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A Surgeon's Memoir Of 'Full Face Transplant'

In 2008, Dr. Maria Siemionow and a team of doctors made history when they performed the first near-total face transplant in the United States. Siemionow writes about the procedure in the memoir Face to Face.


Other segments from the episode on June 10, 2009

Fresh Air with Terry Gross, June 10, 2009: Interview with Maria Siemionow; Interview with Anna Paquin; Review of the new 50th anniversary reissue of the original cast album of "Gypsy."


Fresh Air
12:00-13:00 PM
A Surgeon's Memoir Of 'Full Face Transplant'


This is FRESH AIR. I’m Terry Gross. More than any other part of our body, the
face defines our identity. It expresses emotion and has the gateways to taste,
sight, smell and hearing. I guess that’s why the idea of a facial transplant
still seems so shocking.

In late 2008, my guest, Dr. Maria Siemionow, led the team at Cleveland Clinic
that performed near-total face transplant in the U.S. The patient was Connie
Culp. Her husband had shot her in the face with a shotgun.

The transplant was performed four years after the hospital’s institutional
review board announced that it considered a face transplant to be both ethical
and possible.

Dr. Siemionow grew up in Poland and first came to the U.S. for a fellowship in
hand surgery at the Institute for Hand and Microsurgery in Louisville,
Kentucky. She’s now Cleveland Clinic’s director of plastic surgery research and
the head of microsurgery training. She’s written a new memoir called “Face to

Dr. Siemionow, welcome to FRESH AIR. Let’s talk about some of the reasons a
facial transplant is so complicated, and let’s start with one of the reasons
why you have to do a facial transplant in the first place, as opposed to just
taking skin grafts from the person’s body. I was amazed reading your book that
there’s so much facial tissue that you wouldn’t have enough skin to graft on
your body. Just give us a sense of the amount of tissue that’s involved in a
facial transplant.

Dr. MARIA SIEMIONOW (Author, “Face to Face: My Quest to Perform the First Full
Face Transplant”): Yes. When you want to cover a face with one perfect sheath
of the skin, you really do not have enough of skin in your body which is
pliable, which has the same texture, the same color and also has a vascular
supply, meaning that it’s really having a normal life, like tissue in your
other parts of your body.

And for this reason, quite often you can see that the patients who are victims
of the burn and trauma injuries have a kind of a patchwork of skin of different
colors on their face, because some of the grafts taken from your own body are
taken from different parts of the body. So you can have a piece of the skin
taken from the thigh. You can have a piece of the skin taken from your back or
from your buttocks. So as an effect, it gives an artificial, not natural, look
on the face.

GROSS: Now in the book, you talk about the complexity of motion that’s allowed
by the muscles and tissues of the face. Can you just give us a very brief tour
of the face so that we can follow along on our own faces as we listen? And
that’ll also give us a sense of how complex a procedure a facial transplant is.

Dr. SIEMIONOW: Well, if you go from the front of your face, starting with the
forehead, and then like you are washing, actually, your face every morning, you
can feel exactly that you go through the surfaces which are totally plain, like
a forehead. Then you go to your eyelids, which are a little hollow, where your
eyes are covered. They you go over nose, which is again raise and has its own

Then you go down to your lips, which have a very different type of prominence
and different texture, and then you go down to your chin, which is again, a
little more prominent and standing out.

Then imagine the patients who are now missing at least one component, such as
nose. So when they wash their face in the morning, they are just not only going
through the hollow of their ears or the hollow of their eyes, but then they
have a hollow where we all have a prominence, such as nose, and that’s what is
probably very disturbing on daily basis because quite often for some of the
patients who do not have nose, they even cannot take a shower in the morning
because the water will not allow them to take a shower. It would go down to the

GROSS: One of the things you have to do in a face transplant is remove the face
from the body of the donor. So what are you removing when you remove their
face? Obviously the skin, but what else besides the skin are you taking?

Dr. SIEMIONOW: This will very much depend on the patient who is the recipient
of the transplant, and this will vary from patient to patient, depending on
what kind of trauma they have which caused them to be disfigured and have this
functional disability.

In the situation of our patient, we were removing not only the coverage, which
is the facial skin, but also the three-dimensional functional units, including
bones, the bones of the nose, the lower eyelids, the upper bones of the upper
jaw, also sinuses, hard palate, as well as upper lip.

So as you can imagine, it is a very, very complex, 80-percent of face of the
donor was removed in order to cover the very deep defect of our patient.

