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Out of sight and trapped behind facial disfigurements, they talk about repulsed looks, quick glances, pitied comments, isolation, and depression. Some can't eat, drink or be understood when they speak.

by Dick Peterson, Public Relations

She looked directly into Denise’s eyes and told her, “I can help you.”

To a woman facially disfigured from cancer surgery, the words were a healing balm, penetrating flesh and bone to touch her emotions and bouy her spirit.

“I was looking into the eyes of my angel,” Denise Lewis said. Betsy Davis, DMD, M.S., is an angel to many.

“I wouldn’t be here, if it weren’t for her,” said Garry Stith. “I lost my looks. My attitude. My outlook on life. My future. I wouldn’t be here,” he said.

Lewis and Stith are among the hundreds of “forgotten patients” who have sought help at Davis’ maxillofacial prosthodontic clinic, which relocated in 1998 to the 10th floor of Rutledge Tower.

Stith’s problem began with a bad nasal discharge and was thought to be polyps until the doctor removing them discovered cancer. “He just stopped. It was beyond him. I came to MUSC.”

But that was 1993 — before Davis set up her original clinic in what was barely more than a closet and a connecting hall on the second floor of the Clinical Science Building.

The cancer surgery and subsequent radiation therapy saved his life and stole his life. Stith was devastated.

And there’s little 4-month-old Kimmie. With huge dark eyes that could melt a permafrost heart, she glanced about and pulled tenaciously on the bottled formula her mother was feeding her. Barbara Chisholm-Oates of Hilton Head cradled the bundle — her third — and talked about the day Kimmie was born — her cleft lip and palate.

While Barbara recovered from her Ceasarian section at Beaufort Memorial Hospital that day, her husband was left to cope with what he saw — Kimmie’s birth defect. He cried. He ran. He came back. He suffered under the tender cruelties of love for his daughter.

Below her tiny nose, there just wasn’t anything there. And the roof of her mouth opened into what should be her nasal passages. She couldn’t nurse. Her formula would leak out her nose if she wasn’t held just right and the plastic bottle squeezed to force the milky liquid close to her throat where she could swallow it.

But today, after her bottle emptied, she smiled.

Major Larry Merrifield, retired, neat and crisply dressed. Physically straight and trim. Close-cropped and clip-speeched. What service? “Marines, the only service.”

It was April 28, four years ago, the day that MUSC’s Khanh-Gien Hoang, M.D., removed the cancerous bone tissue from beneath the skin of Merrifield’s face.

After enduring sinus infections and reactions to pollen that became increasingly severe over the years, Merrifield reached a point where the pain was intolerable and antibiotics and nasal sprays had no effect.

Unlike Stith, Merrifield’s surgery included Davis and her team of prosthodontic specialists. Working with Hoang, they fabricated a prosthesis to replace what had been surgically removed and followed Merrifield as wave after wave of radiation bombed the malignancy into what he hopes will be oblivion. His progress toward restoring his original appearance was enhanced by the early intervention of Davis’ team.

“Five years is the magic number,” Merrifield said, referring to the time-span after which a recurrence of the cancer is unlikely.

He still travels from Beaufort twice a month to MUSC. “I’d like to have the money I’ve spent just on gas alone. I could have one fine vacation,” he mused.

Deborah Henderson knows that being different is a childhood pain not easily numbed. Born without a right outer ear, she recalls her long hair that never changed style. And the head-tilt toward her right shoulder that nearly became an added disfigurement, though self-induced.

“The first nine years of my life I was in and out of hospitals,” Henderson said. She counts eight surgeries — all attempts to correct the birth defect. Doctors tried heroically, but in vain, to fashion a rudimentary ear from skin incised from her pubic area. As she matured, it grew hair, adding to her emotional pain.

And after childhood taunts faded, there were the innocent questions of her own children. And then their show-and-tell antics as they tried to one-up their playmates. “They had a mom with no ear.” She recalled the oddity of it.

At age 42, after enduring hearing loss and recurring infections, she acquiesced to a Spartanburg doctor’s recommendation that she seek a solution at MUSC. Under the direction of facial reconstructive surgeon Marcello Hochman, M.D., the failed appendage was removed and Davis’ team crafted an attachable prosthesis, a silicone “ear.”

Bittersweet memories of years past have morphed into smiles. Today, Henderson, a cosmetologist, doesn’t hesitate to talk about her skillfully crafted prosthetic ear. She detaches it and admiringly compares it with the genetically designed folds, creases and skin color of the ear God gave her. “And look. It’s pierced for an earring.”

To Lewis, Stith, Chisholm-Oates, Merrifield, and Henderson “saving face” takes on a whole new and desperate meaning, and therein lies their common pain. They’re called “forgotten patients,” because they stay out of sight and for most of them there is little or no insurance, Medicare or Medicaid coverage. They talk about repulsed looks, quick glances, pitied comments, isolation, and depression. Many of them lose the ability to communicate — to form understandable words. Some can’t eat or drink.

“I lost hope,” Lewis said. She defines “depressed” as wanting to die, and that wasn’t her. But isolation, the inability to talk, being fed through a tube and looking in a mirror took its toll. For two years after her surgery, Lewis stayed out of public view. “A big family and a wonderful husband” get the credit for pulling her through.

“I’m back in public again,” she said.

“And I’ve begun to see people differently now.” Lewis said she looks for the person on the inside, the person behind the face. “I’ve learned to look people in the eyes and give them the best smile I’ve got. I’ve learned that I’m the same person I always was, and I’ve learned that I have to adjust to live in the world around me — to cope.”

Stith, who lives in Myrtle Beach, says he’ll “do anything to help Dr. Davis,” He shows what Davis has done for him. He removes his glasses with one black lens that covers a missing eye and then reaches into his mouth to dislodge a prosthesis nearly the size of a baseball, but carefully crafted to replace the supporting bone, tissue, and teeth surgically removed to stop the spread of cancer.

Following surgery, Stith endured the radiation, designed to eliminate the last vestiges of cancer, without a prothesis. The radiation destroyed the blood vessels to the tissue left behind. His skin lost its natural elasticity and caused facial scarring.

“I went so long without a proper prosthesis,” Stith said. “I’m probably one of the worst cases she’s had.”

Stith’s wife, Grace, takes special comfort in Davis and the team. “We’re so fortunate to have found her. I can pick up the phone if I have a problem or a question. She’s more than a doctor.”

Some call her an angel.