Johanna: Facing Forward
Dr. Michael Fritz gulped the first time he saw Johanna Orozco's smooth face looking up at him from the front page of the March 11 newspaper.
Johanna, wearing a tiara and silky pink dress, had become Cleveland's princess in distress overnight as her pictures flashed across television screens. Stories railed that the system failed her. That teen dating violence was often hidden.
That wasn't his concern.
She was so beautiful, Fritz thought.
The lower half of the high school senior's face was now a mangle of bluish oxygen-deprived tissue pocked with rounded metal pellets. Bone fragments poked from where Johanna's jaw once was. The roof of her mouth was suspended with wires from a bone below her eye.
It was Fritz's job to piece the puzzle together.
Fritz, a facial plastic surgeon, planned to rebuild Johanna's face using "spare parts" from around her body -- a sliver of leg bone here, a vein, some skin and cartilage there.
Like a carpenter, he started with the foundation. The rest would come later.
The 37-year-old is a trailblazer in his field, known for reconstructing faces without sacrificing cosmetics.
Put simply, Fritz is not satisfied with a face that only functions.
Chewing, squinting and mustering a strained smile are a start. But Fritz wants the face of each patient to reflect a range of emotions -- from a subtle smirk to a stern stare.
Fritz's easy smile belies his cutting humor.
He lives in an older Rocky River colonial a block from Lake Erie. He doesn't drive a flashy sports car or play golf. He's more likely to be found at home after a dozen hours of surgery bathing his three young kids.
Fritz is the only son who walked away from the family produce business, a world where bananas are caressed to ripeness and potatoes are piled taller than two men.
During a morning run near the lake shore, Fritz looked over the water and images of Johanna's face flipped through his mind.
How would he fill the void in her face?
Past surgeries jogged through his mind.
How had he repaired those faces? Would it work for her?
Fritz culled his knowledge, plucking the best ideas to develop his blueprint.
Most of Fritz's patients have cancer. He knows that despite his meticulous repair work, they could still die. Other patients had a hand in their own fates. Some botched suicide attempts, other were shot during drug deals.
Johanna would live with her face -- his work -- for a long time.
Fritz found himself caring deeply about her future.
Something was different about Johanna. He noticed right away, before he knew the volume of tragedies that preceded the shooting.
Fritz was drawn by her energy.
She straddled the worlds of giggling girl and ripening woman.
Other young patients sulk in bed, letting their families do the talking.
Not Johanna. She scribbled on a dry-erase board -- she couldn't speak -- hurling questions in script. She also joked with Fritz, and razzed him. He teased her back.
Fritz would try to examine her when she was in a sedated twilight sleep. Then he could poke and prod Johanna without making her feel uncomfortable.
The doctor was confident he could fix most of what Johanna lost. He would start in a few weeks, on April 3, by using part of her leg bone and a metal plate to remake her jaw.
But "fixed" in the mind of an attractive 18-year-old is a high standard.
Fritz talked honestly with Johanna. He wields a scalpel, not a magic wand. Every cut he makes leaves another scar.
But Fritz made Johanna a promise:
I'm not done with you until you are done with me.
He knew it could take years.
Every day, people told Johanna she was lucky, that it wasn't her time to go or that God kept her here for something special. She liked to think two angels she called Mom and Daddy looked out for her that day in the driveway.
It seemed, at the very least, some force worked in her favor.
Juan had loaded several different types of ammunition into the shotgun.
Birdshot. Buckshot. Deer slug.
The peppercorn-size birdshot came out first, ripping into Johanna.
It didn't kill her.
But it was close.
One of the pellets skidded to a stop near her spinal cord. Another was millimeters from her optic nerve.The other slugs -- all of which packed more powerful blasts -- would have likely killed her instantly.
Johanna didn't feel lucky.
She was missing the best part of her senior year. Getting measured for a cap and gown. Flip-flopping on what hairstyle to parade at the prom. Signing yearbooks and posing for pictures with friends.
Instead, Johanna was stuck in a stuffy hospital room. She wore unflattering hospital gowns. She couldn't shower or wash her hair. The last thing she wanted to do was mug for pictures. She couldn't even feel her mouth.
Johanna spent her days jonesing for a tall, cool glass of water, or a slice of pizza oozing with cheese. Eating, her favorite pastime aside from dancing, was still weeks away.
