Article: Psychological Effect of Facial Injuries On Teen-Aged Girl

The following is reprinted with permission from HANDLING ACCIDENT CASES and first appeared in print in February 1987. Copyright © West Group. Please click here for information about this work

Psychological Effect of Facial Injuries On Teen-Aged Girl

Adolescence and young adulthood is often a time of intense concern, even to the point of preoccupation, with ones appearance, attractiveness, and social desirability. When a person of that age sustains serious injury to the face that can never be totally repaired, the effect on the young persons mental well-being and sense of self can be devastating.

The following transcript is reprinted through the kind permission of Denis H. Mark, Esq., William C. Waller, Jr., Esq., and Jersey M. Green, Esq., of Denver. Their client, a 17-year old woman, suffered conspicuous and permanent facial scarring, as well as nerve damage, following an automobile accident. In the course of the trial, the plaintiff's mother testified as to the devastating effect of these injuries on plaintiff's social life and self-esteem. Mr. Green's examination illustrates how a knowledgeable and sympathetic witness can convey the plaintiff's loss to the jury, despite the intangible nature of that loss. Mr. Green's skill can be measured by the verdict: the jury awarded plaintiff $3.05 million total damages.

Additional material from this case appears in the supplements to Volume 2 (at chapter 21, section 210 Shielding Traumatized Plaintiff from a Witness) and Volume 6 (at chapter 99 Testimony of Plastic Surgeon).

The transcript has been lightly edited for clarity and to delete proper names.

Q. Will you please state your full name and address for the record.

A. (name), (address), California.

Q. What is your relationship to (Plaintiff)?

A. (Plaintiff) is my daughter.

Q. Where was she born?

A. She was born in (city), Maryland, on (date).

Q. Does she have any siblings?

A. She has three brothers.

Q. What occupation did her father have as she was growing up?

A. My husband was in the military and in (Plaintiffs) lifetime he was in the military the full time.

Q. Did that involve the family moving around?

A. Yes. (Plaintiff) was born in (city) and both my husband and I are from (same city), and (Plaintiff) was just about five years old, and my husband received orders to go to Germany. And from (city) we went to Germany. And we were there three years, and then we came back to the States. And when we came back to the States, we lived in (city), Washington and in California. And then we were overseas to Okinawa.

Q. When did you return to the United States?

A. (Date). (Plaintiff) was about eight years old at the time.

Q. How did this uprooting affect her ability to make friends?

A. I think being a member of the military and having to move around a lot, I think that it gives children an advantage over others. I think you have to have a little more confidence in yourself and you make friends rather easy. Being uprooted at different points and different times in your life, you have to make friends and you do cope with it, and you make friends easily.

Q. Did she make friends easily?

A. Yes, she did. I think (Plaintiff) was a normal child and first day in any new place I think is difficult and, you know, oh, I am a little afraid, but once she was in class or once we got to a new place, she blended in and had many little boy friends and girl friends.

Q. How did she do in school?

A. Well, I think (Plaintiff) was an average student, werent any failures and werent any really high honors. She was an average student.

Q. What was your observation as to her ability to make friends in the year preceding the collision?

A. Well, again, I think having a military background helped (Plaintiff) and she was able to make friends. She had friends in school. She had boy friends and girl friends. And they would come to the house, I mean not excessively so and not never sitting home. I mean, she had average boy friends and girl friends.

Q. What kinds of things did she like to do?

A. As a teenager (Plaintiff) liked to shop. She would talk on the phone if her girl friend wasnt at the house or her friend wasnt at the house. Sometimes (Plaintiff) we had one phone and sometimes (Plaintiff) would be on the phone an hour and a half, you know, say, can I use the phone. She talked with her girl friends and, you know, what do teenagers talk about. And we would go shopping together frequently.

