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Photography by Jay Fram
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Photography by Jay Fram
During his recovery, Oberle has become an unofficial spokesman for the Sinceriously campaign, started by Stephen Amell, the star of his favorite show, Arrow.
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Photography by Jay Fram
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Photography by Jay Fram
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Photography by Jay Fram.
Young zookeeper Andrew Oberle extends a pole topped with a tennis ball toward Tumbo, a 5,500-pound hippopotamus. He says, “Target,” touching the ball to the behemoth’s nose. Then Oberle gives Tumbo an apple and hits a clicker, which the hippo recognizes as a “good boy” reinforcement. He repeats the cycle, giving Tumbo a chance to pick up on the pattern. Next, he moves the pole a few feet from Tumbo’s face, again says “Target,” and hopes that the hippo will bring his nose to the ball. If he does, Oberle gives him another treat and increases the distance for the next attempt. If not, they start over.
This lesson, like all training at the San Antonio Zoo, is intended to make the animal’s life easier and safer. For instance, if Tumbo were to cut his leg, a target against the glass of his enclosure would bring him close enough that the vet could take a good look. Working with a group of the zoo’s capuchin monkeys, Oberle trains them to sit still on a scale. Weighing animals regularly is a good way to monitor their health (and to tell whether they might be pregnant), a task made easier for both trainers and monkeys when it doesn’t require darting and bagging them.
Oberle is working at the zoo while studying for his master’s in anthropology and primatology at the University of Texas–San Antonio. He decided on a career involving monkeys as a grade-schooler in St. Louis, when his teacher told the class about Jane Goodall, the trailblazing researcher who spent decades with wild chimpanzees in Tanzania. As a teen, Oberle spent his summers as a counselor at the Saint Louis Zoo’s summer camp. He even has a tattoo of the zoo’s symbol, a lesser kudu. As an undergraduate at St. Mary’s University in San Antonio, he studied abroad in Hawaii, where he persuaded a professor to let him help with a chimpanzee study at the local zoo rather than doing his homework. Oberle sat with a notebook and watched the chimps during meals, recording social behaviors associated with their eating habits.
In San Antonio, Oberle wows his roommates, married couple Anthony and Misa Reimherr, with the tricks he teaches his dog, Angie, a precocious mutt he adopted from the humane society and named after the Rolling Stones song. For her show-stopping stunt, Oberle points an imaginary gun and says, “Stick ’em up,” and Angie puts her front paws in the air. Then he says, “Bang,” and she plays dead. Photos of the animals he’s worked with hang on his bedroom walls, next to paintings done by monkeys and okapis. His bookshelf is lined with texts on primates: Animal Tool Behavior, Primate Behavioral Ecology, Chimpanzee Politics.
This summer, he’ll put all he’s learned to the test in South Africa, where he’ll work at the Jane Goodall Institute’s Chimp Eden, a sanctuary for rescued chimpanzees, many of which have been abused by humans. All these years after telling his mom, Mary Flint, that he wanted to work with monkeys, Oberle will take a giant, international step toward his dream job as a primatologist.
Around 1 p.m. on June 28, 2012, Annie Coogan is sitting in a meeting when her phone rings. She doesn’t recognize the international number. The man on the other end identifies himself as Eugene Cussons, director of Chimp Eden. He tells Coogan that her nephew has had an accident and is hurt and that he needs to get in touch with his parents. Cussons doesn’t go into detail, but Coogan figures that if he’s calling from South Africa, it must be bad.
She calls her brother Andrew Oberle Sr., but he doesn’t pick up. She calls again. And again. And again. Finally, he answers. “You need to get a hold of Mary,” Annie Coogan tells her brother. “Andy’s been hurt.”
Several hours later, the elder Oberle calls back. He tells Coogan that “Little Andy” has been attacked by chimps.
In San Antonio, Anthony Reimherr’s phone rings, too. It’s Flint, frantic. Andy’s had an accident, he’s in a hospital in a town called Nelspruit, and he needs help. Reimherr tells his boss he needs to go, drives home, and starts calling his family.