In a journal, Johanna wrote she was staying strong for her family and friends. But she also was frustrated.
"I'm not going to lie," she jotted. "It sucks being in the hospital. . . . It's hard to know that most of your face is missing."
Not much longer than two weeks after she was shot, Johanna's room was already party central. More than a half-dozen teenagers lounged on chairs, tables and her hospital bed.
As they arrived, she hopped up to hug each one, her arms loosely encircling them, careful to protect the football-helmet-like bar fused to her face.
Stuffed animals and get-well cards were propped on a small table and a Lincoln-West Drama Club shirt hung in the window, scrawled with messages: "We love you Jojo."
She still wrote to her visitors, nurses and family on a dry-erase board the size of a medium pizza box.
At first, Johanna's writing was as wobbly as a first-grader's. She would write one letter on top of another, frustrated when people couldn't make out her words. Hardly the penmanship that was her father's pride.
By now her hand was flying across the board, leaving smears of bluish-purple ink on the meat of her palm.
"I really thank you guys for being here," she wrote to the crowd. "You guys mean so much to me."
Johanna motioned to her visitors to turn around. She used a hollow plastic tube to suck up the spit that pooled in her mouth, sometimes spilling over her numb bottom lip onto her gown.
"Sorry guys, this is nasty," she wrote. A nurse poked her head in to ask Johanna if she was tired. Johanna waved her away.
"Hey guys, look alive," she wrote, trying to joke with her friends as she used to, before looking at her made them uncomfortable. Her shoulders shook and her eyes blinked as she chuckled silently. Johanna's tongue, which she couldn't quite control yet, slid from the corner of her mouth.
"I'm still the same old happy Johanna here," she wrote. "Just in bed."
When Johanna got bored, during the long days she was confined, she often used the tan push-button phone in her room to tease her Aunt Hilda.
Hilda would answer her phone, as she worked cleaning houses, only to hear multitoned beeps.
Hello, Hilda would repeat. Who is this?
The wheezing sound of Johanna snickering through the air tube in her neck gave her away.
Hilda saw Johanna accept her reality in waves.
When Johanna first regained feeling on the tip of her tongue, she moved its wiggly tip around the inside of her mouth.
Teeth? Johanna wrote to her.
There's nothing that can't be fixed, Hilda responded that time and every time Johanna discovered a new defect.
She knew it would all hit her niece at some point.
While Johanna's face was nearly untouched above the crest of her nose, below it crusty red rivers snaked, bridged by stitches. The left corner of her lips curled inward, threatening to create a sneer where a smile belonged. Her left nostril looked melted.
Hilda, the mother of two girls and two boys, found it hard not to cry when she looked at her niece. That's how Hilda's emotions worked -- tears or punches. She came to Cleveland at age 13, not knowing the language. Kids she thought were friends actually laughed at her for her thrift-store styles. She was just glad to have more than one pair of shoes.
But they underestimated the power in her tiny 4-foot-11 frame.
Hilda fought her way through high school before dropping out in the 11th grade when she got pregnant. Though she took a bumpy road relationship-wise, Hilda had an inner compass that put family first. When Johanna's father died, Hilda stayed in Tennessee for a month caring for his kids before they returned to Cleveland. Her own kids felt ignored.
But she explained to them: It was the right thing to do.
In the hospital, Hilda fingered the gold-cross chain her brother had worn. Johanna had taken it from around her own neck and given it to Hilda, for strength.
Johanna's grandfather, Wosbely, visited her hospital room but only in short stints. He couldn't talk about the shooting, referring to it only as "that day" and "when this thing happened."
Johanna's grandmother, Juanita, walked the mile or so of uneven sidewalks to get there each morning, even in a cold drizzle. As others visited, she worked word puzzles in the waiting room.
But mostly, she kept vigil at Johanna's bedside.
"My baby, my baby," she murmured, stroking Johanna's arm or leg as she drifted into another nap.
Juanita stayed close as Johanna slept. Soon Johanna started to whimper. Something was invading her sleep.
From under a SpongeBob blanket, Johanna pushed downward. She was shoving something away, her arms flailed.
She moaned fitfully, her eyes shifting under their lids.
As she wrested herself awake, her grandmother was there to tell her:
"Todo va estar bien, Esté tranquilo." . . . "It's OK, Mami. Stay calm."