Q. What kinds of things did she like to shop for?

A. (Plaintiff) liked to shop for clothes, makeup. We again, maybe as a mother of a teenager, we would go to 12 stores and she would try on 32 blouses. And at that time we would come back to the first store and maybe try on the second blouse, and maybe I liked this, but she was particular. This blouse was too puffy. This one didnt have enough buttons. This one had too many. This one had buttons but a collar. And this one had a collar and no buttons. Very particular.

Q. How concerned was she about her appearance?

A. (Plaintiff) was quite concerned. She tried the new makeups that would come out. She would primp in the mirror sometimes quite a long time. If she had a date I would say to her, will you start getting ready at three oclock. (Plaintiff) had a few pimples as a teenager. Most teenagers do. She was concerned with that. If something new came on the market, Clearasil or a soap or something, right away we had to try that or she had to try that because this will get rid of it. Mom, I know this will. She was concerned about her appearance. There were times when if she were getting ready for a date, there was one time particularly that in one day she went through a complete roll of toilet tissue. She was in the mirror. And you know, maybe the mascara didnt go on right, so off it would come, get the toilet tissue, and that would come off, and then try it again. Or maybe the lipstick wasnt right, and off it would come, the toilet tissue. And that would come off. And this just isnt right. And we would try again. Every hair had to be just in its place, and the sleeves puffed or just right.

Q. You were mentioning boy friends. What kinds of boys did she go out with?

A. Before her accident (Plaintiff) had several boy friends. They were good-looking boys. She brought them to the house. She was not embarrassed or ashamed to bring them to the house. They were clean-cut, well mannered and well behaved.

Q. How many did she have?

A. Oh, I guess in the year before the accident she had, oh, maybe four, maybe five.

Q. What were her career ambitions?

A. In the year before the accident, Marianne had talked about two things: She wanted to be an air line stewardess. She also talked about being a model. She had sent away for brochures in both fields and had received some information back regarding both of those.

Q. I am handing you what has been marked as Plaintiffs Exhibit J-1. Can you identify that, please?

A. Yes. Thats my daughter (Plaintiff).

Q. Does that photograph truly and accurately portray the way she appeared prior to the accident?

A. Yes, it does. This was taken within a month prior to the accident.

Q. I am handing you Plaintiffs Exhibit J-3. Can you identify that?

A. Thats also my daughter (Plaintiff). This was taken a short time before the accident.

Q. Does it truly and accurately portray how she appeared?

A. Yes, it does.

Q. When was that second one taken, maam?

A. A short time before the accident. I dont know just I cant pinpoint a date.

Q. Were they both taken about the same time?

A. No. The first one was taken within a month. The second one was maybe four months, three months.

Q. Was there anything significant about the date of the accident besides the accident itself?

A. Yes. It was my birthday.

Q. Had (Plaintiff) made any plans for that day?

A. (Plaintiff) had made two cakes for myself. It was a new recipe and it was a new cake. It was a pistachio cake. The first one she made she left the oven on preheat and after the time she went in and saw the cake that way so she had to run out and get some other ingredients to make a second cake. And she had the second cake made and we were going to have just a little get together that evening.

Q. Where were you when you learned of the accident?

A. I was at the office. I work for the government. I was an accountant bookkeeper for the hospital at ________ here in (city). I was called approximately twenty after four that day by one of the doctors at the hospital. And he asked me if I had a daughter named (Plaintiff), and I said yes. He asked me, could she be in _________. And I said, yes, thats where we lived. And he said, well, she had been involved in a car accident. And I said, How serious? And he said, Well, dont run any red light getting here, but get here as quickly as possible. And so I did. I wasnt able to drive. I didnt have a car that day. A friend of mine that worked there at ___________ also was there, so I called her and she immediately came to take me to the hospital. We werent even sure where __________ Hospital was at that time, but we got to the Hospital I guess about five-thirty.

Q. Were you permitted to see (Plaintiff)?

A. No, I was not. I wanted to and I asked to and the doctor said that she was in the emergency room, trauma room one or trauma room two, and that the doctors and nurses were with her, that I could get to see her later. Later wasnt until much later. They never let me see her at that time.