He’d met Oberle at St. Mary’s, where they became best friends after pledging the same fraternity. When Reimherr married his college sweetheart and bought a house, Oberle moved in with them. He helped with the bills and was just a good guy to have around, always upbeat. Their porch was falling apart, in shambles, but an overhaul wasn’t in the budget. Oberle said they could do the work themselves; Reimherr, who’s “not into manual labor,” wasn’t so sure. They went to a hardware store together and bought a nail gun and a power saw. They took measurements and cut boards. Within three weeks, Oberle had rebuilt the whole porch. For holidays, Oberle sometimes couldn’t afford to go home, so he’d tag along with Reimherr. Anthony’s parents, Mike and Nancy Reimherr, view Oberle as another son, and Oberle calls them his second family.
Now, with him fighting for his life half a world away, the Reimherrs brainstorm ways to do something—anything—to ease the feeling of helplessness. They know that money is tight for Oberle’s family, so they set up a website to accept donations. Anthony has just passed the CPA exam and Misa has finished her master’s, and they have a party planned at his parents’ house to celebrate. They turn the event into a fundraiser for Oberle, asking guests to make a donation in lieu of buying gifts. Word about the event spreads, and a television reporter shows up, interviewing Anthony and Misa and Angie, whom the younger Reimherrs are dogsitting while Oberle is abroad.
From there, the media attention snowballs, with Anthony doing a string of interviews, always directing people to the funding site. Soon, donations pour in from all over the globe. Oberle’s friends from the San Antonio Zoo help the Reimherrs organize another fundraiser at a local bar. Businesses donate merchandise for a raffle, and Oberle’s ex-girlfriend asks a friend with a band to play. They raise thousands in one night. Another of their fraternity brothers dubs the effort Operation Oberle, and they like the sound of that so much, they print rubber bracelets with the phrase, which they sell for $5 apiece.
First, the money is put toward plane tickets to get Oberle’s parents to South Africa. The rest goes into an account to pay for medical expenses. Then, out of the blue, Reimherr receives a call from Red McCombs. The billionaire has heard about Oberle on the news, knows he might not make it, and wants to help.
His wife already has her prayer circle on the case, and McCombs knows of no greater power. He jokes that he tries to stay on her good side so her whispers in God’s ear will remain in his favor. He asks Reimherr whether they have a tax exemption for donations. As accountants, Reimherr and his father know how arduous it is to apply for that status. McCombs says he’ll call back shortly. Within hours, he tells Reimherr that he’s spoken with an executive at the United Way and that the organization would be happy to collect tax-exempt funds for Oberle. McCombs makes a donation and asks other community leaders to join him. In St. Louis, supporters will hold mouse races, a trivia night, and a golf outing.
In the end, between the website and the United Way fund, they will raise about $150,000. McCombs won’t disclose the amount of his own contribution, saying only that it’s “sizable.”
Back in St. Louis, the Coogans pray and cry and pray some more. Quickly, their business, a chiropractic office in St. Peters where Annie works with her husband, Danny “Doc” Coogan, becomes a sort of mission control for Operation Oberle. They’re in constant contact with their nephew’s friends in San Antonio to coordinate fundraising efforts and with his parents in South Africa, to receive updates on his condition. Oberle is on a ventilator in a drug-induced coma, undergoing surgery after surgery to stop his bleeding and to clean and close his wounds. Once again, Annie doesn’t have the heart to ask her brother about her nephew’s specific injuries. He tells her only that they’re “horrific.”
On July 1, three days after the attack, Doc sits down at his computer and composes an email. “Dear Little Andy, I know this is silly and you will not read this right away because you are in a coma,” he begins. He mentions a scene from the movie Gladiator in which Maximus appears to be near death. “Not yet,” a companion tells him. “Some day, nephew, your life will end, but ‘not yet,’” Doc writes. “It was not your time, not yet, you have so much more work to do following your dreams… Recovery for you will be a long slow process, with lots of therapy and probably many surgeries. Please understand part of my reason for writing this is because of the extreme frustration of not being able to do anything right now to help except to pray… Andrew you have so much more to do for this world and we are all so very lucky that you are still with us.”
