SOUL 58 PSYCHE AND

WITH THE THREE VOLUMES OF CLEFT CRAFT HAVE BEEN INVOLVED AND DETAILED DE BASIC SCIENCE SURGICAL PRINCIPLES CRAFTSMANSHIP AND DEVOTED TO THE VELOPED THROUGH CENTURIES OF EXPERIENCE

WITH CLEFT INTO THE IDEAL NORMAL TRANSFORMATION OF PATIENT AND SOUL AFTER ALL THIS WHAT ABOUT EACH PSYCHE

INDIVIDUAL REACTION TO DEFORMITY

LIFE ITSELF HOW WE ARE GOING TO REACT TO DEFORMITY OR EVEN TO

IN THE INFLUENCE OF MAY ALREADY BE DETERMINED OUR GENES DESPITE FACTORS AS STRAITH AND WROTE IN 1951 SPECIFIC ENVIRONMENTAL

CHILDREN BORN IN DIFFERENT FAMILIES BUT BOTH WITH HARELIP LET US COMPARE TWO 18 MONTHS OF THE MOTHER OF AND CLEFT PALATE AND BOTH APPROXIMATELY AGE FOR TREATMENT AT THE OF UNC BROUGHT HER TINY DAUGHTER IN SURGICAL AGE YEARS SHE HAD FOUND THE LITTLE IN FRONT OF THE SHE REPORTED THAT SEVERAL TIMES GIRL HER UNUNIRED IN AN MIRROR WITH HER FINGERS PUSHING THE EDGES OF LIP TOGETHER HER THEM STICK THIS CHILD WAS NOT ONLY AWARE OF DEFORMITY ATTEMPT TO MAKE ABOUT IT IT COULD BE BUT SHE WAS TRYING RO DO SOMETHING CONSTRUCTIVE HAD BEEN COMPLETED THIS CHILD PREDICTED THAT AS SOON AS ADEQUATE SURGERY

WOULD CONTINUE TO MAKE HER ADJUSTMENTS QUITE NORMALLY IN THE BACK OF THE THE OTHER CHILD WAS LITTLE BOY WHOWAS KEPT HIDDEN OF HE WOULD THE BEDCLURHCS AND HOUSE UPON THE APPROACH STRANGER GRAB IN HIS FACE ONE INTO THE FRIGHTENED HOLD THEM UP OVER THE CLEFT GLANCE

THE BEDCLOTHES REVEALED THAT THIS NEGLECTED LITTLE PATHETIC EYES PEEKING OVER AND MERE CLOSURE MIGHT NOT FELLOW WAS FAILING IN HIS ADAPTATION SUIGICAL INFLICTED THUS THE BEST CHANCE COMPLETELY HEAL THE PSYCHIC TRAUMA ALREADY WOULD SEEM TO BE SURGICAL TO AVOID UNDESIRABLE PERSONALITY CHANGES COMPLETE

CORRECTION OF THE DEFORMITY AT THE EARLIEST DATE FEASIBLE

1041 IT HAS BEEN POINTED OUT BY MEYER THAT

THE SOCIAL AND INTRAFAMILIAL ASPECTS OF DISFIGUREMENT THE CULTURAL MILIEU

ABHORRENCE OF DEFORMITY AND REACTIONS FROM AND FAMILY PEERS SCAPE GOATING ARE AT LEAST AS OF SENSE OF PRODUCTIVE DEFORMITY AND DEVIANCY AS

THE INDIVIDUALS OWN REACTION TO HIS DEFECT

IN 1978 LYNN REICHMAN OF THE UNIVERSITY OF IOWA NOTED

TEACHERS RATE THE INTELLECTUAL ABILITY OF CLEFT CHILDTEN WITH MORE NOTICEABLE

FACIAL LESS DISFIGUREMENT ACCURATELY THAN CLEFT CHILDREN WITH RELATIVELY NORMAL FACIAL WITHIN THE APPEARANCE GROUP OF CLEFT CHILDREN WITH MORE NOTICEABLE FACIAL TEACHEIS DISFIGUREMENT UNDERESTIMATED THE ABILITY OF BRIGHTER CHILDREN AND OVERESTIMATED THE ABILITY OF LESS BRIGHT CHILDREN

IT IS INTERESTING HOW SIMILAR DEFORMITIES CAN INVOKE SUCH VARIED REACTION BEETHOVENS PATTERNS POCKMARKED COUNTENANCE PROBABLY WAS FOR GREATLY RESPONSIBLE HIS SEEKING REFUGE IN SOLITUDE TO

MINUET RATHER THAN HIS COMPOSE SPENDING ENERGY AT SOCIAL SOMEONE ELSES DANCING MINUET IN CONTRAST GEORGE BERNARD

SHAW WHO ALSO HAD SCARS FROM ALLEGEDLY SMALLPOX MERELY PTO DUCED HUGE GROWTH OF BEARD TO COVER THEM AND SCOFFED AT THE WORLD LOUIS XIV DECREED NEW FASHION IN FOOTWEAR TO MAKE HIS

FEET UNGAINLY LESS OBVIOUS JIMMY DURANTE WITH THE FRONT BRIM

OF HIS HAT TUINED UP SEATED AT THE PIANO BANGING OUT MY NOSES BIRTHDAY TURNED HIS HEAD FROM SIDE SIDE TO PRESENT HIS HUGE NOSE IN YET DE PROFILE CRANO BERGERAC POINTS UNHAPPILY AT HIS

TELL ME WHAT OF WHAT HOPE GLORY HOPE OF ANY KIND THIS PROTUBERANCE OF MINE COULD EVER LEAVE ME

WILLIAM REVEALED SHAKESPEARE AN ACUTE SENSITIVITY TO THE BUR DEN OF CLEFT WHEN HE WROTE

SO SHALL ALL THE COUPLES THREE EVER TRUE IN LOVING BE

AND THE BLOTS OF NATURES HAND

SHALL NOT IN THEIR ISSUE STAND NEVER MOLE HARELIP NOT SCAR

NOR MAIL PRODIGIOUS SUCH AS ARE

DESPISED IN NATIVITY

1042 CRIME

THAT DEFECTS CAN BE IT HAS BEEN STANDING ASSUMPTION PHYSICAL WITH FACTOR IN ANTISOCIAL BEHAVIOR AS WROTE STRONG CONTRIBUTING

STRAITH IN 1951

CALLED CHILD HAS NOT NOTICED HIMSELF OR HAS NOT BEEN TO ANY DEFORMITY THAT WILL BE TO IN SCHOOL HIS ATTENTION BY SIBLINGS CERTAINLY BROUGHT LIGHT THE AND WITH NO TO CONCEAL CHILDREN ARE QUICK TO OBSERVE UNUSUAL ATTEMPT

REFRAIN FROM RIDICULE WILL BE FRANK IN THEIR DISCUSSIONS CURIOSITY OR TO THEY SHUN DEFORMED OR THEY DUB HIM AND OPINIONS THEY TEND TO PLAYMATE THE DEFORMED CHILD HAS THE WITH NICKNAME WHICH REFLECTS HIS DEFECT

FOR BY OTHER CHILDREN MENTAL AND PHYSICAL FACULTY SELFEXPRESSION POSSESSED RESTRAINED OTHERS OR AVOIDS THE BUT BECAUSE OF HIS DCFORMITY HE IS EITHER BY

FOR SUCH THE HANDICAPPED CHILD PERSONAL CONTACTS NECESSARY EXPRESSION CHILDREN AND CRAVES MANY TIMES THESE FEELING INFERIOR ALONE POPULARITY ONE IN ORDER TO OBTAIN TO ATTRACT FRIENDS BOY RESORT TO PETTY PILFERING MONEY STOLE TO BUY CANDY TO GIVE TO WITH FACIAL BURNS NICKNAMED SCARFACE MONEY WOULD NO BE AFRAID TO HOLD HIS HAND IN GAMES HIS PLAYMATES SO THEY LONGER THE HANDSOME AND THE BEAUTIFUL CHILDHOOD FAIRY STORIES POSE PRINCE COMIC BOOKS THIS THEME WITH PRINCESS AGAINST THE UGLY WITCH REPEAT

CHARACTERS AS AND DETECTIVE TRACY AGAINST SUCH FUNNYLOOKING FLATTOP

WHITEHAT HEROES AGAINST BLACKMUSTACHED EYES MOVIES PORTRAY WESTERN OF THERE IS NOT ONLY THE VILLAINS THUS THROUGH THE EARLY YEARS DEVELOPMENT AND OF WITH EVIL CONSTANT IDENTIFICATION OF BEAUTY WITH GOODNESS UGLINESS BEAUTIFUL SELF WITH THE AND THE BUT THERE IS ALSO THE ATTEMPT TO IDENTIFY GOOD OF DEFORMED CHILD WHEN HE REALIZES BUT THERE COMES TIME IN THE LIFE EVERY

HIS IDEAL HERO HE IS REMINDED OF THIS OVET THAT HE CANNOT TAKE THE PART OF FROM FRIENDS AND SECOND FROM AND OVER BY THOUGHTLESS REMARKS GLANCES CHILD BECOME DELIN IT IS TO SEE HOW HANDICAPPED MIGHT STIANGERS EASY DRIVEN INTO CRIME REAR ADMIRAL QUENT AND IF MERELY PUNISHED OF WHO WAS EVANS OF THE BRITISH NAVY TELLS THE STORY BOY HE WAS TAUNTED AND RIDICULED BECAUSE OF HIS UGLY PROTRUDING TEETH GIVEN

