Dr. paul Brand is 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 is 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.” (An interview with Brand can be interrupted by long distance phone calls from surgeons who are stumped in the very process of surgery. He shouts complicated directions to them over the phone, and they resume their procedures.)

For these accomplishments, Brand has been awarded the prestigious Albert Lasker Medical Award and made a Commander of the Order of the British Empire. The last decade he has spent at a leprosarium in the United States, the Public Health Service Hospital in Carville, Louisiana. There, he has concentrated on rehabilitation techniques, designing shoes and tools for use by insensitive patients. He has also developed the concept of “hand rehabilitation centers” where patients can live and work to get ready for normal life. About fifteen of these halfway houses are now attached to major hospitals across the country. Yet Paul Brand seems to reserve his greatest enthusiasm for studying ...

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