GROSS: So, was the donor’s face removed in one piece, or did you have, like,
several different sections and pieces?

Dr. SIEMIONOW: No, that was in one piece, and we have prepared as a team to
this type of live transplantation by a series of what we call mock
transplantations in anatomy lab, where as a team, we’re meeting on weekends,
and we were mimicking the transplant, which we would perform on our patient.
And this was based on three-dimensional CT-scan of our patient’s defect. So we
knew exactly what we are doing.

As a team of eight surgeons, we were working almost the same as on the day of
surgery, a real transplant. We were working in anatomy on two operating tables
and we’re just creating the defect on one potential patient and then
transferring the transplant from another anatomy lab cadaver.

So this was a very long preparation to the surgery. So we haven’t done it just
without thinking about every detail, anatomical detail - what kind of arteries,
what kind of veins, what kind of nerves we need, also about complexity of the
bones and to be sure, as you rightly ask, that they have to be taken in one
piece which is intact.

GROSS: So I’d like you to describe the face of the facial transplant recipient,
who was a victim of a gunshot wound. She was shot in the face by her husband.
So what was her face by the time you were doing the face transplant? And I
should back up and say I think you or another team of surgeons had performed
several facial reconstruction – reconstructive surgeries, but it still wasn’t
sufficient to give her a real face.

Dr. SIEMIONOW: Yes, she was missing major functions of possibility of breathing
through the nose, because she did not have a nose. She was lacking an upper
lip, and she was also missing lower eyelids, and most of her skin was either
scarred or damaged on about 80 percent of her face.

So what we have to replace was the entire nose, with nasal passages, sinuses,
also upper lip, lower eyelids and the hard palate, which was missing.

GROSS: And since she only had a hole where her nose was, she was breathing
through a surgically created hole in her trachea.

Dr. SIEMIONOW: Yes, she wore a tracheotomy tube. So she was breathing through
the tube.

GROSS: So did you have to find a donor whose facial proportions kind of matched
the recipient’s facial proportions so that the eyelids would fall in the right
place, and the nose would fall proportionately in the right place?

Dr. SIEMIONOW: This really – if we would be looking into the matching, could be
difficult. We were really lucky that the donor was really matching our
patient’s features. So that was light complexion of the skin, similar width and
length of the skeleton, as well as the fact of course that she was a female
because that’s very important that the donor can be matched for the gender and
for the complexion of the skin and for the race.

So this was the first donor we signed. The donor family signed consent for the
donation of the face, and really amazingly, I must say, we were so lucky that
we couldn’t believe that the difference in the color of our patient’s, for
example, forehead, and her own chin, which was left, was exactly matching the
color of the donor.

So even today, it’s very difficult, except that there is a little bit of scar
tissue, which is not very visible, to recognize which color is coming from the
donor, which part of the face is hers.

GROSS: Well, the transplant surgery took over 20 hours. One of the things you
had to do was take the blood vessels from the donor’s face and attach them to
blood vessels in the recipient’s body. You’re working in this world of
microsurgery. Would you give us some sense of what it takes to attach the small
blood vessels of one face to another?

Dr. SIEMIONOW: Well, if you think about, for example, the fact that artery
under magnification of the microscope has a hollow appearance, which is a
little flat because of the fact that there’s no blood flowing through it when
you do that, and it’s white. It’s kind of without appearance of blood in it.

So it looks really like spaghetti which got flattened out, and then you are
just connecting this spaghetti from end to another end, and you are trying to
reconstruct the hollow structure and three-dimensional structure of this
artery, and once you are done, and you are actually using a very small sutures.
The needle is small, the thread is very small, and if you compare them, for
example, the thread is about 40 microns in diameter, which reminds the size of
a human hair.

So you can imagine that you are putting the stitches with something as thin as
a human hair, under magnification of 20 times, and you are just looking through
the loops, and you are concentrated on what you do, and after, for example, 40,
50 minutes of reconstructing this spaghetti to the hollow element, which at
some point becomes pink when you take the clamps off, and you see that the
blood is going through this new reconstructed artery, and it’s actually not
leaking, and it’s starting to pulsate, and you almost hear in your eyes, boom,
boom, boom, boom, and you know it’s working.

GROSS: In order to get a facial transplant, you have to take immune-suppressive
drugs for the rest of your life unless something better comes along, but
otherwise your body will reject this transplant. So what are the long-term
effects of taking immune-suppressive drugs, I mean, in addition to leaving you
vulnerable to a lot of disease? Do they shorten your life? Are they likely to
wipe years off your life?