HE TURNED NOT ONLY THOSE THE NICKNAME BARRACUDA GRADUALLY AGAINST AND UNDER HIS WHO RIDICULED HIM BUT AGAINST ALL SOCIETY GATHERED TOGETHER AND RUTHLESS BUCCA COMMANDTHE SCARLET FLEER HE BECAME THE MOST FEARED

WHO HAD AT HIM AS CHILD AT NEER ON THE SEAS AND MANY OF THOSE LAUGHED DEATH DO THE CRUELTIES OF YOUTH SCHOOL WALKED THE PLANK TO THEIR THUS

MAKE ROGUES

WITH CHARACTERS WHOSE ANTISOCIAL BE THE LITERATURE IS REPLETE SOME DEFECT LEWIN HAVIOR IS DETERMINED IN LARGE PART BY PHYSICAL

1043 NOTED TWO EXAMPLES VICTOR HUGOS QUASIMODO THE HUNCHBACK

OF NOTRE DAME IS ACUTELY AWARE OF HIS OWNUGLINESS AND SEEMS TO

BE PROPELLED BY HIS HATRED OF HIMSELF AND REPUGNANCE OF HIS OWN

IMAGE INTO THE PROTECTION OF BEAUTY SHAKESPEARES RICHARD III IS

VILLAINOUS CHARACTER WHOSE AWARENESS OF HIS PHYSICAL DEFECTS

PRESENTS AN INSURMOUNTABLE OBSTACLE TO NORMAL SOCIAL INTERCOURSE

AS IT BECOMES THE MOTIVATING FACTOR IN HIS LIFE

IN HIS BOOK THIS GUNFOR HIRE GRAHAM GREENES PROTAGONIST

RAVEN IS POSTOPERATIVE CLEFT LIP WHO JUSTIFIES HIS LIFE OF CRIME AS

RETALIATION AGAINST SOCIETY FOR ITS CRUELTIES TO HIM

MURDER DIDNT MUCH MEAN TO RAVEN IT WAS JUST NEW JOB THE COLD WIND HIS FACE IN CUT THE WIDE CONTINENTAL STREET IT WAS GOOD EXCUSE FOR THE COLLAR OF TURNING HIS COAT WELL UP ABOVE HIS MOUTH HARELIP WAS SERIOUS IN HIS EJ HANDICAP PROFESSION JR HAD BEEN BADLY SEWN IN INFANCY SO THAT NOWTHE WAS TWISTED AND SCARRED UPPER LIP WHEN YOU CARRIED ABOUT YOU SO AN COULDNT EASY IDENTIFICATION YOU HELP BECOMING RUTHLESS IN YOUR METHODS IT HAD FROM THE RR ALWAYS START BEEN NECESSARY FOR RAVEN TO ELIMINATE THE EVIDENCE

PLASTIC HAS BEEN USED IN SURGERY AN ATTEMPT TO REHABILITATE

ADULT PENITENTIARY INMATES THE RESULTS HAVE BEEN EQUIVOCAL IN AND 1966 SPIRA CHIZEN GEROW HARDY INDICATED THAT 17 PERCENT OF THE INMATES RELEASED FROM TEXAS PRISON AFTER LECEIVING PLASTIC

SURGERY WERE RETURNED DURING FIVE YEAR FOLLOWUP PERIOD WHEREAS THE RECIDIVISM RATE AMONG THAT GENERAL PRISON POPULATION

WAS 316 PERCENT IN 1967 VELASCO WOOLFAND BROADBENT REPORTED

213 AND 30 RECIDIVISM IN PERCENT PERCENT RATES INMATES RECEIVING AND NOT RECEIVING PLASTIC SURGERY RESPECTIVELY YET ALSO IN 1967 AND SCHURING DODGE REPORTED NO SIGNIFICANT DIFFERENCE BETWEEN INMATES RECEIVING PLASTIC SURGERY AND NONOPERATED CONTROLS 48 RECIDIVISM PERCENT RATE FOR BOTH AS EARLY AS 1948 PICK NOTED

WHERE CRIMINALITY HAS BECOME AN ESTABLISHED HABIT ESISRANT TO REHABIL

IN OF ADULT ITATION IMPROVEMENT APPEARANCE AN INCORRIGIBLE MAY CHANGE THE STANDARD OF HIS CRIMINAL PRACTICES UPON RELEASE FROM THAT OF COMMON THIEF

TO THAT OF OF ORDEI IT SPECIALIST HIGHER IS THEREFORE FELT THAT WHERE BODILY DEFECTS OR GROSS FEATURES EXIST IN THE YOUTHFUL DELINC SUCH DEFECTS SHOULD BE CORRECTED AND THEIR TRIGGER VALUE REMOVED BEFORE THE BOY DELIN QUENT BECOMES THE MAN CRIMINAL

1044 BE MORE EFFECTIVE IN IT WAS THOUGHT THAT PLASTIC SURGERY MIGHT ADOLESCENTS THE REHABILITATION OF DEFORMED DELINQUENT KNORR

1LOOPES AND EDGERTON IN 1968 REPORTED

ARE MORE INTO THE PHYSICAL CHANGES VIA COSMETIC SURGERY EASILY INTEGRATED ADOLCSCCNR BODY IMAGE PERCEPT BY THE

STUDIED 21 DE IN 1973 MEYER HOOPES JABALEY AND ALLEN

FORMED ADOLESCENT DELINQUENTS 14 OF WHOM HAD PLASTIC SURGERY WERE ONE OF THESE HAD SECONDARY CLEFT LIP DEFORMITY UNOP ERATED THEY DETERMINED

THOSE WHO THERE WERE NO REMARKABLE BEHAVIORAL DIFFERENCES BETWEEN PATIENTS

THOSE WHODID NOT INTERVENTION AS AN ADDED FACTOR HAD SURGERY AND SURGICAL THAN WAS FELT TO BE NO MORE EFFECTIVE IN ACHIEVING POSITIVE CHANGE PSYCHO

ALONE LOGICAL OR SOCIAL INTERVENTION

IT WAS SUGGESTED

BE FIXED IN THEIR IMAGE CONCEPTS SO ADOLESCENTS MAY ALREADY RELATIVELY BODY

IS INEFFECTIVE IN THAT SURGICAL INTERVENTION ACCELERATING PROGRESS

IN WHICH YET THERE ARE MANY ENCOURAGING EXAMPLES SURGICAL DEFECTS THAT WERE CORRECTION OF MAJOR OR MINOR COSMETIC TRIGGER REACTIONS AND THE INDIVIDUAL ING CHANGE OF PSYCHOLOGICAL LEADING

INTO CHRONIC CONFLICT WITH SOCIETY SUDDENLY ENABLED HIM TO COPE

LIFE SUCCESSFULLY WITH HIS

MICHAEL LEWIN WROTE ME IN 1972

MAN MY OWN ATTENTION WAS DRAWN TO THIS PROBLEM YEARS AGO BY YOUNG CLEFT AND WHO SHOT HIS WITH AN INADEQUATELY REPAITED BILATERAL LIP PALATE

HIS CLEFT THIS LATE WAS FRIEND FOR TAUNTING HIM ABOUT PALATE SPEECH REENAGER FOR MURDER HE WAS REHABILITATED IN THREE OR FOUR SENTENCED TO SINGSING

WHILE IN HE HAD BONE GRAFT REVISION OF THE LIP AND OPERATIONS PRISON

IN CONTACT WITH HIM FOR OVER HE IS PHARYNGEAL FLAP HAVE BEEN TWENTY YEARS OF SOLID CITIZEN GOOD FAMILY MAN PILLAR SOCIETY

THESE SELECTED AND COM IT IS IMPORTANT THAT LITERARY EXCERPTS FICTION HAS OCCASION STATISTICS DO NOT MISLEAD ALTHOUGH PARATIVE CRIMINAL CLEFT AND DEFORMITY WITH PERSON ALLY COUPLED LIP PALATE CLEFT INDIVIDUALS FACT REMAINS THAT THERE ARE VERY FEW ALITY THE WHO HAVE BECOME INVOLVED IN CRIMINAL ACTIVITY

1045 SUICIDE

MEDICAL AND THAT OPINION TEACHING SUGGEST SEVERE FACIAL DEFORMITY RENDERS AN INDIVIDUAL LIABLE TO DEPRESSION DESPONDENCY ANGER

RESENTMENT FRUSTRATION HOPELESSNESS AND POSSIBLY SELFDESTRUCTION AS RECENT STATISTICS SUICIDE SHOW IS TWELFTH IN FREQUENCY AMONG THE CAUSES OF DEATH IN THE UNITED STATES OLDER AMONG TEENAGERS AND ADULTS IT RANKS FOURTH NUMEROUS CLEFT YOUNG LIP AND PALATE BE PATIENTS MIGHT EXPECTED TO APPEAR IN THESE STATISTICS IN 1973

JACK OF AFTER BERGER CHICAGO HAVING SEARCHED THE LITERATURE FOUND DISCREPANCY HE REPORTED ONLY TWO CASES IN WHICH

CLEFT OR COULD CONGENITAL LIP PALATE BE CONSIDERED PRIMARY CAUSE OF SUICIDE ATTCMPT

38YEAR OLD MALE HAD BEEN BORN WITH BILATERAL CLEFT LIP AND PALATE THE HAD BEEN LIP REPAIRED ON TWO OCCASIONS WITH UNSATISFACTORY RESULTS THE HAD PALATE NEVER BEEN HE LIVED SECLUDED LIFE OPERATED AS JANITOR LIVING IN SMALL BASEMENT APARTMENT WITH HIS MOTHER WHEN HIS MOTHER BECAME

