Jim Maki doesn't remember falling off a Boston subway platform -- but in that instant his face, and life as he knew it, was gone.
Four years later, Maki would get an astonishing second chance. He would receive another man's features thanks to a groundbreaking face transplant surgery and one woman's generosity to honor the man she loved.
But the procedure came with enormous risks. At the time, Maki would become only the second person ever to receive a face transplant in the U.S., so the surgical team would be heading into uncharted waters.
Watch the exclusive behind-the-scenes of Maki's face transplant on "Boston Med" tonight at 10 p.m.
Burn center director Dr. Bohdan "Bo" Pomahac was on call on June 30, 2005, when Maki was admitted to the intensive care unit of Brigham and Woman's Hospital. Maki had accidentally fallen face first onto an electrified subway rail.
"The tissues basically got vaporized. It was literally like how you would create a crater in the middle of the face," Pomahac said.
Maki suffered third-degree burns and had lost his nose, cheeks, teeth, part of his mouth, muscle, bone and nerves, in addition to damaging his arm and one of his eyes. In all his years as a plastic surgeon, Pomahac never had seen a facial injury so severe. He knew the lost tissues were irreplaceable, so "patients like him are doomed."
"It was difficult for him to speak, eat or drink," Pomahac said. "I don't think that any one of us can quite imagine what it is like living without a face. ... If you're horribly disfigured, and you can't really express yourself when you speak, it's a bad combination. You are just at the mercy of people and their judgment."
Unable to endure the stares, insults and, sometimes, physical assaults, Maki became recluse, preferring to stay in his home outside of Boston.
"I've had young kids come up to me and ask if I was real," Maki recalled. "It was uncomfortable. ... They usually stay away from me."
Over the years, Pomahac performed multiple procedures on Maki's face, but felt helpless that he couldn't do more. So after several extensive medical and psychological evaluations, Maki became listed as a face transplant candidate in February 2009. Now, all that was needed was a donor.
A child of Holocaust survivors, Joseph Helfgot, grew up dirt-poor, but would go on to become a university professor, a radio talk show host and, eventually, a successful Hollywood businessman. He had no idea his long list of achievements would also include "life saver."
Helfgot suffered from heart problems his whole life, but his condition became worse after he entered his 50s. When he was wheeled into surgery at Brigham and Woman's Hospital for a heart transplant in April 2009, he had a stroke on the operating table and was declared brain dead.
"It happened so fast I couldn't really believe it, and I just flashed back to the night before when Joseph and I had this conversation," said Helfgot's widow, Susan Whitman. "'If anything happens to me,' Joseph said, 'I really want you to remember that I'm an organ donor and I want you to do it.' "
Whitman and her family prepared to donate Helfgot's liver, kidneys and his transplanted heart.
But the New England Donor Bank had another request it had not asked many people before.
"I just remember thinking, how can you take somebody's face off of them?" Whitman said.