It was just two days before Christmas in 2006, when 21-year-old Andy Sandness finally reached his breaking point.
Having been drinking more than normal recently, and feeling “super, super depressed,” Andy was at his very lowest point.
That night after work, he grabbed a rifle from his closet. He stared at it for a long time before putting a round in the chamber. He positioned the barrel beneath his chin, took a deep breath and pulled the trigger.
Like many survivors of suicide attempts will tell you, the eastern Wyoming man instantly knew he’d made a terrible mistake.
Police arrived on scene, and one of the officers happened to be a friend of Andy’s. He cradled him in his arms as Andy cried out to him, “Please, please don’t let me die! I don’t want to die!”
He was rushed from his home, treated at two hospitals, then transferred to Mayo Clinic. He woke to his mother holding his hand, her face a reflection of unfathomable pain.
Dr. Samir Mardini was the surgeon on call at the Mayo Clinic on that Christmas Eve. In the days that followed, he reassured Andy that he’d do everything he could to fix his face.
“I just need you to be strong and patient,” he said.
The damage could not be fixed overnight. It would take a lot of time and many extensive surgeries.
Andy no longer had a nose or jaw. 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. At first, he needed breathing and feeding tubes just to survive.
Dr. Mardini and his team removed dead tissue and shattered bones, then connected facial bones with titanium plates and screws. They reconstructed his upper jaw with bone and muscle from the hip; transferred bone and skin from one of his legs to fashion the lower jaw and used wires and sutures to bring together his eyelids, which had been spread apart because of the powerful blast.
After 4½ months and eight surgeries, Andy finally headed home to Newcastle, Wyoming. But his world had completely changed.
When he’d go out in public, he’d avoid making eye contact with anyone—especially children as not to scare them. He’d occasionally hear kids ask their parents why his face looked the way it did.
When people asked him what happened, he’d often lie. “I would tell them it was a hunting accident,” he says.
His social life was nonexistent. He typically kept to himself and spent most of his time in the hills where he could hunt and fish unseen.
Of course he struggled with insecurity—who wouldn’t? But Andy learned to adapt. He tore his food into bits because his mouth was too small to fit a spoon. He wore a prosthetic nose, but it often fell off, and he had to carry glue to reattach it. The nose also discolored, so Andy regularly had to paint it to match his skin.
For the next five years, Andy made annual visits to the Mayo Clinic. In 2012, he received a call that would again change his life.
Dr. Mardini informed Andy that Mayo was launching a face-transplant program, and he might be an ideal patient. The surgeon had already met with various doctors across the globe who had already performed transplant surgeries.
To say Andy was excited was an understatement. He eagerly asked how soon he could undergo the surgery himself, but Dr. Mardini advised him to do as much research as possible. The transformation would not be an easy process for anyone.
“When you look like I looked and you function like I functioned, every little bit of hope that you have, you just jump on it,” he says, “and this was the surgery that was going to take me back to normal.”
Only about two dozen transplants of the like had ever been performed worldwide, and the aftermath of a successful surgery meant a lifelong regimen of anti-rejection drugs.
It would be three more years before Mayo would finally get the face transplant program approved.
In the meantime, Dr. Mardini’s team spent countless hours rehearsing the surgery. They used 3-D imaging and virtual surgery technology to master how they’d perfectly fit a donor’s face to Andy’s.
After undergoing an extensive evaluation to determine whether or not the surgery should be performed on someone who’d attempted suicide, Andy got the okay.
In January of 2016, nine years after the night that first changed it all, Andy’s name was added to the waiting list of the United Network for Organ Sharing.
Doctors expected it would take up to five years to find the right donor: a man with matching blood and tissue types, roughly the same size as Andy, within a 10-year age range and a close skin tone.