The Coogans’ phone rings around the clock with calls from reporters wanting to talk to Oberle’s parents. Annie thinks that interviews would help the fundraising cause, but Mary, a private person by nature, is adamantly opposed. At the hospital, in South Africa, she takes great pains to make sure that no photos of her son are taken, and she asks hospital staff to stop giving the media updates on her son’s status after news outlets report on his hours-long surgeries and gradually stabilizing condition.
In the absence of information coming from the family, the public narrative of the attack, parroted on the nightly news, comes from Cussons, who implies that it was Oberle’s fault. He portrays the 26-year-old student as a novice, never mentioning his years of experience at zoos. (Oberle wasn’t comfortable sharing his memories of the attack for this story, and the Jane Goodall Institute did not return calls requesting comment.)
According to Cussons, Oberle was giving a tour of the sanctuary when he left the group, crossed an outer fence into a “no go” zone, and attempted to move a rock lodged beneath an inner electric fence, ostensibly to keep it away from the apes. Cussons describes this as “a lapse in judgment.” Two chimps, Amadeus and Nikki, interpreted Oberle’s movement as an infringement on their turf and “were determined to defend their territory at all costs,” Cussons tells the media.
The chimps—pound for pound more than twice as strong as humans—grabbed Oberle and attempted to pull him under the fence into the enclosure. He fought. Eventually they crawled under the fence, through the gap created by Oberle’s body, and dragged him away. As the chimps mauled him, the sanctuary locked down. When Cussons arrived on the scene, he fired warning shots to scare off the chimps. They failed. Then Nikki came after him, leaping onto the hood of his vehicle, and Cussons shot the chimp through his windshield, a nonlethal blow to the stomach. At that point, the chimps retreated and Cussons was able to reach Oberle. “I found him awake,” he says. “I found him conscious. He was asking for help.”
“When we arrived there, he was curled up in a ball, really deeply lacerated from head to toe,” first responder Lloyd Krause tells ABC News. “We see a lot of animal attacks, and this is by far the worst that I’ve ever seen.”
On July 3, less than a week after the attack, an investigator rules that the chimps won’t be euthanized, because the incident resulted from human error. Two days later, with Oberle still in a coma but his life no longer in immediate jeopardy, he is moved from the small hospital in Nelspruit to Milpark Hospital in Johannesburg, a first-rate facility that’s better equipped to treat Oberle’s injuries. Later, his American caregivers will suggest that Oberle might have been moved earlier if officials hadn’t assumed he was going to die.
A week later, his father calls Doc. They have to find a Level I trauma center in St. Louis that will take Andy within two weeks. He needs more than $1 million in care, and he has no health insurance.
Doc sits back down at his computer and writes another email.
Despite working in emergency departments for 40 years, a career that has exposed her to all manner of disaster, Helen Sandkuhl believes that everything happens for a reason, even heart attacks. If not for hers, Oberle might be dead. And if not for his accident, she might have never recovered.
Photography by Kevin A. Roberts
A few weeks earlier, on June 11, 2012, Sandkuhl was at Saint Louis University Hospital, where she serves as the administrative director for Nursing, Emergency, Trauma & Disaster Services, a big title that comes with big responsibilities. She’s something of a legend, known for her work in Joplin after the tornado, New Orleans after Katrina, Haiti after the earthquake… But even saints have bad days, even heroes can’t stand the human resources department. Sandkuhl was stressed out, having spent a hectic day dealing with personnel issues. At 4:30, she gave up and went home. When she got to her house on The Hill, she checked the mail and found a letter from the hospital—another staffing issue. “I’m so sick of this!” she thought, and she started to feel chest pressure.
Sandkuhl has long battled stomach ulcers. Remembering her emergency nursing guidelines, she went to the fridge for a 7 Up. “It can’t be Sprite; it has to be a 7 Up.” If that doesn’t work, try a bottle of Pepto-Bismol. “Bismol cures everything.” And if all else fails, just take a hot shower. But the pain only intensified. As she was toweling off, she said to her daughter, also a nurse, “Get the car. You need to take me to the hospital. I’m having a heart attack.” Her daughter wanted to wake Sandkuhl’s husband, who was working the night shift, but Sandkuhl wouldn’t hear of it: “Don’t wake up your father. Get the car.” Then her daughter suggested calling 911. Sandkuhl wasn’t having that, either. “Get the damn car.”
