During a recent Christmas season, Donnie Fritts made 75 birdhouses from scratch in his Georgia home for friends and family. He had nothing else to offer. But he wanted to give, just as a trio of Bethesda and Chevy Chase doctors gave him a new life.
Fritts' trouble began in 2002, with mashed potatoes. His wife, Sharon, started making them whenever possible because his teeth were getting loose. Initially, a simple cavity was supposed to be the problem. Then a sinus infection was identified as the culprit. His head began throbbing with pain at all times.
It took 14 doctors, according to Fritts, and increasing levels of agony before, in December 2002, it was finally revealed that he was suffering from ameloblastic carcinoma, an extremely rare form of aggressive jaw cancer that was ravaging his face. The cancer became so pervasive that his nose swelled up and would crack and ooze whenever he touched it or even smiled at people. Black circles materialized under his eyes.
A month after his diagnosis, Fritts lost his job running washers and dryers and driving delivery trucks at a dye house. It would have meant the end of his health insurance, except Fritts had already canceled it because of cost considerations.
In an effort to save his life, doctors removed part of his forehead, nose, palate, upper lip, facial tissue and bone in a 12-hour surgery in Atlanta in August 2003. They were successful.
But when Fritts first saw his reflection during a follow-up medical test, he flinched. Vast portions of his facial tissue and his sinuses were gone, in addition to his entire nose. Some of his remaining bone mass dissolved into his body. He would suffer through nightmares, all too real, about doctors dissecting his face. He had trouble eating and speaking. He was ashamed about not being able to work, and Sharon had quit her job as a Wal-Mart cashier to be his caretaker. He wore a mask in public.
"I thought, maybe I should have let the cancer just take me," said Fritts, 51.
Then the couple thought that government health programs would not pay to have his face restored, since such surgery was ultimately deemed "cosmetic," although his wife felt differently.
"You take things like kissing for granted. I would have to kiss his bottom lip. He would just stick it out," said Sharon Fritts, 52.
Fritts was staring into a financial and emotional abyss. He and his family despaired of finding surgeons who could restore his face.
But one day in desperation, Sharon Fritts typed "My husband lost his nose" into an Internet search engine. It led her to a group of doctors more than 600 miles away in Bethesda and Chevy Chase who have collaborated on several procedures for over a decade, although between them they have only worked on a handful of cases similar to Fritts'. Over the years they have become an informal team.
The idea of a facial prosthesis may seem daunting enough, but making preparations for it made the task truly bewildering. Reconstructing Fritts' forehead and creating a new upper lip fell to Dr. Craig DuFresne, a plastic surgeon in Chevy Chase. Bethesda oral surgeon Dr. David Ross, meanwhile, installed titanium implants and performed procedures similar to teeth replacement operations. Finally, prosthodontist Dr. Michael Singer in Bethesda worked with Dr. Robert Barron in northern Virginia to create a facial prosthesis and installed a gold frame in Fritts' face that would hold his new face in place.
"When Donnie came here, he didn't really know what to expect. He had been told that there was really nothing that could be done," said Singer, formerly a surgeon who worked on wounded soldiers at Walter Reed Army Medical Center in Washington, D.C.
He called Fritts' case one of the most difficult of his career.
His prosthesis is fitted with glasses, eyebrows and a mustache to complete the picture of Fritts as no different than any other person one might see in a restaurant or on the street. A filter in the nasal implant allows Fritts to breathe the clean air he needs.
The entire recovery process, beginning in 2004, has required about 20 surgeries, more than a dozen trips from his Georgia home to Bethesda, and hours upon hours of consultation. Fritts still requires some "touch-up" surgeries. He is scheduled to get an upgrade on the nasal prosthetic he has now, for example.
"Something this complicated takes multiple people's talents," DuFresne said.
Compared to his usual flow of dental patients, whom he usually treats for just a few minutes before they leave, Singer has been out to eat with Fritts several times, at one point witnessing a group of men shouting at Fritts that he looked like an idiot for wearing a mask. During one recent parting at Singer's office, both men shed tears.
"Whereas there was no hope at all before, he can now live a normal life," Singer said.
In addition, DuFresne found a way to obtain some financial help from government medical programs for Fritts' procedures, Sharon Fritts said.
At least another two or three more surgeries await Fritts. A foundation set up for him and his wife collects charitable contributions, although the foundation only pays for his medical expenses, not everyday living costs. So far, the cost of his surgeries has been about $1.5 million, according to Sharon Fritts, and all the costs to date have been paid, although the cost of his future surgeries isn't clear yet.
Donnie Fritts said he dislikes relying on charity, but the medications he takes makes everyday work impossible at this point. Sharon Fritts said it will probably be about a year before she can go back to work.
"I love work, I really do. I've always enjoyed a good day's work," Donnie Fritts said.
It is this attitude that led Fritts to build the birdhouses, which he used to build for the woodworking business he ran before he married Sharon Fritts. Neighbors would bring him scraps of wood, and he would sit in his basement, making birdhouses for Christmas presents because he had no money to give or buy presents. But this year, for the first time in more than six years, Fritts will be able to sit with his six children and seven grandchildren at Thanksgiving and have a normal meal.
"It's been really wonderful to have a vision for a patient and then go talk to Dr. DuFresne or Dr. Ross and say, this is my vision," Singer said.
Sharon Fritts, meanwhile, said one day she and her husband will come back to enjoy a full vacation's worth of sightseeing in the Washington area.
"We've never come up there just to be tourists," she said.
