The Emotional Journey of Photographing a Face Transplant

Maggie Steber and Lynn Johnson reflect on capturing the story of Katie Stubblefield, the youngest face transplant patient in the U.S.

Taking advantage of a sunny spring day, Katie and her parents, Robb and Alesia Stubblefield, indulge in a nap in a park near the Cleveland Clinic. With Katie in a wheelchair, the three explored the park, wandering amid blossoming trees and singing birds. The outing came after Katie had spent a month in the hospital. To reposition her eyes, she had surgery to implant what’s known as a distraction device. In the three years before her transplant, Katie was hospitalized more than a dozen times.

Katie sits beaneath a tree along the Wade Lagoon in Cleveland, Ohio. During a walk with her parents, her father parked her wheelchair in the spot and described the scene before leaving her for some rare alone time.

Katie and her parents leave the Crile Eye Clinic at Ohio's Cleveland Clinic. Katie's eyesight was damaged during her suicide attempt and doctors have inserted contact lenses to help her see better.

Katie's mother, Alesia, helps her get ready for bed at their Ronald McDonald House apartment. Every night, Katie takes a cocktail of pills through a hole in her stomach. On this night, Katie's forehead, where a metal plate sits behind her skin, was itching so badly that Alesia held her while her father, Robb, read Bible passages out loud until she felt tired.

Katie hugs her mother as they stand outside Cleveland Clinic's eye clinic after an appointment.

At Cleveland’s Tudor Arms Hotel, Katie and her father sing “Have I Told You Lately That I Love You?” as they share a dance. “Before this, I never spent so much time with my parents,” said Katie, who credits their love and devotion with helping to save her life. “Are we still broken over this whole thing? Oh my gosh, yes,” Robb said. “Things happen in life that shatter us to pieces, but I think it’s where we go from there.”

Before Katie Stubblefield had a face transplant, she posed for this portrait. It shows her severely injured face—but photographer Maggie Steber also wanted to capture “her inner beauty and her pride and determination.”

Celebrating Katie’s 21st birthday, her mother tells her to make a wish and blow out the candle. The family went to restaurants even though Katie sometimes heard people whisper about her face. It upset her, but she pretended she didn’t hear. She wanted to tell them, “I got hurt, but I’m getting better.”

The evening before surgery, Katie, whose damaged face was reconstructed, gestures to show that she’s excited to be getting a new one. She shares the lighthearted moment with Diana Donnarumma, a friend she made at the Ronald McDonald House, and nursing assistant Karnyia Wade.

Papay (at right) and Raffi Gurunluoglu, another surgeon, work to remove the face of the donor. The operating room was often packed with surgeons, specialists, nurses, and residents who were observing. Images of Katie Stubblefield on the wall behind the team remind them what’s at stake.

Sixteen hours into a transplant operation at the Cleveland Clinic in Ohio, surgeons finish the intricate task of removing the face from an organ donor. Awed by the sight and by the gravity of their work, the team falls suddenly silent as staff members document the face in between its two lives. The surgeons would spend 15 more hours attaching the face to Katie.

Katie's family looks at her new face after the transplant surgery is complete. During the procedure, surgeons returned to Katie's parents multiple times to discuss how much donor tissue they should use. In the end, her parents decided to transplant the entire face, despite the greater risk of rejection, since they knew that's the choice Katie would have made.

Alesia hugs Katie's swollen and stitched head at the Cleveland Clinic. After her transplant surgery, Katie was almost never alone—frequently being checked on by medical professionals and consistently tended to by her parents.

Determined to help Katie live a life as normal and valuable as possible, Robb and Alesia put their own lives on hold for more than four years. Pushing through exhaustion, relying on their faith in God, they accompany their daughter to endless appointments and therapy sessions. They’re already looking into ways to improve Katie’s vision, including the possibility of eye transplants. They expect to remain in Cleveland near the clinic and Katie’s doctors for the near future.

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The face, detached from its organ donor, rested on a tray. The surgeons who had removed it stared, pausing before transplanting it. “It was just a breathless moment,” says photographer Lynn Johnson. “People were sort of stunned.”

