posted from NaplesNews.com for anaplastics
For seven years, Amalia Mendoza lived in a state of near isolation.
A tragic accident cut her off from an outside world where once she was the center of everything. Those years left Mendoza withdrawn and depressed, with only a small circle of family and clergy between her and suicide.
By early 2008, desperation permeated everything she encountered. Her doubts and anxieties infected her family.
From her home in Albany, N.Y., Mendoza’s daughter, Rocío Villa, began searching every night online to find something, anything, that could make her mother whole again.
After searching fruitlessly for months, she stumbled upon a Web site for the Center for Ocular and Facial Prosthetics — a small practice in Naples that boasted one of the world’s best anaplastologists. Better yet, it was a group that did pro bono work. All she had to do was get her mother to Southwest Florida. The man on the phone promised he would take care of the rest.
The man was David Trainer.
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The place where Amalia Mendoza’s life changed is a spot on an empty road in the flat, rural nothings that separate western Venezuela and the mountain cities of eastern Colombia.
Thickets of pine and oak form walls along both sides of the arrow-straight road, occasionally giving way to a small field or clearing. If you block out the mountains that pop up in the distance, the road could easily be a deserted street deep in Golden Gate Estates, a place where you rarely see another soul.
It is so unmemorable a location that even when she tries, Mendoza isn’t able to tell you a single thing about it, despite having driven by it hundreds of times. When asked, she struggles to find words to describe it. Remembering is like walking through a heavy fog. Each step reveals itself only after the foot is already on the pavement.
Mendoza doesn’t remember how the day ended. But she does remember the beginning.
She got up at 5 a.m. and, although she owned a car, she took a three-hour bus trip from her hometown of Valledupar, Colombia, to a city just across the Venezuelan border, where supplies for her restaurant were less expensive. It was a trip she made a few times each month.
“I didn’t want to risk my car on the roads,” Mendoza explains in Spanish, with Villa translating, as to why she didn’t drive herself.
Once there, she and her brother spent less than $100.
Ready to head back home shortly before noon, Mendoza and her brother looked in vain for a bus heading east. So they settled on a cab, an old, beat-up, yellow four-door sedan that looked like a Toyota, although it’s tough to make out in photos. They waited for a few other people to join them for the ride back, and then they piled into the taxi and set off.
She sat in the back seat next to the passenger side window. One of the other passengers offered to let her sit in the front, but Mendoza preferred to sit next to her brother. After all, she didn’t know any of the other passengers. Or the driver.
From the very start, the cab driver wasted little time, speeding along the narrow road that connected Venezuela and Valledupar.
“I can remember he was driving very fast,” Mendoza says. “He just kept getting faster, too. I’m certain he thought that he could make more fares that day if he got us there sooner.”
When it started raining, Mendoza began to sense trouble. “I told the driver, ‘Don’t speed up or you are going to kill us all,’ ” she says.
That’s the last thing she’d remember for an entire year.
A hazy picture of the rest of the trip later became more clear, through bits of information her family has collected since.
The car began swerving on the wet pavement. The driver lost control. The car went into a ditch and it rolled for 30 or 40 yards before coming to rest upside down against a pine tree.
All the men in the car where able to free themselves quickly. But once outside, they saw Mendoza lying motionless in the back seat. What they didn’t notice was how her face was pinned between the headrest of the back seat and the top of the car. It was pinching her head right at the nose.
When they realized Mendoza wasn’t going to make it out of the car under her own power, they started to pull her out. But the crumpled steel had a tight grip on her face.
The men were frightened, especially as the smell of gasoline became more prevalent. What if the car exploded with Mendoza still inside?
They decided to pull her from the wreckage rather than wait for help, which could take hours to arrive.
As the men worked to free her, they were actually pulling off her face.
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It’s early October, and David Trainer is sitting on a round, rolling stool that serves as his chair in his office off Immokalee Road. Listening to a radio announcer discuss the current financial crisis, Trainer rolls his eyes — one of those long, slow rolls where you wonder whether the eyeballs are going to get stuck before they come back down.