SERIOUSLY ILL HE BECAME THREATENED THAT HE WOULD LOSE HER SUPPORT WHICH CAUSED HIM TO SUICIDE WITH ATTEMPT SHOTGUN PLACED UNDER HIS CHIN HAVING CHOSEN THIS METHOD OF SUICIDE THE PATIENT ACCOMPLISHED ABLATION OF THAT DEFORMED OF PART HIS BODY WHICH HE MUST HAVE HATED ALL HIS LIFE THE PRESENT DEFORMITY WHICH WAS NO BY MEANS AN IMPROVEMENT OVET HIS PREVIOUS DEFORMITY AT LEAST COULD BE THE RESULT EXPLAINED AS OF AN ACCIDENT NOT AS DEFECT OR WITH WHICH HE BORN DEFICIENCY WAS ONCE HEALING WAS COMPLETE HE BEGAN TO ESTABLISH SOME SOCIAL CONTACTS

19 OLD CAUCASIAN FEMALE YEAR WAS BORN WITH PIETRE ROBIN SYNDROME WITH POSTERIOR HAID AND SOFT PALATE CLEFT AND MICROGENIA SHE HAD CLOSURE OF

THE VELUM AT AND YEATS WAS FITTED WITH DENTAL PROSTHESIS FOR THE RESIDUAL

HOLE IN THE HARD PALATE HER SPEECH DEVELOPED SLOWLY AND POOLLY HER FATHER WENT TO TO HER ORTHODONTIC GREAT EXPENSE GET AND SPEECH THERAPY AND SHOWED AT HER THE ANGER POOR PROGRESS CHILD SENSING REJECTION DEVELOPED DEFENSE CHATTERBOX AND BY BECOMING THE FASTER SHE TALKED THE LESS INTELLI

GIBLE SHE BECAME HER ROOMMATESTUNED HER OUT AND FORCED HER ISOLATION

BUT SHE GRADUATED FROM SCHOOL AND ENTERED HIGH COLLEGE HERE HER ATTEMPTS TO BELONG BY EXCESSIVE WERE UNSUCCESSFUL TALKING SHE WAS IGNORCD BY IICI CLASSMATES BECAME FAILED IN HER DEPRESSED GRADES AND FINALLY ATTEMPTED SUICIDE BY HER WRISTS SHE SLASHING WAS HOSPITALIZED ON PSYCHIATRIC SERVICE WHERE SHE UNDERSTAND BEGAN TO WHAT SHE HAD BEEN DOING TO CAUSE UNSATIS RELATIONS WITH FACTORY AND THE IMPROVEMENT OF HER SPEECH WITH NEW AID AND THERAPY SHE REENTERED AND CHOSE COLLEGE VERY SUITABLE FIELD SOCIAL SERVICE

1046 THAT IN BOTH OF THESE SUICIDE ATTEMPTS IT IS IMPORTANT TO NOTE HAD BEEN AND THE RESULTS UNSAT THE CORRECTIVE SURGERY INADEQUATE

ISFACTORY OF IN 1976 ARVEZ URIEL AND VILARSANCHO MADRID

CLEFT AND SPAIN STUDIED 90 POSTOPERATIVE LIP PALATE PATIENTS AND 25 WHEN NONADAPTATION AND BETWEEN THE AGES OF YEARS MANIFESTED CONCLUDED FRUSTRATION ARE MOST INTENSELY THEY

THAT THE AXIS OF SCHIZOPHRENIA OCCUPIES HIGHER PLACE IT IS WORTHY OF NOTE IN SECOND PLACE IN THE BOTH IN MALES AND FEMALES DEPRESSION APPEARS IN THE FEMALES IT THIRD WITH PARANOIA CASE OF MALES WHILE FOR OCCUPIES PLACE INTROVERSION WAS IN THE FEMALES HUT SECOND PLACE ALSO SOCIAL CONSPICUOUS

NOT IN THE MALES OF THE GOODAESTHETIC RESULTS IN THE MALES FAVOURED DECREASE PATHOLOGICAL

THIS DID NOT OCCUR IN THE FEMALES SYMPTOMS HOWEVER

SUCCESS STORIES

ANTISOCIAL CLEFT AND PATIENTS ARE NOT MOST POSTOPERATIVE LIP PALATE SUICIDE TO THEIR AND HAVE NO INTCREST IN CRIME OR THEY ADAPT AND ORTHODONTIC ENVIRONMENT AND DEPENDING ON THEIR SURGICAL

LESS WITH THEMSELVES RESULTS ARE MORE OR HAPPY CROCKER AND BARBARA IN 1972 EDWARD CLIFFORD WITH ELEANOR MADE STUDIES OF 98 CLEFT POPE OF DUKE UNIVERSITY PSYCHOLOGICAL PICKRELL 22 TREATED SURGICALLY BY KENNETH LIP AND PALATE PATIENTS AND 78 HAD RECEIVED NO SPEECH THERAPY TO 27 YEARS BEFORE PERCENT ORTHODONTIA IN GENCRAL THEY PRESENTED RELATIVELY 65 PERCENT NO WITH 77 OF THE MARRIED THESE HIGH SELFSATISFACTION SCORES GROUP GOODSTEINS STATEMENT FINDINGS SUPPORTED

IS THAT THE ADULT WITH CLEFT INFORMAL OBSERVATIONAL IMPRESSION TYPICAL

MARRIED EMPLOYED AND GENERALLY USEFUL CON PALATE IS HAPPILY GAINFULLY

TRIBUTING MEMHER OF SOCIETY

CLIFFORD DID REVEAL MORE DETAILED INVESTIGATION BY

OVERALL SATISFACTION SCORES WHEN VARIOUS ITEMS DESPITE THESE RELATIVELY HIGH RANKED TO MEAN SATISFACTION OF THE BODYSATISFACTION SCALE WERE ACCORDING

WITH CLEFTS RATED RELATIVELY LOW FOR EXAMPLE LEVELS THE BODY ITEMS ASSOCIATED FOLLOWED BY THE ITEM WITH THE LOWEST SATISFACTION LEVEL WAS TEETH CLOSELY ORDER OF SATISFACTION AND LIPS FOLLOWED IN ASCENDING SPEECH TAKING NORE

1047 ALMOST NONE OF THESE ITEMS APPEAR AT SUCH RELATIVELY LOW LEVELS OF SATISFAC TION IN NORMAL ADOLESCENT POPULATION

ALSO IN 1972 PICKRELL CLIFFORD QUINN AND MASSENGILL RE THIS OF VIEWING SAME GROUP 100 CLEFT PATIENTS OPERATED ON OVER 20 FOUND YEARS BEFORE INTERESTING SCHOLASTIC ACHIEVEMENT

DID THOUGH 15 NOT GO BEYOND THE 9TH GRADE AN ADDITIONAL 58 ACHIEVED

10TH TO 12TH AND GRADE EDUCATION 27 WENT ON BEYOND HIGH SCHOOL TO TRADE SCHOOL COMPLETED YEARS OF COLLEGE WAS CPA PHARMACIST

REGISTERED NURSE COMPLETED COLLEGE COMPLETED THEOLOGICAL SEMINARY OBTAINED MASTERS DEGREES IN GRADUATE SCHOOL

EDWARD CLIFFORD PSYCHOLOGIST AND CODIRECTOR OF THE FACIAL

REHABILITATION CENTER AT DUKE UNIVERSITY ADMITTED

MUST ENJOY PSYCHOLOGICAL LIFE AS MARRIED PSYCHOLOGIST

AT THE EDUCATIONAL FOUNDATION SYMPOSIUM IN 1973 CLIFFORD

EXPLAINED HOW HE TO OF CLEFT RESPONDED PARENTS LIP AND PALATE EDWARDSFORD CHILD WHEN ASKED WHETHER HE THEY WOULD GROW UP TO BE NORMAL

OUR IS TO REVIEW WITH THEM APPROACH SOME OF THE RESEARCH FINDINGS WITH

REGARD TO THE CLEFT PALATE THAT THAT POPULATION IS THEY COMPARE FAVORABLY WITH NORMAL IN POPULATIONS TERMS OF INTELLECTUAL LEVEL THAT ONE CAN FIND OF WIDESPREAD ARRAY OCCUPATIONS RANGING FROM THOSE IN THE PROFESSIONS TO

UNSKILLED LABORERS CLEFT AND AMONG PALATE EI THAT IN OUR EXPERIENCE THE CLEFT IS NOTED PALATE POPULATION NO MORE FOR THE PRESENCE OF EMOTIONAL DISTURBANCE THAN ANY GROUP JE OFTEN CONCLUDE BY STARING THAT OUR BEST

ABOUT THE FUTURE CAN BE MADE GUESS BABYS BY LOOKING AT HIS FAMILY THE MOTIVATIONS AMBITIONS ABILITIES AND VALUE STRUCTURE OF THE FAMILY WILL

PROBABLY HAVE THE INFLUENCE ON THE CLEFT GREATEST PALATE CHILD OR ANY CHILD

AS NOTED IN 1971 CHARLES BY WIRLS PSYCHOLOGIST FOR THE LANCASTER CLEFT PALATE CLINIC

IN OF THEORETICAL BASIS SPITE COMPELLING FOR SOCIAL AND PSYCHOLOGICAL MALAD

JUSRMENR IN HILDRCN WITH DEFT PALATE THE RESEARCH RESULTS HAVE BEEN

INCONCLUSIVE IF THE RESULTS REND IN ANY DIRECTION IT IS TOWARD THE ABSENCES RATHER THAN THE EXISTENCES OF MALADJUSTMENTS

IN 1979 KATHY KAPP OF THE UNIVERSITY OF ILLINOIS AT THE MEDICAL CENTER CHICAGO INVESTIGATED THE RELATIONSHIP OF THE OF CHILDREN SELFCONCEPT WITH CLEFT LIP ANDOR PALATE TO THE SELF

