Her face was a Picasso portrait—as if some tectonic rift had shifted the halves of her face. A giant shard of windshield had inflicted the wound in an instant. The well-intended but misguided repair probably took a couple of hours. Three years later, the hideous deformity persisted: eyeball exposed, half a nose splayed out, the corner of a mouth partially hidden by a fold of flesh. Anxious, but hopeful, she lay on the operating table. Margo held the patient’s hand and murmured soothingly as the young woman slipped into the oblivion of anesthesia.
Dr. Marshall handed the scalpel to Margo. “You’re the surgeon today. I’m just the coach.” A crowd of observers huddled around the table, and Dr. Marshall provided a running commentary during the three-hour procedure. “The basic principles of wound closure are simple. The skin edges should be on the same level. You want the scar to heal flat, so it won’t cast a shadow. And it’s critical to match up landmarks, like the eyelid, the edge of the lip. This woman has lived for three years as a social outcast, because her injury was not repaired correctly in the first place.”
Margo paused to admire her work. “She’s going to be beautiful again.”
Dr. Marshall pulled off his gown and gloves. “You did a great job. You’re a talented surgeon.”
“I’m going to Nairobi next year to do a fellowship in trauma surgery. But I don’t think they can teach me things like this.”
“You should come over to Philadelphia for a while. You wouldn’t be able to do any operations. But you could observe us.”
“Why couldn’t I operate in Philadelphia?”
“You’d have to get a training license, and that would require passing some US exams. A full license would require at least two years of training in the US.”
“Because I’m from Africa?”
“It’s the same for all overseas doctors. There are some exceptions. For example, an expert can get licensed as a visiting professor.” He nodded at Pieter. “Someone like him. His altitude research is fascinating.”
Margo looked at Sarah and wiggled her eyebrows.
When she awoke, the woman stared at her face in a mirror. Her features were swollen and dotted with tiny sutures that looked like gnats. But everything was back in the right place. “Asante,” she whispered, as tears trickled down her face. “Asante sana.”