True miracles

Doctors are often accused of wanting to play God. No, we don’t make any pretence in that direction

A miracle remains a miracle only until a plausible scientific explanation for it comes up, one that is based on logic and reason allied with human experience. Accounts of so-called miracles are a forte of some religions and they become ingrained beliefs and convictions which rule the lives of the adherents in ways which, if they become ideological, can cause havoc to themselves and to others.

One must however make a distinction between such entrenched fantasies and wondrous feats which are a product of the imagination and are meant to illustrate a point, whether such events actually took place or not. An example – since Hanuman Jayanti was celebrated a few days ago – is Hanuman carrying a mountain that contained a medicinal herb in his hand, because he could not identify it himself. The trouble with miracles is that they cannot be replicated, and therefore from a logical point of view they will always remain a big query.

People are usually keen on medical ‘miracles’ or on phenomena associated with the dead body, for example the preservation of bodies of saints in a certain state. This has probably more to do with environmental factors such as temperature, humidity, lack of oxygen – which is needed for decomposition of organic matter –, alkalinity or acidity of the soil and perhaps a host of other factors not yet known to science. On the other hand, there is almost a pathological interest in medical cures – such as some types of cancer (e.g. melanoma, a skin cancer) that have regressed spontaneously.

But spontaneous regression does not equate to miracle cure, because what we don’t know yet is vastly greater than what we know. Some explanation may well emerge in future, as scientific knowledge develops by leaps and bounds. There is, for example, the case of a man who is living with the HIV-Aids virus and is in perfect health without taking any medicines. This is most likely because his immune system is able to cope by means of a mechanism or mechanisms as yet unknown, which would be the scientific point of view rather than a layman’s perception of this being a ‘miracle’.

 True miracles

 On the other hand, though, what I would call ‘true miracles’ – but not in mystical sense! – keep happening daily in the field of medicine. They are carried out by dedicated doctors, whose greatest ally in these ventures is the inherent recuperative power of the body. The doctor is only an instrument, albeit a very special one, in this process. This is captured in the expression, ‘the doctor treats, God cures.’ It’s an adage which genuine doctors, the ones who never vaunt their qualities or skills, sometimes use too, as an acknowledgement of their humble contribution in life saved, suffering relieved, or function restored – the ‘God’ part being the so far ‘unknown unknowns’ of Nature which play their fundamental role in the treatment.

Advances in basic science and medical technology are the basis of such medical wonders, which are to be found in almost all branches of medicine. In my own specialty of orthopaedics and traumatology, a key development which has allowed dramatic transformations to take place is what is known as microsurgery: that is, surgery which is carried out using the microscope to visualize and operate on structures, such as blood vessels and nerves, that are too small to be dealt with properly with only the naked eyes. The magnification provided by the microscope allows enhanced visualization and therefore more accurate alignment and suturing of the nerves and blood vessels. Other specialties, such as ENT and Ophthalmology, had already been using the microscope, but what the term ‘microsurgery’ refers to is the specialty of suturing tiny nerves and blood vessels using the microscope which has developed in the past three decades or so.

Nowhere has this technique been more dramatically successful than in reconstructing damaged or destroyed parts of the body, and some well publicized cases in the past few years have become known to the public at large, such as partial or complete facial transplants which gave a new life to the recipients. Some of the most successful applications early in the development of this super-specialty have been in hand surgery, beginning modestly with the reattachment of an amputated finger, and progressing by the by to transplantation of a toe in replacement of a thumb.

A big leap from there has been the transplantation of a whole forearm or a hand. One can imagine how this is transforming for a patient, instead of having to use an artificial hand – which is still, of course, the primary option for several reasons where it is available.

 Double hand transplant

 And last week, the British press reported on a patient who had undergone a double hand transplant in July last year, at the Leeds General Infirmary, where many Mauritians have been trained. The article began with, ‘The first person in the UK to have a double hand transplant has picked up a pen and written a letter to his surgeon to thank him for performing the life-changing operation.’

‘Chris King, 57, said he had been getting on “fantastically” since undergoing the pioneering surgery last July. Being able to write the letter was one of the highlights of his nine-month recovery, he added,’ being the first person in the UK to have both hands replaced. He lost both his hands, apart from the thumbs, in an accident involving a metal pressing machine at his workplace about four years ago.

‘It’s been going fantastically’, he said. ‘I can make a fist, I can hold a pen, I can do more or less the same functions as I could with my original hands. There are still limitations but I’m getting back to the full Chris again’. He is now able to perform a range of everyday tasks, including writing, making a cup of tea and gardening, and is progressing faster than doctors expected. He thanked the family of his donor for their ‘wonderful gift’ and encouraged people to sign up to become organ donors. Isn’t that truly wonderful?

Even more so will be the transplant of a human head: this is perhaps not as far off as we think, according to the neurosurgeon who intends to attempt the first ever human head transplant, and who may do so in the UK. He is an Italian, Professor Sergio Canavero, who made the announcement to skeptical and perhaps horrified medical and scientific audiences about two years ago, and attracted a lot of criticism. But he has forged ahead honing the technique and devising the assistive devices such as a new ‘virtual reality system’ in Glasgow, promising that it would be used to ‘prepare patients for life in a new body’.

Doctors are often accused of wanting to play God. No, we don’t make any pretence in that direction. What we are most keen on is to help our patients in the best way we can, using all the possible means that advances in science and technology put at our disposal, and open up vast new opportunities.

In due course what was once a miracle becomes a routine procedure in medical practice, to the benefit of patients whose lives in practically all cases get transformed as they regain both structure and function. If the patients and the public choose to call this a miracle, so be it – but unlike the once-only miracle lost in the obscure mist of religious lore, not possible of verification let alone replication, the medical miracle is there for all to see, over and over again. And the list keeps growing.

Wait until Professor Canavero does his ‘miracle’…

RN Gopee