Paul taught the men to use pliers to hold the nails they were hammering so that they would not injure their fingers with the hammer. He also discovered that the blisters many of the men had on the sides of their hands were formed when the men turned off their kerosene lanterns at night—their hands inadvertently coming in contact with the lantern’s hot glass. He had wooden extenders fitted to the control knobs of the lanterns so that the men’s hands would stay a safe distance from the hot glass.
Paul still did not know whether the way some leprosy patients lost large sections of their fingers was part of the disease. Despite the great number of missing fingers, no one had ever managed to bring a lost finger to him so he could determine the reason for its having fallen off.
Then one morning at the New Life Center one of the young men showed his hand to Paul. Nearly a third of his index finger was missing. Paul asked him what had happened to it.
“Sahib doctor, I do not know,” the young man replied. “My whole finger was there yesterday. Last night you even measured it.”
“Where is the piece of your finger that is missing?” Paul asked.
The young man had no idea what had happened to his finger during the night. All he knew was that it was there when he went to bed and gone when he awoke.
Paul went to the young man’s hut to investigate and see whether he could find the missing piece of finger. But he found no finger on or near the young man’s sleeping mat. All he could see was drops of blood.
“Sahib doctor, look,” one of the other men said who was helping Paul search.
Paul cast his eyes in the direction the man was pointing, and there he saw not the missing piece of the young man’s finger but some more spots of blood and the trail of a rat’s feet in the dust of the earthen floor of the hut. The young man’s finger had not fallen off. A rat had gnawed it off in the night to feast on. Because the young man lacked feeling, he had not even been aware of it as he slept. Given the number of rats in India, Paul wondered how many other leprosy sufferers over the years had lost their fingers in the night.
The rat problem at the New Life Center was fixed by the introduction of cats to the complex. When any of the residents returned to their village to ply the trade they had learned at the rehabilitation village, they took a cat with them.
By now twelve men were living at the New Life Center. Knowing how susceptible their fingers were to injury, they all watched out for each other, checking up to make sure no one had inadvertently injured himself. Paul was pleased with this teamwork of patients helping patients. Not only did it speed the rehabilitation process, but also it gave each person a greater sense of purpose.
Not long after Nava Jeeva Nilayam opened, Ruth Thomas, a Welsh physical therapist, arrived at Vellore and asked to see Paul. She explained that she had been a missionary in China, but the Communist takeover of that country had forced her to flee. While in Hong Kong awaiting a ship to return home to Wales, Ruth heard that a Dr. Brand at Vellore, India, needed help. She immediately changed her plans and sailed to Colombo, Ceylon, and then on to Madras, where she caught the train to Vellore. Ruth was ready and willing to do whatever Paul needed her to do.
Paul was delighted. He put Ruth straight to work. She spent hours at the New Life Center showing the men how to look after themselves. In fact, by the time she was through with them, they knew more about hands and how to care for them than did many surgeons. Although Ruth was shy and modest about her abilities, she was able to draw out the most despondent patients.
One particularly difficult patient Ruth worked hard with was Namo. Namo was studying to become an electrical engineer and had just passed his exams with distinction in 1946, when he was diagnosed with leprosy. Suddenly all his dreams had come crashing down. Namo arrived at the New Life Center in early 1951, despondent and bitter at life and the way people treated him. Ruth worked with Namo, talking with him as she massaged his hands and fingers. Slowly she began to draw him out of his despondency. So impressed was Namo by the love and patience of Ruth and Paul and the other workers at the New Life Center that he decided he wanted to become a Christian. Following his baptism in the Church of South India, Namo decided he’d had enough of his bitterness toward the way society treated him because of his leprosy. Like Ruth, he wanted to have an impact on the lives of other leprosy sufferers.
Ruth began to teach Namo how to care for the hands and feet of leprosy patients. She showed him how to massage patients’ hands and fingers to keep them subtle and soft to avoid the hardening and lack of joint movement that came with the onset of the disease. Soon Namo was playing an invaluable role in helping leprosy patients in Vellore.
After one long weekend at the Lady Willingdon Leprosy Sanatorium in Chingleput, Paul returned home feeling sick and tired. It was dark when he entered the house. Margaret asked him to come upstairs so that they could talk away from the children.
“There is a man staying on the veranda,” Margaret said. “He has a letter from Dr. Jagadisan, and he came to see you.”
Paul felt his heart beat faster. “You mean he has leprosy?” he asked.
“Yes,” Margaret replied resolutely.
“But darling,” Paul said, “you know children are more susceptible than adults to the bacterium. It’s a risk we don’t want to take. Why did you invite him here to the house?”
“Well,” Margaret began as she turned to face Paul. “My Bible reading on Saturday morning said, ‘I was a stranger and you took me in.’ He was a stranger. It seemed very clear to me that I should take him in.”
Paul could not argue with Margaret’s logic. He put his arms around his wife and hugged her. Even though he would have liked nothing better than to crawl into bed, he went downstairs to meet the stranger, whose name was Sadagopan. As Paul examined Sadagopan’s leprous hands and feet, he had no way of knowing the stranger that Margaret had welcomed into their lives would one day be an immense help in his research.