Q. How long was it before you saw her?

A. It was about midnight before I saw (Plaintiff).

Q. During the time that you were waiting, did anyone else come and see (Plaintiff)?

A. Yes. I called the parish to which we belonged and Father J______ from that parish came down to see us to be with the family and with (Plaintiff). Father J_______ administered the last rites to (Plaintiff). Being a member of the clergy, he was allowed to see (Plaintiff) before I was, to administer the last rites.

Q. When you were permitted to see (Plaintiff), describe what you saw.

A. When, after all this time, I was finally allowed into the Intensive Care Unit at the hospital, there was a scurry of nurses and doctors around (Plaintiff). To me it seemed like the room was filled with probably like six or eighth of them. There were tubes in (Plaintiffs) nose. There was a small tube in one corner of her mouth and a large funny-looking tube which I learned was the respirator, the other side of her mouth. There were tubes in both arms and there were tubes in her shoulders. When I went in, I went to the other side of (Plaintiffs) bed because with the nurses and the doctors scurrying around (Plaintiff), I thought, where can I fit it. And at that time it seemed like a little opening on the other side of the bed, so I went around to the other side of the bed and there I fell over because theres this, I guess it was pumping blood into her, but this big bottle, jar, whatever, and you could see the blood gurgling through the tubes from (Plaintiff) and this blood in this jar, whatever it was, just gurgling, and it was gurgling in her arm. (Plaintiff) was awake. She was conscious. And although she was strapped down to keep herself from pulling any of the tubes or removing anything or doing any damage to herself, further damage to herself, her hands were free and she reached for my hand and I held on tightly. She later said that was her lifeline with me and her brothers, that she felt as long as she would be able to hold onto us she would live. Excuse me. At one point in time that night she took this one hand and was going like this, and one of the doctors saw her, and he turned his head and just shook his head and kind of just like that, and one of the doctors or nurses, they just looked and they thought she was having some kind of traumatic seizure or they said it was her nerves and she kept going like this. And one of the nurses that came in finally said it just dawned on her, she said (Plaintiff), do you want to write something, do you want paper and pencil. And (Plaintiff) just shook her head, nodded yes. So the nurse went out to get a pencil and paper. And when she brought it in, (Plaintiffs) legs were up in the bed because she had such a severe cut in the one knee and she was like propped up, her legs, and (Plaintiff) wrote on the paper. First she said I love you. And then she wrote, Am I going to die. And at that time I prayed very hard to give her the right answer. I couldnt ever give up. So I threw the burden back on her and I looked at her directly and I asked her if she wanted to, and she shook her head no. And I said, well, then, its up to you, if you dont want to. (Plaintiff) looked a mess, and I didnt see how she could live. She didnt have (Plaintiff) has long blonde hair. She had long blonde hair since I guess I think (Plaintiffs) gotten her hair she's had it trimmed recently, and she has it trimmed, but (Plaintiffs) always had long hair. When I saw her that night she had gauze around her forehead. She had gauze that jutted out completely down each side of her face. She had gauze under. And (Plaintiff) had red hair. There wasnt one strand that I could see of blonde hair on her head.

Q. How long were you permitted to see her?

A. I guess I was in the room 15 or 20 minutes.

Q. Did you see her the next day?

A. Yes, I did.

Q. What happened?

A. (Plaintiff) asked for a mirror. She wrote, can I have a mirror? And I didnt know how to cope with that. They had removed some of the gauze from around her forehead and from the side of her face although the face was still patched and bandaged, and the big stitches on the side of her face and under her chin and around, and I thought, I cant let her see herself. I didnt know what it would do to her. The doctor wasnt there, so I just stalled her and I told her that I didnt bring my purse with me and I didnt have a mirror with me. And I stalled her as far as letting her see herself. And then I thought to myself, you know, how long can I go on with this.

