The miracle of the hand

Doctors created a new hand from the abdomen of a hockey player after an accident nearly threatened him with amputation.
Archana Masih/Rediff.com spends time at the hospital that draws patients from all over India giving them hope by saving limbs and wants you to know that when you donate skin you save a life.

Nine months after a road accident on a highway in Assam, Srikant Chowdhury is holding a hockey stick again.

Dr Raja Sabhapathy, who reconstructed his hand after it was crushed by the wheels of a truck, has assured him that he will be able to move his wrist and wield that curved stick gradually.

"The doctor believes I will -- and so do I," says Srikant, a hockey player who represents Assam.

Two days after the accident as he lay in a Guwahati hospital, the doctor told him that if he did not want an amputation he should fly to Coimbatore.

He underwent six surgeries at Coimbatore's Ganga Hospital where doctors used tissue from his abdomen to reconstruct his hand.

Last month, Srikant was in the city to see Dr Sabapathy. He can now move his fingers and does not need help to attend to personal needs. He is doing exercises to regain wrist movement.

"He may not get back to the state team again, but can coach children. You can't imagine the tragedy of losing a hand. Saving it makes a tremendous difference to life," says Dr Raja Sabapathy, head of the department of hand reconstructive surgery and burns at the hospital.

The department conducts 1,000 such operations a month and draws patients from different parts of India.

That morning, a little boy who had lost control of one hand had come from Gujarat.

A year-and-half-ago, an IPS officer who had lost his forearm in an explosion while quelling a riot in West Bengal, was brought here and underwent several surgeries.

The hand was saved. The affected area is covered with good skin. The grafted bone has united and the last stage of tendon work remains.

In January, Dr Sabapathy sent a fitness certificate so that the police officer could resume duty.

That afternoon, his team was going to reconstruct a boy's thumb by replacing it with the toe. The operation would take 7 to 8 hours.

"Reconstructive surgery not only improves the quality of life, but phenomenally helps in nation building and the economy," says Dr Sabapathy, who comes from a family of doctors and had just returned after delivering the guest speaker's address at the Paediatric Hand Study Group of America in Denver.

"If someone can't use a limb, it affects not only her/him, but the family. The person cannot work and is totally dependent on the wife or mother. In all my years as a doctor, I have seen that they are the only two people who will go the full journey with you," adds Dr Sabapathy whose team of doctors arrives at the hospital at 7.30 am each morning and stays till after 8.30 pm.

"Mother and wife are the two greatest institutions of the world," he says.

A testament to that eternal truth was present in a room on the floor above where Prateek Jaiswal's mother was standing vigil at his beside.

Prateek, a Delhi resident, had suffered a severe injury the day he finished his last MBBS exam. He was driving to meet friends for a celebratory dinner and met with an accident that shattered his upper arm.

"He has had several surgeries. Doctors say he will heal, but it will take time," says his mother Rashmi.

The hospital is a centre for training with a state of the art microsurgery lab and attracts foreign doctors. Last month, doctors from the USA, UK, Ghana, Sierra Leone, Uganda and Jordon were honing their skills and learning from the cases.

"I've seen some similar injuries, but what I've seen here have been more complex in terms of degree of injury and also the sheer number of patients," says Dr Stella J Lee, a resident at the Harvard Medical School, who has spent several weeks at the hospital.

Dr Lee will soon start hand fellowship at the Massachusetts General Hospital in Boston.

On her first trip to India, the young Harvard MD squeezed some time out to visit Hyderabad and Ooty on weekends.

"What we did differently was that we did not remain exclusive. We built up volumes which gives us operation efficiency. The cost of care is also much lower than other hospitals," says Dr Sabapathy, whose son, a surgeon trained in the UK, is looking after the newly introduced breast reconstruction department.

Dr Sabapathy's interest in the field had begun in the 1970s -- in the early years of microsurgery.

"I thought this is where the future will be. People at that time thought this was not for India, but few of us thought otherwise."

The department was started in 1991, just as liberalisation opened the Indian economy from strangleholds of the past.

"India liberalised and all who came at that time succeeded. We must thank Manmohan Singh and Narasimha Rao for doing a great job for India. The nation hasn't looked back since then," says Dr Sabapathy, in between seeing new patients and old.

The hospital also has a skin bank and is spreading awareness for skin donations.

Donated skin is critical in treating burn victims. The burnt skin is surgically removed and grafted with new skin to temporarily tide over the critical period, allowing the patient to heal.

Just like eyes, skin can be donated after death and harvested up to 6 hours from time of death.

Less than .55 mm of the skin is taken from the legs and back. It can be harvested from people's homes by a team from the skin bank and takes 30 to 45 minutes. There is no bleeding and disfigurement -- the areas from where the skin is harvested are bandaged. After the procedure, the deceased can be made to wear clothes as intended by the family.

Most often burns patients die for want of skin.

A beautiful girl with 65% burns was being treated at the hospital with a fighting chance to live.

Reconstructive surgery is being used for accident victims, cancer treatments, birth defects, burns, diabetic feet etc.

"When you do this you don't compare with the god given hand or body, but with what would it have been otherwise," says Dr Sabapathy.

"We are not treating people, we are rebuilding lives."