Best Doctors

Saving Face

A few moments later, he found what he was looking for: a lane beneath the skin with room to maneuver.

“Okey dokey,” he said.

“As long as you’re not saying ‘Oops,’ ” his assistant replied.

Music played from a boom box attached to Waner’s iPod.

Classic rock: Eric Clapton, the Beatles, the Stones.

Occasionally Waner sang along, but his voice barely rose above a murmur. Having found the plane, Waner was now in control. He moved along the top of the hemangioma, making small brushstroke-like motions with the electrocautery device, cutting through the tumor. He was in a state of rapt attention, oblivious to the presence of others in the room, oblivious to the passage of time or to hunger or fatigue.

He knew his luck would run out soon, that his progress would be halted by the feeder artery that was buried in the mass. He could tell he was close to it. His assistant held back the skin flap with a two-pronged retractor. He made tiny stabs at the tissue. Then, abruptly, he froze. He had glimpsed the artery tunneling through the tumor. He called for a pair of fine forceps, and sliced tissue away from the artery on one side, then the other, picking away at the tumor until he found daylight beneath the artery. He maneuvered a clamp beneath it and shut down the supply line that was fueling Aslynn’s tumor and destroying her heart.

Waner had turned a corner. He was about three-quarters of the way through the eight-hour surgery, but the greatest danger had been conquered, and he could see his way toward the end. He continued to undermine the tumor, at times using a scalpel whose blade was heated to 350 degrees—perfect for simultaneous cutting and clotting. When the threads that had connected the hemangioma to healthy tissue had all been severed, he gingerly scooped the mass out in a single piece. He gazed at it with some bemusement. It was, he thought, the size of a giant South African mango.

Now, with the tumor gone, he went about the task of trimming and molding Aslynn’s stretched skin. He worked like a sculptor, making tidy folds and creases, discarding excess material, building a scar that would flow naturally along the contours of her skull. He began knitting seemingly endless loops of sutures. He worked Aslynn’s bent ear back into shape. For the first time in nearly a year, her head tapered smoothly to her neck. The distended skin was gone. The incision was closed with a tidy seam. The surgery had been “backbreaking,” Waner conceded. Then he stood back to examine his handiwork. “Lovely,” he said.

“Waner knew he was close to the feeder artery buried in the mass. He made tiny stabs at the tissue. Then, abruptly, he froze.”

The Browns returned to Iowa five days after the surgery. The next week, at Aslynn’s 15-month pediatric checkup, her heart murmur was barely detectable. Today, she has begun tapering off her heart medications and is gaining weight. “Aslynn has really come alive,” Jill says. “She climbs all over furniture and dances up a storm.” Hair has quickly grown over her incision, and she betrays no awareness of having had surgery. Unless something unexpected happens, she won’t need any more.

Sometimes Jill forgets that the hemangioma is gone. When she lays Aslynn down to sleep, she finds herself surprised to feel the hardness of Aslynn’s scalp. For the first time, she can fasten the buttons of Aslynn’s shirts around her neck. She and Paul are still adjusting to life as parents of a healthy baby. On trips out of the house, Jill is taken aback by how little attention Aslynn attracts. “We haven’t heard one negative word since we came home,” she says.

Jill has a habit, she says, “of elevating Dr. Waner to the status of God,” but Waner doesn’t like to hear such talk. “I grew up with low self-esteem,” he says. “I’m uncomfortable with adulation.” Still, some facts speak for themselves: No patient of Waner’s has ever died during surgery, and as far as he knows, none of his thousands of patients with vascular abnormalities has ever failed to benefit from treatment.

This much, the doctor will allow: “Aslynn Brown,” he says, “is a perfect child.”