CLEVELAND -- In the next few weeks, five men and seven women will secretly visit The Cleveland Clinic to interview for the chance to have a radical operation that has never been tried anywhere in the world.
They will smile, raise their eyebrows, close their eyes, open their mouths. Dr. Maria Siemionow will study their cheekbones, lips, and noses. She will ask what they hope to gain and what they most fear.
Then she will ask, ''Are you afraid that you will look like another person?"
Because whoever she chooses will endure the ultimate identity crisis.
Siemionow wants to attempt a face transplant.
This is no extreme TV makeover; it is a medical frontier being explored by a doctor who wants the public to understand what she is trying to do.
It is this: to give people horribly disfigured by burns, accidents, or other tragedies a chance at a new life. Today's best treatments still leave many of them with freakish, scar-tissue masks that do not look or move like natural skin.
These people have lost the sense of identity that is linked to the face; the transplant is merely ''taking a skin envelope" and slipping their identity inside, Siemionow contends.
Her supporters tout her experience, her careful planning, the team of specialists assembled to help her, and the practice she has done on animals and dozens of cadavers to perfect the technique.
But her critics say the operation is way too risky for something that is not a matter of life or death, as organ transplants are. They paint the frighteningly surreal image of a worst-case scenario: a transplanted face being rejected and sloughing away, leaving the patient worse off than before.
Such qualms recently scuttled face transplant plans in France and England.
Ultimately, it comes to this: a hospital, a doctor, and a patient willing to try it.
The first two are in place. The third is expected to be shortly.
The ''consent form" says that this surgery is so novel and its risks so unknown that doctors do not think informed consent is possible. Here is what it tells potential patients:
''Your face will be removed and replaced with one donated from a cadaver, matched for tissue type, age, sex, and skin color. Surgery could last up to 10 hours; the hospital stay, 10 to 14 days.
Complications could include infections that turn your new face black and require a second transplant or reconstruction with skin grafts. Drugs to prevent rejection will be needed lifelong, and they raise the risk of kidney damage and cancer.
After the transplant you might feel remorse, disappointment, or grief or guilt toward the donor. The clinic will try to shield your identity, but the news media probably will discover it.
The clinic will cover costs for the first patient; nothing about the others has been decided."