He chats up anyone who will listen. He has plans for fixing the economy — have Bill Gates give everyone in the United States $1 million. Then just as quickly he’s off on another topic. Horror movies. Sports. Women.
His droll British accent and graying hair hide a personality akin to an excitable teenage boy. The only clue is a boyish face that lights up at a good joke.
And, of course, there are the eye rolls at least twice an hour.
Look closer at what he is doing and you get a very different impression. He’s joking and carrying on, sure, but he’s also carefully painting layers of silicone into a mold of a human ear.
He’s nearly finished, and now he’s just working on the details. In a few hours, the ear will come out of the mold and look so lifelike, you’d swear it was the real thing.
When it comes to anaplastology — or facial prosthetics — there are few in the world who can do what David Trainer does. He possesses a rare combination of scientific knowledge and artistic skill.
“He’s a genius,” says Heidi Oatis, a hair prosthetics maker from San Francisco who has worked with and studied under Trainer. “He can give people back what they’ve lost.”
While he’ll rarely go that far, if pushed, he’ll tell you what everyone else in the business knows. “I’m the best at this,” he says.
For the most part, he prefers to let his work do the talking.
One night, after finishing a successful nose prosthesis, the grateful client offered to take Trainer out for a couple of drinks. They went to a bar on Fifth Avenue South, one of those tony places with mirror-lined shelves full of high-end scotch and small-batch rums. After chatting with Trainer for a bit, the client — a man in his 40s — began talking to a woman seated at the bar next to them.
The man started telling her about Trainer and his wizardry with prosthetics.
“So the next thing I know, the guy says, ‘You want to see how good he is?,’ ” Trainer says. “And then he pops off his prosthetic nose. I thought the woman was going to be sick.”
Knowing Trainer, and his love for and work on horror movies, a suddenly upset stomach might be the greatest compliment he’s ever had.
In reality, most of his work has just the opposite effect. With our faces so important in how people react to us, Trainer’s work often allows people to blend in.
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“What was it that Aristotle said?” asks Arlette Lefebvre, a psychiatrist who has helped patients with facial differences for more than 30 years. “The face is the mirror to the soul.”
If your face is deformed or damaged, people tend to think that something internal is damaged, too. It’s not that we mean to be cruel, we just can’t help it, says Anna Pileggi, executive director of AboutFace, an international support network for people with facial differences.
“We have expectations about how people should look,” Pileggi says. “When they don’t, it creates confusion and tension. So then people who already feel uncomfortable with themselves feel even worse.”
Amalia Mendoza will tell you that losing three-quarters of her face didn’t change who she is. She’s still the same fun-loving, hard-working woman who was once a pillar of her community.
“I have not changed,” she says. “It is the others who are different.”
Emotionally, she’s right. Physiologically, the truth is stark. To see Mendoza’s face, something few people have, is to see inside your nightmares. Through no fault of her own, she’s become something that makes people uneasy.
From her upper lip down, Mendoza’s face is fine. Above, it’s a different story.
Between her lip and her brow line, her face craters. Where her nose should be, a pink cavern offers a glimpse into her sinuses. Above that, the lower portion of her ocular cavity is missing. She has no eyes. But more disturbingly, there is no place for them to go if she did. The tops of both of her ears look like melted wax.
Her skin is sickly yellow, oily from the lotion she must apply frequently to keep it from becoming raw. The surgical netting she uses to hold up the rudimentary prosthesis she’s worn for the past six years leaves deep, painful indentations criss-crossing her bald skull. A few small patches of salt and pepper hair grow on the back of her head. She keeps them closely cropped.
Even though she’s very much alive inside, to most people, Amalia Mendoza died with the loss of her face. All they see is a poorly constructed mask, covered by sunglasses and a wig.
The truth lies somewhere in the middle.