For now, however, other matters pressed on Paul, who was due—overdue—for a furlough. Paul found it difficult to imagine leaving his work at the hospital. How could he be idle in England for a whole year when so much had to be done at Vellore? The perfect answer to Paul’s dilemma came in the most unexpected way. Early in 1952 Paul learned that the Rockefeller Foundation, based in New York in the United States, had granted him a scholarship. He hadn’t even applied for a scholarship with the foundation, but they had heard about his groundbreaking work in leprosy research and had sent a representative to talk to Paul. The rep told Paul, “See anybody you want, anywhere in the world: surgeons, pathologists, leprologists, anyone you think can help you, and take as long as you need. Send us the bills.”
This was perhaps the most astonishing news Paul had ever received, and he was overjoyed about the possibilities. Now he could justify being away from Vellore and Nava Jeeva Nilayam for a year. He immediately set about booking tickets for his family of six and making a list of all the specialists he wanted to question. The first leg of Paul’s dream come true would be England.
Chapter 13
Hands and Feet
When Paul overheard eight-year-old Christopher talking to his six-year-old sister Jean, he had a sinking feeling that things were not going to be easy for Margaret and the children in England.
“Will there be trees to climb in London?” Jean asked.
“I’m not sure,” Christopher replied, “but at least there’ll be walls.”
Paul thought back to his own transition from India to England, how he and Connie had been let loose upon his two aunts in London. Now Aunt Hope and Aunt Eunice were thirty years older, and four young children were about to descend on them.
Descend they did! Paul was amazed when he found Jean hanging upside down ten feet from the ground on exactly the same lamppost he and Connie had swung from. The aunts had put away their fine china, yet the children managed to demolish several pieces of furniture.
Meanwhile, Paul was scouring England for people who could help him learn better hand surgery techniques. He had brought thousands of postmortem research slides with him and was eager to discuss the surgeries he had performed and learn whether any advances could be made. To that end, he met with Sir Archibald McIndoe, a famous plastic surgeon who had performed complicated surgeries on burned airmen during the war. Paul took hundreds of slides to the meeting, and as he showed them to the surgeon, he explained what he had been doing.
“There’s not much I could add,” Sir Archibald concluded. “You appear to be up with things, or even more advanced in some cases. I say, every English surgeon should hear what you are pioneering in India. Would you mind frightfully if I put your name in the hat to be a Hunterian lecturer?”
Paul was flabbergasted. He had come to learn from this great surgeon, and instead he was being asked to consider the highest honor any English surgeon could attain. The Hunterian lectureship had been awarded each year by the Royal College of Surgeons since 1805 to encourage the best surgeons in England to discuss their latest research and techniques with their peers.
Since the deadline for choosing the lecturer was looming, Paul rushed back to his aunts’ house to write a paper on his leprosy hand surgeries. He was soon informed that he had won the lectureship. He was thrilled to think that he would have the opportunity in late October to illuminate the work done at Vellore to a large group of surgeons from all over the English-speaking world.
October 24, 1952, arrived, and thirty-eight-year-old Paul Brand did his best to conform to the solemnity of the event. The first Hunterian lecturer had stood in the same room at the Royal College and donned the same style of robe since the inauguration of the lectureship. Paul was escorted into the lecture hall by a beadle (official) carrying a gold mace (staff) on a cushion. Not a word was spoken as Paul made a ceremonial bow to his audience and began his lecture. He had been told in advance that there would be no introductions of any kind; his credentials were listed in the program. His sole task was to read his lecture exactly as it appeared on paper. When it was over, he was escorted out in total silence.
Paul had time for conversation once he had taken off his ceremonial robe. He listened eagerly for information that could help him learn more, but everyone agreed that his lecture material was innovative, and they wanted to hear more from him. This both flattered and disappointed Paul. He hoped that he would learn more in America, where his Rockefeller scholarship was soon taking him.
Meanwhile, Margaret, who was still working in the Schell Eye Hospital in Vellore, took some polytechnic college courses in optics and optometry in London to help fill in some of the gaps in her medical knowledge. Given her reluctance to start work at the eye hospital, Margaret was surprised that she now loved working with eye patients. She knew that what she learned on furlough would make her a more competent eye doctor.
In early December 1952, Paul boarded the Queen Elizabeth II bound for the United States. He knew that he would not be seeing his family for four months. They would be taking a ship heading to South Africa to spend time with Margaret’s parents, who had retired there from England.
The voyage across the Atlantic Ocean was swift. As he sailed westward toward the United States, Paul looked forward to meeting with world-renowned hand surgeons and neurologists in Boston, Chicago, San Francisco, Los Angeles, and New Orleans.
The time sped by as Paul visited these places and shared his knowledge with others. In Boston he met with Dr. Derek Denny-Brown, Harvard professor of neurology. Derek was a New Zealander and a brilliant neurologist and had probably the untidiest office Paul had ever been in. File boxes, papers, X-rays, and books were stacked everywhere. Derek gave Paul his full attention as Paul pulled out slides of damaged nerves of the leprosy patients he had autopsied and asked the neurologist to explain to him what was happening with the nerves. Why had the nerves swelled the way they had? Dr. Denny-Brown pored over the slides under the microscope, carefully examining each slide. “These slides look just like my cats!” the neurologist exclaimed.
