"I don't know if you have ever seen like a wounded animal trying to get up," O'Brien recalled, "That's what I saw. I saw an injury that nobody survives, except somebody really strong, and she was trying to get up."
Steltz was rushed to the hospital, where she first encountered Dr. Eric Dierks, a maxillofacial surgeon.
She went into a coma and was hospitalized for six weeks. She had no idea what had happened to her once she regained consciousness. O'Brien broke the news to her that she never again would see or smell. She would also lose part of her hearing and her taste.
According to Dierks, "The blast itself removed the contents of her left eye socket, removed her nose and the supporting mid-facial structures and damaged her right eye to the extent that she lost vision."
Steltz still lives with dozens of pellets from the shotgun blast lodged so deeply in her brain that they never can be removed. The blast removed Steltz's eye sockets and sinus cavity, making prosthesis a better route than a face transplant. Undeterred, she worked with doctors to find a solution by rebuilding portions of her hollow bone structure, the first attempt at this type of operation for an injury as extensive as hers.
"It's unique to have an injury of this magnitude to the middle part of the face that removes the vision of both eyes, that removes the nose yet allows the injury to the base of the brain to heal," Dierks said.
Doctors removed damaged tissue, opened a breathing passage to her nasal cavity, drilled dental implants into her facial bones to fix magnets to the tips. They used bone from her right leg, skin grafts and dozens of screws and metal plates so that her prosthetic face could snap on and snap off.
The prosthesis itself was the work of maxillofacial prosthedontists Dr. Larry Over and Dr. David Trainer. They began by creating a plastic mold of Steltz's face. Next, they poured flesh-tone silicone into the mold to form the facial features. It was baked to seal in texture and color, and then painted to reflect the natural flaws of the human skin.
The doctors also ensured Steltz's face came complete with makeup: They baked eyeliner, eye shadow and mascara directly into the mask and poked eyelashes into the silicon with tweezers. They took care to ensure the results were as real as possible.
Getting the eyes down was of monumental importance, Over said.
"If you drew a clock around the colored portion of the eye ... is that little glint in the same position in the left as it is on the right?" he asked. Steltz's procedure cost nearly $80,000, according to Dierks, but her health insurance refused to cover the cost, saying hers was an aesthetic procedure.
"This is certainly not a veneer on a front tooth," Over said. "It's just as much of a medical necessity as an arm or a leg." The doctors and staff who worked to reconstruct Steltz's face donated their time and services so that Steltz could have a face.
The results?
Friends and family gathered to witness the reveal of her new face at the doctor's office. Steltz's friends and family broke into tears. It was the first time she had seen her daughter's face in more than 10 years. Later that afternoon, in a more familiar setting, Steltz revealed her new look to her son, who's only ever known his mother's face in a black sleeping mask.
"It's going really well," she said. "He's not minding it one bit."
Steltz thinks her year-old son actually sees his mother now when he looks at her new face.
Steltz said she also feels like a regular blind person now. Armed with her new look, she went out on a recent shopping trip with her sister and was delighted to discover she no longer felt the stares of strangers.
"To be looked at as a plain Jane," Steltz said, was exactly what she wanted -- "to be treated just like everyone else."