Q. But she eventually came home. What was she like when she got home?

A. When (Plaintiff) came home, and in the hospital too, but when she came home (Plaintiff) was completely devastated. She felt in her own mind, and she told me, why didnt I die. Look what I look like. Who would want me now. Nobody will ever look at me again. I dont see how you can look at me, Mom. Look what I look like. Im a freak. Im deformed and Ill never be me again.

Q. What kinds of things did she do?

A. (Plaintiff) talked about the accident incessantly. Sometimes it would be twelve, one oclock in the morning and she would still be talking about the accident. She would wake up in the morning and the first thing out of her mouth was about the accident. The last thing at night before she went to bed was about the accident. She constantly, constantly talked about the accident. And the opinion of herself, you know, nobody wanted her, nobody would love her, Im her mother, I had to love her, but I certainly didnt want to look at her, you know. How could anybody look at her. She was a freak.

Q. What did she recall about the accident?

A. (Plaintiff) didnt recall a lot about the accident, and this bothered her. It got to the point where she felt it was driving her crazy, and (Plaintiff) wanted to see a doctor to bring this to mind, bring it out clearly. And (Plaintiff) did. She saw a psychiatrist, and she saw another doctor to try to help her bring this out. She couldnt get it out of her mind. There were times when I think, please, lets go to bed, you know. And (Plaintiff) was she was afraid of the dark. She was afraid to turn the lights out at nighttime to go to sleep. She was afraid that when she went to sleep, if she went to sleep she would never wake up.

Q. Where there any happy moments?

A. If there were, they were few and far between. In the very beginning I couldnt remember many happy moments. I tried to tell her that, God, you are alive. That wasnt enough, not enough for a teenager, you know. All her hopes, her dreams were shattered. She had not only facial scars, but she has scars on her body, too, and, you know, to a teenager, never being able to wear a bikini again or never being able to wear a strapless formal because of the welts and scars she has up here from the tubes, that meant something to her, and her life was over at that time, to her.

Q. I am handing you whats been marked for identification as Plaintiffs Exhibit J-2. Can you identify that?

A. Yes. The girl with the purple halter top is (Plaintiff), my daughter.

Q. When was that photograph taken?

A. It was taken just about a year before the accident. (Plaintiff) liked to sunbathe, and that was very important to her, and not necessarily to swim in the bikini. She had a bikini, she would be out to sunbathe, have a good time, and that was part of her makeup, part of looking good, of presenting herself.

Q. Did she do any sunbathing afterwards?

A. Very little. Not in a bikini.

Q. Why not?

A. Because of the scars on her body.

Q. Was she able to keep herself composed?

A. (Plaintiff) keeps herself composed. You mean after the accident?

Q. Yes.

A. No. She had a lot of crying jags. Sometimes, and again, in the morning when she would wake up sometimes she would talk about it, sometimes she would be just all choked up. Sometimes maybe in the evening I would be watching television and (Plaintiff) would get up and disappear, and I thought she is going to the bathroom, and she wouldnt come back. And I would go look for her, and she would be in her room just crying her heart out. And I would say, whats wrong. And again, it was the accident. Who would want her. Who could ever love her. I had to, I was her mother. This type of thing.

Q. How frequently did this kind of thing happen?

A. Many times a day in the beginning. I did have off from work for a while and was home with (Plaintiff), and any hour of the day when I went to work and came home in the evening, I dont know how many times during the day, but in the evening she would be on crying jags, something she could be watching on television or just set her off and she would cry and go back to her room. And I would ask her, whats wrong. And we would go back to the accident and how she looked and how she would never be the same again.

Q. Were there any photographs of the accident or of her after the accident?

A. Yes, there were photographs of her, I believe at the scene of the accident. There were photographs of her in the hospital. And we had some photographs after the accident, simply photographs, pictures taken.

