HARBOR BEACH, MI - Night had fallen over Harbor Beach, covering the shoreline in darkness when the town's quiet was shattered by a father's anguished scream.

"No, Derek, no!" Jerry Pfaff screamed.

Ten years ago, on an unassuming winter morning, Jerry found his son lifeless on the living room floor, the remnants of a single gunshot marking an unspeakable act of desperation.

The young man, Derek Pfaff, a boy in his father's eyes, had harbored an unseen storm, a silent battle that no one had guessed.

Blood pooled around him, the evidence of a mind too tortured to cry for help, and as the paramedics arrived, the father clung to one fragile truth -- his son was still breathing.

What followed was a decade of struggle and survival.

His son's face, once vibrant and alive, had been obliterated, leaving behind a shadow of the person he once was.

Fifty-eight surgeries later, the scars told a story of resilience as much as tragedy.

And then, at the height of despair and hope, came a breakthrough.

The Mayo Clinic offered him a chance at rebirth.

The surgery, a face transplant requiring 60 hours and the hands of 80 skilled doctors, was nothing short of a miracle.

Related: Michigan man receives 60-hour face transplant operation at Mayo Clinic

It took his body to the brink and back, weaving new flesh and bone into a face that was both foreign and familiar.

When he awoke, the reflection he saw wasn't the same, but it wasn't a stranger either; it was a canvas of second chances.

Now, with 85% of his face recovered, Derek walks through life as a testament to endurance.

The once-hidden battle has become his story to share, not in whispers but with courage.

Every step he takes, every word he speaks, challenges the stigma that hid his suffering.

The face the world sees today is more than skin and tissue -- it's a picture of his past, his pain, and his unyielding will to live.

Harbor Beach watches as he reclaims his life, inspiring a conversation about the unseen wounds so many carry, urging others to look beyond what their eyes can see.

From tragedy to advocacy: A life reclaimed

Derek, now 30, does not remember the 2014 suicide attempt that nearly ended his life before 2 a.m. on March 5.

A 19-year-old freshman at Saginaw Valley State University, he'd come home for spring break, his mind hidden in darkness his family never saw coming.

That March evening, his father found him motionless in a snowbank outside their home, the bitter chill mingling with the devastating evidence of a shotgun blast.

The stillness in the air was deafening, a stark counterpoint to the chaos that would follow.

Also: 'Don't hold it in': Michigan man's story of hope after suicide attempt, journey to face transplant

There was no suicide note. No warning signs.

"He was feeling pressure from school," Lisa Pfaff, Derek's mother, said. "We didn't think he was going to make it."

Jerry loaded his son into the backseat of his car, with Derek face down, and drove him nearly three miles to Harbor Beach Community Hospital.

The positioning was important because health officials later noted Derek would have choked on his own blood if he faced the opposite way.

He spent several critical hours at the hospital as doctors and nurses worked to stabilize him.

The plan was to transfer Derek to Hurley Medical Center in Flint by helicopter, but a brewing snowstorm made the flight impossible.

Instead, he was rushed by ambulance, with a nurse carefully managing the instruments keeping him alive throughout the treacherous journey.

When Derek arrived at Hurley, his parents braced themselves for the unimaginable -- saying goodbye to their son.

His brothers had already whispered their farewells before his transfer to Henry Ford Hospital in Detroit, where the fight for his life would continue.

The local priest was prepared to give Derek his final blessing.

No one thought he would survive.

"The doctor sat with us and said there was some brain movement," Lisa said. "They said they weren't sure about his quality of life, but there was a ray of hope and he was on life support."

For as long as his parents could remember, their second oldest son had been the embodiment of ambition and drive.

Derek excelled academically while also leading the Harbor Beach football team as a starting running back, a team player who inspired those around him.

To his siblings, he was more than a brother -- Derek was a role model.

But beneath the surface, he was struggling.

In the decade since, Derek has turned unimaginable pain into purpose.

Alongside his parents, he has embraced the opportunity to become a suicide prevention advocate, sharing his journey to shed light on the silent battles that claim so many lives.

