In the weeks that followed, Paul watched as John studied the Bible, holding it solidly in his hands. Paul felt a deep sense of satisfaction in serving the bodies and souls of the Indian people. Perhaps one day he would make some medical breakthroughs that would serve leprosy patients all over the world.
For now, Paul had another obstacle to overcome. He knew that he had to understand more about the nerves of people with leprosy. The only way to do this was to extract some nerve tissue and view it under a microscope. In order to accomplish this, he needed to perform autopsies on the dead bodies of leprosy patients. This created a problem. Muslim mullahs (scholars) decreed that it was unholy to cut into a body after death, and the Hindu religion required that the entire body be burned upon a person’s death. Strict Hindus would not even allow an arm or a leg with gangrene to be amputated, even if they knew the person would die without amputation.
To overcome this obstacle, other departments at the hospital in Vellore used the bodies of dead prisoners or of those with no family ties on which to perform scientific autopsies, but very few of these people had leprosy. Paul put the word out as far away as Bombay and Hyderabad: “Telephone or telegraph me any time of the day or night if a leprosy patient dies and you have permission to do an autopsy.” He also instructed his assistant, Ceylonese Dr. Gusta Buultgens, to prepare the sample jars filled with formalin and the surgical instruments necessary to perform an autopsy. Then he prayed for a phone call.
Chapter 11
A Body Reveals Its Secrets
Family life for the Brands continued. With the arrival of the hot season in 1948, Margaret and the children once again retreated to the mountains in Kotagiri. Margaret was pregnant and expecting another baby in October 1948 and was glad to be away from the sweltering heat of the plains.
While his family was gone, Paul moved into a new duplex on the medical college campus. College Hill, as the campus was called, was located four miles from the hospital on the edge of Vellore.
In September, at the end of the hot season, Margaret and the children arrived back in Vellore and moved into the duplex with Paul. On October 22, 1948, Margaret gave birth to a daughter, whom they named Mary. As Paul welcomed Mary into the world, he thought about how different the circumstances were from Christopher’s birth back in London: no bombs, no fires, and no ration cards.
One evening, two weeks after Mary was born, a messenger arrived at the door with a note for Margaret. Paul heard her groan as she read it.
“Listen to this,” Margaret said. “It’s from Dr. Carol Jameson. ‘I don’t want to hurry you, but we are very short at Schell, and we would be glad if you would pop in there for a few hours each day and just keep an eye on things.’”
“I’m sorry,” Paul said. He knew that his wife had offered to help out in any of the medical departments at the hospital except the Schell Eye Hospital.
“I really don’t know a thing about eyes,” Margaret lamented. “I missed that rotation in medical school because of the bombings. It would take me years to learn. I’d be much better in pediatrics.”
Margaret then sent a note back to Carol apologizing for not knowing anything about eyes and thus being the wrong choice for the job. Both Paul and Margaret assumed that the decline would be the end of it, but an hour later the messenger returned. This time the note from Carol read, “You’ll learn. Please start on Monday.”
“It doesn’t sound like you have much chance arguing with Carol,” Paul said. “Perhaps you should try it and see how it goes.”
“Do I have a choice?” Margaret sighed, shrugging her shoulders.
Paul felt for his wife. He knew how much she liked to master a subject, and he could see how deflated she was about having to start out in a new area. Even the nurses in the Schell Eye Hospital would know more than she did.
A few weeks later, while Paul was enjoying a rare moment of relaxation before dinner, the telephone rang. Paul picked it up and heard the voice of Dr. Harry Paul from the leprosarium in Chingleput. The connection was noisy with static, but Paul could understand what Harry was saying. An elderly male leprosy patient had died at the leprosarium and would be cremated in the morning. Paul and his team could do what they wanted with the body, as long as it was sewn up and in one piece by dawn tomorrow.
Paul had waited a long time for such a call, and he dared not turn the opportunity down, although it meant he had to work fast. He briefly explained the situation to Margaret and ran out the door. All thoughts of dinner evaporated. An hour later he was driving a borrowed Land Rover on the road to Chingleput with a technician named Jayaraj beside him, Dr. Gusta Buultgens in the back seat, hundreds of tiny specimen jars filled with formalin neatly packed into boxes, and the instruments they would need for the autopsy.
Paul was nervous about the seventy-five-mile drive from Vellore to Chingleput. Under normal conditions this distance could be covered in less than two hours, but nothing about driving in India was normal. Motor vehicles shared potholed roads with pedestrians, bicyclists, bullock carts, and cows. Because cows were sacred in Hindu society, they always had the right of way. During the day it was easy to spot them on the road, but not so at night. Night driving required great concentration and constant vigilance for sharing the road.
It took every ounce of Paul’s concentration to keep the vehicle moving forward at a modest rate. Paul glanced at his watch. It was already eleven o’clock, and they had only just passed through the town of Kancheepuram, the halfway mark on the journey. The town, with its towering temple turrets, looked very different in the moonlight.
As they drove on, Paul felt a sudden intense heat on his feet. He looked down and saw flames shooting up through the opening in the vehicle’s floor and engulfing his sandaled feet. Paul pulled his feet away from the pedals as fast as he could and swerved to the side of the road. Because of the flames, he could no longer use the brake pedal. He yelled for his passengers to brace themselves as he steered toward a clump of shrubs at the side of the road. The Land Rover crashed into the shrub, which slowed its momentum.