“You do become a different person when you suffer a traumatic injury of any kind, but especially to your face,” Lefebvre says. “The question is, do you accept your new self or do you try to get back what you’ve lost?”
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Amalia Mendoza’s survival is nothing short of a miracle. The doctors who have examined her since the accident come to that conclusion. The sheer magnitude of the injuries surely signals death in 99 out of 100 cases, and that might be a generous estimate.
“This is a one-in-a-million case,” says Dr. Stephen Laquis, the reconstructive surgeon who implanted the titanium studs that hold up her Mendoza’s prosthesis. “You don’t see many like this, because everyone else would have died.”
Her life becomes all the more impossible when you consider the care she was given in the crucial first hours and days after her accident.
An ambulance didn’t arrive for two hours. It took another 45 minutes to transport her to a hospital near Valledupar, Colombia, where the care was subpar by modern medical standards.
She spent five days in the hospital in Valledupar. The injuries forced the doctors to remove both of her eyes, and by the time she finally arrived in Bogota to Colombia’s best medical facilities, she was fighting an infection that would nearly take her life. Nothing could be done for days while the doctors tried to get the infection under control.
“The infection had to be treated first because it attacks the whole body, all the organ systems,” says Dr. Monica Ramirez, the reconstructive surgeon who operated on Mendoza in Bogota.
During the many surgeries Ramirez performed on Mendoza, she came to the realization that the options were very limited for any permanent reconstruction.
“After having performed surgery on her and seeing how defective her face was, I knew the options were facial transplants or a facial mask,” Ramirez says.
At the time, facial transplants were more pipe dream than reality. The first wouldn’t happen for another four years. Mendoza was on a list of possible candidates to be one of the first facial transplants in the world, but after months of working with doctors in the United States and Europe, it was determined that she wasn’t a good fit.
“The way they reconstructed her face would make it almost impossible to do a facial transplant,” says David Trainer, the Naples-based anaplastologist who made her new prosthesis.
Mendoza’s first — a poorly constructed mask.
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Nestled in a landscape concrete-block buildings in Valledupar, Colombia, Mendoza’s restaurant is easy to miss. The only clue is the word “RESTORANTE” scrawled in tight black letters on the green exterior. It sits on what used to be an impromptu landfill, with garbage so deep the land had to be filled in before anything could be built on top of it.
The road outside rumbles constantly with the sound of passing motorcycles, which outnumber cars by at least two to one.
Inside, the space is small, with eight tables covered in thin, green-checkered tablecloths packed tightly. The air is hot and sticky, with the musty smell of an antique store. Two lazy ceiling fans, squeaking as they turn, do little to cool it. But the room opens up to the outside, so if you come on a windy day, the breeze makes the heat bearable.
The simple kitchen is open except for the metal cage surrounding it, so it can be locked up at night.
In its heyday, before the accident, Mendoza’s restaurant was a thriving enterprise, open
16 hours a day and always full.
“The people knew me and they liked me,” she says in Spanish, as her daughter, Rocío Villa, 42, translates. “They came to my restaurant because they knew they would get something good.”
The restaurant was more than just a business to Mendoza; it was her life. She sacrificed creature comforts to save money to build it. And for
26 years, she put nearly every waking moment into it. Every day, she was there, acting as chef, hostess and life of the party. People came as much to have fun as they did for the food.
“My mom is one of those people who is always at the center of the party,” Villa says. “Until the accident, she would never be alone. There were always people wanting to go out and have a party with Amalia.”
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While not born into privilege, Mendoza started her life with a leg up on her fellow Colombians.
She grew up on her grandmother’s prosperous farm, which her father inherited. It was a pastoral place, full of horses and cows and rich soil in which to grow vegetables and fruit.
“You could grow anything there,” she says. “We all worked together and played together.”
But, at age 8, that life was taken from her. In the middle of the night, bandits murdered her father in the room where the entire family slept. No one woke up. No one saw anything. They found his body the next morning.
