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Haitian teenager looks forward

The 3-year-old girl in the photograph wore a white dress and cap. She had her mother's nose, big brown eyes and two baby teeth peeking through her wide smile.

But what Marlie Casseus now saw in the mirror bore no resemblance to the girl in the picture. All that was left of Marlie's nose were two distended nostrils. A single tooth poked through the membrane of her upper lip. Her reflection barely looked like a girl.

As a toddler, Marlie looked like she had the bone structure and symmetry of a beauty. By the time she was 14, whatever was under Marlie's skin looked like a basketball, two eggplants, a Voodoo curse, a hippo's snout, a second stillborn head.

One night last year she stood at the mirror with a knife, making slashing motions, as if she wanted to cut the massive deformity out of her face and end her misery.

It would take a team of Miami doctors to cut away the 16-pound monster and release the girl inside.

Dr. Jesus Gomez, the maxillofacial surgeon who led the medical teams operating on Marlie at Holtz Children's Hospital in Miami, says the tumor-like mass that engulfed Marlie's face probably started growing when she was as young as 5.

The bone was softening and seeping into the hollow spaces of her skull.

Maleine Antoine says Marlie's speech was never really clear, and her permanent teeth weren't coming in, but she never worried until she noticed the two small bumps growing on either side of her 8-year-old daughter's nose.

With no advanced medical imaging in the impoverished Caribbean country, no one could see that the bumps were not growing on the bone - the bumps were the bone growing wrong, ballooning and turning to jelly, riddled with pockets of liquid and air.

What everyone did see was Marlie's nose stretching into a snout, her eyes sliding farther apart and her upper lip pushing out past her chin.

She retreated home to do the ironing, wash her family's clothes, clean their concrete block house and cook their meals.

Antoine gave up consulting doctors. One of the last they saw told Antoine and her husband to take comfort in their other two healthy daughters, because Marlie was a lost cause.

By chance, Marlie's father caught a local news broadcast last summer about Gina Eugene, a Miami woman who, with her twin sister, runs a Haitian children's charity. He called to Marlie, "This is your savior!"

She endured a series of surgeries starting in December 2005. The latest was performed in early October and removed the mass from her face.

Dr. Gomez says the lesion that distorted Marlie's face probably will not grow back, though her condition - a rare form of polyostotic fibrous dysplasia, a nonhereditary genetic disease - requires lifelong monitoring.

"Part of the recovery is to try to introduce a patient to their home environment again, not to keep them in a bubble," Gomez says.

Before her last surgery, Gomez told Marlie to start practicing her whistle to strengthen the facial muscles she'll need to eat and speak.

Marlie has not eaten real food in a year, just the liquid diet pumped directly into her stomach.

A scar loops from one tear duct, down around the reduced nostrils and the back up to the other side.

The 15-year-old used to count down the days to each surgery. Now she asks her mother when she'll be starting school.

"She's happy she will go back to school," Antoine said, "because she will be like everyone else."

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