From March 2014 to June 2020, Derek underwent 58 facial reconstructive surgeries at Henry Ford.

He had to learn how to walk, talk and eat all over again.

A miracle

The face transplant procedure was led by Dr. Samir Mardini, a facial reconstructive and facial reanimation surgeon and surgical director of Mayo Clinic's Reconstructive Transplant Program.

In a statement, Mardini estimated 85% of Pfaff's face -- including the mandible and maxilla -- was reconstructed and replaced with donor tissue.

To ensure precision, a digital surgical plan was created that relied on scans of both the donor and recipient's faces, Mayo Clinic officials said. The approach allowed the team to perform the surgery digitally first.

The surgical team also performed "nerve mapping" of both the donor and recipient's nerve systems to understand the function of each nerve, Mayo Clinic officials said.

The transplant involved replacing "virtually everything" below Pfaff's eyebrows and part of his forehead, including his upper and lower eyelids and intraorbital fat, upper and lower jaws, teeth, nose, cheek structure, neck skin, hard palate and parts of his soft palate.

One of the most critical aspects of the surgery involved ensuring the donor and recipient's delicate facial nerves -- 18 branches between the two sides -- were properly connected to restore function, Mayo Clinic officials said.

A new microsurgery technique also was applied that transplanted the donor's tear drainage system, which would allow Pfaff's tears to drain normally into his new nose.

The first time his parents walked into the hospital room to see him after surgery, they couldn't believe it.

"We were just amazed," Lisa said. "Derek was laying there with a complete face again. It was 10 years that we didn't see Derek with cheeks, lips, and a nose. It far exceeded our expectations."

Pfaff can now express happiness, sadness, joy and disappointment through his transplanted facial muscles and nerves, Mayo Clinic officials said.

"Most organ transplants are lifesaving," Mardini said in a statement. "With facial transplantation, it's a life-giving operation. You can live without it, but you are missing out on life."

Derek's face may bear the physical reminders of his past, but his voice carries the strength of someone determined to transform his scars into a message of hope.

Through his advocacy, Derek invites others to confront mental health challenges with compassion, creating a legacy that reaches far beyond Harbor Beach.

"I want to help people in any way I can with my story," he said.

Bishop Robert D. Gruss of the Catholic Diocese of Saginaw said he was struck by the resilience, dedication and faith of Pfaff and his family.

"Their story is a witness of God's merciful love and how the Lord Jesus cares deeply for each of his children, even in the midst of pain and suffering," Gruss said.

Derek's medical journey, though, is far from over.

He still faces the daunting task of having all his teeth removed, followed by receiving dentures and eventually dental implants.

Derek's right wrist remains immobile -- a lasting consequence of surgeons harvesting multiple flaps of skin from his arm.

However, hope remains on the horizon, as he prepares for an upcoming surgery at the Mayo Clinic aimed at restoring function to his arm and wrist.

"I've learned to do everything left handed," Derek said.

The only times he would leave home were for appointments, camping and family gatherings around the holidays.

People would point and give a certain look toward him, dehumanizing him.

Derek has become a public speaker on mental health and suicide prevention, speaking in front of hundreds of people with confidence.

When family and friends saw Derek for the first time - they were amazed.

"It's a new Derek with a new face," he said.

Derek enjoys playing video games - a classic Nintendo 64 sits on the living room floor - along with golfing, pool and bowling with his family.

"It's the little stuff you take for granted and don't realize it until you can't do it," he said.

Derek's story continues to touch hearts, inspiring countless families to address mental health struggles within their own homes.

The Pfaff family has received letters from parents who credit Derek's journey with giving them the strength to support their own children.

Amid the impact of his story, one moment stands out as a testament to healing: the Pfaffs recently gathered for their first family photo in over a decade -- a symbol of resilience, unity, and the enduring power of hope.

"If you have something on your chest, talk to someone," Derek said. "Get it off your chest and you'll feel a whole lot better."