As the vehicle lurched to a stop, everyone jumped out. Paul pulled branches from a nearby shrub to beat out the flames. He was grateful to see Dr. Buultgens grabbing the specimen jars and instruments from the back of the vehicle. Meanwhile, Jayaraj scooped up sand to help Paul extinguish the fire. Everyone worked fast before the flames could reach the gas tank.
Within a few minutes the fire had died out. Paul wrapped his hand in a rag and gingerly opened the hood. Smoke billowed out, and as it thinned, Paul could make out a mass of melted wires in the glow of a flashlight beam. “This Land Rover won’t be going anywhere soon,” he said. “We’d better start walking.”
Leaving the Land Rover at the side of the road, Paul and his two helpers hoisted the boxes of specimen jars and instruments onto their shoulders and started walking. Paul hoped that someone would come along and pick them up, but as they trudged on, his hope faded. Not a single car or bus passed them. The only vehicles on the road were bullock carts, passing like shadows in the night, headed in the opposite direction. The trio walked on, keeping a weary eye to the east. Paul wondered whether they would still be walking when dawn broke.
Paul’s mood brightened when he realized that the next town was home to a Christian mission school. Perhaps they would find someone at the school who could drive them the rest of the way to Chingleput. A short time later they reached the school and roused the teacher from his bed. The teacher did not have a car, but he offered them all a bed for the remainder of the night. Paul had not come this far to give up, and he persuaded the teacher to get dressed and go in search of a car they could hire. This was a tall order. It was after midnight, but the teacher eventually returned with a car and driver.
Soon Paul and his assistants were again headed for Chingleput, and at two-thirty in the morning, the weary medical team pulled up to the gate of the leprosarium. Everything was dark and quiet. Paul banged on the gate, and a watchman carrying a kerosene hurricane lamp shuffled over to see what the commotion was.
Paul identified himself and explained that Dr. Paul had given him permission to enter the grounds and perform an autopsy. The night watchman recoiled at the word and held up his hands to indicate he wanted nothing to do with the conversation. Paul took a deep breath, aware that it was going to take all his skills of diplomacy to get through the gate. The old man lay between him and the body Paul so desperately needed to examine.
Paul was adamant with the night watchman that he was not about to turn around and leave, especially after all he had been through to get this far. Eventually the watchman relented and told the group to follow him. Leaving the driver in the car at the gate, Paul, Dr. Buultgens, and Jayaraj, their instruments and specimen jars in tow, made their way behind some huts and followed a winding, rocky, uphill trail. After about ten minutes of walking, the watchman stopped in front of a tiny stucco hut and opened the door. The smell of a corpse in the Indian heat hit Paul immediately. The watchman shrugged as if to tell them he thought they were crazy to go inside, and then handed over his kerosene lamp and disappeared. The hut had no electricity, and Paul was very grateful for the lamp, which hung from the central beam of the roof.
The hut was empty except for a long wooden table, on top of which lay the body of an elderly man. Paul surveyed the body while the other two unpacked the specimen jars and laid out the instruments. The man had severely deformed hands, almost no fingers and toes, and a reduced nose. He was a perfect example of what the ravages of leprosy could do to one’s body.
Paul glanced at his watch. It was three o’clock. In just three and a half hours the sun would come up, and they had much to do before then. They all donned rubber aprons and gloves, which made Paul start sweating in the stifling heat. With the efficiency of a surgical team and the aid of a small flashlight, the researchers set to work. Paul began on one side of the cadaver to make long cuts the length of the arm and leg. He rolled back skin, fat, and muscle tissue to expose the nerves.
Meanwhile, Dr. Buultgens started work on the other side of the cadaver. She took nerve samples every two inches up and down the leg and arm. Jayaraj placed each sample in a formalin-filled specimen jar and wrote a detailed label for each jar. These nerve specimens would be studied later under the laboratory microscope.
The group worked quickly and mostly in silence, the only sound being the buzz of cicadas outside and the hiss of the kerosene lamp overhead. At the end of three hours Paul had made great progress. He had uncovered most of the cadaver’s nerves from where they emerged from the spinal cord to the extremities. He had also exposed the nerves of the face, seeking to discover the cause of both eyelid paralysis and nose reduction in leprosy patients.
By now Paul had not slept in twenty-four hours, and the muscles in his back were tight from being hunched over the cadaver. As Paul stopped to stretch and gently massage the muscles in his lower back, the early morning sun crept above the horizon. Beams of golden sunlight streamed into the hut, filling the room with light other than the dim glow of the kerosene lamp and the small flashlight, the batteries of which were starting to wear down. When Paul turned back to examine his work, he was amazed by what he saw. His eyes ran up and down the exposed nerves. “Look at the nerve swellings,” he declared as Dr. Buultgens leaned over to observe.
Such swelling of the nerves was an abnormality and was clearly visible behind the ankle, above the knee, at the wrist, and just above the elbow. The same swelling was also visible on the facial nerves where they branched at the cheek and chin. Paul knew that the swelling was a result of the leprosy infection. But he had not expected to see it at only a few key sites where the particular nerve ran close to the surface of the skin, such as the ulnar nerve just above the elbow. The nerves that were embedded deeper in the tissue were not affected at all by the leprosy, and Paul recognized that this was why some muscles were paralyzed in a leprosy sufferer while other muscles were not. But he had no idea why the nerve swellings occurred where they did.
