By Annmarie Cronin Special writer <>Trauma n. 1) physical injury. 2) physical shock following this 3) profound emotional shock I had a long time to reflect on the word trauma in the past week as I spent time with the family of a young accident victim who had part of his face rebuilt following a snowboarding collision with a skier. I thought of the many ways we use the word, its varied meanings, its intensity. we tend to use the word loosely many times to describe minor scrapes and insults, but to the physicians and surgeons who deal with trauma on a daily basis, the word takes on a very definite meaning. It defines a time space in which you have to repair an injury and it defines a level of care the provider or institution must be prepared to render. Fortunately for 15-year-old Erol Sarikaya, his injury was not life threatening. He had narrowly escaped what could have been a more serious head injury. But the blow he took was sustained to his left cheek where a CAT scan later revealed he had suffered four fractures. It was an accident whose inception lay in the daredevil of youth, and his wish for snow. It was to be a new experience. Erol, the son of Turkish parents, grew up in saudi Arabia and had never seen snow. Therefore, when his parents reluctantly gave in and bought him the snowboard he had asked for at Christmas, it was not without trepidation and a few skipped heartbeats. The fall season was filled with new beginnings for him and new challenges. He had traveled many thousands of miles to come to school in America, leaving behind family and friends and a different culture. A boarding student at Cranbrook, in Bloomfield Hills, he was living in a dorm, adapting to life in America and anxiously awaiting his first snow with all of its possibilities. When his parents came to visit him at the Christmas break, they took him to his first few snowboarding lessons. At the end of two weeks, his mom and dad headed back to turkey, leaving him with the admonishment to be careful. Two days later, they would be back on a plane headed back to Detroit and William Beaumont Hospital in Royal Oak. Sitting at the foot of his bed after the surgery, his mother reflected, "We did not want to get him a snowboard, but that's how life is. Young people want to take risk and have fun. "I kep praying that he would change his mind. This was his first snow. He had never seen snow before. "We watched his first lesson and it was scary, (but) it is also a different experience when your parents are always telling you 'no, no, don't do that, that's dangerous.' We cannot let them not experience. We allow him to experience and try to watch on the side." After the surgery, his parents said they were thankful for three things: that the accident had not been a lot worse, that the school officials had acted quickly and with diligence, and for finding Dr. Michael Freedland, a plastic and reconstructive surgeon whose specialty is cranio facial surgery. Freedland would put their son's face back together. During the two hour procedure, Dr. Freedland inserted two titanium metal plates in Erol's cheekbones, working mostly under the skin through two small incisions at the inside base of the lower eyelid and up inside the upper left cheek, going in through the mouth. Photo by Alpha Photographic Agency Trenton Plastic surgeon Dr. Michael Freedland Feels for bone structure. Dr. Freedland explains surgery to Erol's parents. He would work under the skin from the base of his eye socket and from the jaw line. Commenting on the surgery performed at Beaumont Hospital, Dr. Freedland said, "We basically have a three-week window after these types of traumas to reset the damage before the bones set in the wrong position and the damage becomes harder to correct. "The longer you wait with this type of facial trama, the greater the risk of complications due to the increased risk of nerve damage, he added. "In other words, the sooner we get it taken care of, the better." Freedland is a Trenton-based plastic surgeon with a talent for understanding the bone structure of the face. He credits his talent not only to his excellent training in cranio facial surgery, but also to the artistic talents that he developed while studying ceramics and line drawing at Interlochen, a school for the performing arts located near Traverse City. "I came to understand the three dimensional structure of the face and how it is put together and can be put back together," he saud. "The cranio facial training helps me move along quicker, using both vision and the tactile experience, and a feel for the bones and how they move," he said. "Facial trauma is extremely challenging because of all the bones, and it is difficult to get in and out of the face." As for Erol, he is on the ment, spending some quiet time with his parents befor they return to their homeland. When asked how he feels now after his near brush with disaster, he said, "I want to wear a helmet. A helmet could save lives. I used to never wear a seat belt. I used to trust my parents driving, but I never thought about the other guy." "I guess we have to be responsible if we want to enjoy snowboarding," he said. "We also have to enjoy the responsibility of protecting our lives. I wear my seatbelt now." As for his parents, they are slowly recuperating from their psychological trauma and the stresses of flying half way around the world and back again. soon they will be back home in turkey. And Erol will be wearing a helmet when he needs to. Annmarie Cronin, a free lance writer for the medical industry, owns and operates a public relations agency in Birmingham.