Dr. SIEMIONOW: Potentially. The difference between the transplant patients of
the solid organs and our patient, what is known as composite grafts, and faces
an example of composite graft, is the fact that these are usually healthy

So to start with, they do not have, like renal failure for the kidney
transplant patients, which are usually very sick patients. But the side effects
are the same, and that’s a very important question, Terry, because we have
present to our patient all the risks and benefits, and we have outlined what
may happened.

We have presented the risk of developing diabetes, of potential kidney failure
in years to come, but we are hoping with a healthy patient to start, with our
protocol of minimal immuno-suppression, trying to wean off patient from immuno-
suppression, we at least will be able to help her to go through many years
without major side effects. But these are really significant factors to
consider when you present to the patient risk and benefits of face

GROSS: My guest is Dr. Maria Siemionow. In late 2008, she led the team that
performed the first near-total face transplant in the U.S. She’s the director
of plastic surgery research and head of the microsurgical training unit at the
Cleveland Clinic’s Department of Plastic Surgery. She’s written a new book
called “Face to Face: My Quest to Perform the First Full Face Transplant.”
We’ll take a short break here, and then we’ll talk some more. This is FRESH

(Soundbite of music)

GROSS: My guest is Dr. Maria Siemionow, and she led the team that performed the
first face transplant in the United States. This was in December of 2008, and
she’s at the Cleveland Clinic where she’s the director of plastic surgery

How was Connie Culp chosen to be the first recipient in America of a facial

Dr. SIEMIONOW: Well, she was fulfilling many of the requirements as per our
institutional review board ILB protocol, which the first one was that from the
very beginning, we were considering as potential candidates only patients who
have exhausted all potential convention means of reconstruction.

The second was that the patient has to be psychologically stable, and she was
evaluated and found to be in good spirits and very good to go through the

The third was also ethical evaluation, that the patient was evaluated by our
ethics experts to understand that she would be a first patient, and it bears a
lot of ethical issues, as well as the fact that she is a research patient, and
understanding what does it mean that she’s a research subject - meaning that we
cannot tell her exactly will be the outcome because not many patients like that
were done worldwide, that she would be, in a way, example for others to follow
up how her face transplant over time will be doing, how she will be doing as a
patient, how she will be integrated into society.

The next important part was to find out the social and family support, who will
be supporting her - not only before transplant but also after transplant, and
all these things were prerequisites of considering her as potential candidate.

GROSS: How is Connie Culp now. She was the first recipient of a facial
transplant. You led the team that performed the surgery. So what does her face
look like now?

Dr. SIEMIONOW: Well, her face looks like a normal human face, which is very
important. You know, she has a beautiful nose, actually. She has a little,
maybe too much, on the sides of her skin, and that was taken purposely, and we
will remove the part on the side of just only her skin, which was used also for
biopsies to monitor her rejection.

But really, if you think and see her on the street, and you don’t know her just
from the media and recognize her as a face transplant patient, then she’s now
going back to her grocery stores in her community. She was walking her dog.
She’s exercising. She’s just back to her normal life.

GROSS: And does she look anything like the donor looked? Is Connie’s face
similar to her donor’s face?

Dr. SIEMIONOW: No it’s not, and this is a good question because quite often,
the question was posed, you know, how much of the donor look, and how much of
the recipient will the face transplant patient have, and since we were
adjusting the bones, and we are adjusting the width and depth to her own
skeleton, she still has her own face reconstructed.

And I would say of course you can on the computer models, when colleagues and
ourselves were evaluating the potential of how the recipient will look like a
donor and vice versa. And also in anatomy lab we were just doing kind of mock
cadaver studies, looking at the different sizes of skeletons, we found that the
most of the assimilated transplants look as kind of a mixture between
themselves and the donor.

GROSS: How often do you see Connie Culp now?

Dr. SIEMIONOW: Well, we are at this point seeing her even on a weekly basis
right now. And as long as she will be doing fine - in the beginning, we are a
little more careful in evaluating her more often, but we are for the first year
thinking about just having a monthly schedule.

So if everything goes well, and there are no signs of kind of a rejection or
suspicion, which we have not so far seen, once-a-month visit for not only
myself but team members, as well as psychology, psychiatry, social worker and
having her blood drawn and looking at all possible needed during the follow-up
visits of, for example, functional re-education, physical therapy. So that
would be a checklist of things which we want to be sure we are pretty closely

GROSS: I wonder if you see faces differently than you used to now that you’ve
done a face transplant.