“Nobody knew what happened, but we all knew,” she says. “The bandits were infamous in those days for killing the men, especially the men. That way they could steal from you whenever they liked.”
After her father’s murder, the family moved to Valledupar. But Mendoza remained scarred.
“To have that happen right there with you in the room is difficult,” she says. “You don’t know when you can be safe.”
Her idyllic life was over. So was that of her homeland. In 1948, the assassination of politician Jorge Eliécer Gaitán set off a period known as La Violencia, which saw 200,000 people in rural Colombia die.
From the 1960s on, Colombia became overrun with guerrilla fighters and drug kingpins. The rebel group Fuerzas Armadas Revolucionairias de Colombia, better known as FARC, began its ongoing campaign of violence.
“For a long time, everybody was desperate. And it was very dangerous,” Mendoza says.
“It’s still dangerous,” Villa adds. “But she has to go back. She loves it. Colombia is her whole life.”
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In reality, everything changed. The lives of almost everyone around her fell apart. Her son, Antonio, 26, quit school to take care of her. Her daughter Amanda, 35, was living in Washington, D.C., at the time of the accident and about to be married. She returned to Colombia to be with her mom and her relationship failed. Another daughter, Norca, 38, also moved closer to home — and eventually got divorced because of the strain of her mother’s injury.
After Mendoza returned to Valledupar from a year in the hospital, nothing was the same. Her customers didn’t return. They said if Mendoza wasn’t cooking and serving them, they would just go somewhere else.
Worse yet were the longtime friends who were suddenly nowhere to be found. Those who did stop by started to cry. To them, Amalia Mendoza was gone.
She is defiant about the situation now. “If they don’t want to be around me, then I don’t need them,” she says. “Those who didn’t come around when I was at my worst aren’t welcome as my friend now.”
But at the time, the loss of her face, her sight, her livelihood and her friends was soul-crushing. Suicidal thoughts she believed she had left behind at the hospital started creeping back.
Here was a fiercely independent woman suddenly reliant on her children. Depression and claustrophobia set in before she’d even left the hospital. Mendoza wanted to die.
“She asked us many times to kill her,” Villa says. “She would say, ‘Let me jump out of the window.’ ”
She was about as far away from the woman her children knew as she could get. The mother they knew was a fighter. Someone for whom struggle was nothing new.
“It was so sad to see her in that state,” Villa says. “But I knew she would bounce back; she would be the woman she used to be.”
To do that, she had to find a way to make the person the world saw more like the woman inside.
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To call the first facial prosthesis given to Mendoza primitive is too kind. Holding it in your hand, it looks like someone modeled an Etruscan statue in tan gum rubber and then chipped off the face.
When she was wearing it, she looked even more ghastly. Without a strap to support the prosthesis, Mendoza held it in place with surgical netting, which dug deep indentions into her fragile scalp. Even topped with a wig and sunglasses, the look was that of a rudimentary wax sculpture on top of a human body.
“Quite simply, it’s one of the worst prosthesis I’ve ever seen,” says Trainer, the Naples anaplastologist. “I know we were dealing with Third World technology, but it’s as if the person who made it didn’t even try.”
For Mendoza, who let only a few people see her face, it was the only option she could find that would allow her to leave home.
But even with the mask, people still stared.
“Of all the physical deformities, facial differences are the most stigmatic,” says Dr. Arlene Lefebvre, a Toronto-based psychiatrist who has worked with patients such as Mendoza for the past 30 years. “Other areas you can cover up, but your face is there for the whole world to see. And they will notice.”
Walking with Mendoza through Marshalls discount department store on U.S. 41 in Naples is to understand what Lefebvre is talking about. While no one comes out and says anything to her, it’s easy to read the discomfort on their faces.
As she walks, holding onto the shopping cart her daughter pulls along the narrow aisles, the reactions are unmistakable. First you look, then quickly look away. But something pulls your gaze back again. Only the most ambivalent or polite manage not to stare for a few seconds. Those less sensitive find it impossible to look away.