CONCEPT OF NONCLEFT CHILDREN SHE REPORTED

1048 CHILDREN BETWEEN THE OF 11 AND 13 THIRTYFOUR CLEFT LIP ANDOR PALATE AGES NONCLEFT SCHOOL CHILDREN EACH WERE INDIVIDUALLY MATCHED WITH THIRTYFOUR SCALE CHILDREN WITH CHILD WAS GIVEN THE PIERSHARRIS CHILDRENS SELF CONCEPT DISSATISFACTION WITH CLEFTS REGARDLESS OF SEX REPORTED SIGNIFICANTLY GREATER

INTERACTION EFFECT BETWEEN SEX AND PRESENCE PHYSICAL APPEARANCE SIGNIFICANT THREE CLUSTER SCORES WITH CLEFT OR ABSENCE OF CLEFT WAS FOUND ON GIRLS

AND DISSATISFACTION LESS SUCCESS IN SCHOOL AND REPORTING GREATER UNHAPPINESS THAT BE MORE AFFECTED BY THE MORE ANXIETY IT WAS SUGGESTED GIRLS MAY BECAUSE OF THE OF PHYSICAL ATTRAC STIGMA OF PHYSICAL DISABILITY IMPORTANCE

TIVENESS IN OUR SOCIETY

AND INDIVIDUALS THERE ARE AMONG THE CLEFT LIP PALATE MANY THAT WHOHAVE ACHIEVED UNUSUAL SUCCESS KHOO BOOCHAI REPORTED THE CHIN INVOLVED THE FIRST SUCH SUCCESS STORY DURING DYNASTY WEI WHO HAD HIS CLEFT FOURTHCENTURY CHINESE LAD YANGCHI LIP OF SIX CHINESE CLOSED AND LATER BECAME THE GOVERNOR GENERAL

PROVINCES IN THE TENTH BLAIR ROGERS FOUND THREE MORE SUCCESS STORIES WAS FOUNDED CENTURY SEASIDE TOWN IN YORKSHIRE SCARBOROUGH

RESULT OF INVASION SCANDINAVIAN BY AND NAMED AS THE AN BY THE THOMAS THORGILS SKARTHI THARELIPPED EIGHTEENTHCENTURY AND ROBERT MAITHUS DESPITE CLEFT LIP SPEECH IMPEDIMENT

UNTIL HIS HE PREACHED AS AN ANGLICAN MINISTER BISHOP SUGGESTED DEFAULT MALTHUS TURNED TO GIVE UP THE PRIESTHOOD THUS BY ECONOMICS AND WAS LATER APPOINTED PROFESSOR OF MODERN HISTORY

IN THE EAST INDIA COMPANYS COLLEGE AT AND POLITICAL ECONOMY BRUCE AN AMERICAN HAILEYBURG TWENTIETHCENTURY LOWERY AWARDED THE PRIX RIVAROL IN 1961 FOR WRITER LIVING IN PARIS WAS SENSITIVE NOVEL ENTITLED LA CICATRICE WHICH WRITING IN FRENCH AFFECTED WITH CLEFT SCAR TELLS OF THE PROBLEMS OF YOUNG BOY LIP

HERE IS REVIEW OF HIS BOOK IN ENGLISH

THE RELIC OF AT HOME IN THIS IS STORY OF BOY WITH SCAR HARELIP HAPPY SUFFERS AND THE DEVOTED AFFECTION OF YOUNGER BROTHER HE HIS PARENTS LOVE AND FUN SHOCK AT SCHOOL IN THE STUPIDITY CRUELTY SPITEFUL HIS FIRST GREAT IN THE WORLD OF CHILDREN DISCON MAKING THAT IS SO PREVALENT THOUGHTLESS WHICH HIS SMALL INFIRMITY HE HIMSELF ENDS CERTED BY THE WICKEDNESS PROVOKES THE FEW WHO HAVE SHOWN HIM ANY AFFECTION BY DRIVING TO DESPAIR BEINGS HE HARMS AN COMPLEX URGE DRIVEN BY SOME TROUBLED IMPULSE BY EXTREMELY LOVES AND WHO HAS DONE MOST TO PROTECT HIM THE ONE BOY WHOMHE REALLY

IS IN THE MOST FIOM THE OTHERS THE REMORSE THAT FOLLOWS THIS ACT CONVEYED

THE WITHOUT BEING ABLE TO PUT IT INTO MOVING FASHION WHILE BOY DISCOVERS 1049 WORDS THAT PHYSICAL AFFLICTIONS ARE AS NOTHING BESIDE SCARS ON THE SOUL HIS

THE FRUIT OF EXPERIENCE SUFFERING IS COMPLETE AT LAST WHEN STRANGE AND BEAUTIFUL FROM GIFT BEYOND THE GRAVE REVEALS TO HIM THE MEANING OF LOVE

BOOK WAS ACCLAIMED LOWERYS WIDELY IN FRENCH LITERARY CIRCLES

AND THE AUTHOR HIMSELF BORN WITH UNILATCRAL CLTFT COMPLETE LIP WELL CLOSED BY AN AMERICAN SURGEON SUBSEQUENTLY TRANSLATED HIS INTO STORY ENGLISH AMERICAN VERNACULAR SPANISH AND GERMAN IN 1976 AARNE RINTALA OF HELSINKI IN PLASTIC AND RECONSTRUCTIVE THE REMARKABLE AND SURGERY PRESENTED STORY WORK OF THOMAS RAGAWALDINPOIKA THE EIGHTH CHILD OF FARMER OF TYRV IN THE

KINGDOM OF SWEDENFINLAND WHO HAD BEEN BORN IN 1774 WITH

UNILATERAL CLEFT OF THE LIP AND PALATE ALTHOUGH HE SUFFERED FROM

HEALTH AND HAD OF THE POOR NONE ADVANTAGES OF HIGHER EDUCATION IN THAT TIME HE BECAME THE MOST IMPORTANT FINNISH LAY PSALMIST OF HIS TIME LAY PSALMS WERE VERSES PRINTED ON LOOSE SHEETS IN TO MODERN CORRESPONDING WAY NEWSPAPERS IN THE OPENING

OF HIS FIRST PSALM PUBLICATION HE DESCRIBED HIMSELF NOTING HIS CLEFT ABNORMAL CHARACTERISTICS APPEARANCE SPEECH DIFFICULTY AND

INABILITY TO SUCK

HAIL TO GOD THOU CREAROT BUT ANOTHER FLAW LIES HIDDEN GREAT WHCN CAME INTO THIS POOR WOILD WITH COUNSEL THOU HAST IN THE OF TH ROOFING MY MOUTH BORNE OF PAIENRS ICIND AND GOOD ME WHICH SOUGHT CONFUSES MY SPEECH SADLY GOD GAVE THEM HEAVY HURDEN FIOM LIFES MY STAIR THOU CUTS ME OFF FROM OTHER FOLK THEY MUST BCAR WITH FORTITUDE SPLIT THUS VOICE DOTH MY NOR SOUND THEY WERE CAUSED DEAL OF RIOUHLE HAST PROTECTED MERCIFULB CLEATLY ON BEHALF OF THEIR POOR CHILD TO THIS VAIC OF TCARS THOU IN THE LAI OF OTHER FOLK FOT MX MOTHERS MILK COULD NOR NUI WOIDS FROM BRUUGHRSR ME WINE LIPS DRINK TOT MY DEFORMITY MAIKED WIRH DEFORMITY TIGHTLY OTHER NOURISHMENT WHICH BEAR THEY GAVE ME UPON MY BODY THOUGH MY MEANING IS TIGHT CLEAR SUCH AS ANIMALS PROVIDE ON MY FACE FOR ALL TO SEE WHILE THERE LAY IN MY CRADLE

CARED FOR ME AS BEST THEY COULD

IN ANOTHER HE DESCRIBED HIS LAY PSALM PREOPERATIVE FEARS AND

TRIALS THE THE AND OPERATION ITSELF AFTERCARE HIS OWN GRATITUDE TO GERHARDT ODENADT SURGEON OF THE TURKU ROYAL DRAGOON GUARDS REGIMENT AND TO GOD

WORK OF GOD SING TO THEE BUT AH THAT POOR THING AM FOR HIS MERCY GREAT IF AUGHT WHO HEALED MY DEFOIMIRY NOR DO UNDERSTAND RIGHTLY LIES BEYOND THE POWER OF THOUGHT COMEWITH PSALMS AND SOUL OFJOY HOW TO DO THIS SKILFULLY WHAT IN FACT TO ME BEFELL THAY AND SING TO HIM ON HIGH MOST THOUGH TRY MANFULLY HETEWIRHALL WOULD FAIN TELL

1050 AND DREADFUL 27 WHEN RHE DOERORS WORK WAS FOR WHEN BORN IN MY POOR LIP 16 FELT SHARP PAIN FELT RHE CEASED FROM THE FIRST RHERE WAS SLIP AGONY AGAIN FROM HIS TASK HE WAS RELEASED SO FLESH SHIVERS AND SHAKES WHIEH PREVENTED ME RO TALK MY THEN AT LAST OPED EYES FACE AT FAULT ALL BODY THE PAIN TAKES MY STRANGELY SEEMED MY MY AND MY HANDS DID CLEAN AND DRY WITH OFTENTIMES FOR MY SAD FLAW 17 BUT WITHIN JESOS STRENGTH 28 THE SWEAT OFF BROW FIND WAS MIND AT LENGTH WIPED MY DID TRY TO CURE HELPEN MY DID AND SO SOUND FROM ME WAS HEARD THAT FROM PAIN START FLOW BUT IT WAS NCR YER THE DAY NO WORD AND MY SHIRT TOO DID CHANGE WHEN GODS HELP WAS GIVEN TO ME NOT CRY NOT YET CLEANED THE BLOOD FROM EVERY WITH ME 18 THOUGH RHE BLOOD FROM ME DID FOR THIS THOUGHT BORE PLACE