So they got in the damn car and as they made the short drive, Sandkuhl called the hospital and said, “OK guys, I’m coming in. I’m having a heart attack.” When they arrived, a room was waiting. The doctor told her to strip down, but she wouldn’t do it unless he left the room. “You cannot watch me get undressed,” she told him, “because I have to work with you.”
Sandkuhl was now relying on her own staff, people whose personnel files she had stressed over, to save her life. They put defibrillation pads on her, and gave her morphine, oxygen, and aspirin. The cardiologist was on the way, but suddenly, the unflappable Sandkuhl felt despair, tears welling in her eyes. That’s when a diminutive nurse, whom she had just hired, said, “Helen, do you want to pray?” Sandkuhl said yes. About the time the prayer finished, she said, “Oh God, I feel dizzy.” She went into ventricular fibrillation. They shocked her and began CPR. She was dead for a minute before they brought her back. When she woke up, she saw her daughter being carried from the room.
When she met the cardiologist, he was young, so she interrogated him, asked whether he was a resident. “No,” he said defensively. “Calm down. I’m the attending.” It’s hard to blame the guy for feeling intimidated. Sandkuhl is an imposing figure, and at this point, she was being escorted by an entourage of maybe 30 of her devoted employees. They put a stent in, she spent a couple of days in the intensive-care unit, and she went home.
It was then that the real problems started. For the first time, it occurred to her that she, too, was mortal. And the prospect of her demise, “when you finally realize that you can kick the bucket,” sent her into a deep funk. She refused to leave the house, telling people that she couldn’t be more than five minutes from the hospital, in case she had another attack. Sandkuhl felt sorry for herself. She reluctantly agreed to visit her grandchildren, but only after their father, a doctor, offered to bring a defibrillator.
On Saturday morning, she checks her email. Sandkuhl is an officer in the Emergency Nurses Association, and Doc’s message finds its way through the group to her. As Sandkuhl reads about Oberle and the attack, about “an intelligent, considerate, and caring young man who did not deserve a fate such as this,” she stops worrying about her heart. She gets to work.
Before Sandkuhl can bring Oberle to SLU, she must find a doctor willing to take him. Dr. Bruce Kraemer, the hospital’s straight-and-fast-talking chief plastic surgeon, volunteers. He sends Sandkuhl an email that reads like a job application, explaining his qualifications, with a list of the many gruesome trauma cases he’s handled, including a list of various animal bites and attacks. The idea also needs approval from Phil Sowa, the hospital’s CEO, who could easily balk at the prospect of handing out $1 million in free care. When asked to do just that, he responds with a question of his own, “Is there a chance the kid is not going to make it if he doesn’t come back here?”
Yes.
“Go get him.”
If only it were that simple. First, they need to acquire Oberle’s South African medical records so the SLU doctors will know what they’re getting themselves into. Those records are handwritten on awkwardly large sheets of paper. There are no digital copies. They’ll need to be mailed. Then there’s the matter of actually transporting Oberle. His care in South Africa is being paid for by his travel insurance, which wants SLU to pay to fly him back. SLU wants the insurance company to charter him a medical plane. Negotiations progress slowly.
Meanwhile, Sandkuhl coordinates conversations between SLU doctors and those caring for Oberle in South Africa. About three weeks after the attack, Oberle wakes up in Johannesburg. He’s still on a ventilator, so he can’t talk, but he recognizes that he’s in a hospital and sees that his parents are there. The first few days are tough as he comes to terms with his injuries. His dad must return to the U.S. for work, but his mom never leaves his side.
Changing Oberle’s head-to-toe dressings takes up to four excruciating hours as the bandages are peeled off his weeping wounds and replaced with fresh gauze. Every 15 minutes, he receives another dose of painkillers intravenously. Flint covers her son’s eyes with a towel. He never liked gory movies; his stomach can’t handle the sight of himself. She turns on his U2 playlist, and Bono’s voice drowns out the world.