Even though she is blind, Mendoza senses when someone stares for too long.
“I just know,” she says. “You can feel the stares. It is embarrassing.”
Lefebvre says this kind of loss is unfortunately very normal for people who suffer from facial trauma. Those whose friendships are more superficial, who don’t have a steadfast bond, usually don’t stick around after the fact.
“For the most part, family stays,” she says. “But others leave. Any relationship based on attraction usually ends, even friendships.
“It’s doubly difficult because the person has now lost two things, an identity and friends.”
It was after seeing her mother’s pain over the loss of her social circle that Villa decided there had to be other options.
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When most people see photos of Mendoza without her prosthesis, their first reaction is to say, “How did she survive?”
When Trainer saw them, all he thought was, “How can I change this?”
“Most people just see a monster, a freak,” he says. “I can’t see people like that. How could I help them? I just see a person, just like you or me.”
In a meeting shortly after Mendoza made her first visit to Naples in August 2008, Trainer and Laquis, a Fort Myers surgeon who specializes in facial reconstruction, studied an MRI of her skull. For Trainer’s prosthesis to work properly, Laquis needed to insert as many titanium studs into Mendoza’s fragile skull as possible. On top of each stud, a small magnet would be attached. Those magnets would be paired with corresponding pieces molded into the silicone mask, allowing it to rest on her face without a visible fastener.
The studs were designed for use with cochlear implants, which help deaf people hear. But in the past five years, Trainer has found them an invaluable tool in his work. Thanks to the studs, his patients no longer need to use irritating adhesives.
With Mendoza, however, problems arose the minute Laquis and Trainer saw her MRI results. Because her skull was so severely damaged, very little bone and tissue remain. In some places, the layer of tissue between her skin and bones was paper-thin. In others it was nonexistent.
Ideally, for a prosthesis as large as Mendoza’s, Laquis would have inserted as many as 10 studs and at the very least seven. But once the surgery started, Laquis realized the MRI results were right on. They had to settle for five.
The lack of tissue under her skin also required Laquis and Trainer to speed up the implant process. Normally, the doctors use two surgeries to ensure the studs bond properly to the skull. The first surgery implants the screws into the bone. The second attaches the magnetic pieces to the screws. But with too little tissue, Laquis and Trainer had to do both at the same time.
They weren’t sure it would work.
As they sent Mendoza back to her daughter’s Albany, N.Y., home, all they could do was hope. It would be more than two months before they’d see her again.
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Two months separated Amalia Mendoza’s two visits to Naples.
For all the parties involved, the wait seemed excruciatingly long.
The two months in the fall of 2008 that separated Mendoza’s first visit to Naples and her return were hard for both Mendoza and David Trainer, the man building her facial prosthesis.
For Mendoza, the weather at her daughter’s upstate New York home had turned from a pleasant summer into an unseasonably cold fall. It was the first cold snap she’d ever experienced.
“There’s only one type of weather in Colombia — hot,” daughter Rocío Villa says. “She wasn’t ready for it.”
Mendoza was homesick. She would call Colombia every day, checking in on her rental properties. Some renters had stiffed her, assuming her visit to America would end up a permanent stay.
For Villa, even with all of the facial reconstruction work being done for free, taking the two trips to and from Albany to Naples and sending her mother and brother Antonio back to Colombia was taking a toll financially, and at work.
“People have been really supportive during this whole time,” she says. “But it’s difficult.”
Meanwhile, Trainer grew increasingly frustrated. Villa, who was coordinating all the procedures her mother was having done, proved difficult to reach. At one point, she changed cell phone numbers without telling anyone in Naples.
Between paying clients, an upcoming recertification test and trips to Arizona to see his family, Trainer’s window to fit in the week of work Mendoza needed shrank each day.
