‘The blown-up guy’ rebounds

SAN ANTONIO – His first glimpse in the mirror was largely a blur.

Sgt. Darron Mikeworth had just come out of a drug-induced coma – his mind was still in a fog and he was so weak he could barely stand.

Three weeks before, in Iraq, a suicide bomber had raced up to the right side of his Humvee, igniting a barrel of explosives that tore into the machine gunner’s face. He nearly died.

Mikeworth awoke in a hospital bed, thousands of miles away.

He was relieved he still had his arms and legs. He was thrilled, too, his ears had survived. But he had wounds he could not see, life-changing wounds. His wife, Dea, helped break the news: His face was in bad shape. His left eye was useless.

And there was more.

At first, Mikeworth was too groggy to absorb it all. He was caught up in hallucinations of basketball players in the hospital, of cars on the highway floating in air. He didn’t know what was fantasy and what wasn’t – until he shuffled into the physical therapy room and stood before a full-length mirror.

“I just had to keep telling myself I’m NOT going to wake up out of this one,” he said. “THIS is not a dream. THIS is real.”

His head was one giant purple bruise, his eyelids were nearly swollen shut. His left eye had been removed. His eyelashes were singed off. His nose was mostly gone, just a sliver of cartilage remaining; skeletal-like bones revealed his sinuses. His top right lip was curled into a snarl, making it impossible to close his mouth. His right jaw was torn. His bottom teeth, loosened by the blast, were wired together.

His face – every bone had been shattered – was splattered with pinkish third-degree burns.

“I could have just flipped out,” he said. “But I looked in the mirror and said, all right, there’s no changing it. I just have to deal with it. This is me now.”

Darron Mikeworth’s face was his identity. So, too, was his life as a soldier.

He was about to embark on a long journey to regain both.

Changed forever

Sgt. Mikeworth, the warrior, will tell you he is the same man he was Before The Bomb.

The 32-year-old soldier who served two stints in Iraq (and two more in Kosovo and the Sinai) still wants to take down the bad guys, still thrives on being a cog in the big Army machine.

But Sgt. Mikeworth, the survivor, also knows that no matter how much he heals, he’ll forever be defined, in some way, by what happened near Baghdad on April 29, 2005.

“I’m going to be ‘the blown-up guy’ wherever I go,” he said. “Anytime I walk into a room, I just know I’m going to be different-looking and I’m going to be perceived differently.”

Mikeworth knew his wounds were so extensive there was no way doctors could turn back the clock. But he refused then – and now – to dwell on his losses.

“I have no reason to feel sorry for myself. I could be in a box underground somewhere,” he said. “Every day above ground is a GOOD day.”

But he needed to become himself again, so that he at least would recognize the face in the mirror and so that the people he encountered would see him as a man, not as a victim.

That’s where Operation Mend came in.

A one-of-kind partnership between the UCLA Medical Center and Brooke Army Medical Center – the military’s main hospital for burn patients – the program provides reconstructive surgery to members of the military who’ve been severely disfigured in Iraq and Afghanistan. So far, 24 men and women have been treated.

Mikeworth’s road to recovery has been part medical marvel, part profile in courage – the stalwart soldier who rebuilds his confidence as doctors rebuild his face.

All along, as UCLA surgeons have tucked and trimmed, adding a bit of cartilage here, a flap of skin there, Mikeworth has yearned to return to the simple routines in life, dreaming of the day when he could:

Pick up his two sons without worrying he’d scare their classmates.

Walk around the mall without turning heads.

Be a face, not THE face, in the crowd.

Believe it or not

Dea knew instantly what would bother Darron most: Half his vision was gone. His features were mangled. People would stare.

She knew, too, how hard that would be for her husband, an introvert who preferred the sidelines to the spotlight.

“I used to like to be able to stand in the back of the crowd and not be noticed,” he explained. “I like to be anonymous.”

Suddenly, he was the center of attention, and often not in a good way.

Weeks after his release, Mikeworth and his family visited Ripley’s Believe It or Not museum. His legs were bandaged, his burned hands in gloves. He wore sunglasses, his nose was just a pair of slits.