Q. Was she aware of any of those photographs?

A. I dont think she was aware of the photographs in the hospital at all. Afterwards, if the family were together, brothers come out, it was picture-taking time and (Plaintiff) would always try to keep the one side of her face away from the camera. It got to be, dont take my picture unless its my good side, meaning the side that was not scarred.

Q. She have friends before the accident, immediately before?

A. Yes, she did.

Q. What was her relationship with them afterwards?

A. (Plaintiff had quite a few girl friends in high school, things that she did together with her girl friends. And (Plaintiff) was in Intensive Care, it was limited to family as far as visitors, but when she got out of Intensive Care she called some of her girl friends and they never came around.

Q. What about the boy friends?

A. She asked them to come see her and they didnt do it.

Q. What about the boy friends?

A. She was dating a boy named K______ before the accident. He sent her flowers to the house. He did not come to the hospital. When (Plaintiff) came home from the hospital and crying and being so depressed and being so down on herself, I called K_____ one day and I asked K______ how sincere was his friendship, and he said, well, I would like to see (Plaintiff). I didnt know whether she could have visitors at the hospital. He didnt ask. And he said, I am not too sure I can cope of it, from what I hear of the seriousness of the accident. And I said, K______, (Plaintiff) does look bad, but if you are sincere about your friendship, it may help her a little bit if you would just come over and talk to her and maybe take her for a ride or whatever. (Plaintiff) does not know that I made that phone call. K_________ did come over. He came over one time and that was all. None of her girl friends came in the hospital. None of them came to the house. And none of the boys that she had known came to see her at the house, either.

Q. How old were these kids?

A. Oh, 16, 17, 18, right around that age group.

Q. What happened on the occasion when K_______ came over?

A. Well, although I wanted to stay right there as a protective mother, I knew that she had to have a little bit of space; so although I was in the house, I was not right there with (Plaintiff) and K________. K________ didnt offer to take her for a ride. He wanted to take her to a drive-in movie to get her out of the house. And Im sure his intentions were good. (Plaintiff) saw it, as she told me, K________ only asked me to go to a drive-in movie because he was ashamed to be seen with me in a public place anywhere else, out in the movie or out getting a hamburger. So, again with K________ not coming back to see her, that was a downer for (Plaintiff).

Q. Has she been able to reestablish any of the friendships that she had prior to the accident?

A. None that Im aware of.

Q. You said that K________ was trying to get her out of the house. How did she feel about going out of the house?

A. (Plaintiff) didnt want to go out of the house. To try to get her out of some of these crying jags and the depression that she was in, I said to her (Plaintiff), lets go shopping, lets go get a pretty blouse or lets go get a blouse. Lets go get a pair of jeans. Lets go get a pair of slacks. Lets go shopping even for underwear. (Plaintiff) would be quite adamant with me and, no, Im not, and get quite angry with me. No, Im not. Dont you see what I look like. Im not going to have people staring at me. No, Im not going out. And no matter how much I tried to plead and cajole with her or cajole her, she didnt want to go out of the house, nor did she want anyone to come to the house to see her. She just didnt want to be seen. (Plaintiff) said to me, if I can stay the rest of my life in here, I just will stay here. I just dont want anybody seeing me and I dont want to go out and see anybody. Im a freak.

Q. How long was it before you were able to get her to leave the house?

A. It was some time after the accident when her brother, who was in the service and lives in Kansas called well, they called frequently, but he called and said he had a week off, and I thought this was great, I thought, not just being her mother, but her brother could maybe help me and help her to get her out of the house. So he did come out here and he took a very strong hand with her and wouldnt let her say no. He begged and cajoled and pleaded with her. And finally he did say, you are going out, and he took her out. He took her out to the zoo.