On top of that, there were other people’s schedules to consider. Trainer’s boss, Raymond Peters, needed to make the eyes; the maker of a specialized prosthetic hairpiece needed to fly in from San Francisco; and Mendoza’s surgeon, Dr. Stephen Laquis, needed to sign off on the success of the studs.
“Not hearing from them is difficult,” Trainer said with a sigh in October. “So many people are giving so much of their time to make this happen. So many schedules have to be rearranged.”
After a few weeks of trying, Trainer got in touch with Villa and worked out a schedule. In the last week of October, Mendoza made her way back to Naples for the final leg of her journey.
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Although the earliest prostheses date back to Greece and Egypt before 500 B.C., the first recorded facial prosthesis was made by Danish astronomer Tycho Brahe, who lost the bridge of his nose in 1566 in a drunken duel with a fellow Danish nobleman. To make up for his loss, Brahe fashioned a realistic false nose from silver and gold and used paste to attach it.
Facial prosthetics lagged behind those for limbs for obvious technological reasons. Extremely functional leg prostheses were developed in the 1940s, but the magnetic implants Trainer uses weren’t developed until the mid-1980s.
“I was there for some of the early workshops on it,” he says. “It was kind of a ‘wow’ moment.”
Since then, the advances have been subtle — better materials, better training. But there haven’t been any more “wow” moments.
And therein lies Trainer’s biggest challenge with Mendoza: With so much of her face missing, his job is to make the prosthesis look as lifelike as possible.
Her eyelids won’t blink. Her cheeks will never flush. The wrinkles he gives her will be the only wrinkles she’ll ever have.
“There are so many limitations to what the prosthesis can do,” Trainer says, almost dejectedly. “Even if we could set up the eyelids to blink, say, every five or seven seconds, that would add so much more life to her face.”
He only has one week to make Mendoza’s prosthesis. One week to transform her. One week for a miracle.
That word makes Trainer bristle slightly. He knows a miracle is what everyone is looking for.
“Wonders, I can do in a week,” he says. “Miracles, that takes a little bit longer.”
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As a boy in England, David Trainer never thought much about what he wanted to be when he grew up. He was more interested in girls and horror movies.
So how did a boy with no clear career aspirations end up a skilled anaplastologist, someone who can use chemistry, physics, medicine and art to create lifelike facial prosthetics?
“When they asked me what I wanted to do after school, I told them two things: architect or dentist,” he says.
“In dental school, I went to a presentation where they were showing people who had lost parts of their face and the things people were doing with prosthetics. Right then I thought, ‘This is cool.’ And that was it.”
After graduation, Trainer answered an ad for a anaplastologist in Germany.
“Basically, I had to relearn my whole job in another language,” he says.
In Germany, he began perfecting his craft, working both on patients and on movie sets, helping create ever more fantastically gruesome prostheses for horror movies.
Sitting in his office, Trainer reaches for a mold of a face covered with a thin layer of silicone that looks like skin melting.
“Quick, whose face is this?” he asks. He gets bored after a few incorrect guesses. “Look at the nose. It’s Tom Cruise.”
The mold was used for a scene in “Interview with a Vampire.”
Germany is also where he met his wife and where his three kids were born. Several times a day, Trainer gets a call and immediately starts speaking in German with a very convincing accent.
But wanderlust and an impossible workload led Trainer to the United States in the late ’90s. At the height of his German practice, Trainer was making between 140 and 150 prostheses a year. Now he makes about half that.
“I was getting burned out,” he says.
He held a teaching residency at Indiana University and later ended up in the Phoenix area doing research and development for a leading prosthetics company. As part of his job, he helped develop new techniques and materials that have proven helpful to prosthesis makers around the world.
But, again, he got bored.
Enter Raymond Peters, a Naples-based prosthetic eye maker. Peters, a cantankerous veteran who learned to make prosthetic eyes while in the Navy 50 years ago, was looking for someone to help him grow his business into a full range of facial prosthetics. He needed some new blood to compete.
“The game had changed,” Peters says. “David was doing things that few people can do.”
