It's like doing a jigsaw puzzle, says Dr. Daniel Orr. Find the border pieces first and then start filling in the middle. Only Orr's pieces are the bones and tissues of a person's face, displaced by a collision with pavement or the violence of a bullet.
The director of oral and maxillofacial surgery at the School of Dental Medicine also is a longtime volunteer with the UNLV Athletics medical staff. In 1990, when basketball player Greg Anthony broke his jaw, Orr was there to wire it back together.
His reconstructions generally are done a day or two after the patient is stable. Not so at 3 a.m. one day this year. A trauma center doctor texted him a picture of what he was dealing with: an accidental shooting victim whose jaw was dangling 90 degrees away from normal. Orr stared at the image, trying to figure out where the patient's midface bones were, then jumped out of bed.
"Usually I know exactly what I'm going to do from the start. This one I had to take one baby step at a time, like climbing Mount Everest," Orr says of the six-hour surgery. "Fortunately, (the patient) hadn't left any tissues on the ceiling -- all the anatomy was there, somewhere."
He concedes that his profession can be cringe-inducing, though after 30 years and 2,000 major trauma surgeries, he seldom is shocked himself. "It can be intense, but I pinch myself every day that I get to do this job."
Orr received the received the 2011 Daniel M. Laskin Award for Outstanding Predoctoral Educator from the American Association of Oral and Maxillofacial Surgeons.