AND IT WAS BURDEN SORE POUR FROM VEINS CAME MORE AND 29 TWAS WITH WEARY TOIL THAT DAY THAT THE PAIN COULD NOT STAND MY FROM CHAIR WENT AWAY IRWOULDLEAVEMEQUIREUNMANND MORE MY WENT TO LIE MY BED WAS IN SORRY PLIGHT UPON IT WAS ALSO IN MY MIND ON PILLOW LAID HEAD AND WAS GORY SIGHT MY MY WHEN CURE TRIED TO FIND FOR CLOTHES 30 NOW WAS PRISONER THAT GODS WILL IT COULD NOT BE 19 MY SHIRT MY MY BOUND UP LIKE POOR SLAVE THERE SINCE AT BIRTH TWAS GIVEN TO ME BREAST OF WAS MESSED NOT PIECE OF BREAD TO EAT EVERY PART ME TILL AT LAST GOD ME STRENGTH WEEKS NO TASTE OF MEAT GAVE WITH THE STREAM OF WARM RED FOR TWO BROKE THE BONES OF FEAR AT LENGTH BLOOD 31 THE WHILE THE DOCTOR CAME TO SEE AFRAID OF SO THAT BEING PAIN DOWN ME LIKE FLOOD RUNNING ME SEEMED NO SURPRISE AGAIN SEVERAL THAT HE COULD 20 BUT THE GOOD GODS MERCY TOO TIMES SEE FOUND IN CONSCIENCE PEACE HOW LIPS THEY DID LOOK MY HELPED ME IN MY PLIGHT ANEW MY POOR IN HEART SWEET RELEASE LAST FROM ME THE NEEDLES TOOK MY AND THE HARDEST PAIN HE TEMPERED AR FOR THE PREACHER OF THE WORD HIS SONS SUFFERING REMEMBERED LORD 32 THE FLRSR HE TOOK UPON THE STRENGTHENED ME TO TRUST MY 21 AND WHEN MY POOR GUMS WERE TUESDAY 10 OCRNR DID THE SECOND HE REMOVED NN GO CUT TO SHOW MY DEFORMITY WHERE THE DOCTORS KNIFE WAS WEDNESDAY AND HE VOWED TO ME HE WOULD THE THIRD HE TOOK ON FIRDAY THEN PUT DO FOR ME ALL THAT HE COULD FEEL THE THEN DID REMEMBER JESUS AH COULD REALLY PAIN

WITH HIS WOUNDS THAT CAME TO 11 AND DID RN SELF PREPARE FOR THAT RHC HAD RUSTED FAST SA US CALLED TO JESUS IN NR PTA ER TO THE FLESH HAD TUCK AS LAST

THAT HE WHO HAD SUFFERED SO IN 22 AND WHEN THE SCRSSORS CUT AWAY SO THAT AS CHANGED FEATURE MIGHT HELP MCIN NRY TROUBLE NOW PALE CREATURE SKIN FROM FLESH OF LRP THAT DAY WAS SORRY

GODS MASS KNEE REMEMBERED HOW HE BORE 12 AR UPON MY YEA RS AS DREADFUL THING HUMBLE HARSH BLOW SO SORE DIND MAKE MY PLEA MANY IIOU RHC NEEDLES THEY DID STING

AND INDEED WAS ASSURED THE DOCTOR THEM OUR 23 WHEN THE NEEDLES SHARPLY PRRCKED WHEN PULLED OF FROM THE LORD SUFFERED WRTHOUT DOUBT HELP COMING STITCHED THEN AND MY LIP TOGETHER MONTH OF SWEET REMEMBERED THEN THE SPEAR 13 IN THE APRIL 35 BUT ALL THANKS TO GOD SING DEAR OF THAT DID PIERCE OUR LORD SO ON THE SIXTEENTH DAY IT WHO CREATED EVERYTHING DID THE DOCTOR ME ATTEND THE HE ME RELIEVED 24 PIERCED THE SIDE AND THROUGH THE FROM PAIN TO MEND FROM MY DEFORMIR HEART AND MY DEFORMITY OF CHRIST 14 PUT BEFORE ME THEN CHAIR OUR SAVROUR JESUS 36 AND GOOD PHYSICIAN GAVE IN THESE THOUGHTS DRD ATTAIN AND SAT ME GLADLY THERE DOCTOR ODENADR THE GRAVE SWEET RELIEF FROM ALL HELD PACE AND WITH MY PAIN MY KNIFETIP BLESSINGS TO HIS POTENT SALVES CUT INTO DEFORMED BALMS MY LIP 25 SEE HOW GODS MIGHTY TO HIS OINTMENTS AND HIS

SOON HELD CLOSED STRENGTH 15 MY EYES TIGHT 37 THUS SHE MERCY OF SHE LORD GAVE ME COMFORT NOW AT LENGTH AND MY HANDS WISH ALL THEIR TO MANS WORK HE DOTH AFFORD SO THAT MY HEAD DID NOR SWOON MIGHT LET US HONOUM HIM MOST HIGH NOR HEART BEARING 500 ON MY HEART TOGETHER PRESSED MY STOP TO SHE WHO GRXES HELP NEEDY TWISTED IN DISTRESS FINGERS 26 NYHEN SAW HEFORE ME NEXT 38 SO SUFFERING AND SORROW HOW THE BLOOD MY BREAST UPON WERE RELREXED FOR THE MORROW IN KIND OF JELLY SET JESUS OF PHYSICIANS BESS THEN WITH DREADFUL FEAR SWEAR TIN THEE BE MY SHANKS ADDRESSED

1051 THE SUCCESS OF THE AFTER THE PATIENTS ADJUSTMENT SURGERY IS

AS HE SOON MARRIED BRIDE IMPRESSIVE 10 YEARS YOUNGER THAN HIMSELF WHEN THIS MARRIAGE WAS BROKEN BECAUSE OF HER INFI

DELITY HE MARRIED AGAINPRODUCING TOTAL OF NINE CHILDREN CANADIAN BORN JOHN STEPHENSON WITH CLEFT OF THE PALATE STUDIED MEDICINE IN EDINBURGH AND AFTER PALATE SURGERY BY ROUX IN PARIS IN WROTE HIS 1819 GRADUATION THESIS ON HIS OWN OPERA TION HE THEN RETURNED TO MONTREAL ENJOYING SUCCESSFUL CAREER HONORABLE PETER MCGILL GAVE STEPHENSON CREDIT ABOVE ALL OTHERS FOR MCGILL COLLEGE OTHER OF EXAMPLES POSTOPERATIVE CLEFT PATIENTS WHO HAVE ATTAINED FAME AND FORTUNE INCLUDE RENOWNED BRITISH SURGEON SIR INNOVATIVE JAMES BERRY NEWCASTLE ANESTHETIST PHILIP AYRE SEVERAL NOTABLE AMERICAN PLASTIC SURGEONS AND SEVERAL BRITISH AND AMER

ICAN THE ACTORS INCLUDING SHAKESPEAREAN ACTOR STACY KEACH STAR OF TELEVISION SERIES CARIBE WHO HAS BLAIRMIRAULT LIP CLOSURE AND WAS HONORED IN 1976 WITH THE AMERICAN CLEFT PALATE EDUCA TIONAL FOUNDATION AWARD

SUCCESS WITHOUT SURGERY

FAVORITE CLEFT MY LIP STORY IS PRECIOUS BANE WRITTEN BY MARY WEBB RECIPIENT OF THE FEMINA VIE HEUREUSE AWARD FOR 1924

1925 FOR THE BEST WORK OF IN IMAGINATION PROSE OR VERSE DESCRIP TIVE OF LIFE THE ENGLISH SETTING IS THE VILLAGE OF SAM MERE IN

SHROPSHIRE NEAR THE TIME OF WATERLOO THE HEROINE PRUDENCE SAM HAS AN INNER IN OF HER BEAUTY SPITE UNOPERATED CLEFT LIP

DEFORMITY BUT SHE IS TORTURED BY GUILT SUPERSTITION PREJUDICE AND CONSTANT WITH COMPARISON THE IDEAL OF FEMININE BEAUTY HER SENSE

OF AND IS FUTILITY SUFFERING EXPRESSED IN THESE QUOTATIONS

COULD IT HELP IF THE HARE CROSSED MY PATH HIDEOUS MY POOR LIP WAS AS IT WERE MY SIN THOUGH KIND OF INNOCENT WICKEDNESS

AND ID TO DREAM OF HEGIN HEING AS HEAUTIFUL AS FAIRY

HER JEALOUSY WAS UNDERSTANDAHIE ALL IN MINUTE HER MOUTH WAS ROSE AND KNEW COULDNA AHIDE HER

COULD HE HEARD VILLAGER TO SAY OF POOR PRUDENCE THE WOMANWITH THE

HARE SHORTEN LIP CREATURE BUT IT MAKES VERY QUEER EM QUEER YOU MIND TO HE HORN THE LIKE OF THAT SOME SAY SHES HIT OF WITCH

1052 COULD HAVE OF HER BROTHER GIDEON PRUDENCE HAD SAID GIDEON GROWN AND LOOKED WELL AND NONE NEED HAVE WHAT THEY CALL MOUSRACHIO VERY

KNOWNHED GOT HARESHOTTEN LIP WHEN GIDEON HAD SAID TO PRUDENCE BEING AS HOW THINGS ARE YOULL HER HEART BEAT SOFT NEVER MARRY PRUE HER THOUGHTS EXPRESSED DESPAIR MY

