Face to Face with Sharrona Pearl

Face to Face with Sharrona Pearl

I recently had the pleasure of speaking with Sharrona Pearl about her new book, Face/On: Transplants and the Ethics of the Other. Below are excerpts from our conversation, which ranged from disability, to artistry, to parenting, to sex transitions, all illuminated by Sharrona’s insights from the history and culture of face transplants.

Lara: I really appreciated how you dealt with including pictures of people who had had face transplants. In your book you explain that you debated how to handle visual images. You knew that clearly some of your readers would feel like they wanted to see images of people before and after the face transplants, and you acknowledged that these images are readily available on the web.

On the other hand you wanted to avoid participating in the reality-show rendition of the face transplant, so you took a very particular approach, which was to put very small pictures of the face transplant recipients in an appendix to the book. I’m wondering — was that decision something that was obvious to you at the beginning, or was it something that evolved over time? Was it something you struggled with in public presentations?

Sharrona: Thank you for asking that, because it was such a huge struggle for me. I struggled on both a personal moral level, and on an intellectual level. I’ve thought a lot about image use, and how historians deploy images. Whenever we mention someone — usually a man — we put his picture up with his birth and death dates, even if it’s not central to the story. This convention is problematic in all kinds of ways, but even more so in this case, where so much of what’s at stake is the sensationalization of what face transplant recipients describe as just a way to become normal.

I had imagined that I would write this book and not put images in it at all, because my point was that we have to rethink how we encounter people, and maybe reevaluate the status of the face entirely. But then I got my reviews back from the press, and they both said that they were distracted by the lack of images. They said they spent all their time wondering, and haunted by it, which took away from the book. It was a real yearning that was left unsatisfied. I spent a lot of time thinking about it, immersing myself in the really smart existing literature about this, and that was the compromise I came up with.

Book jacket, a white woman's face is blurred out, and the words FACE ON with a slash between them is centered.
Face/On: Face Transplants and the Ethics of the Other (University of Chicago)

I’m glad that you noticed that the pictures were small. I wanted it to be sized in a way that I thought was appropriate to the size of the importance of it. I’m happy about the way it came out, because it allows the people who need it to find it, and allows people who don’t want to look at it to put it aside. It also allows the images to be supportive of the arguments but not integral to them.

Lara: I appreciated it because I’m one of the people who needed to go take a look. I wanted to understand some of the ways face transplants were covered in the press and received. What were people seeing that they were reacting to? My previous points of reference were from fiction. I pictured the spy show Alias, in particular an episode in which a spy suddenly turns into someone else, and his before and after faces are both impossibly gorgeous.

In contrast, when I looked at the images in your book, I thought, “oh, this is kind of an assist, to give someone a face that appears to have had quite a bit of medical work, and a difficult personal history, but is present.” It was a good reality check. Nobody’s going to line up to have a face transplant because they don’t think their first face is pretty enough.

Sharrona: It’s amazing—in nearly all of the talks I’ve given about this, question number one is about the military using face transplants for spying, and question number two is, “what’s to stop people from stealing faces?” It would be so impractical! There are so many better ways of transforming your face that do not require all this suturing and convalescence and a lifetime of immunosuppressants, not to mention a donor.

No woman or man is going to do this to make themselves look better because that’s just a bad strategy! The images in my book help a lot on this front. After a transplant, people look halfway in between how they used to look and the person whose face they now have. The bones of your nose are still the bones of your nose, your cheekbones, and so on and so forth. The images help make that more manifest.

Various faces.
Faces. (Collage created by A Earls/Flickr)

Lara: How has working on this book affected how you interact with the world? Are you aware in a different way of how you look at people?

Sharrona: In a very day-to-day way I try to be a little bit better, to check my first impressions a little bit more. And I’ve also been talking to my kids differently (and here I’m drawing on Rosemarie Garland-Thomson’s concept of not averting our eyes). As opposed to shushing them, or wincing if they ask questions about people—being very audible and also straightforward. Encouraging them to understand in a real-life context that it’s not shameful or embarrassing to have a mark on your face, or be missing a leg, and so on and so forth.

And sometimes that happens when you were born and sometimes that happens over time, and it’s something that we really need to talk about and to be really public about. And also acknowledging how different people relate to their own bodies very differently. It’s important to me to acknowledge that for some people, a disfigurement or other kind of physical difference or disability is something they want to own and cherish, and live with and to be comfortable with.

For other people, it presents a barrier that they feel that they cannot live a real life with, and that’s totally dependent on the person. I now understand that what for some people might be a point of pride or identity, for other people might be deeply destructive. I can’t tell which it is because I can’t get inside that person, so I don’t get to be prescriptive. And I don’t get to be judgmental.

Lara: You analyzed a lot of problematic media representations of face transplants in your book [including horror movies and reality TV]. Could you imagine an alternative work of art that might bring your view of face transplants to the table?

Woman with her face bandaged in gauze peers through venetian blinds.
Still from the film Goodnight, Mommy

Sharrona: I think what you’re raising so beautifully is the problem of translating senses. We can never be in somebody else’s body. I think so much art is after that problematic: how can we understand the experience of somebody else, particularly somebody whose experience in the world is radically different from and embodied differently than our own might be? We need art. We can never fully understand the experience of someone else, but art is such a special and wonderful way for someone to translate their own experience.

I think my fantasy work of art would somehow celebrate difference in a way that shows the beauty in the ugly. And it would be something, I think, that would allow us to look. Something that would force us to look. Something that would insist on the face-to-face encounter. And not in a way that would desensitize, but would defamiliarize.

Maybe it would blow up into huge proportions the things on faces that seem to make us need to avert our eyes, and compare it to a face that wouldn’t make us avert our eyes, so that in the enormous, defamiliarized, non-contextual image, you can’t tell what you think is bad and what you think is good. That would not be saying, “oh, look, we’re all skin underneath,” it would be emphasizing the difference, showing that the differences are actually important too. It would have to be so big.

Then maybe also really small. I think I would mess with scale a lot. Because I think part of what happens is that faces are a certain size, skin is a certain size, pores are a certain size. If you could mess with those sizes you might actually understand that things like a burn, or a hole in a person’s face, is on some level a question of scale, as much as anything else.

Lara: I can picture that! It’s an interesting way to think about it! What are you working on next? Are you continuing some of these themes?

Sharrona: I’m starting the third book in the “face trilogy.” It’s tentatively called Changing Faces, which is what it’s about, but also a nod to a wonderful organization in England that does a lot of work with artistic representations of people with facial differences. The book will be a history of prosthetics and make-up on screen, thinking about how that becomes a character, and using that to deal more head-on with the problem of balancing, on the one hand, lived experience and materiality, and on the other hand, not being limited by the faces that we have.

Lara: I can’t wait to see where you go with this fascinating work!

Lara Freidenfelds is a historian of health, reproduction, and parenting in America. She is the author of The Myth of the Perfect Pregnancy: a History of Miscarriage in America and The Modern Period: Menstruation in Twentieth-Century America. Sign up for her newsletter and find links to her op-eds and blog essays at