(Soundbite of laughter)

Dr. SIEMIONOW: Probably I do, and you know, sometimes I look at all these
beauty shows, you know, and shows where they are showing like a total makeover
- not that I look at them every day - but this is something which I always
wonder if people are not really exaggerating with changes of quite often
beautiful faces, even what is now like more beautiful because you need a little
bigger lips, or you need a little, you know, more narrow nose or something like
that - I think we should be happy with what we are if we have just normal-
looking human faces.

GROSS: Dr. Siemionow, thank you so much for talking with us.

Dr. SIEMIONOW: Well thank you. It was a great pleasure. Thank you for

GROSS: Dr. Maria Siemionow has written a new memoir called “Face to Face.”
She’s Cleveland Clinic’s director of plastic surgery research and the head of
microsurgery training. I am Terry Gross, and this is FRESH AIR.
Fresh Air
12:00-13:00 PM
Anna Paquin, In Flesh And 'Blood'


This is FRESH AIR. I’m Terry Gross.

The HBO vampire series "True Blood" begins its second season Sunday, and season
one just came out on DVD. My guest, Anna Paquin, stars as Sookie Stackhouse.
Sookie isn't a vampire, but she's in love with one, Bill. He became a vampire
during the Civil War and has tried to maintain the gentility he had as a human.
But that's hard to do when you're a vampire. Sookie has a special gift which
sets her apart from humans. She's able to read their thoughts. That gift is
often a burden because she can't shut off their thoughts, and what people are
thinking is often not very pleasant. She can't read the thoughts of vampires
like Bill, and that's one reason she finds it calming to be in his presence.

Anna Paquin won an Oscar at age 11 for her performance in the 1993 film "The
Piano." Let's start with a scene from the new season of "True Blood." Season
one ended with Sookie killing in self-defense the man who had murdered several
women in town. But another murder remains unsolved. Who killed her uncle, the
uncle who had abused her when she was younger? Something she had confided in

(Soundbite of TV show, “True Blood”)

Ms. ANNA PAQUIN (Actor): (as Sookie Stackhouse) Did you have anything to do
with Uncle Bartlett's death?

Mr. STEPHEN MOYER (Actor): (as Bill Compton) He hurt you.

Ms. PAQUIN: (as Sookie Stackhouse) Oh my god. Is it that easy for you to kill?
Does human life mean so little you can just kill on command, toss someone in
the water? I cannot have people dying every time I confide in you. I never felt
more inhuman than when I had to kill Rene. It still haunts me. And now you've
made me feel like I killed another person. I feel sick. I always thought as
different as we are, somehow we could still be together. And now I don't know.
I don’t know anything. Please, please, don't kill, Bill.

(Soundbite of footsteps)

Mr. MOYER: (as Bill Compton) I can not and I will not lose you. For all the
ways that I have dismayed, aggrieved, or failed you, I swear I will atone. But
I am not sorry. I refuse to apologize for what you have awakened in me. You,
you are my miracle, Sookie. For the first time in 140 years I felt something I
thought had been lost to me forever. I love you. And for that I shall never
feel sorry.

Ms. PAQUIN: (as Sookie Stackhouse) Oh, damn you, Bill Compton. I love you.

GROSS: Anna Paquin. Welcome to FRESH AIR. I really enjoy your performance on
the show. Most movies and dramas are heightened versions of reality. They’re
just more dramatic than reality.

Ms. PAQUIN: Or you condense a lot of really dramatic real moments into a short
amount of time that makes it appear more dramatic.

GROSS: Exactly. But a story like "True Blood" is even more exaggerated and more
dramatic because so many of the characters have some kind of secret power or
gift that they can use for good or evil. And things are especially heightened
in the romance scenes because, like in your romance scenes with Bill, there's a
certain danger, because after all he is a vampire. And arousal brings out his
fangs, which recede in regular life, and he sometimes bites your neck while
making love. How does all of that affect how you play those love scenes

Ms. PAQUIN: Well, you play it for the reality. You play it for the emotional
truth of it, and the things like fangs and blood gags and effects, those I
think serve to make the story more exciting and to heighten the reality. But
basically it's two people who are falling for each other experiencing something
really intimate together. And for him, when his fangs come out, he's scared
that she's going to pull away, and instead, you know, it’s them being literally
bare before each other and accepting each other for who they really are.

