Face transplants do change lives, but should we surgically remove difference?

http://www.theguardian.com/commentisfree/2012/mar/29/face-transplants-richard-norris

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To look on photographs of the changing face of Richard Norris is to contemplate deep mysteries about who we are and how our faces define us. Reports this week on the face transplant operation that has changed Norris's life were illustrated with a triptych of three portraits: as he looked before his accident, then after most of his face was shot away, and finally after the innovative surgery that has restored him to a "normal" appearance.

We can't help staring at these pictures. What would that experience of life be like? How do you survive the kind of injury he suffered? And what must it be like to look in the mirror, as Norris did after his transplant operation, and see a "real" face after spending years as a recluse, wearing a mask, shopping for food at night to avoid being stared at – as he reportedly did?

The picture of Norris after a gun accident 15 years ago – depriving him of his nose, lips and part of his tongue – is on first sight harrowing. The contrast with his new face seems genuinely miraculous. It would be inhuman to feel anything but joy for Norris now. And yet, in releasing the before and after photographs, presenting a visual narrative of a life blighted by facial injury and redeemed by a transplant, Norris's surgeons have perpetrated an injury of a different kind on many people who live with disfigured or simply different-looking faces.

The young Norris before his accident is, in his photograph, a full person: he looks like he has a life, a personality, a future. In the picture of him after his accident he seems deprived of all these things – the transplant, these pictures imply, has given him back his humanity.

This is reportedly how Norris experienced his injury, as something impossible to live with. No one can dispute his right to feel that way. But there other ways of experiencing facial trauma. There are people who have severe disfigurements who live not just "normal" but extremely fulfilled lives. There are also many people adjusting every day to what may be smaller, but for them dramatic, scars or surgical procedures, who would never be candidates for face transplants but need to feel proud and happy with themselves.

As so often in history, scientific technique is one step ahead of human enlightenment. What is a good society: one that surgically removes all differences, or one that tolerates and accepts them? To be clear: the operation that has changed Norris's life genuinely is "miraculous" and to see a downside to his transplant would be absurd. His experience is one thing. Its representation is another.

These pictures tell a crude story that suppresses the variety of ways people live with different-looking faces – indeed, the variety of human experience itself. The logic of such images has a science-fiction creepiness to it. Medicine is looking into a utopian future where every difference is surgically corrected. We are already a society in which cosmetic surgery is regarded as a normal option for healthy people. The utopia we are headed for is one profoundly opposed to true individualism. Like most utopias the medical future is a prison of conformity. So I would like to put in a word for the disfigured face of Norris before his transplant. It had character.

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