Once Oberle’s able to speak, he and his mother meet with a chaplain at the hospital. Because he’s so heavily medicated, Oberle forms only hazy memories of the conversation, but it gives him hope. The chaplain tells him, in essence, that stuff happens. What matters is how you respond, how you move forward. God still has a plan. Oberle’s always been at his best when working toward a goal, and now they’re giving him one. If he wants to leave, he has to be able to sit up on the side of his bed, a sign that he’ll be able to survive on a plane. He’s lost 30 pounds, can barely move an arm or leg. They pry him up and tell him to hold it. He can’t. He tries again.
Back in St. Louis, the Coogans can’t understand why the medical records are taking so long. Annie fires off an exasperated email to someone at the hospital named Sowa, with no idea that he’s the CEO. He’s understanding. Doc calls Sen. Claire McCaskill, and she phones the consulate in South Africa. Finally Doc receives a UPS tracking number. He stays up all night, watching as the package makes its way across the globe, trading updates with Sandkuhl. Eventually she says, “Go to bed. We got them.”
They compromise on flying Oberle commercial, but with a nurse. Sandkuhl is in disbelief, furious that it’s not a medical plane, worried sick that Oberle won’t make it alive, but it’s the best they can do. He’s unplugged from his machines, loaded into a wheelchair, slapped with a patch of Fentanyl—“morphine’s big strong sister”—and loaded onto the plane. They’ve reserved him several rows in the back so he can stretch out on a pile of blankets. This time, it’s Sandkuhl’s turn to stay up late tracking Oberle’s progress. She refreshes her email countless times, expecting to hear the worst.
Instead, on August 6, Oberle and his mother pull up the ramp to the hospital in an ambulance. Flint gets out of the passenger seat and wraps Sandkuhl in a hug.
Oberle is wheeled straight into an operating room, and a crowd of doctors gathers to inspect his injuries. The chimps tore away his scalp down to the skull. His ears and nose are gone, and he can’t close his right eye. He has wounds on his trunk and all four limbs. He’s lost most of his fingers, and his right forearm has been eaten, the tendons gone. He’s lost parts of his feet, and his right ankle is destroyed. Kraemer refuses to cast aspersions on the lifesaving care that Oberle received in Africa, but many of the skin grafts aren’t taking, and his body is riddled with infection. As the doctors take stock, a trauma surgeon notices that Oberle has a gastric feeding tube in that’s clogged and not working. He tells Oberle that he’s going to remove it on a count of three, says “One,” and yanks. It’s one of the only times during his entire three-year recovery that Oberle will let his pain show.
Photography by Kevin A. Roberts
Kraemer hits Oberle with a “full frontal attack,” trying to gain control of all his injuries at once. That starts with surgical wound debridements: opening his wounds, cleaning them, and removing dead or infected tissue to give the remaining healthy tissue a chance to heal. To help Oberle regain the weight he’s lost, he’s fed as much as he can eat.
One of Oberle’s first visitors is Annie. She happens to come during a dressing change, when most of her nephew’s bandages are off. He looks terrible. Just how terrible doesn’t hit her until the next morning, and she’s a basket case, sobbing all day. She regrets ever questioning Mary’s decision to shut out the press. Worried about his weight loss, Annie bakes cupcakes and brownies, anything to fatten him up. Soon after, the Reimherrs drive up from San Antonio to bring Oberle his car and, more important, Angie. Anthony knows that the dog will be a big part of Oberle’s recovery. The day they come to visit, Doc is there, and they’re glad to meet in person after exchanging so many emails. Hearing about something and seeing it up close are two very different things, and seeing Oberle hits Anthony hard. He can’t help but think about the hard road ahead for his brother, who will surely be dealing with these injuries for the rest of his life.
As the infections are treated and Oberle’s nutrition improves, his wounds no longer leaking valuable proteins, Kraemer moves to skin grafts, patching up wounds that have now been open and not healing well for more than a month. Kraemer uses split-thickness skin grafts on Oberle, taking a thin top layer from the healthy skin of his thighs and then transferring it to cover wounds.