GROSS: So let's talk a little bit about the special effects aspect of "True
Blood." Like in season one you actually, you are near death and I think your
back has been broken in an attack, because you can’t feel your legs. And to -

Ms. PAQUIN: Mm-hmm. Sookie gets almost killed on multiple occasions.

GROSS: Yeah.

Ms. PAQUIN: I’d just like to point out.

GROSS: And Bill, the vampire, shows up to rescue you and explains that you
should feed on his blood because vampire blood has restorative powers. Vampires
try to keep that a secret. So you have to, he...

Ms. PAQUIN: I feed off of his arm.

GROSS: You feed off of his arm. So what are you doing for real in that scene?

Ms. PAQUIN: For real, there is a guy named Dan from Masters Effects with a
prosthetic arm that is exact replica of Steve's arm, except made out of latex.
Complete with hairs on the arm that were individually like threaded through the
latex. There's a tube up the inside. There's an opening and it’s like an
animatronic arm, and Steve has his arm sort of taped or stashed behind his

And Dan is maneuvering the fake arm, which has a blood pump attached to it,
which I then – I’m supposed to drink gallons – oh, I actually kind of did drink
gallons and gallons of blood from, slash, have it run all over my face. At
about four or five in the morning while we were fighting the day, the sun from
coming up in the back lot at the Warner Brothers jungle.

GROSS: Oh yeah. Good point, because he can't be in daylight. So you had to do
some (unintelligible) at night.

Ms. PAQUIN: Yes. So all of those nighttime scenes...

GROSS: Yeah.

Ms. PAQUIN: Well, obviously there's a lot of night shooting, but also, you
know, there's a limited number of hours of nighttime. So by the end of the
night, you know, you're racing to get everything done. And because of the messy

nature of a lot of the blood gags, often they're left to last because a massive
cleanup is not really an option in the middle of a shooting day/night. So yeah,
so it's interesting.

(Soundbite of laughter)

GROSS: So what is the blood that you're feeding on? What's it made out of?

Ms. PAQUIN: I actually don't know. I would imagine it’s some kind of food
coloring-type situation. But it has, depending on what it has to be used for,
it has a different consistency. I - they offered me low carb blood.

(Soundbite of laughter)

Ms. PAQUIN: Because they were being considerate of my, you know, short shorts
diet. And being an idiot I said, oh yeah, that sounds great. Yeah. You know,
low carb blood, i.e. flavorless blood, really gross after like the first 10
takes of feeding off it through a latex arm, which already tastes like, I don't
know, dead...

(Soundbite of laughter)

Ms. PAQUIN: ... and nasty. Yeah. I was kind of regretting going the girlie girl
route on that after the sort of first few gulps because, you know, a little
sugary watermelon, strawberry flavor, something or other I think might've made
it go down a little easier.

GROSS: So they couldn't have just put in some vanilla extract or something...

(Soundbite of laughter)

GROSS: ... to take the edge off?

Ms. PAQUIN: I have no - no, I mean there's different flavors of blood. I mean
they make it in different flavors depending on who's going to be drinking it
and what they prefer. Yeah. So lesson learned.

(Soundbite of laughter)

GROSS: Your character, Sookie, is - she seems like she'd be a tomboy, but she
dresses very like tomboy sexy. She wears shorts and tank tops, but they're very
revealing tank tops. But they’re very plain tank tops.

Ms. PAQUIN: She's a practical girl, she has a limited budget, and she lives
somewhere where it's like 110 degrees...

(Soundbite of laughter)

GROSS: In the summertime.

Ms. PAQUIN: You know, but she's athletic and comfortable in her body and
comfortable in her skin, and confident.

GROSS: So it takes a lot of fittings to get something that looks like it was...

Ms. PAQUIN: I mean...

GROSS: ...bought at the local Wal-Mart or something.

(Soundbite of laughter)

Ms. PAQUIN: ...except ironically...

GROSS: Yeah.

Ms. PAQUIN: costume actually, my main, like my Sookie shorts, my waitress
shorts from last season, they were off-the-rack Old Navy, and the T-Shirt was
just American Apparel. But it's a matter of finding the right, you know...

GROSS: Right.

Ms. PAQUIN: ...the exact right item, and the right bra. You know, it’s got to,
it's got to look right. Also one of the things that we do try to do in the
costume fittings and then the - as far as each character - is not shopping too
far outside of the budget of the actual character. So the fact that we have
Sookie in a lot of stuff that is, you know, from Target or Old Navy or sort of,
you know, similarly not high-end stores I think is really appropriate because
she obviously wouldn't be able to afford some really snazzy designer something
or other with her lifestyle and with her salary.

