Aug. 10, 2012 at 1:15 PM ET
Charla Nash, the victim of a horrific attack by a 200-pound chimpanzee, appeared Friday at a Connecticut legal hearing, where officials are deciding whether she can sue the state for $150 million.
The attack occured when Nash had gone to visit her friend, Sandra Herold, back in 2009. She had just gotten out of her car when Herold’s chimp spotted her, went berserk and attacked. A terrified Herold dialed 911 and Charla was rushed to the hospital where doctors managed to save her life, but not her face or her hands.
Speaking clearly and looking remarkably recovered from the disfiguring attack and her 2011 face transplant, Nash spoke exclusively to NBC News about her recovery and her hopes for the future.
"I need to keep building up my stamina," Nash said. "Hopefully by Christmas I could get hands."
Back in May 2011 doctors gave Charla her new face, from an anonymous donor, in a grueling 20-hour surgery. The 30-member surgical team, under the leadership of Dr. Bohdan Pomahac at Brigham and Women’s Hospital in Boston, performed a groundbreaking full face and double hand transplant. She later lost the hands due to complications, but her new face thrived.
As time went on and the swelling went down, Charla's new face began to mold to her underlying bone structure, giving her an appearance reminiscent of the way she looked before the horrifying attack in 2009.
Looking at Nash on Friday, it was hard to imagine that just three years ago she had no nose, lips, or ears. Though the right side of her mouth droops a bit because of nerve damage, Nash’s face looks otherwise quite normal.
“Overall, it’s really superb – a remarkable result,” said Dr. Eduardo Rodriguez, a professor of surgery at the University of Maryland School of Medicine and Chief of Plastic Surgery at the R Adams Cowley Shock Trauma Center.
Rodriguez, who led the team that transplanted a face in March of this year, suspects that Nash will continue to improve with time as nerves continue to rewire and the facial muscles get more use. Nash told NBC that she's been exercising to build up her muscles, and demonstrated with pride how she can now close her lips fully.
Experts say it takes months for the nerves emanating from transplanted faces to connect with a patient’s brain.
In Nash’s case, “she is more than a year past her surgery and the nerves have started to grow back so she can make facial expressions and do the kinds of things a normal face does,” said Dr. Daniel Alam, section head of facial plastic and reconstructive surgery at the Cleveland Clinic. Alam was Nash’s initial reconstructive surgeon and took part in her transplant surgery.
“The holy grail for us is to learn to make the nerves work better,” Alam said. “Right now, we can make them work and recover function, but there tends to be some asymmetry, with the nerves on one side working better than the other.”
The magical part, Alam said, is not that the transplant survives and molds to the patient’s face, but that it actually hooks up with the region of the brain that tells it how and when to move.
“Inside your brain there’s a part near the ear, called the facial motor, that tells the face what it needs to do,” Alam explained. “Its branches tell the eyes when to close, the mouth when to smile. Each tiny movement of the face is like a note in a piece of music. If you think of the face as an instrument, the brain is sending all the notes to that instrument and making it play.”
The process doesn’t end when doctors put in their last stitch, though. After surgeons connect up what they can, the brain does its own bit of rewiring.
“It’s fascinating,” Alam said. “Six months to a year after the transplant, the recipient’s nerves grow into the face. So you get a hybrid. You’ve got the donor face, but your own nerves grow into the muscles and tell them what to do.”
Nash said she was tired after the hearing because she's not used to such lengthy public outings, but overall said, "I'm doing OK."
Nash, who has amassed millions of dollars in medical and other bills, said she's holding out hope she will be granted permission to sue the state's Department of Energy and Environmental Protection, which she holds responsible for not seizing the animal despite a state biologist's warning it was dangerous, according to the Associated Press.
Assistant Attorney General Maite Barainca told Claims Commissioner J. Paul Vance Jr. that Nash deserves sympathy for her plight and admiration for the courage she has shown in dealing with her situation, but argued that the state should not be held liable for actions of the privately owned animal, the AP reported.
A decision on the state's motion to dimiss is expected to be issued within 30 days. If the commissioner rules against Nash, she can ask state legislators to overrule the decision. If the state's motion to dismiss is denied, a trial-like hearing will be held. Then the commissioner would then have to decide whether to allow Nash to sue the DEEP in superior court, according to the Associated Press.
Charla Nash's family has established a fund for her care at nashtrust.com.
For more about Charla: NBC News takes an in-depth and intimate look at the Charla Nash story in the eBook The Woman Who Lost Her Face. For more information go to NBCpublishing.com.
The Associated Press contributed to this report
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