Q. Did she enjoy that?

A. She was very scared and apprehensive and wore a hat, kind of a floppy hat. I think she had mixed emotions. She was I think she knew her brother in a sense would protect her, but there was one incident that when she came home she turned around and she had caught somebody staring at her, and unlike (Plaintiff) to come back with such a snippy answer, she asked them if she said to them Would you like me to take my hat off so you can stare a little longer. I think she was quite hurt by that.

Q. How did scars affect her relationship with men or boys?

A. After the accident (Plaintiff) had a very low opinion of herself. And it seemed like she was attracted to that type of person that I would say would be undesirable. Some of the boy friends that she had later, they were not the well-kept, the well mannered, the clean, good looking boys she had gone out with before the accident.

Q. How long was it after the accident before she would go out with a boy?

A. I dont know just the exact month or time. It was quite some time before except for the time that K_______ came over to the house. And then she went out with her brother. It was quite some time. I guess maybe after the first of the year before she went out with anybody.

Q. Who was the first boy she went out with after the accident?

A. The first boy that she went out with after the accident was a boy that she had met through work. (Plaintiff) was working part time. He was a pilot for a local airline and he took her to a party and she didnt go out with him again after that. The second boy she went out with, well, I dont know whether it was the second or third, one of the boys that she went out with she met through a girl friend at work.

Q. J_________?

A. She went out with J_________. J_________, she met through her girl friend A________. J_________ worked for A_______s parents and J_________ had a disability, and (Plaintiff) took to him and his disability realizing that this was the best she could do; she had a disability, a disfigurement, and he did, too, so therefore he wouldnt mind looking at her, he wouldnt mind what she looked like because he wasnt that desirable either.

Q. What was their relationship like?

A. J________ used (Plaintiff). J________--well, (Plaintiff) bought J________ things. She paid for his attention, for his affection. She paid his college tuition. She paid for a very expensive guitar because he liked music and also wanted to form a band. She bought him a motorcycle. As a mother, I could see that (Plaintiff) was paying for his love, paying for his attention, paying to like me.

Q. How long did that relationship last?

A. A little under two years.

Q. How did (Plaintiff) handle the end of that relationship?

A. (Plaintiff) told me that theres nothing that I could do or say, it was nothing that her brothers could do or say to make her end that relationship. It was what she had to learn herself. And shes told me a few times that it was a bitter lesson but she had to go through it. And she had to learn it herself. I think she began to realize just how he was using her and there wasnt any love and affection there. He was bleeding her dry for whatever she could give him.

Q. Shes married now. Tell us about her husband.

A. Im afraid (Plaintiffs) not happily married. After she broke up with J_______, (Plaintiff) did well for a while and she met S_______. And S_______, too, is not the most desirable. Hes not the clean-cut, handsome, well-mannered fellow that she had been dating before the accident. And S_______ asked her to marry him. (Plaintiff) has said to me that if I dont marry S_______ no one else will ever ask me, and I think like any young girl, any woman, theres a certain sense of loss and you need some love and affection. And (Plaintiff) was looking for that and it wasnt parental love or brother love that she needed or wanted, particularly. She knew that we loved her, and if I think she knew underneath when she said you have to love me, you are my mother, I think she knew that wasnt the case, but it was her way of lashing out. And she knew her brothers loved her. But as she said to them at times, well, you have to love me, too, because you are my brother. And I think underneath she knew that wasnt true. But I think we all kind of feel that maybe our parents love us and our brothers or sisters love us and you strive for something else. And I think when S_______ asked her to marry him, as she said to me, if I dont nobody else will ask me.

Q. You told us what her career ambitions were. What were her personal ambitions in life prior to the collision?

A. (Plaintiff) wanted to get married eventually and she wanted to have a family, the ideal family, a boy and a girl. (Plaintiff) is married. I dont think shell have that family now, not with S_______, and (Plaintiff) is afraid to have a family. Real or unreal, its certainly real to her. What would a pregnancy do to her now. Would it affect her in any way. Would she survive a pregnancy. These thoughts go through her mind. So her dreams of a family or her hopes of a family are not as they were.