Hanging from a corkboard strip along the wall in Trainer’s office is a sampling of his handiwork — a silicone ear and matching nose.
Both are so perfectly fleshy pink, complete with blemishes and veins, that you almost do a doubletake each time you see them, looking for dripping blood. As you move closer, the effect is staggering. It’s one thing to fabricate a nose that looks realistic at 10 feet. It’s quite another to make one that looks lifelike at 10 inches.
This is what makes David Trainer special. He pulls the nose off the peg and runs a little water around the thin, silicone edge. Then he sticks it to the palm of his hand. The effect is disconcerting.
But if that nose were placed on the face of a woman who had lost her nose to sinus cancer, you wouldn’t notice at all.
That’s the promise Trainer made to Amalia Mendoza.
“The goal is to make her blend in as much as possible,” Trainer says.
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Once Mendoza got to Naples, Trainer took detailed molds of the front of her head, which he then cast in plaster. From those molds, he made a wax version of her face.
This is his rough draft. He can mold the wax into any shape he chooses. Once the silicone is set, there’s no going back.
He carves the wax deliberately, holding his knife over a flame to keep it warm as he studies the wax. Each stroke is careful, even though he could add wax back if he made a mistake.
The biggest challenge in making Mendoza’s new face is the nose. Mendoza’s broad chin protrudes a little farther than most people’s, a feature amplified by her caved-in face. Trainer has to make the nose big enough so it lines up with her chin without making it beakish. He spends close to five hours working on just the nose.
Every few minutes or so, he gently places the mold on Mendoza’s face. The wax mask in his right hand, he delicately slides his left hand along the back of her head, gently pushing her forward.
The magnets in the mold match up with the studs in her head with a cold, metallic snap. She flinches each time.
“The sound of the magnets is magnified by the pieces in her skull,” Trainer says, as if to reassure everyone in the room that it didn’t hurt.
He studies her for a few seconds, and then gently removes the mask. He starts carving again.
The process is long and often tedious. Occasionally Mendoza nods off, her head snapping back to attention when she realizes she’s falling asleep.
Trainer becomes oblivious to the room full of people staring at him. He studies the wax mold, then himself in a handheld mirror. He models the age lines off his own, even though Mendoza is a decade older.
Each person in the room amplifies the awkwardness that comes with watching someone work. There’s Trainer, Mendoza, her daughter and son, a reporter, a photographer and for a little while a two-man crew filming a documentary for the Discovery Channel. The entourage will continue to swell. A few days later, a couple from San Francisco will arrive with the hair prostheses — two amazingly light wigs made from human hair. Later in the week, all of those people, plus a gaggle of nurses and aides, will gather around to see the final results.
Mendoza seems to take her relative celebrity in stride. She jokes with Trainer about the color of the false eyes he’s going to put in the prosthesis. He says blue and she laughs. Everything is a joke until he says the wig will be blond.
“Rubio, mama,” Villa says.
Mendoza wags her right index finger to say, “No.”
Villa laughs. It seems dumb blonde jokes are universal. “Where we are from, rubio also means a kind of stupid person.”
Trainer keeps things light, too, but his sense of humor is more macabre. He plays peek-a-boo with the false eyes as he installs them into her prosthesis.
For the final stages of the wax mask, he puts a plastic bag over the mask and runs over it with a wire brush. This helps give it a texture more like human skin, and it keeps the wax clean while he’s working.
“The best bags are the produce bags at Wal-Mart,” he says when asked about this decidedly low-tech technique. “I go and buy two tomatoes and leave with 20 bags.”
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Happy with the wax model, Trainer makes another set of plaster molds into which he will paint in silicone. Now the second part of his artistry comes into focus.
For years, Trainer has worked on a system to match the coloring of his prostheses with his clients’ skin tone. It’s not unlike an artist painting on canvas. He mixes paint into clear silicone on a small paper pad that doubles as his palette.
