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N O V E M B E R / D E C E M B E R 2 0 0 9
A W A R E N E S S M A G A Z I N E /
The following excerpt from "The
ScalpelandtheSoul"by Allan
Hamilton, MD, FACS, relates the
story of Thomas, a ten-year-old boy
burned beyond recognition. While
Thomas was in a coma, his father
died of a heart attack. Dr. Hamil-
ton was the attending resident at
the time.
Hopeprevailed.Thedecision
wasmadetotakeThomastothe
operating room and cover him
withhisfather'sskin.At8:30a.m.,
weremovedallthedeadgrafttis-
suecoveringThomas.Painstak-
ingly,overthenexteighthours,
wequiltedhisfather'sskinonto
him.Tome,thegraftslooked
lifelessandgray.Ihadlittlecon-
fidence.AllIcouldthinkabout
wasthewaste.Thomas'syoung
life.Hisfather's.Longpartsofour
ownlifetimes.
Bydinnertime,wehadfinished.
Freshbandagesinplace,Thomas's
comatosebodywaswheeledback
intoitsslotinMummyWorld.His
vitalsignsseemedstableenough.
Weknewhe'dsurvivedconsider-
ablesurgery,butwehaddoubts
abouthisphysiologicreserves.I
wentintothecallroomandfell
asleepinstantly.Ihadbeenonthe
moveformorethanforty-eight
hoursstraight.
Onlysecondsseemedtopass
beforeIwokeupangryanddis-
oriented.Anursewasknocking
loudlyonthecallroomdoor.I
lookedatmywatch.Ihadbeen
asleep for over two hours. The
nursewashammering,anditsud-
denlyflashedintomymindthat
Thomaswasprobablydying.May-
behishearthadalreadystopped.
Maybeshewascallingmetosu-
perviseCPR.Isteeledmyselfto
beabletocallitoff.Lethimslip
away.We'ddoneeverythingpos-
sible.Iwastoletgo.
Iopenedthedoor.Thenurse
wasstammering."It'sThomas...
he's...he'strying...totalk!"That
simplywasn'tpossible.Thomas
mustbehavingproblemswithhis
ventilator.She'dmisinterpreted
his respiratory efforts as an at-
tempttotalk.Hadn'thebeenin
acomafornearlyamonth?
I went right to the ICU. Not
onlywasThomastryingtospeak,
he was moving all of his limbs
--somethinghehasneverdone
before.Hewasfightinghisban-
dages and constraints. It must
havebeenextremelypainful,as
manyofthefractureshadn'tyet
healed.Buttheeffortswereun-
mistakable.Hewastryingtopull
theendotrachealtubeoutofhis
windpipe.Ofcourse,hishands
were wrapped in dressings and
tieddown.Therewasnowayhe
could bend his arm enough to
reachit.
Islippedmyhandsinsidethe
plastic-encased arm ports and
reached around his throat to
undo the knot. There's a small
balloonattheendofthetubethat
helpsholditsecurelyinplaceat
thetopofthetracheaandbelow
thelarynx.Igotthetieundone
anddeflatedtheballoon.Icould
hearThomastryingtomoveair
aroundthedeflatedtube.Sodar-
ingmorethanhoping,Ipulled
thetubeoutofhismouth.
Hecoughedviolentlyacouple
oftimes.Suddenly,hespoke.He
voicewasperfectlyclear.
"What happened to my fa-
ther?"werethefirstwordsoutof
hismouth.
Ofcourse,noonehadsaida
wordtoThomasabouthisfather.
Howcouldwe?He'dbeenuncon-
scioustheentiretime!Thenurses
lookedatme.Itwasmyresponsi-
bilitytoanswer.Afterall,I'dbeen
theonewhoremovedtheboy's
endotrachealtube.
Idecidedtolie."Nothinghas
happenedtoyourfather,Thomas.
He'sjustfine,"Isaid.
Thomaslookedatmeinconfu-
sion."Areyousure?"Theboywas
completelylucid.
"Yes.I'msure.He'sfine.He'll
begladtohearthatyouareget-
tingbetter."
Today,Ideeplyregretthatlie.
Ishouldhavetoldhimthetruth
rightaway.ButIwasayoung
resident.Ididn'tknowbetter.I
thoughtIwasbeingkind.Thomas
knewsomethingwaswrong.
"Mydad'sjuststandingthereat
theendofmybed.Whydoesn't
hesaysomething?"Therewasthe
hammerblow.
Foracrazyinstant,Iblanked
outwhathadactuallyhappened.
The father's death. The harvest
of skin. Then reality returned.
Thomasmustbeseeingsomeone
throughtheplastic,adistorted
silhouettethatremindedhimof
hisdad.Ilookedaround.Noone
wasthere.Justthedrapesandthe
lightsbeyond.
"Thomas," I asked, choking
backtearsindisbelief,"wheredo
youseeyourfather?"
"He'sstandingrightthere,"he
answered, staring at the empty
foot of the bed. "Hi, Dad!" he
calledout,andhefeeblyattempt-
edtowave.
Oneofthenurseschokedback
asob.
"Thomas,yourdadhaspassed
away,"Iadmitted."Hediedthree
daysago.Hehadaheartattack."
Icouldseetheshockregister-
ingwithin,evenbeneathsomany
layersofbandages.ThenIheard
himwhispersomething.Ileaned
over.
"Thatmustbehisghostthen
that'swavingbackatme,"hesaid
softly.
I know without a shadow of
a doubt that what Thomas saw
atthefootofhisbedwashisfa-
ther'sactualspiritstandingthere,
watchingoverhim.Herewasmy
Bedside Angel
By Allan Hamilton, M.D.
ownfragilemomentofawaken-
ing.Itleftmetinglingallover,
asifsparksweredancingoffmy
skin.
Thomasgotbetter.Hedidn't
rejecthisfather'sgrafts.Andover
thenextmonth,aresearcherat
the Massachusetts Institute of
Technology announced a new
researchmethodtoharvestepi-
dermalcells.Thepatchesofskin
required for this experimental
techniquewereexactlylikethose
Thomashadstillintact.
Theharvestedcellsfromthese
patchesweretakentoalaborato-
ry,inducedtogrow,andspread
atopalayerofdenaturedcolla-
gen.Eventually,thecellswould
coalesce on the collagen sheet
anditcouldbegrafteddirectly
ontothepatient.Sincetheorigi-
nalcellswereallderivedfromthe
patient(whowasnowthedonor
andlaterwouldbecomethehost),
therewasnoriskofimmunologic
rejection.
Thomaswasthefirstpatient
in medical history to undergo
thisprocedure.Hissurvivalwas,
in effect, the culmination of a
longsequenceofmiracles--not
theleastofwhichwasthepro-
tectionhisfather'sspirithadpro-
vided.
Reprinted from "The Scalpel and
the Soul" by Allan J. Hamilton, M.D.,
FACS by arrangement with Jeremy P.
Tarcher, a member of Penguin Group
(USA), Inc., Copyright (c) 2008 by
Allan J. Hamilton. Now available in
paperback
.
Allan Hamilton, M.D., a Har-
vard trained neurosurgeon, is a
professor at the University of Ari-
zona College of Medicine. His web-
Life'smosturgentand
persistentquestion...
Whatareyoudoing
forothers?
-- Martin luther King, Jr.