Kraemer also treats Oberle with a new product called MatriStem, made by the company ACell. It’s from a developing and mildly controversial field, called regenerative medicine, in which Kraemer is emerging as a national leader. Made from pig bladders, MatriStem is an “extracellular matrix” that provides the body with proteins and collagens to stimulate healing, regenerating healthy tissue and preventing scarring. Because of the number and variety of his injuries, Oberle is a perfect MatriStem guinea pig for Kraemer. He puts a powder form on Oberle’s left index finger and nose, initially applying it surgically and then adding more when changing the dressings. Somewhat miraculously, Oberle regrows part of the finger. Kraemer applies sheets of MatriStem to Oberle’s scalp, legs, and feet. In each case, the healing is better than Kraemer could have imagined.
“I was doing stuff that I wasn’t sure was even going to work,” Kraemer says. “We offered him the newest, latest healing.”
Oberle stays in the hospital for more than three weeks. He spends another few weeks at The Rehabilitation Institute of St. Louis. At first, his caregivers there plan to send him home with a hammock-type lift so his mother can get him in and out of bed. Flint is terrified by that possibility, so Oberle trains himself to move from bed to wheelchair and vice versa. He still needs several more surgeries, but they’ll be outpatient procedures. It’s time for him to go home.
He moves in with his mom in the South City house that was once his great-grandparents’. What was the dining room when he was a kid becomes his bedroom. Every good bedroom needs a bed, and money from the fundraisers goes to buy Oberle one. The Emergency Nurses Association buys him a TV so he can kill time with Netflix like any other American. For Oberle’s care at home, Sandkuhl recruits Tony McNeese, the hospital’s manager of clinical outreach and disaster services. A nurse of nearly 40 years, McNeese is in charge of first aid at Chaifetz Arena. He doesn’t usually make house calls. For Oberle, and for Sandkuhl, he makes an exception.
A few days each week, McNeese comes to Oberle’s house. First, he makes sure that Oberle has enough pain medicine. Then McNeese changes his dressings, a process that in the first few weeks Oberle’s home takes hours. He also helps Oberle change his tracheostomy tube, which will stay in for more than a year. McNeese pulls it out, Oberle holds gauze over the hole at the base of his throat so it doesn’t close, and McNeese cleans the tube and sticks it right back in as fast as he can. The tube causes a lot of phlegm to build up in Oberle’s throat. He coughs and coughs, but it sticks around the tube. He pounds on his chest until he finally hacks it up. Once Oberle is able to shower, McNeese bathes him.
Sandkuhl stops by frequently, too, dropping off ointments and other supplies. Sometimes she brings Oberle a plate of chicken fettuccini, or she nags him about finishing his master’s. She holds her breath as Angie leaps onto the bed next to Oberle, worried that the dog will land on one of his wounds. But Angie never does. (Oberle has her DNA tested, and they learn that she’s a quarter Boston terrier and 15 percent each pit bull, mastiff, Rottweiler, Shetland sheepdog, and cocker spaniel.)
Spending so much intimate time together, Oberle and McNeese form a friendship. McNeese cringes when Oberle tells the story of his accident, which he remembers in excruciating detail. Occasionally McNeese uses the steam from the shower to hide his tears. Other times, the banter is lighter: They talk about sports, women, school, jobs. Only once before has McNeese grown this close to a patient—his mother, years ago, when she was dying of cancer. Now that she’s gone, and McNeese and his wife are separated, he envies the closeness between Oberle and his mom. In a way, their connection fills a void for him.
Oberle makes steady progress. Doctors in South Africa told Flint that her son would never walk again, but at Thanksgiving he shocks everyone by leaving his power wheelchair behind and strolling into the Coogans’ house, using a walker. By Christmas, he’s ditched that, too.
When he first examines Oberle’s injuries, Dr. Michael Bernstein describes them as “impressive, and that is from somebody who sees a lot of crazy trauma at SLU.” Over the course of five surgeries, Bernstein gives him a new nose.
