sydney airport contracts for its security operations, is desperately trying to recruit personnel, while the airport has reallocated back office, IT and retail workers to the departure hall to comb queues so they can prioritise passengers at risk of missing their flight.
“We are working around the clock to resolve these issues and have teams in the terminals bringing passengers forward in order of priority,” a Sydney airport spokesperson said.
He added that the airport is “anticipating it will [be] busy right through the school holiday period and peak over the Easter and Anzac Day weekends, in some cases at 90% of pre-Covid passenger levels”.
“We’re deeply grateful to passengers for their ongoing patience and we’re sorry to everyone who has been inconvenienced,” the spokesperson said. “We would also like to thank passengers for getting to the airport early and treating staff and each other with kindness and respect.”
The Qantas chief executive Alan Joyce was forced to clarify comments he made on Friday that passengers were “not match fit” and that those forgetting to remove laptops and aerosols from their bags at the security check contributing to the delays.
“Just to be clear, I’m not ‘blaming’ passengers,” Joyce said. “Of course it’s not their fault,” he said.
Qantas shed thousands of staff during the pandemic, and outsourced ground crews in a decision that was challenged in court.
On Saturday, Qantas also apologised to a Melbourne family left stranded in Sydney, after domestic flight delays caused them to miss an international trip.
Javiera Martinez, her partner Daniel Capurro and their three children were supposed to be flying to Chile on Friday to visit relatives they had not seen in three years.
But after their 8am Qantas flight from Melbourne was delayed by half an hour, baggage handling and airport transfer delays in Sydney meant they couldn’t make their 11.30am LATAM Airlines flight to Santiago.
Martinez said the airline’s procedures at the airport were chaotic.
“We think Qantas didn’t behave appropriately. I got berated by the person at the counter – they never apologised, they never assumed any responsibility at all,” she said. “It was a rude conversation. We have been mistreated badly I would say.”
The PCR tests they need to travel have now expired and they will have to take them again as they wait for seats on the next flight to Santiago from Sunday.
The airline has apologised and paid for a night’s accommodation in Sydney.
“We sincerely apologise that the family missed their connecting flight on another airline due to delays moving through Sydney airport on Friday,” a Qantas spokesperson said.
The family is among many affected by hold ups amid the busiest travel period in two years, with Sydney, Melbourne and Brisbane airports warning passengers to arrive two hours before domestic flights.
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