Dallas C. Wiens wants to be able to smile, to smell the rain, to feel his 3-year-old daughter's kisses.
Two years ago, Wiens' face was burned away in a horrible electrical accident that also left him blind. Although doctors were able to transfer skin and muscle from Wiens' back and thighs onto his charred skull, he still doesn't have lips, a nose or even eyebrows. Now, after about two dozen surgeries, the new federal health care law has helped make him eligible to become perhaps the third person in the U.S. to ever undergo a face transplant.
"I do miss my sight," said Wiens, who lost his eyes in the accident. "But I miss the sensation of my face and my sense of smell the most."
Wiens underwent dozens of physical and psychological tests before Brigham and Women's Hospital in Boston _ one of only two U.S. centers to perform the procedure _ approved him as a candidate this month. The federal health care law helped him overcome one hurdle by allowing the 25-year-old Fort Worth man to be covered by his father's insurance to pay for the expensive medication he'll need after the operation. Wiens will likely wait months more, according to doctors, before a donor is found.
"I'm a little nervous as you can expect with any major procedure like this. I'm extremely excited over the possibility of just having a normal life back," he said. "There's no words to describe what that would be like."
Wiens has no memory of the November 2008 accident that took his face. Working as a contractor, he was helping his brother and uncle paint a church when, while high above the ground on a boom lift, he hit a power line.
"I'm told I lost control of the lift and ended up moving directly into the power lines," he said.
He was in a coma for three months and spent a total of six months at Parkland Memorial Hospital in Dallas undergoing surgeries. A smooth layer of skin now covers where his eyes and nose once were and he has learned to get around with the help of a walking stick. Although he has no lips or even teeth, he speaks with a strong, clear voice and is easy to understand.
"I see every day as a challenge, an opportunity for hope and joy. I'm happier now than I think I've ever been in my life," said Wiens, who lives in Fort Worth with his grandparents.
Wiens had no health insurance when he was injured; Medicaid paid for his initial care at Parkland. But he was dropped from the government health care program for the poor when his disability payments put him over its income limits.
He needed his father's insurance to help him pay for anti-rejection drugs he'll need after the surgery, which will cost $1,300 to $2,000 a month, Wiens said. He was able to qualify for his father's insurance because a provision of the federal health care law extends family insurance coverage to adult children until age 26.
Wiens turns 26 in May. As a disabled person, he'll be able receive Medicare by June.
The Department of Defense will pay for the cost of surgery, he said. It's underwriting the transplant with the hope of eventually being able to help soldiers with severe facial injuries.
Dr. Jeffrey Janis, chief of plastic surgery at Parkland Health and Hospital System, said when he met Wiens, his head was "a burned skull." Janis was the one who first told Wiens about the possibility of a face transplant.
"It's really miraculous that he was able to survive surgery, leave the hospital," Janis said.
About a dozen face transplants have been performed worldwide since the first one, a partial transplant in France in 2006. Wiens is currently the only person awaiting a face transplant at Brigham and Women's, a hospital spokesman said. And no one is currently listed for the procedure at the Cleveland Clinic, the only other U.S. center to previously perform the surgery.
A donor must match Wiens' blood type and have a similar skin color and texture, Dr. Bohdan Pomahac said in a statement from Brigham and Women's. Pomahac is among a team of more than three dozen who would perform the transplant at the hospital.
Wiens also knows that after the transplant, it will take time for him to regain feeling and functionality in his face.
He said his daughter _ who refers to his facial deformity as his "boo boo" _ and his faith have kept him motivated and given him a purpose.
"She says, 'Daddy has a boo boo, but God and the doctors are making Daddy's boo boo all better,'" said Wiens, who is in the process of getting a divorce. "She doesn't care and she never has since day one that I was disfigured."
Brigham and Women's Hospital, http://www.brighamandwomens.org/
Parkland Health and Hospital System, http://www.parklandhospital.com/