Normally Bernstein would take skin from the forehead, pull it down over the brow, and attach it to the nose so a skin bridge connects the two structures. This gives the skin a new blood supply from the nose. That would be his first step with Oberle, except he can’t: Because of the scarring on Oberle’s forehead, there isn’t enough good skin with which to build a nose. Bernstein needs to make more. So he inserts a balloon under Oberle’s scalp, and every week or so for a couple of months, Oberle returns to have a bit more saline solution pumped into the balloon, which slowly stretches and expands his skin. His uncle Carl buys him a fedora to cover the tennis-ball-sized bulge growing from his head.
For the second procedure, Bernstein would normally borrow some cartilage from an ear, but Oberle doesn’t have ears. Instead, he takes cartilage from one of Oberle’s floating ribs and fits it over the tissue that Kraemer was able to regenerate with the MatriStem, creating the structure of the nose. He then pulls down the extra forehead skin to form the flap, which looks a bit like a bulbous elephant trunk. McNeese helps him keep it dry in the shower. Six weeks later, Bernstein begins to sculpt the flap into the shape of a nose, an “old-school” process done with knives and scissors. In surgery No. 4, he removes the skin connecting the forehead to the nose and puts the eyebrow back where it belongs. The final procedure involves “fine-tuning” the nose’s shape, using additional cartilage grafting, because “particularly in really large nasal reconstructions it’s hard to hit a home run” on the first swing. Both times Bernstein takes rib tissue from Oberle for his nose, it feels like, well, a broken rib. In a bonus sixth surgery, Bernstein takes hair follicles from Oberle’s remaining eyebrow to fill in the one he lost.
This process takes more than a year, but to Oberle the end result makes the balloon and the trunk and all the hassles worth it. When you meet someone new, the first thing you look at is the person’s face. And what’s right in the middle of that face? The nose. Having one gives him his confidence back. When he sees Bernstein again after the surgeries, he tells him, “I was able to look in the mirror and actually smile for the first time without having this big hole on my face.”
When Oberle comes to SLU, his right ankle is in shreds, having lost much of its soft tissue, including most of the key ligaments, with deep lacerations through the skin and into the underlying fascia. About half his foot has been gnawed off. To allow Kraemer to restore the soft tissue, orthopedic surgeon David Karges is brought in to apply an external fixator to stabilize the ankle. Once the tissue heals, Oberle is left with a floppy ankle.
That’s why, now, Karges is called back in to fuse Oberle’s ankle. Afterward, he won’t be able to flex it, but the joint will be stronger. Karges makes an incision in Oberle’s heel and inserts a titanium rod, 25 centimeters long and 11.5 millimeters in diameter, up through his heel and talus and into his tibia. The rod pushes the bones into alignment. Next, Karges takes a screw and drives it perpendicularly through the bone and the top of the rod. He inserts a second screw at the bottom of the rod, advancing it from the outside of the heel toward the inside. Finally, he uses a tool sort of like a screwdriver to push on the bottom of the rod, which compresses the bones together.
Most patients take two months to heal after an ankle fusion. Oberle does it in half that. Roughly a year to the day after the attack, he and several of his Operation Oberle supporters do the Macklind Mile, an annual race hosted by Big River Running. It’s a slow, triumphant walk.
Because Andrew would like to return to running—he’d completed his first marathon, in four hours and 33 minutes, shortly before the accident—he and Karges are working on procuring a special brace that would take the load off his foot and give him better shock absorption. Karges has worked with professional athletes, even some Olympic medalists. Few show the level of determination that Oberle has. “Working with Andrew is truly the reason I enjoy my work,” he says. “He’s really doing it all on his own. He succeeds with every step.”
Oberle is right-handed, but the chimps have wrecked his right forearm, ripping out his tendons and making it next to impossible to lift anything. Kraemer wants to perform a tendon transfer to restore function, but first he needs a better layer of tissue and fat on the arm. Because of the weight loss, Oberle has some extra skin on his abdomen. Kraemer, knowing how to make the most of what he has, cuts a flap in Oberle’s belly, sticks the arm in there, and sews it all together. For three weeks, Oberle will have to live without his dominant arm.