AND SAD IT SEEMED SUCH TERRIBLE THING NEVER TO MARRY

FOR THESE FARM WAS FORMIDA THE COST OF CLEFT LIP SURGEON POOR PEOPLE

AND KNEW IT WOULD TAKE DEAL BLE OBSTACLE AS EXPRESSED BY PRUE HERSELF

OF MONEY TO CURE HARESHORTEN LIP

HER TO FIFTY WHEN YET IT HAD BEEN PROMISED GIVE MONEY UP POUND

WEVE SOLD SAM TO CURE HER LIP PRUE ADMIRED FROM THE HERO KESTER WOODSEAVES YOUNG WEAVER WHOM OF AND IN DISTANCE TOOK STAND AGAINST THE BRUTALITY BULLBAITING BY DOGS

OFFERED TO TAKE THE ON ONE AT TIME HE HAD ORDER TO STOP THE CRUELTY DOGS VICIOUS ONE THAT WENT NO TROUBLE AS THEY WERE ALL HIS FRIENDS EXCEPT NEW FOR HIS FOR HIS THROAT PRUE SAVED HIM WITH KNIFE SHE HAD CARRIED PROTECTION

THE ALMOST UNNOTICED AND SAYING TO HERSELF AND THEN QUIETLY LEFT SCENE BUT HIS AND DAGGLY SORT OF NAY PRUE SAM YOU BE NOUGHT ANGEL POOR

ANGEL TOO HARVEST THAT WOULD THEN FOLLOWED FRANTIC TOIL AND THRIFT TO BRING IN CORN

AND AN FOR PRUDENCES LIP GIVC CURITY TO THE SAM FAMILY OPERARIC FIRE AND ALL WAS MISFORTUNE INTERVENED HOWEVER THE CORN CROP WAS SET ON

AND HAD TO STONE HER TO DEATH LOST THE VILLAGE FOLK TURNED ON PRUE BEGUN HER WHEN KESRER WOOKSEAVES RODE UP CLEARED THE CROWD AND AS HE LIFTED

ONTO HIS HORSE SAID COME HERE THEN PRUE WOODSEAVES LIKE PRUE CRIED IN DISBELIEF BUT NO KESRER XOU MUN MARRY GIRL

HARE SHORRCN LILY SEE BE INTO HER HE SAID NO BUM KESTER WOULD NOR LISTEN LOOLCING DOWN EYES TIS BREAST DRAR MORE SAD TALK IVE CHOSEN MY BIT OF PARADISE ON YOUR MY HED FINISHED THOSE WORDS HE BENT HIS COMELY ACQUAINTANCE AND WHEN MOUTH HEAD AND KISSED HER FULL UPON THE

EXPORTING GOODWILL

FACE AND MOUTH IS IR AS THE DEFECT OF ANY CLEFT OF THE HANDICAP WILL BENEFIT THE FOLLOWS THAT EFFECTIVE CORRECTION OF THE DEFORMITY

WHETHER HIS CULTURE BE INDIVIDUAL IN HIS SOCIAL SETTING SOPHISTI

LIKE CATED OR PRIMITIVE THE GOODWILL ENGENDERED PEBBLE SEND FAR THE ORIGINAL DROPPED INTO POND WILL OUT RIPPLES BEYOND

TINY SPLASH

THIS KIND OF WORK MY FIRST EXPERIENCE IN DIPLOMATIC MISSIONARY DIVISION INCIDENTS OF CAME IN KOREA WITH THE FIRST MARINE MANY

1053 THAT TIME HAVE BEEN RELATED THROUGH THESE PAGES AT THE END OF HOSTILITIES THE PURPOSE OF THE MARINES WAS TO REHABILITATE THE COUNTRY AND THIS WAS POPULATION TOTALLY UNTOUCHED BY PLASTIC EVERY AND SURGERY ANOMALY DEFORMITY IMAGINABLE WAS ROAMING AND ABOUT WENT TO WORK THIS WAS LITTLE UNORTHODOXBECAUSE

ORDINARILY WHEN THE MARINES WERE NOT FIGHTING THEY WERE JUST AS

HO ABOUT AND THIS GUNG RELAXING ATTITUDE PERVADED THE CAMP IN ORDER TO DO CLEFT IT WAS SURGERY OCCASIONALLY NECESSARY TO HAVE AN

ANESTHETIST AT FIRST HE WAS REASONABLY ENTHUSIASTIC AS HE WAS NOT

QUITE AS INFATUATED BY CLEFTS AS IT BECAME NECESSARY SOMETIMES TO ASSIST HIM ALMOST THE SCRUFF OF BY HIS NECK TO THE OPERATING ROOM RECENT NOTE FROM BERTRAM BROMBCRG PROBABLY TELLS IT BEST HE WROTE

RALPH MY BROTHER IN LAW 1EV WAS WEINBERG AN ANESTHETIST SERVING IN KOREA DURING TOUR OF THERE YOUR DUTY MANY YEATS AGO AT ANY RATE WHEN HE RETURNED AND WAS HIS RELATING EXPERIENCES THE FIRST THING HE WANTED TO KNOW FROM ME WAS IF KNEW SCREWBALL PLASTIC SURGEON BY THE NAME OF MILLARD

WHO OPERATED AND ON CLEFT NIGHT DAY EVERY LIP IN KOREA HAVE BEEN

SUBSEQUENTLY DELIGHTED RH THROUGH YEARS TO EXPLAIN TO HIM YOUR CONTRIBU TIONS WHICH IN WERE THEIR EARLY STAGE OF DEVELOPMENT AT THAT TIME AND HAVE

POINTED OUR THAT HE IN ALSO SOME SMALL WAY PLAYED ROLE

IN EDITORIAL IN THE MY 1962 JOURNAL OF THE FLORIDA MEDICAL ASSOCIATION MISSIONARY SURGERY IN UNDERDEVELOPED COUNTRIES WAS SUGGESTED AS AN IMPORTANT STEP PLASTIC SURGEONS COULD TAKE TOWARD IMPROVING INTERNATIONAL RELATIONS

IN THIS DO ITYOUR THE DIPLOMACY PLASTIC SURGEON CAN BE PARTICULARLY

EFFECTIVE OURS IS SPECIALTY WHICH WITH ITS HINT OF MAGIC TOUCH OF DRAMA AND THAN MORE DAB OF ART IS MASTERED SO FEW BY YET RESPECTED BY SO MANY THERE IS ALSO ITS GREAT HUMANITARIAN WHAT APPEAL ACT CAN BRING GREATER IN REJOICING FAMILY AND VILLAGE THAN THE TRANSFORMATION OF AN INFANT WITH

CLEFT IN LIP AND EXPRESSION PALATE SPEECH TO HAPPY SUCKING BABY THE INFINITE INFLUENCE OF THIS SPECIALTY LIES IN ITS POWER TO RENDER THE DEFORMED AND MUTILATED SUITABLE TO TAKE THEIR IN AND PLACE SOCIETY SERVE AS LIVING MONUMENTS NOT TO OUR BUT ONLY SPECIALTY TO OUR WAY OF LIFE

JAMAICAN PROGRAM

IN 1959 KENNETH MCNEILL AND STARTED JAMAICAN PLASTIC SURGICAL THIS CONTINUED WITH PROGRAM ONLY MINOR INTERRUPTIONS UNTIL THE LAST FEW YEARS JAMAICAN SURGEON TONY JACKSON HAS 1054 AT THE COMPLETED YEAR IN OUR PLASTIC SURGICAL RESIDENCY PROGRAM TO TAKE OVER UNIT IN JAMAICA UNIVERSITY OF MIAMI PREPARING TO HIS UNIT RESIDENTS FROM MIAMI MAKE SHORT ROTATION WORKTRIPS

AND THAT OF SIDNEY WILLIAMS CONTINUING THE TWOWAY GOODWILL

RELATIONSHIP

AN AMERICAN IN TAIWAN

IN IN GRAND SAMUEL NOORDHOFF TRAINED PLASTIC SURGERY RAPIDS OF THE FOUNDATION 1600BED MICHIGAN IS SUPERINTENDENT NEW OF CHANG GIANG MEMORIAL HOSPITAL TAIPEI TAIWAN REPUBLIC IN CHINA WHEN ASKED HOW HE GOT TO TAIPEI HE WROTE 1977

FOR OF CHURCH THE REFORMED IN 1959 RESPONDED TO REQUEST SURGEON MY WANTED ME TO DO IVE STAYED CHURCH IN AMERICA FEELING THIS IS WHAT GOD TALKED HERE BECAUSE OF RHE PEOPLE AND THE CHALLENGES HAVING RALPH WAS HIS FIRST RESIDENT BLOCKSMA INTO STARRING PLASTIC SURGERY PROGRAM SAMUEL WITH NOORAHOFF HIS AS HE WAS TEACHER AND SURGEON GRCATLY APPRECIATE TRAINING SUPERB MOST OF THIS EXCELLENT CONCEPTS IN LIP AND PALATE SURGERY INTERESTING ASPECT ON AND THEN HAVE WORK HAS TO DO WITH ABANDONED BABIES THAT WEVEOPERATED

ITS TO CHRISTMAS CARD WITH CN ADUPRED INTO AMERICAN HOMES GREAT GET THE SMARTEST ONE IN THEIR CLASS ITS THE NOTE THAT OUR LITTLE GIRL 01 BOYS DO FOR CHILD AND THATS UNBELIEVABLE WHAT LOVE AND PROPER CARE CAN GUESS