As he stood, motionless, a young woman apparently thought he was a wax exhibit. When he moved, she was startled. Figuring he was an actor, she blurted: “What are you supposed to be?”’

“I just looked at her and said, ‘I’m a blown-up soldier.’ ”

Mikeworth was understanding, even empathetic.

“I was pretty gruesome in the beginning,” he said. “I looked like I came out of some Halloween horror movie. I know that. Sometimes if I was having a bad day, I’d get mad at the situation I found myself in, but I would never get angry at the people.”

But his appearance didn’t faze his sons, Ryan, 7, and Connor, 6.

They brought laughter into the home when they returned from a two-month stay with Dea’s parents in Illinois.

When Mikeworth had to wear round plastic devices called nasal trumpets – they act like fake nostrils – the boys dubbed it his Pig Nose.

When he got a latex wider-than-normal prosthetic nose attached with glue, they dubbed it his Big Nose. One day the glue wore away and the nose fell off while Mikeworth was napping. Their cat, Anastasia, snatched it, with Connor, Ryan and Dea in hot pursuit.

Those funny moments, though, were just a temporary distraction.

“When you’re without a nose, with burns on your skin, without an eye, it’s a hard thing to swallow,” said Lisa Gustafson, his former case manager and Operation Mend coordinator at Brooke. “You don’t know if you have a future, if you have a paycheck. That’s pretty scary.”

Rebuilding a face

At Brooke, Mikeworth endured about 16 surgeries, many on the lower right arm that he almost lost in the blast.

He had skin and bone grafts and titanium pins inserted around his eyes and cheekbones.

Within three months, he had asked to return to his unit, the 603rd Transportation Co., even though he could barely walk. “I think that was kind of denial,” Dea said. “He wanted to be a regular soldier again.”

The Army later recommended he retire – he’s classified as having an 80 percent disability – but Mikeworth was insistent. His attitude, Gustafson said, was “I’m staying in the military with or without a nose, with or without an eye.”

But reconstructive facial surgery at Brooke proved to be slow going.

Gustafson tried to boost his spirits with daily phone calls. “You are a soldier,” she’d tell him. “You are NOT going to give up.”

In fall 2007, Gustafson heard about a pilot program at UCLA called Operation Mend. Mikeworth flew to California to be evaluated. “They said they were going to fix me up,” he said. “It was a golden opportunity and I knew it.”

Starting in January 2008, doctors began operating about once a month.

For his nose, they used a small piece of cartilage grafted from his ear, then tucked it under a flap of skin on the right side of his forehead above his eyebrow. They stored it there for about four weeks.

Doctors partially elevated the flap before pivoting it clockwise down to his nose. It remained attached so it looked like an elephant trunk for a time while they made sure there was proper blood flow. Then they shaped and thinned it.

The lower left side of his nose that had been worked on at Brooke was a bulbous mass (Mikeworth’s boys dubbed it his Bubble Gum Nose). Surgeons removed thick cartilage that made it hard to breathe, inserted new cartilage and thinned it out.

For his left eye, they created a new lower dam-like eyelid (he lost his in the blast), using forehead skin and a piece of tissue from the roof of Mikeworth’s mouth. It’s strong enough to hold a prosthetic eye, which will come later.

“It’s amazing what they can do,” Mikeworth said. “They just take parts of you from everywhere and rearrange them.”

Each time Mikeworth returned from a major surgery, friends noticed progress. “I was seeing it, too … ,” he said, “and smiling about it the whole time.”

A ‘pretty good feeling’

Sgt. Mikeworth hopes to join an Army unit by summer.

He’s on medical hold while he looks for a suitable slot. He’s thinking about military intelligence or becoming an instructor.

“I don’t want to be put on a shelf or a back burner, or left in a corner anywhere,” he said.

Dea is elated to see Darron’s transformation. He goes on errands alone and last year attended a parent-teacher conference – an unimaginable thought not long ago.

“I used to be afraid to go pick up the kids at the bus stop because I was afraid I looked like a monster,” he said. “Now I pop on my sunglasses and just walk down the street and unless somebody walks up and gets into my face and starts talking to me, they have no clue.

“It is,” he said, “a pretty good feeling.”