To an untrained eye, the colors he uses look garish. Deep purples and reds lie in tacky pools of silicone much larger than their tan and brown counterparts. But as any child with a coloring book learns, a perfect skin-toned crayon doesn’t exist. Those reds, purples, pinks and blues will add to the illusion of life beneath the skin, of the thousands of tiny blood vessels, the millions of tiny imperfections that, combined, make us look like something other than a mannequin.
The painting is a two-step process. He makes the base of the prosthesis, bakes it in an oven for a few hours and then paints another layer of silicone on top, adding the tiny details. His brushstrokes often yield imperceptible changes. Still, each stroke adds another small piece to the overall puzzle.
By the time he’s finished, the piece of silicone Trainer holds in his hands, now with eyes, lashes and brows, will look as human as anything man can create. Yet with all this work, a week filled with 15-hour days, the end result won’t please the perfectionist.
“It’s never good enough,” Trainer says. “It can always be better.”
The reaction of his patient says differently.
After it cools down from its final trip into the oven, Trainer wets the prosthesis’s transparent-thin edges with a damp index finger. He gently places the prosthesis to Mendoza’s face until magnets make their now familiar click. He lightly presses the damp edges to her face, smooths her wig and steps back.
“How do I look?” she asks in Spanish.
“Beautiful, Mami,” Villa replies. She sobs uncontrollably.
Mendoza cries, too, in her own way. Without eyes, there aren’t any tears. Without a nose, sniffles become small wheezes. But that moment passes quickly.
The rest of the day, she just smiles.
■ ■ ■
Sitting in a chair under the dim lights of Miami International Airport, Mendoza chats with Villa and a family friend now living in Miami. It’s a scene happening all over the airport. Another Hispanic family sits in chairs two rows down, talking in a very animated, rapid-fire Spanish.
To Mendoza’s right, a man shrink-wraps bags for a steady stream of passengers who stop by before heading to the nearby ticket counters.
None of them look twice at Mendoza.
She’s wearing a long, straight human-hair wig that wouldn’t look out of place in Haight-Ashbury in 1969. A woven headband pulls the hair back off her face, a style she would have never worn before because it would have called attention to her features.
A pair of reading glasses rests on her nose, defusing one of the prosthesis’s two flaws. You don’t notice she’s not blinking as much with the glasses.
The other flaw is difficult to hide. Because of the structure of her face, when Mendoza smiles a small opening appears between the right side of her upper lip and the edge of the prosthesis. No matter how he approached it, this is the one riddle that Trainer couldn’t solve.
Mendoza doesn’t mind. She smiles broadly as she talks to her family and friends. She laughs loudly as she plays with their young son on her lap. The child is not afraid of her.
This scene will be duplicated when she returns to Colombia. She’ll have glorious, tearful homecomings with family and friends. They’ll know what the child is oblivious to — Mendoza is whole again.
Throughout the two hours Mendoza waits for her flight, the only thing that calls any attention to her is the wheelchair Antonio brings to get her comfortably through the security checkpoint. But there are at least a half dozen other women sitting in similar chairs, all waiting just like Mendoza.
When the time comes to leave, there are hugs and tears — the same scene that plays out hundreds of times a day at the airport. Mendoza pulls her daughter in tight and tells her thank you.
She waves to the rest of her party. And with that, Antonio pushes the wheelchair into the crowd.
For the first time in nearly a decade, Amalia Mendoza blends in.
![[cold]](http://s.wsj.net/public/resources/images/NA-BD335_COLD_s_D_20100108184038.jpg)
Icicles hang from an orange tree after it was sprayed with water throughout the night in Plant City, Fla., earlier this week. The water was sprayed to protect the other plants in the nursery from cold weather in the state.
The Nation magazine headline was sensational: 
, exploded on screen during a must see 
, Bill Moyers, one of this nation's finest journalists, offers his lament for Jim Lehrer’s belief that “unless an official says something is so, it isn’t news.":