I kind of like - you know, whereas some of the vampires have these really
fabulous closets of clothes because they’ve been around a really long time and
the sort of, you know, the premise of our show, I guess they’ve figured out how
to be rich because they all seem to drive fantastic cars and wear expensive
clothes and that sort of, you know, they’ve got it figured out over the last,
you know, few thousand years.

GROSS: My guest is Anna Paquin. She stars in the HBO vampire series "True
Blood." Season two premiers Sunday. We'll talk more after a break. This is

(Soundbite of music)

GROSS: If you're just joining us, my guest is Anna Paquin and she's now
starring in "True Blood" on HBO. Now, you and your costar, Steven Moyer, who
plays the vampire, Bill, that you're in love with, you're a couple in real life
now, right?

Ms. PAQUIN: Yes.

GROSS: It must be funny to be in a real romantic relationship while playing
characters whose relationship is so powerful because she has special powers
that will prevent her from ever being herself with any human man. At least
that's what Bill's convinced her of.

(Soundbite of laughter)

GROSS: And he's a vampire. So like when they come together, I mean it's just
like such drama.

(Soundbite of laughter)

Ms. PAQUIN: Mm-hmm.

GROSS: Like no human relationship, I think, could like quite measure up to the
drama that surrounds theirs. So you play that dramatic relationship. So is it
funny to be in a real relationship while playing this like super-heightened
dramatic, you know, vampire/mind-reader relationship?

Ms. PAQUIN: I mean...

(Soundbite of laughter)

Ms. PAQUIN: I don’t know it any other way...

(Soundbite of laughter)

Ms. PAQUIN: ... as far as my particular job and my particular relationship. I
mean, you know, obviously the reason we were cast opposite each other is
because we had chemistry. So that energy has been there from day one. And you
know, it's, this is how we’ve grown as a couple. So it's kind of hard to
imagine it any other way. I mean it's kind of funny when you think about it,
that, you know...

(Soundbite of laughter)

Ms. PAQUIN: ... we go to work and that's, that some of the scenarios we end up
and, you know, as far as our job is concerned. But it's, that's just the way it

GROSS: Did having a real relationship affect the on-screen chemistry and make
it either stronger or any different?

Ms. PAQUIN: Well, I think that with any acting and any medium, really trusting
the people that you're with makes it easier to go to deeper and more, more open
and scary places. And being as how a lot of the Bill and Sookie plot line is
physically demanding in various ways, it's really great to completely and
utterly trust the person that you're in those scenes with. And I think it just
makes it easier.

GROSS: If you're just joining us, my guest is Anna Paquin and she stars in the
HBO series "True Blood." Now, everybody knows that you won an Oscar at the age
of 11 for your portrayal as, in "The Piano," the Jane Campion movie which is
set in the Outback of New Zealand, and without getting into kind of complicated
story here, let's just say it's a kind of transgressive version of a romance
fantasy with Holly Hunter playing your mother. And she kind of symbolizes
creativity. She refuses to speak but she plays this like wild beautiful piano.
And Harvey Keitel kind of symbolizes masculinity freed from the constraints of

Ms. PAQUIN: Literacy.

(Soundbite of laughter)

GROSS: ... morality.

(Soundbite of laughter)

GROSS: Yeah. And European repression. He's freed from European repression. So
in this film you witness your stepfather chopping off your mother's forefinger
with an ax in punishment for her infidelity with Harvey Keitel.

Ms. PAQUIN: Mm-hmm.

GROSS: And you witness the infidelity when you peak through a keyhole and see
your mother lying naked with Harvey Keitel. I'm guessing that when you shot
this, you didn't actually see Harvey Keitel naked.

(Soundbite of laughter)

Ms. PAQUIN: No. No I did not. They, as with most films, shoot the interiors on
stages and the exterior where I was peaking through, there was a bunch of
camera equipment inside covered with, you know, blue – like rain protection

(Soundbite of laughter)

Ms. PAQUIN: Yeah, also that – I didn’t even get a full version of the script.
There was a cut and paste and a scrapbook that I had.

GROSS: Oh, interesting.

Ms. PAQUIN: I was nine and that wouldn’t have been appropriate.

GROSS: Yeah well, and Harvey Keitel is totally full frontal in this. So when
the movie came out, did your parents let you watch the movie?


(Soundbite of laughter)

Ms. PAQUIN: I got to see like the first 20 minutes.