WHAT MAKES IT FUN TO BE PLASTIC SURGEON

ROTH IN KOREA AND ROBERT ROTH OF SALEM VIRGINIA STUDIED GENERAL SURGER AND KOREAN AT ST LUKES HOSPITAL NEW YORK PLASTIC SURGERY AFTER WHICH HE WAS COMMISSIONED LANGUAGE AT YALE UNIVERSITY UNITED METHODIST CHURCH AT BUCK HILL FALLS MISSIONARY OF THE HE WORKED AT THE WONJU PENNSYLVANIA FROM 1962 TO 1972

ASSISTED DUK TRAINED UNION CHRISTIAN HOSPITAL IN KOREA LEWJAE

RESIDENTS AT THE YONSEISEVERANCE BY KERWIN MARCKS TAUGHT CONSULTANT FOR THE INTERNATIONAL MEDICAL COLLEGE IN SEOUL AND AS ROTH ON ALL OF THEIR CLEFT LIP AND HOLT ADOPTION PROGRAM OPERATED HIS IN HE RETURNED TO THE STATES TO COMPLETE PALATE CASES 1966 WITH DICK STARK AND GEORGE CRIKELAIR PLASTIC SURGERY TRAINING OF CAROLINA THESE ARE HIS REFLECTIONS AND AT THE UNIVERSITY NORTH

IN 1977

TRAINED AND IN AND RECON IN THE MISSION FIELD THE SURGEON GIFTED PLASTIC ALMOST FOR SERVICE AND FULFILL STRUCTIVE SURGERY HAS LIMITLESS LUXURY OPTIONS

1055 MENT ONE SOON THAT ALL IN APPRECIATES SURGERY THE BROADEST TERMS IS EVEN THE P1ASTIC PURELY COSMETIC IS AVAILABLE AS MONEY CROP TO RECONSTRUCTIVE FOR SUPPORT SURGERY INDIGENT PATIENTS AND FOR NONPAYING IN PUBLIC THE BED PROJECTS HEALTH ROCK OF ALL MISSION MEDICINE AT FIRST THE

REALIZATION THAT FOR MILLION ONE OR TWO PEOPLE YOU ARE THE ONLY QUALIFIED TO CHEILO OR BE PERSON PERFORM PALATOPLASRY CAN AN AWESOMECHALLENGE EVEN SOMEONE WITH MINOR BLEMISH HAS TROUBLE GOING TO SCHOOL FINDING JOB AND MARRIED IN KOREA SOMEONE WITH GETTING AN UNREPAIRED OR POORLY CLEFT OR HAD BEST CRAWL INTO HIS REPAIRED LIP PALATE GRAVE AS EARLY AS POSSIBLE

SO THE OF IS TO CLOSE TEACH ANSWER COURSE CLEFT ONE OVER AND OVER AGAIN THE SOONER MAKE YOU YOURSELF DISPENSABLE THE FINER YOUR SERVICE WHILE THE VAST MAJORITY OF CLEFT LIP PATIENTS IN DEVELOPED COUNTRIES ARE CORRECTED THREE BY MONTHS BE PREPARED OVERSEAS FOR PATIENT FROM HOURS

TO 60 OF WILL BE YEARS AGE BOYS CHARACTERISTICALLY BROUGHT SOONER FOR REPAIR

THAN IN RURAL COMMUNITIES IT IS GIRLS SOME NOT UNTIL GIRL REACHES MAR

THAT IT IS TIME TO THE RIAGEABLE AGE REPAIR LIP THE FEMALE PALATE MAY NEVER HAVE ITS TIME SINCE SILENCE IS CONSIDERED VIRRURE IN THE FAR EAST

BE FOR PREPARED TOO SOME UNEXPECTED CULTUTAL FACTORS MULTIPLE BIRTHS ARE

VEILED IN AS IF CURSED SUPERSTITION ANIMALISTIC NOT COUPLED WITH VERY REAL OF NO OF THE HANDICAP SUPERMARKET SUPPLY MILK NEW MOTHER WILL GIVE ALMOST EXCLUSIVE PREFERENCE TO THE STRONGER OF TWINS ESPECIALLY MALE NEWBORN SHOULD OF THE ONE TWINS HAVE CONGENITAL MALFORMATION

CLEFT CULTURAL OF INFANTICIDE PARTICULARLY LIPPALATE TIIAGE BY NEGLECT IS ON ACCEPTED PRACTICE ONE OCCASION DESPITE PERFOIMING CHEILOPLASTY

FOR NEWBORN TWIN THE EMACIATED BOIL STUDDED BOD OF THE DEAD INFANT

WAS ICTURNED TO THE FOUR WEEKS HOSPITAL LATER AS IF TO PROVE IT WAS HIS FATE

SUIGERY OR NONE DERISIVE RAUN TING ONCHUNGEEVA ONCHUNGEEYA

OJ OF OJ HARELIP IN KOREAN IS SEVERE CON DEMNARION FOR ANYONE WITH OR WITHOUT THE ANATOMIC BLEMISH WHENEVER

TO CHILD OF THAT POSSIBLE PULL OUT PIT OF DESPAIR IS AN ETERNAL MOMENT

FREQUENTLY UNDERAPPRECIATED IN WESTERN MEDICINE

THE AMONG SURGEONS PLASTIC SURGEON IS TEMPTED TO SPORT CERTAIN DEGREE OF SINCE THE HUBRIS TECHNIQUES IN HIS FINGERTIPS EMBODY DRAMATIC CREATIVE THE CHANGE MISSIONARY PLASTIC SURGEON IS ALSO TEMPTED BECAUSE HIS CREATIVE

EFFORTS ARE THE MAGNIFIED BY UNSOPHISTICATED EYES OF NATIONALS OVERSEAS AND COULD LEAD TO DELUSIONAL PEICEPTION OF SELF AS THE CENTRAL FIGURE IN LIFES

SISTINE FARNILIAI ALL IMA SO TO US THE TEMPTATION IS THERE BUT IT IS ONLY FOOL WHOTAKES BITE TO BE TRULY EFFECTIVE AS MISSIONARY DOCTOR ONE MUST HAVE SENSE OF CALL LIVE FAITH AND RIGHT SPIRIT

BARSKY UNIT IN VIETNAM

THE FAMOUS MOST FOREIGN PROGRAM WAS THE NATIONAL CENTER FOR PLASTIC AND RECONSTRUCTIVE SURGERY WHICH CONSISTED OF SEVERAL

1056 INTERCONNECTED BUILDINGS ON AN ACRE OF LAND IN SAIGON VIETNAM

THIS CENTER WAS ESTABLISHED BY ARTHUR JJ BARSKY OF NEW YORK AND

OF HEALTH THE UNIT IT DESIGNATED BY THE MINISTER AS BARSKY BEGAN CONTINUED UNTIL TO EVACUATE IN OPERATION IN JULY 1968 AND OBLIGED

FROM ALL THE WORLD VOLUNTEERED APRIL 1975 PLASTIC SURGEONS OVER EXISTENCE TO WORK AND TEACH IN THIS UNIT DURING ITS SIXYEAR

ADMITTED AND ANOTHER TREATED AS 6288 PATIENTS WERE 21842 WERE

THIS OUTPATIENTS TOTAL OF 2033 OPERATIONS WERE CARRIED OUT AT

CENTER 593 CLEFT LIP OPERATIONS 140 CLEFT PALATE AND 1300 CLEFT LIP

INTRODUCED IN VIETNAM AND PALATE SPEECH THERAPY TRAINING WAS

FOR THE FIRST TIME

BARSKY AND HIS UNIT LATIN AMERICAN PROGRAM

PLASTIC PROJECT INTERPLAST INTERNATIONAL SURGERY PROGRAM BEGAN INTO BACKWARD LATIN IN 1965 AND HAS SENT PLASTIC SURGERY TEAMS FROM AMERICAN COUNTRIES AS WELL AS TRANSPORTING PATIENTS THESE

COUNTRIES TO STANFORD MEDICAL SCHOOL FOR SURGERY EDUCATOR

SURGEONSCHOLAR DONALD LAUB DIRECTOR OF PROJECT INTERPLAST

RECALLS HIS FIRST CASE

OLD FROM NINE YEARS AGO ANTONIO VICTORIA FOURTEEN YEAR BOY MEXICALI ARNEIICAN MISSION THE CHILD WAS BROUGHT TO STANFORD BY THE LATIN PROJECT DOD AID

THAT IN WAS GROSSL DEFORMED BY CONGENITAL CLEFT LIP AND PALATEDEFECTS OF AND RHTEE THIS COUNTRY WOULD HAVE BEEN REPAIIED BETWEEN THE AGES ONE

ANTONIOS DEFECTS HAD MADE HIM SOCIAL OUTCAST HIS FAMILY THOUGHT THEY

HAD COMMITTED SIN WHEN THE CONCEIVED HIM WHEN HIS DEFORMITY WAS

COSTTTTCD HC WAS ALIT TU RCRURN HOME AND TO LEAD NORMAL LIFE

EAST AFRICA FLYING DOCTORS SERVICE

SIR ARCHIBALD MCLNDOE MICHAEL WOOD AND THOMAS REES WERE IN OTHER ON THE CONCEPTION OF THIS GREAT PROGRAM PLASTIC SURGEONS

HAVE SERVED ONE OF THEM DAVID FURNAS OF THE UNIVERSITY OF

CALIFORNIA WROTE IN 1977

MY MOST CONSUMING INTEREST OUTSIDE OF PLASTIC SURGERY IS DOING PLASTIC

WHETE NEEDS ARE CASES ARE SURGERY IN DEVELOPING COUNTRIES GREAT MANY UNIQUE

IS ADVENTURE CHALLENGES THE SETTING IS ROMANTIC AND EACH DAY AN THESE SOUTHERN QUALIFICATIONS APPLY IN CONSIDERABLE DEGREE TO CALIFORNIA PARTICU

