October 10, 2008

Update: Enabling Others to Face the World

Dr. Alex Greenberg ’79 heals traumatic facial injuries and deformities

By Dan Edelen

The robotic voice on Alan Doherty’s talking keypad said, “Can you get me a new face?”Born with otofacial syndrome, one of only two known cases, the Irish teen lacked what most of us take for granted: a lower jaw. He was unable to speak, breathe, or eat normally, but the most devastating aspect of his condition to him was the face he saw in the mirror.

While on a trip to America to compete in sporting events for disabled youth, he found an answer to his question in Dr. Alex Greenberg ’79.

“This is a young man who would have stayed in the shadows,” says Greenberg, a pioneering oral and maxillofacial surgeon. “He had a very disfiguring condition and was affected enough that anytime anyone looked at him it would pierce him.”

To fulfill Doherty’s dream, Greenberg and a team of plastic and reconstructive surgeons at Mount Sinai Medical Center in New York City performed a series of surgeries that stretched from June 2007 to August 2008 and took more than 70 hours to complete. The operations attempted several new techniques that had never been performed in combination.

“There was substantial risk in a procedure that hadn’t been done before,” says Greenberg, “but we were willing to take that risk because of the condition of his life.”

Facing the unknown doesn’t faze Greenberg. The biology graduate’s perspective is less that of a scientist confronted with technological challenges and more that of a far different profession. “Whether I am rebuilding someone’s chin, reshaping their jaw or cheekbones, or doing something cosmetic, it’s totally unscientific,” he says. “It’s pure art.”

Art in the Doherty case consisted of fashioning a jaw with dental implants from a portion of his hip bone. The team then placed the new jaw under the skin of his shoulder to provide necessary blood vessel and nerve growth. In a later procedure that stretched 16 grueling hours, Greenberg and the team implanted the jaw, reworked the young man’s facial musculature to accommodate it, and answered affirmatively the question that had dogged Doherty all his young life.

Seeing the joy on Doherty’s new face in the months afterward thrilled Greenberg. It’s one of the perks of his work. One grateful Israeli patient went beyond the typical thanks, though. Greenberg says with a smile, “He wound up fixing me up with my wife.”

In 1998, Greenberg became the first American chosen for a prestigious fellowship in Basel, Switzerland, where he studied under the father of modern craniofacial surgery, Dr. Paul Tessier. At only 33, an age when most in his field are still honing their skills, Greenberg wrote and edited his first book on craniomaxillofacial fracture repair. An inventor of medical tools, he holds 11 patents, with eight more pending. He also founded two companies, iDent Imaging Inc. and SipDisc Inc., the latter based on a device he invented for holding drinking straws to ensure better oral health.

“I have moments of insight that are extremely practical,” he says. “That’s worked for me in a lot of different areas, whether it’s a dental product, a new surgical device, or a new surgical procedure.”

In the case of Denise Egielski, a children’s book illustrator who lost her lower jaw to tumors as a toddler, Greenberg’s insights gave her a new face to show the world. By injecting her own bone marrow into a jaw taken from a deceased 15-year-old boy, he avoided the rejection common to transplant surgery. He later grafted her new jaw in place, giving Egielski’s children an opportunity to witness something new: their mom’s smile.

“Someone has abdominal surgery—you never know. You don’t see their scars,” Greenberg says. “But the face is exposed to everyone. When you’re able to give a person their appearance and restore their self-esteem, that’s a powerful service to give.”

Beyond his practice, Greenberg teaches at Columbia University, shares new surgical procedures during trips to South America, where the Government of Venezuela named him Honorary Professor of Plastic Surgery, and is an attending surgeon at five hospitals.

Greenberg’s pursuit of knowledge started in the small, private high school outside his hometown of Englewood Cliffs, N.J. With a desire instilled by his parents to excel in academics, he accrued more than a year’s worth of college credits. When college beckoned, he found Lafayette’s intimate class sizes and personal attention from professors appealing. “Lafayette was very progressive in accepting advanced placement courses,” he adds.

The Division I sports program also attracted the cross-country runner, who earned a varsity letter in his senior year. He indulged other interests at Lafayette, including Spanish, one of five languages he now speaks fluently. He won the College’s senior poetry prize, too. “I started writing good poetry in high school,” he says. “When I got to Lafayette and found an active poetry group, I decided to join.”

Gerald Stern, later a winner of the National Book Award for Poetry, worked with the group led by longtime English professor Fred Closs and struck up a friendship with Greenberg. Synchronicity would later bring them together in New York, years after Stern was shot in the neck; the poet became one of Greenberg’s patients. “I got a mention in a chapter regarding the shooting in Stern’s autobiography,” he says.

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