Doctors have already transplanted tissue from her forearm to her face. That tissue will form the inner lining and lower part of her nose, explains Safa, who is with the Buncke Clinic in San Francisco. Aesha, who had to go to physical therapy after that surgery, says she couldn't use her left hand for two months.

On Monday, Mati says, doctors will take cartilage from Aesha's rib beneath her breast. Safa concludes that they will perform a procedure called a "forehead flap."

The rib cartilage, says Safa, will be used to build the structural support of her nose. One piece will run along the bridge, and others will be used to help shape her nostrils. Then, he says, skin from her forehead will be flipped down -- keeping the blood vessels intact -- and sewn atop the structure. The result will be trimmed, shaped and tweaked in the coming weeks and months.

I am in awe of all she continues to endure. As we talk, Aesha leans into me, then turns to take my fingers. She guides them to touch her blown-up forehead.

"Does that hurt?" I ask, stroking her head lightly.

"Yes," she answers, crinkling what's starting to look like a nose.

I stop immediately, and she clasps my hand to admire the beaded ring on my finger, one she made and gave me. "It's nice," she says, before wrapping her arms around me and squeezing.

Continuing education

The Aesha I first met about two years ago was caught between different worlds. She was, all at once, a stubborn child, a moody teenager, a broken woman. And though she's evolving and finding her footing, she still has her moments.

When she can't figure out how to open a large new bag of coffee from Costco, rather than ask for help she tears a hole in the middle of the package, letting the coffee grounds spill all over the cabinet. After falling outside the Capitol building last week at the end of a meeting with Sen. John McCain, she screams wildly to play up the drama and to welcome an ambulance. She barks at the hospital doctors to leave her alone and not touch her. Five hours later, she leaves with a sprained ankle.

Jamila calls Aesha "Dracula" because she stays up at night and sleeps during the day. Sometimes, when she's supposed to be sleeping, she hides beneath the covers and fake snores, but the light of her laptop computer gives her away.

The difference now, though, is that when it really matters, she wakes up on her own with no complaints. On a recent morning when Aesha had an early hospital appointment, Mati marveled as he watched her trudge toward the shower at 6:15 a.m. It used to be that they had to return to her bedside five times -- "Get up! Get up! Get up!" -- to get her moving.

"Before, she was very hard to handle," Mati says. "Over the past month or so, she's a totally different person."

The surgical process has not only helped her trust people more, but it also has made her more responsible and attentive to her own well being. She no longer goes to the playground to swing, one of her favorite pastimes, because she's scared she might fall and hurt herself and ruin the progress doctors have made. Though she misses going to her English class, she studies alone, afraid of catching a bug that would complicate an already complicated process.

Excited to show off how her reading and writing has improved, she finds a notebook and we exchange notes.

"What is your last name?" I write. She reads aloud, bends over the notebook and responds, "My last name is Mohammadzai."

"What is your favorite color?" I ask. She sounds this one out slowly and then writes, "My favorite color is Red."

"Where are you from?" I jot down. She rolls her eyes. This one is so easy. "I am from Afghanistan."

"Where do you live now?" I say at the bottom of the page. "I live in Frederick Maryand," she writes, passing the notebook back to me with a triumphant smile and a missing "l".

Her responses come quickly and her pen barely pauses.

"Jessica, remember in New York? Cat. Man. Pan," she says, recalling the simple words I saw her struggle to read a year and a half ago. I tell her I admire how far she's come.

Then, a minute later as my attention starts to turn elsewhere, she thrusts out her hand: "Jessica, you like my nail polish?" It is, of course, red.

These days, her education extends beyond reading and writing. She's learning from her doctors, too. After the last round of surgery when the raw tissue transplanted onto her face smelled like rotting meat, she religiously flushed it with water, just as she was instructed.

She used to relish wearing makeup, but has let go of vanity to keep her changing face free of possible contamination. So committed is she to being in a clean environment, at one point she was stripping her bed and changing her sheets every other day. The only problem? Others were left to do the laundry.

"One thing I will not let her do is wash clothes," says Mati, who worries she'll break the machine. "She fills it to the max."