DRIVE DISTANCE THE THE IS ALMOST LARLY IF YOU ANY ON FREEWAY PAPERWORK

NONEXISTENT SOUTHERN CALIFORNIA LOSES ONE OF THE GREATEST JOYS OF MY LIFE

AFRICA DOCTORS SERVICE IN WAS WORKING AS SURGEON FOR THE EAST FLYING

1057 197273 UNDER DIRECTOR GENERAL MICHAEL WOOD IT WAS HERE UNDER MR

WOODS THAT SAW ITS TUTELAGE PLASTIC SURGEIY IN PURE FORMSURGERY OF THE

SKIN AND ITS CONTENTS ON ONES SCHEDULE ONE MIGHT HAVE TO REPAIR SOME CLEFT

LIPS PLACE KIINTSCHNER NAIL IN FEMUR DO PROSRARECTOMY TAKE OUT AN OVARIAN EIGHT POUND CYST REPAIR VESICOVAGINAL FISTULA DO CARTILAGE GRAFT FOR COLLAPSED LEPROUS NOSE AND PERHAPS REPAIR HYENA BITE LION CLAWING

OR CORNEAL TEAR FROM THORN TREE

HIGH POINT EACH YEAR NOWIS RETURNING TO KENYA TO CONTINUE THIS WORK

ALTHOUGH NOW STICK TO MORE CONVENTIONAL PLASTIC SURGERY AND LEAVE THE

INTO THE ABDOMINAL TO FORAYS CAVITY MR WOODNONETHELESS THE SPECTRUM OF PATHOLOGY AND IS MONUMENTAL MICHAEL WOOD CHALLENGE ALWAYS

THE EPITOME OF GOODWILL

MAMMITUPPU IS VERY PRINIITIVE ISLAND IN THE 350 SAN BIAS ISLAND

STRING THAT FRINGES THE NORTHERN COAST OF PANAMA IN THE CARIBBEAN

SEA OF THE MANY KUNA INDIANS INHABITING THIS ISLAND WERE MASSACRED BY SPANIARDS 400 YEARS AGO AND SINCE THEN THEY HAVE DISTRUSTED VISITORS IN FOREIGNERS ALLOWING NO 1958 MISSIONARY ROLAND ICKE ADMITTANCE THE ISLAND GAINED TO AND SPOTTED YOUNG

BOY WITH CLEFT LIP THE BOY BEING THE GRANDSON OF THE CHIEF HAD BEEN SPARED THE USUAL PRACTICE OF KILLING CLEFT INFANTS BY WITH FOOD AND HOLDING FLUIDS ICKE DECIDED TO USE THIS CLEFT AS WEDGE

TO BRING THE CHRISTIAN GOSPEL TO THE ISLAND AND INVITED RALPH HAD BLOCKSMA WHO BEEN INVOLVED IN MISSIONARY MEDICINE SINCE

IN 1949 PAKISTAN TO STOP OFF ON HIS WAY TO QUITO ECUADOR

VISIT TO THE ISLAND FOR GAINED PERMISSION THE OPERATION FROM

THE BOYS FATHER BUT BOTH GRANDFATHERS WHO WERE MEDICINE MEN

STRONGLY OPPOSED IT THEY SAID THEY HAD GIVEN THE BOYS MOTHER

THE BEST POSSIBLE PRENATAL CARE WITH THEIR NATIVE HERBS MEDICINE

BATHS AND CHANTSAND IN SPITE OF THIS THE CHILD HAD BEEN BORN

WITH THE DEFORMITY THEREFORE NOTHING COULD BE DONE AFTER

MUCH PLEADING BY THE BOYS FATHER CONSENT WAS GRANTED UNDER

ENDOTRACHEAL THE CLEFT ANESTHESIA LIP WAS CLOSED SUCCESSFULLY AND

AS SOON AS THE SUTURES HAD BEEN REMUVCD TH CHILD WAS TETURNED

TO MAMMITUPPU THE ENTIRE VILLAGE MARVELED AT THE MIRACLE AND

THE PATIENTS GRANDPARENTS THE MEDICINE MEN STATED THAT DR BLOCKSMA MUST BE GOD FOR CERTAINLY NO MAN COULD HAVE

MENDED THE BOY IN THAT MANNER HE WAS GIVEN THE NAME OF

RAFAEL AFTER THE SURGEON AND BROUGHT SIX EGGS AS TOKEN OF HIS

1058 THUS THE CLOSURE OF CLEFT THE SAN APPRECIATION LIP FINALLY OPENED BIAS ISLAND MAMMITUPPU TO THE TEACHING OFCHRISTIAN MISSIONARIES

EXTENSBN IN PANAMA

DANIEL GRUVER BORN INTO KANSAS CITY BAPTIST MISSIONARY FAMILY

ALASKA AND COSTA EARNED AN AT SOUTH SERVING IN RICA AOA KEY

WESTERN MEDICAL SCHOOL IN DALLAS AND COMPLETED RESIDENCY AT

HE THEN BECAME THE FIRST DOCTOR IN GORGAS HOSPITAL IN PANAMA FINISHED MARVEL IN SAN THE PARTIALLY IGLESIAS HOSPITAL AILIGARDI GRUVE THE DOCTOR AND DENTIST FOR BIAS PANAMA AND FOR YEARS WAS ONLY

30000 INDIANS IN ADDITION HE FLIES AN AMBULANCE PLANE STARTCD IN SAN BLAS 100ACRE FARM SET UP THE FIRST WATER SUPPLY SYTEM

RUNS THE TOWNS LIGHT SYSTEM CREATED FEEDING CENTERS TO PREVENT IN THE AS KWASHIORKOR AND GIVES DAILY DEVOTIONS KUNA LANGUAGE

HE WROTE IN 1977

ANOMALIES AND THE KUNA INDIANS HAVE AN EXTREMELY HIGH RATE OF CONGENITAL

IN THE WORLD THE KUNA INDIANS THE HIGHEST INCIDENCE OF AIHINOISM HIGH IN THE WORLD INCIDENCE OF CLEFT LIP SEVERAL TIMES GREATER THAN ANYWHERE ELSE

OF TO HE THE CLOSURE OF HIRRHS CAUSES THE MAJOR PART MY PLASTIC SURGERY IN OTHER OF CLEFTS ALTHOUGH HAVE HAD NO FORMAL TRAINING PLASTIC SURGERY SCRUHHED WITH HAVE THAN THE SEVERAL DAYS IN JAMAICA IN 1969 WHEN YOU

BEEN ABLE TO MAKE THESE BABIES ACCEPTABLE TO THEIR FAMILIES AND HAVE ADOPTED BOIN SEVERE BILATERAL CLEFT WHICH HAS HAD PRELIMINARY ADHESION BABY DO NOT WITH CLEFT HERE WILL BE DESTROYED IF NOT OPERATED BEFORE DISCHARGE

THE RESULTS OF HAVE SEE CLEFTS IN ADULTS SINCE CLEFT CRAFT MY SURGERY GREATLY TAKE IMPROVED HAVE LEAVE OF ABSENCE DURING WHICH RIME HOPE TO ONE AND TWO OF IN MIAMI YEAR OF ROTATING GENERAL SURGERY YEARS PLASTIC SURGERY IN MIAMI IN MID1979 HE TOLD ME WHILE IN TRAINING IN PLASTIC SURGERY

BUT COSTS IN 1968 DRUM OF OIL DELIVERED TO SAN BIAS COST FIVE DOLLARS TODAY

WHEN RETURN IS TO WINDMILL 60 DOLLARS THEREFORE MY FIRST PRIORITY GET FOR THE WORKING TO PIOVIDE ELECTRICAL ENERGY HOSPITAL OPERATING ROOM REFRIG AND AUTOCLAVE ERATORS XRAY LIGHTING CENTRIFUGE

AND SO

TOLD IN CAN BE SUMMED IN THE COVER BOY THE STORY CLEFT CRAFT UP

IN DETAIL 350 OF VOLUME BUT WHOSE WHOAPPEARS ON PAGE SPIRIT

1059 LINGERS THROUGHOUT VOLUMES II AND III HE MAY BE TWENTIETH

CENTURY AMERICAN 4YEAROLD BUT HE STANDS FOR CHILD WITH CLEFT

OF ANY COUNTRY IN ANY CENTURY THE GENES HE HAS INHERITED FOR

BRAINS AND WILL THE TEMPERAMENT EXERT GREATEST INFLUENCE THE

FAMILY FRIENDS SOCIOECONOMIC SITUATION AND SPECIFIC POINT IN TIME

AND SPACE WITH WHICH HE IS PRESENTED WILL DETERMINE HIS TREAT MENT

HERE HE IS AFTER SURGERY WITH HIS HAIR COMBED IN FRONT OBVI

OUSLY ARRANGED ONLY UNDER PARENTAL DURESS SPECIFICALLY FOR VISIT

TO THE DOCTOR HIS LIP SCAR IS NO MORE NOTICEABLE THAN THE SCRATCH

ON THE SIDE OF HIS NOSE FROM SCRAP WITH THE KID DOWN THE BLOCK

THANKS TO CENTURIES OF SURGEONS THE EVOLUTION OF THIS CRAFT HAS

ADE IT POSSIBLE TO CAMOUFLAGE HIS CLEFT SO THAT AT THE AGE OF 19 HE

CAN TAKE HIS RIGHTFUL PLACE AMONG MEN FREE TO BECOME WHATEVER

ABILITIES WILL ALLOW PLUMBER PICCOLO PLAYER PILOT PEDIATRI

AN OR PRESIDENT

RIP HE BECOME AGE 19 YEARS HOPES TO PILOT

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