GROSS: How strange was that to get an Oscar for a movie that you’re in and yet
not be allowed to watch it?

Ms. PAQUIN: Well, I mean it was – I wasn’t allowed to watch many films that

(Soundbite of laughter)

GROSS: Oh, but you weren’t in them.

Ms. PAQUIN: Yeah, I know. But I’ve done a lot of stuff that wasn’t really
necessarily age appropriate for me viewing-wise. I don’t know, I mean that was
- I didn’t know it any other way. So it doesn’t seem odd. I mean, the whole
thing was odd.

(Soundbite of laughter)

GROSS: Yeah, the (unintelligible) right.

Ms. PAQUIN: The movie was odd.

GROSS: Right.

Ms. PAQUIN: Being in New Zealand one minute, and then being, you know, in L.A.
winning an Oscar and having lots of people that you’ve never met before in your
entire life wanting to talk to you and staring at you. I mean the whole thing
was very - I mean statistically very improbable…

(Soundbite of laughter)

Ms. PAQUIN: …if you like. So that wasn’t really the weirdest part, I wouldn’t

GROSS: So, I know you were protected from seeing things in the movie that would
be upsetting, but in the movie your character witnesses her mother’s finger
being chopped off with an axe.

Ms. PAQUIN: Yeah, that was pretty unpleasant.

GROSS: So, you did witness that.

Ms. PAQUIN: Yeah.

GROSS: Did it scare you?

Ms. PAQUIN: I honestly don’t remember. I mean, it was - you know, those sorts
of scenes - I mean, yeah, at the time it felt intense, but it was also - I
don’t know. It was really muddy and they had the rain machines and it was cold
and I’d been working with those people for several months. So, the - you know,
the line between real and fiction in that kind of instance was pretty well in
place, you know. So, I don’t know. I don’t remember being scared. To me, it
wasn’t obviously happening. I got to play with a rubber axe.

(Soundbite of laughter)

GROSS: Oh, oh, oh, okay, right. So you could see it was rubber.

Ms. PAQUIN: Yeah, you know, like they are very good about that sort of stuff -
like, here’s the finger.

(Soundbite of laughter)

GROSS: Thank you so much for talking with us.

Ms. PAQUIN: Thank you so much.

GROSS: Anna Paquin stars in the HBO vampire series “True Blood.” Season 2
begins Sunday night. Season 1 just came out on DVD. Coming up, Lloyd Schwartz
reviews a 50th anniversary edition of the original cast recording of “Gypsy.”
This is FRESH AIR.
Fresh Air
12:00-13:00 PM
Let This Entertain You: 'Gypsy,' 50 Years Later


“Gypsy,” the Jule Styne-Stephen Sondheim musical based on the autobiography of
stripper Gypsy Rose Lee, and starring Ethel Merman as Lee’s monster of a
mother, opened on Broadway in 1959 and ran for 702 performances. Critic Walter
Kerr famously called it: the best damn musical I’ve seen in years. On the 50th
anniversary of “Gypsy,” our classical music critic, Lloyd Schwartz, still
agrees with that assessment.

(Soundbite of song, “Some People”)

Ms. ETHEL MERMAN (Actor): (Singing) Some people sit on their butts, got the
dream, yeah, but not the guts. That's living for some people, for some hum-drum
people I suppose. Well, they can stay and rot, but not Rose…

LLOYD SCHWARTZ: Although, “West Side Story” may be more directly related to
Shakespeare, “Gypsy” might very well be at heart the more Shakespearean of all
Broadway musicals. When I was in graduate school, some of my classmates
concocted a musical version of “Hamlet,” putting new lyrics to the songs from
“Gypsy.” Critic Frank Rich once said that “Gypsy” was the Broadway musical’s
answer to “King Lear.” I think the two greatest stage performances I ever saw
were the great Shakespearean actor Paul Scofield’s King Lear, and Ethel Merman
as Rose Hovick, the ruthlessly ambitioned mother of actress June Havoc and
superstar stripper Gypsy Rose Lee.

In the ferocity of her sense of betrayal by the daughter who achieves the
success she wanted for herself, Merman rose to tragic heights. “Rose’s Turn,”
her big final soliloquy, is the Broadway version of a real operatic mad scene.
Good as Merman’s successors may have been, none of them came anywhere near her
in this number.

