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Dr. Paul Brand was known in medical circles for two major accomplishments. First, he pioneered the startling idea that the loss of fingers and toes in leprosy was due entirely to injury and infection and was thus preventable.

Leprosy attacks chiefly the nervous system, and resultant tissue abuse occurs because the patient loses the warnings of pain—not because of inherent decay brought on by the disease. The theory, radically new when Brand first proposed it as a missionary surgeon in India, has gained worldwide acceptance.

Second, he was hailed as a skilled and inventive hand surgeon, and most major textbooks on hand surgery contain chapters by him. Brand was the first to apply tendon transfer techniques to the specific problems of leprosy patients, whose hands often harden into rigid "claw-hands."

Philip Yancey interviewed Brand for the December 1, 1978, issue of Christianity Today after Brand was awarded the prestigious Albert Lasker Medical Award and made a Commander of the Order of the British Empire. At the time, Brand had spent ten years working at the Public Health Service Hospital in Carville, Louisiana.

There, he concentrated on rehabilitation techniques, designing shoes and tools for use by insensitive patients. He also developed the concept of "hand rehabilitation centers" where patients could live and work to get ready for normal life.

You once headed up a research project in which you tried to develop an alternate pain system for people who are insensitive to pain, such as leprosy patients. In a sense, you and your team of scientists and bioengineers were playing creator with the human body. What did this teach you about the creation process God went through?

Our most overwhelming response, of course, was a profound sense of awe. Our team worked specifically with the pain system of the human hand. What engineering perfection we find there! I could fill a room with volumes of surgical textbooks that describe operations people have devised for the injured hand: different ways to rearrange the tendons, muscles, and joints, ways to replace sections of bones and mechanical joints—thousands of operations. But I don't know of a single operation anyone has devised that has succeeded in improving a normal hand. It's beautiful. All the techniques are to correct the deviants, the one hand in 100 that is not functioning as God designed. There is no way to improve on the hand he gave us.

I think of the complex mechanical hands you see in nuclear labs for handling radioactive materials. Millions of dollars went into the circuitry and mechanical engineering to develop those hands. Yet, they are so bulky and slow and limited compared to ours.

Nearly everyone would acknowledge the marvelous structure of the human body. But what of the one in 100 abnormal hands? Why did God's creation include the potential for these exceptions that fill our hospitals?

A partial answer to that lies, I believe, in the inherent limitations of any medium that obeys physical laws. In his creation of the world, God chose to work with atomic particles that he made to operate according to physical and chemical laws, thus imposing certain limits. Those were the building blocks of creation. At the upper end of the whole process, for his highest creative achievement, God chose to make a human brain that would be independent and have freedom of choice. C.S. Lewis's example of wood illustrates the limitations of law-abiding material. To support leaves and fruit on a tree, God had to create a substance with properties of hardness and impliability. We use wood for furniture, and to build homes because of these qualities. Yet in a free world that characteristic invites abuse. Wood can be used as a club to bash someone's head. The nature of the substance allows the possibility of a use other than that for which it was intended.

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July (Web-only) 2003, Vol. 47