Doc describes this procedure as “so cool,” but Oberle is less enthusiastic, saying that it’s “a lot tougher than having the nose trunk.” If he accidentally or reflexively tries to move his arm, the stitches pull and hit him with a little shot of pain. The flap is open on the underside, so keeping it clean requires a mountain of gauze. If McNeese hasn’t already earned his wings, he seals the deal with all the dressing changes during these uncomfortable weeks.
Once Kraemer removes the arm from Oberle’s abdomen, they wait a few months to make sure that the new tissue is going to take. Then it’s time for another surgery. Kraemer takes the tendons that Oberle would have used to curl his fingers, which he no longer has, and rethreads them to the top side of his wrist. Now Oberle can raise his wrist—he just has to think about curling his fingers. As he says, “Neuroplasticity is a cool thing.”
After spending months burrowed away in his bedroom working on a replacement thesis project—this time he stays away from primates and instead analyzes maps to track environmental abuses in Cameroon—Oberle graduates from UTSA in May 2015, nearly three years after the accident. It’s like a big family reunion for his supporters. McCombs hosts a dinner in Oberle’s honor. The Reimherrs throw a graduation party at Mike and Nancy’s place. Everyone has a laugh when Annie pours herself what she thinks is a lemonade and takes a big gulp, only to realize it’s a margarita. At the end of the night, as he likes to do, Mike gathers everyone around for a prayer, then makes a speech. He wants people to toss their bracelets into the fire, but everyone declines. No matter, he declares Operation Oberle an official success. With that, the whole team agrees.
Back in St. Louis, Oberle arrives at SLU for another appointment with Kraemer. Outside, he stops to chat with the valet for a few minutes. She greets him like a long-lost relative. In the hallway, it’s more of the same. Doctors’ and nurses’ faces light up at the sight of Oberle. Even the ones who seemed to be rushing off somewhere pause to say hello. One might chalk this up to the extent of his injuries, or the unique way in which Oberle sustained them, but Bernstein says that’s not quite right. “I really think people connect with him because of who he is and not what happened to him. It’s a terrible thing, and it shouldn’t have happened, but he survives in spite of it. That stands out, because it says who you are is important.”
As usual, Kraemer comes into the exam room like an explosion, firing off words like machine gun fire. He asks Oberle about his cheek. It’s cruelly ironic that Oberle, a man with a preternatural zest for life, is only able to half-smile because of damage to the facial nerve. He uses an electrical stimulation machine that Doc recommended to practice smiling, and it’s helped. Kraemer has recently done some work on the cheek and likes what he sees, though he seems to be considering maybe one more tweak. Oberle isn’t sure whether he’s had 23 or 24 surgeries so far. Kraemer suggests maybe he should try some pencil on his eyebrow, but the young man protests, like a son embarrassed by his mother’s public kiss: “I don’t care about all that.” He’s been working with Kraemer’s personal trainer, and he looks ripped, bigger and stronger than he was before the accident. Karges is even considering taking some of the metal out of Oberle’s ankle, so he can run more easily.
Later this summer, Oberle will start a job at SLU, as director of development for the new Center for Innovative Reconstruction and Rehabilitation, devoted to giving trauma victims the kind of care that Oberle received. At the same time, he’ll be working on a degree in physical therapy, his favorite part of his recovery. “I wanted to help animals,” he says, “but with what happened to me, I’ve been shown that I can help the world on a much wider basis, help the human primates.”
Before he heads home, he sits down to catch up with Sandkuhl. Her grandfather emigrated from Italy and sold bananas at the 1904 World’s Fair. When her phone goes off, the ringtone proclaims, “When the moon hits your eye like a big pizza pie, that’s amore.” She’s Oberle’s surrogate Italian grandmother, and you half expect her to scoop him up by his cheeks and plant one on his forehead. Instead, she sings his praises (and offers to make him some chicken fettuccini). She tells stories about the time she hunted Kraemer down because Oberle needed more pain meds and the time that a still-recovering Oberle visited her in the ICU on the coldest day of the year. She’s still miffed that they shipped him back commercial and says that nobody else could have survived that flight.
“I think I watched The Avengers,” he says. “I enjoyed it.”
“See, it’s always half full, the glass,” Sandkuhl says.
Oberle laughs. “I’m just thankful to have a glass.”