(Soundbite of song, “Rose’s Turn”)

Ms. MERMAN: (Singing) Why did I do it? What did it get me? Scrapbooks full of
me in the background. Give ‘em love and what does it get you? What does it get
you? One quick look as each of ‘em leaves you. All your life and what does it
get you? Thanks a lot and out with the garbage. They take bows and you’re
battin’ zero. I had a dream. I dreamed it for you, June. It wasn’t for me,
Herbie. And if it wasn’t for me then where would you be. Miss Gypsy Rose Lee?
Well, someone tell me, when is it my turn?

SCHWARTZ: Gypsy’s magnificently brash, quintessentially American vulgarity
makes it one of Broadway’s greatest showbiz musicals. The music was composed by
Broadway pro Jule Styne, whose best known showstopper before “Gypsy” was
probably “Diamonds Are a Girl’s Best Friend,” from “Gentlemen Prefer Blondes.”
And his lyricist was a young Stephen Sondheim, fresh from writing the lyrics
for “West Side Story.” Though they never collaborated again, they were an ideal
team. Styne’s score was pure Broadway by way of vaudeville and burlesque -
memorable yet unpretentious and never artsy.

Sondheim’s lyrics are by far his earthiest and most colloquial. Yet they also
have their own kind of Broadway wit and elegance, as in these intricate rhymes
in “Together Wherever We Go.”

(Soundbite of song, “Together Wherever We Go”)

Ms. MERMAN: (As Rose) (Singing) Whatever the boat I row, you row.

Mr. JACK KLUGMAN (Actor): (As Herbie) (Singing) A duo.

Ms. MERMAN: (As Rose) (Singing) Whatever the row I hoe, you hoe.

Ms. SANDRA CHURCH (Actor): (As Louise) (Singing) A trio.

Ms. MERMAN: (As Rose) (Singing) And any I. O. U., I owe you-oh’s?

Mr. KLUGMAN: (As Herbie) (Singing) Who, me-oh? No, you-oh.

Ms. CHURCH: (As Louise) (Singing) No, we-oh.

Ms. MERMAN: (As Rose) (Singing) Together! We all take the bow.

Ms. CHURCH: (As Louise) (Singing) Together! We all take the bow.

Mr. KLUGMAN: (As Herbie) (Singing) Together! We all take the bow.

SCHWARTZ: To celebrate “Gypsy’s” 50th anniversary, Sony has reissued the
original cast album with some additional material. One highlight is what seems
to be a demo of Merman singing the poignant song that, in the show, the lonely
young Gypsy sings to her toy animals on her birthday. Anyone who thinks Merman
was only a belter needs to hear this recording.

(Soundbite of song, “Little Lamb”)

Ms. MERMAN: (Singing) Little cat, little cat, oh, why do you look so blue? Did
somebody paint you like that, or is it your birthday too?

SCHWARTZ: New bonus tracks on the cast album include an interview with Jule
Styne and a bizarre autobiographical number recorded by Gypsy Rose Lee herself,
shortly after “Gypsy” opened.

(Soundbite of bonus track from “Gypsy”)

Ms. GYPSY ROSE LEE (Author, “Gypsy: A Memoir”): Hello.

(Soundbite of piano)

Ms. ROSE LEE: I’ve been in show business almost all my life. My fondest
memories were of the years most of you remember as the Depression years.

(Soundbite of music)

Ms. ROSE LEE: Mother and I were so poor, we didn’t even know there was a

(Soundbite of music)

Ms. ROSE LEE: We went broke during the boom. All we knew was that vaudeville
was dead.

(Soundbite of music)

Ms. ROSE LEE: How we missed the good old two-a-day. I mean two meals a day, not
shows. That’s why I started in burlesque. I don’t know how I got the job.

(Soundbite of music)

Ms. ROSE LEE: I was only 15.

(Soundbite of music)

Ms. ROSE LEE: Of course, I was big for my age. I wasn’t exactly what you’d call
a stripling of a girl. I was 38, when I was 13.

Mr. SCHWARTZ: With the great Merman, and the touching Jack Klugman as the man
who loves her but can only take so much, “Gypsy” is one of the best original
cast recordings ever made. More than most show albums, it lets us breathe the
pungent atmosphere of the whole show, of Broadway itself.

GROSS: Lloyd Schwartz is classical music editor of the Boston Phoenix and
teaches English at the University of Massachusetts, Boston. He reviewed the new
50th anniversary reissue of the original cast album of “Gypsy.”

(Soundbite of music)

GROSS: You can download Podcasts of our show on our Web site

I’m Terry Gross.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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