Everything stopped for an instant of “reverence,” she says, as she recorded the moment. “And then they gathered themselves up and got down to stitching it on.”

Click to Hear Lynn Johnson Talk About This Photo

The remarkable photograph became the lead image in National Geographic magazine’s cover story on the surgery in the September issue.

Johnson was one of two veteran National Geographic photographers who documented Katie Stubblefield’s journey as her face, severely damaged during a suicide attempt with a rifle, was reconstructed and then replaced.

For two and a half years, photographer Maggie Steber followed Katie and her family, commuting from her home in Miami to spend weeklong stints at the Cleveland Clinic in Ohio, where surgeons cared for Katie, and the Ronald McDonald House, where Katie lived when she wasn’t hospitalized. Steber did everything the Stubblefields did, leaving them only to sleep, and came to consider herself part of their family.

Click to Hear Maggie Steber Talk about These Photos

“They would share their deepest thoughts with me,” Steber says. “That’s quite a privileged position. Sometimes photographers need to put down the camera and just listen to their subjects.”

But when the call came that a donor had been found, Steber was thousands of miles away in Dubai—too far to make it back in time. “They weren’t going to wait for me, and why should they?” Steber says. “I fell to my knees and wept.”

That’s when Johnson stepped in. “Lynn is a really sensitive photographer and a very good friend,” says Steber. “She’s like my sister. This is our story. We get to share it.”

During the 31-hour procedure, Johnson bounced between the Stubblefields and the surgeons. “There was a very casual kind of tension in the room,” she says.

Click to hear Lynn Johnson Talk about this photo

Johnson captured Katie’s transformation in the operating room, but Steber chronicled a family transformed by a new mission. “They were heartbroken and shocked at what happened, but they have embraced it,” Steber says of Katie’s parents, Robb and Alesia. “They are warriors. They’re like eagles who are protecting a young bird. And now Katie has a mission in her life. She can try to save other young lives.”

She also witnessed Katie’s physical and emotional agony when she suffered through surgeries to repair her injuries and then struggled with her new face. The experience was so intense that Steber sometimes had to call National Geographic photo editor Kurt Mutchler for a pep talk. “You just have to listen to them and have empathy for what they’re going through,” Mutchler says.

Steber decompressed on long walks, absorbed by Katie’s decision to shoot herself and the price she paid. “Sometimes life takes your life from you although it doesn’t kill you,” she says. “Katie paid for it over and over and over and over in ways that were extremely painful.”

Once she stopped photographing, Steber handed over thousands of images—shot on film—to Mutchler and his team. “It was probably four, five thousand pictures,” he says. With shorter shoots, Mutchler notes, it’s easier to construct a narrative. In this case, creating a coherent story out of years of photos was a real challenge, and some of both Mutchler’s and Steber’s favorites were left on the cutting-room floor.

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Weeks after Katie's transplant surgery, doctors remove half of the stitches along the line where her scalp was connected to the donor tissue. The procedure was painful and Katie called for her mother as the sutures were pulled.

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Katie brings her hand to her face as she copes with the pain of the suture-removal procedure.

Katie takes a moment for herself in her room, a rare occurrence in the hospital, as doctors and others frequently stopped by to check on her progress. Her new face, with the sutures still in, remains quite swollen.

One did make it into the final story: an image of Katie sitting alone on her hospital bed after the transplant. As usual, says Steber, the room was “a flurry of constant activity. But nobody was talking to Katie. She was sitting there in her own little quiet moment of reflection.” It was a rare private moment. “In the end, we have to deal with ourselves.”

For Steber, Katie’s new face is much more than a medical marvel. “It’s not about how you look,” she says. “It’s about your spirit. Your face is a map of your life.”

Click to Hear Maggie Steber talk about this photo

She hopes Katie’s story advances scientific knowledge and makes people think. “People look away from everything, don’t they?” she says. “They look away from pictures of starving children, of war. They have the choice. But then I think of all the people who will be very interested. Maybe there are some children who will become doctors one day because they see this. We have to think of the people who will be inspired and informed and changed by this.” 

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