Best Face Forward: Part I

San Diego’s Doctors Offering Charitable Services (DOCS) donate their skills and restore hope to patients

The horrific details are obscured in the fog of memory, like faded photographs bleached by time and sun. Only fleeting images remain: Headlights outlining the uncertain contours of a winding, rain-slicked road. Sheets of water streaking wildly across the windshield. A sudden lurch when the car veered from the pavement and rolled, again and again, down an embank­ment and into the darkness. The deafening cacophony of shattered glass and twisted metal. And finally, a haunting silence.

Ian Grado was a fresh-faced 21-year-old Marine stationed at Camp Pendleton the night he and three of his buddies were involved in a crash that nearly snuffed out his future. Of the three, Grado suffered the most serious injuries: fractures and severe disfigurement to his face and skull, a collapsed lung and spinal damage that left him temporarily paralyzed.

“I found out later that at the scene of the accident, one of the guys had to hold my face together,” Grado says. “It was literally torn apart.”

On that night in April 2001, Grado was airlifted to Scripps Memorial Hospital in La Jolla, where, over a period of one week, he would undergo nine major surgeries performed by Scripps craniofacial specialist Dr. Munish Batra.

After a week of emergency treatment at Scripps, Grado was transferred to a Department of Veterans Affairs hospital in Al­buquerque, New Mexico, his hometown. There, he endured more than six months of rigorous physical therapy and rehabilitation. Progress was steady but achingly slow.

“At first I couldn’t even sit up straight,” Grado recalls. “Eventually I graduated from being bedridden to using a wheelchair, then a walker, then a cane.”

Once he was able to walk under his own power, Grado was determined to return to San Diego. At the same time, having conquered temporary paralysis, his focus began to shift.

“When I was at the V.A. in Albuquerque, my face was the least of my worries,” he says. “But over time, I started feeling self-conscious about my appearance.”

Photos taken during that period show that Grado’s eyebrows were not aligned, there were visible indications of major injuries to his forehead, and a thick scar ran across his right cheek like ramshackle railroad tracks.

“The scar was swollen and blood red,” Grado says. “I felt gross. For a while there, I hated to look in the mirror. It was scary. I didn’t even recognize myself.”

Fast-forward to the present. Thirty-year-old Ian Grado is a handsome, confident husband and father, a mechanical engineer at San Diego–based SPAWAR (Space and Naval Warfare Systems Command), which provides information management tech­nol­ogy for the United States Navy. He walks with a slight limp and bears a faint scar on his right cheek—so faint that he has to trace it with his fingertip before a casual observer can see it.

Grado’s life has been utterly transformed by DOCS (Doctors Offering Charitable Services). The group of specialists provides reconstructive surgery to patients in the San Diego area—free of charge. Many of those patients can’t afford medical insurance. Oth­ers have been turned away by numerous physicians because their cases are extremely rare or dauntingly complex.

“Sometimes when something terrible hap­pens to someone, they don’t get a second chance in life,” Grado says. “DOCS gives people that second chance.”

Established in March 2002 by Drs. Munish Batra and Michael Halls, DOCS has treated more than 30 people. The rarefied roster of patients includes a 27-year-old woman who had been shot in the face; a 41-year-old single mother whose face and skull were peppered with bony tumors; and a young woman suffering from neurofibromatosis, often inaccurately referred to as “Elephant Man’s disease.” But Ian Grado was the first.

“In the days following the accident, Ian’s parents asked me if he would ever walk again,” Batra recalls. “And at the time, I had to tell them I didn’t know. His was a remarkable recovery.”

Since he was still active military when he returned to San Diego, Grado turned to the local V.A. and requested a series of sur­geries to restore his face. “They said it wasn’t something they would cover,” he says. “And I certainly didn’t have the money to cover it myself. I was about to give up.”

Grado’s wife, Stephanie, recalls that period with mixed emotions. “His appearance never bothered me, but kids would stare at him,” she says. “People would say things like ‘Gee, what happened to you?’”

After his medical discharge from the military in June 2002, Grado paid a follow-up visit to Batra, unaware that the meeting would alter his life course. In 2003, Batra and his colleagues at DOCS took Grado’s case. In his 10th major surgery, they reconstructed his face and forehead. Over time, they also performed multiple laser surgeries on the troublesome scar on his cheek, now a vague reminder of the past.

Although Grado still has some lingering discomfort associated with the accident—some lower back pain, occasional soreness in his hip—“I rarely take anything for the pain,” he says. And then an afterthought, a reflection of classic Marine Corps stoicism: “I can handle it.”

