With An Artist's Eye and a Surgeon's Hand, Dr. Burt Brent Constructs Ears for the Earless
Early this month, in El Camino Hospital, Brent began the series of operations that will eventually give Giorgio a new ear. The young man's hearing has not been much affected, because, says Brent, "If a person loses the outer ear, there is only a 2 to 3 percent hearing loss. The organ serves no real purpose. The reason to do surgery is to make someone feel like a whole person." Brent, who disdains the limelight, tolerated it once again, mainly because press attention to his work gives hope to others with ear deformities. After TIME magazine mentioned his successful operation on Getty, Brent was contacted by many Americans who had been unaware surgery might solve their problems. Brent says, "Paul was pleased the publicity let a lot of parents know how their children could be treated."
One out of every 7,500 children is born with an ear missing or misshapen, and traumatic injuries to ears by burns, dog bites and auto accidents are common. Families from as far away as Peru and Australia crowd daily into Brent's office at the California Ear Institute, south of San Francisco. In the last six years Brent has performed 300 ear reconstructions.
A typical Brent success story is Scott Saltzman, 14, of Sherman Oaks, Calif. After years of fruitless searching for someone who could help his son, born with an unsightly, gnarled growth in place of his right ear, Ted Saltzman recalls that he "couldn't get to the phone fast enough" on reading about Brent. At 6, the boy wouldn't "have his hair cut short," his father says. "He didn't socialize with other kids because he didn't want anybody to see." Scott now boasts a normal-looking ear, and his father says, "Dr. Brent is like a partner in your life." Similarly, Jenny Fuller of Benicia, Calif., now 13, suffered endless questions about her "little ear." Her father, Ben, says that one doctor recommended surgery to "form a stump and give her a prosthesis to wear every day for the rest of her life. There was no way I was going to let him do that."
Brent has a better way—sculpting a new ear. Although the work he did on Jenny could not improve the 40 percent hearing in her left ear, she feels "just great" about how she now looks. (Like most of Brent's patients, she has perfect hearing in her other ear.) Says Dr. Mark Gorney, past president of the American Society of Plastic and Reconstructive Surgeons, "What Dr. Brent does is standard procedure for surgeons certified by the American Board of Plastic Surgery, but he does it very, very well."
Specifically, he begins by tracing the patient's normal ear on X-ray film. Then he must obtain the sculpting medium. "It's not like going to the lumber company and getting wood for carving," he observes with a smile. He makes an incision in the chest to extract a three-to four-inch piece of rib cartilage. Using sterilized woodworking chisels, he cuts and shapes one part of the cartilage to make the ear's outer rim, then stitches that to another piece, forming the cuplike interior. Speed is essential to keep the cartilage alive. "It's not like Michelangelo sculpting a piece of marble," says Brent of the operation, which sometimes lasts seven hours. "You can't knock off and have wine and cheese, and finish up tomorrow." Slipping the sculpted cartilage into a tiny opening in an ear pocket of skin, he says, "is like building a ship in a bottle." After the initial operation, the patient may return two or three times for refinements.
Brent was drawn to his specialty because "I love art and I love children." In fact, he originally wanted to be an artist. His maternal grandfather was "a great naturalist, artisan and musician," he says. "He had me building drawers and cabinets when I was 5." That he himself wound up in medicine, he adds, "was an expected, natural phenomenon." His father, Morris, now 75, practiced general surgery in Detroit until a few years ago, and currently is a hospital administrator. Mother Anne was a dental technician and brother Robert is a Detroit-based urologist. Graduating from Wayne State University in 1959, Brent went on to Chicago Medical School. He continued to pursue art, studying museum model making in spare moments during his internship at the University of Michigan hospital. While stationed as a general medical officer with the Green Berets in Panama in the mid-'60s, he reproduced models of pre-Colombian gold artifacts for exhibit at the Gold Museum in Bogotá, Colombia, and met his wife, Belinda, now 41, a medical editor. Later he developed his interest in ears by studying the pioneering work of Dr. Radford Tanzer, a Dartmouth surgical professor who developed the cartilage-sculpting technique. "I'd have fresh cadaver cartilage in the refrigerator and I'd practice carving on the kitchen table," Brent says. "I would have had a problem if I didn't have an understanding wife." He found ear reconstruction and museum model work remarkably similar. "You learn to picture the end product and work back."
Brent Believes in fun as well as reconstructive surgery. A quick-pickin' buddy of famed banjo virtuoso Earl Scruggs, he co-authored Earl Scruggs and the Five-String Banjo. "He also makes very sick jokes," says Jenny Fuller. "He says he's ear-resistible but never ear-responsible." Brent himself is both intensely serious and light-hearted about his role. "Ears make us look better and they're a place to put our glasses," he jokes. Call him ear-repressible.
The brutal ordeal of a kidnapped heir ends with healing and hope
Named for the Sardinian village where it is made, the pattada is a folding knife with a razor-sharp, subtly curving blade. Sheepherders use it to cut identifying marks in their animals' ears and even to slaughter the sheep. For a gang of Sardinian kidnappers, it was a cruelly efficient weapon—one that symbolized their contempt for their victim, 17-year-old jewelry heir Giorgio Calissoni. Taking the boy from the tent where they were holding him prisoner with his mother, Anna Bulgari Calissoni, they brought him into the pink-tiled bathroom of a nearby farmhouse. After dosing him with some grappa, a strong Italian brandy, as a meager anesthetic, they sliced off his right ear with the pattada. On Dec. 17, almost a month after mother and son were abducted in a Rat sedan from their villa southeast of Rome, the family, responding to a phone tip, found the bloody ear in a Rome trash can. Another call sent a newspaperman to a second garbage bin containing a threat to kill the hostages if ransom demands were not met.
That brutal gesture convinced the Bulgari family and Italian authorities that the criminals were not to be bargained with. On Dec. 22 Bulgari lawyer Carmine Punzi took 4 billion lire (around $2.4 million) to a prearranged meeting place in a wood on the Ligurian coast. The cocky masked man who spent two hours counting the ransom took off his disguise at one point, saying, "It doesn't matter. The police will never find us." In fact, pieces of Sardinian bread found in the getaway car had helped tip investigators, and the farmhouse where Giorgio's ear had been cut off was already under surveillance. But police held back until after Christmas Eve, when Giorgio and his mother were let go, as promised, some three kilometers from their home. "You don't kid around with Sardinians," explained investigating judge Giuseppe Mancini. "If they feel they are in danger, they will kill their hostages." The carabinieri moved in Jan. 5, eventually arresting seven men. Among them was the sheepherder who reportedly cut off Giorgio's ear.
A few days earlier Giorgio, wearing a white bandage over his wound and carrying his ear in a jar, arrived in San Francisco to see plastic surgeon Burt Brent. Giorgio's ear had deteriorated too much to reattach, so Brent will create a new one from rib cartilage. Brent started by cleaning and repairing Giorgio's wound to promote proper healing. He hopes that in about six months the repaired tissue will be strong enough for him to begin the actual reconstruction. Giorgio left the hospital the day after his minor surgery. Last week he returned to his Rome prep school to pick up his report card. "After next summer you'll see me with a new ear," he told friends. "I'm very proud of the courage he showed," says his father, Franco Calissoni, a retired general. "When they cut his ear off he didn't shed one tear, and he even comforted his mother. He'll board at school for a while, to study without anybody bothering him. After that ugly adventure he needs time for fun."
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