Surgeons on a Mission

Dr. Munish Batra has a highly successful cosmetic surgery practice in Carmel Val­ley. The flow of upscale patients seeking face­lifts, breast augmentations, tummy tucks and liposuction seems endless. And Carmel Valley and its environs seem a world apart from Batra’s native India, where, as a child, he shared cramped quarters with seven siblings.

Business is brisk. Life is good. And for that, Batra says, he is grateful. That gratitude was the impetus that prompted him to seek out help from Dr. Halls to create DOCS.

“I have a lot of experience under my belt,” Batra says. “I wanted to apply that experience toward helping people right here in San Diego County who have fallen through the cracks.”

Many of the patients who come to DOCS for help have been turned away by insurance companies because of the “cosmetic” nature of their injuries. Others simply can’t afford medical insurance.

Batra and six colleagues, all of whom do­nate their time and expertise, form the core of the nonprofit DOCS organization. Their efforts are bolstered by volunteers. Scripps Memorial Hospital donates facilities and staff—operating rooms and anesthesiologists—and other doctors pitch in to help whenever they can.

Before they created DOCS, Batra and Halls frequently performed pro bono surgeries in impoverished areas of Thailand, India and Mexico. “But I saw there was a need right here in San Diego,” says Halls. “These are people who have been turned away by everyone else. When they come to us, they’re running out of hope.”

Every member of the DOCS team has a private practice and a personal life. They work around busy schedules to devote time—often on week­ends—to the chal­lenging cases that find their way to them.

“It’s difficult to carve out time from our schedules, from our lives, but we just do it,” says Dr. Andrew Chang, an oral surgeon who has been with DOCS since 2003. “We take on cases where people have lost all hope, and we restore that hope. It doesn’t get any more rewarding than that.”

He cites the case of Ana Rodarte, the young woman who suffered from neuro­fibromatosis, a sinister disease that left her disfigured and isolated. After a series of operations performed by Batra and Halls, Ana’s face was significantly restored, and she was ready to brave the world. She plans to become a cosmetologist.

“Here was a woman who was once a recluse with no hope of having a career or a normal life,” says Chang. “And now she’s starting school. DOCS literally changed the course of her life.”

DOCS is a close-knit cadre of physicians who associate with one another socially as well as professionally. Their board meetings, which often take place over dinner, are a pleasant mix of business and friendship. Their easy camaraderie is evident in a recent free-flowing exchange on the joys of working pro bono.

“Doctors just want to be doctors,” says Chang. “They don’t want to run a business. But with insurance companies, you have to. Working for free, you don’t have to deal with insurance companies that pay you 10 cents on the dollar for your services.”

Halls: “It’s up to 10 cents now?”

A Man in Full

Ian and Stephanie Grado form a family portrait of sorts, sitting together in their home in La Mesa. They’ve been married only a few years—they exchanged vows in July 2006—but already their conversation is seamless, pitch perfect. Their life together is full of promise now. Those dark days following Ian’s accident seem light-years away. Ian hopes to earn a master’s degree in engineering, widely considered a prerequisite for ad­vance­ment in his field.

“Of course, our baby girl will be a big part of our future,” Ian says, his blue eyes sparkling in muted sunlight. “And we’d like to have a couple more kids.”

Ian and Stephanie are unabashed cheerleaders for Batra and DOCS. “I would do anything for Dr. Batra,” Ian says. Proving that point, he once addressed a fund-raiser for the organization, squarely facing his fear of public speaking.

“I was worried that I just stood there and mumbled, but people said I did okay,” Ian says.

In a heartbeat, Stephanie adds, “He did a great job.”

“Doctor Batra gave me hope,” Ian says. “He gave me a second chance. I feel more confident now. I guess I just feel more normal.”

Team Effort

DOCS is made up of specialized physicians, each with their own subspecialty. Dr. Munish Batra is a cosmetic surgeon with a subspecialty of craniofacial surgery. Dr. Michael Halls is an expert in the fields of reconstructive breast surgery, hand surgery and microsurgery. Dr. Andrew Chang is a highly respected oral surgeon. Dr. Alfonso Camberos specializes in microsurgery of the hand and extremities. Dr. Lokesh Tantuwaya is an expert in the area of spinal surgery and neurosurgery. Dr. Don Kikkawa is a nationally recognized plastic surgeon specializing in eyelid deformities. And Dr. James Tasto is a renowned cosmetic and restorative dentist.

Lori Varaich is the executive director of the DOCS program. Batra and his fellow DOCS physicians find their patients chiefly through referrals, often from trauma centers. They can be reached at 858-847-0800 or ­docscharity.com.

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