AIWA 126

ADMIRAL 069 192


AKAI 001 160


ANAM 045 055 057 076 095

106 109 112

AOC 001

APEX 216



CANDLE 001 002 003



CITIZEN 001 002 003 045



CONTEC 045 052


CRAIG 045 055 157



CXC 045

DAEWOO 022 023 045 046

056 068 102 108 111 114

116 118 119 127




EMERSON 001 029 033 045

048 049 052 091 139 141

157 162 214



FUNAI 033 045



GE 001 015 021 057 070

071 121 133 141 145 163


GOLDSTAR (LG) 101 104

110 113 118



HITACHI 001 015 016 018

029 043 072 147 204 207




JBL 247

JCPENNY 001 015 035

092 145


JVC 040 079 251


KEC 045


KLOSS 002 060

KTV 001 045 162 248

LLOYTRON 172 173




LXI 145 247

MAGNAVOX 001 003 005

010 030 041 060 061 064

065 118 145 210 225 247


MARANTZ 001 167 247

MEMOREX 053 069

MGA 001 033 044 167


MITSUBISHI 001 011 033

039 042 044 100 154 160

167 168


MTC 001

NAD 031

NATIONAL 177 178 179 180

181 182

NEC 001 022 025 042 057

121 125



ONWA 045




PANASONIC 008 057 076

087 149 247 248 249 250



PHILCO 001 003 045 057

060 061 064 065 118

PHILIPS 001 003 040 060

088 145 231 232 233 234

235 236 247

PIONEER 001 024 029 031



QUASAR 034 057 087 227

232 248

RADIO SHACK 025 045 048

118 163 196 198

RCA 001 005 007 029 057

071 133 145 155 161 163

199 205 206 222

REALISTIC 025 045 048 163


SAA 183


SAMSUNG 001 085 092 096

104 118 124 145 156


SANYO 026 037 038 054 058


SCOTT 033 045 049

SEARS 033 035 058 078 092


SHARP 025 028 033 154 253


SONY 004 012 043 117 194

230 245

SOUNDESIGN 003 033 045

SSS 045


SYLVANIA 001 003 009 027

060 061 064 065 118 145

150 240 247 254


TATUNG 057 063


TEKNIKA 001 002 003 033

036 045 069 092 167



THOMSON 190 191

TOSHIBA 013 035 042 052

063 092 202 246



WARDS 015 025 033 061

064 065 069 071 247



ZENITH 069 070 090



AIWA 040

AKAI 022 048 050 109



ANAM 037 039 089

ASA 134


044 048

BROKSONIC 005 041 043

110 166


CANON 037 039 140



CRAIG 003 116


DAEWOO 012 014 094 096

098 102



DBX 018 029 044 048

DYNATECH 040 057

DUAL 136


EMERSON 033 037 040 041

042 043 050 110 112 171

182 183 184 186 191 193



FISHER 003 016 142


FUNAI 040 133


GE 037 039 067 076 093

095 124 127

GO VIDEO 113 117

GOLDSTAR (LG) 011 018

026 092 l00 107



HITACHI 011 040 048 067


ITT 136

JCL 037 039

JCPENNY 011 018 039


JVC 018 037 039 048 052

054 059 111 132

KENWOOD 020 044 048



LXI 011 020 040

MAGNAVOX 037 039 040

071 072

MARANTZ 018 037 039 071



MEI 037 039

MEMOREX 003 020 037 039

040 057 076 115

MGA 049 050 063

MINOLTA 011 026

MITSUBISHI 011 026 032

049 050 053 055 063 065

131 145 146

MOTOROLA 196 197

MTC 133


NAD 139


NEC 018 029 044 048 052



OPTONICA 057 058

ORION 005 166

PANASONIC 017 024 037

078 150 167 173 176 188

189 201 203 206 209

PENTAX 011 026 037 039


PHILCO 037 039 040 071

PHILIPS 037 039 040 058

071 075

PIONEER 011 018 027 052




QUARTZ 002 020

QUASAR 039 167

RADIO SHACK 003 007 020

057 093 133 134 140 142

152 160 167

RCA 006 011 026 039 066

067 093 095 124 127

REALISTIC 003 020 037 039

040 057 058 093 142 152


SABA 136


SAMSUNG 004 038 090 091

093 095 098 106 109 207

SANSUI 005 048 052 116


SANYO 003 014 020 115


SCOTT 043 098 110 112

SEARS 003 011 016 020

026 037 047 142

SHARP 037 058 156 196



SONY 003 016 037 056 060

061 082 187 196 199 202


STS 011

SYLVANIA 001 037 039 040

063 071 200 208




TATUNG 044 048

TEAC 040 044 048

TECHNICS 037 039

TEKNIKA 037 039 040





TOSHIBA 004 011 013 047

051 063 085 098 112 142

174 185 193 195 198





WARDS 003 011 030 037

039 040 057 058 112

YAMAHA 018 040 044 048

ZENITH 005 040 052 060




ABC 001 003 045 048 052

059 130




ARCHER 012 014 021 031 112


CABLE STAR 033 113



CITIZEN 014 111





DIGI 114

EAGLE 027 037 046 186

EASTERN 063 066 070 115



GI 001 003 015 017 096 097



GE 076




226 227




HAMLIN 055 056 061 099

100 101 117 152 175 207


HITACHI 001 061



JERROLD 001 002 003 015

016 017 073 096 097 140

141 162 166 167 210

MACOM 040 191

MAGNAVOX 017 019 068



MOTOROLA 215 216


NSC 044 075 190

                                                For More


OAK 023 059 196 197 223

PANASONIC 050 053 155

176 177 189 214 225



PHILIPS 013 019 020 027

085 090

PIONEER 001 041 057 119

147 148 171 209 217 219 224



PTS 018 054 075 076



RADIOSHACK 111 112 213

RCA 053 214


REGAL 055 056 061 099 100

101 158 207

REGENCY 063 115


SAMSUNG 037 072 186 224


018 047 048 052 130 145

159 160 183 203 204




SONY 098 229 231

SPRUCER 053 081 177 189

STARCOM 002 015 016 141


STARGATE 015 037





TEXSCAN 036 071


TOCOM 045 046 062 170

205 220


UNIKA 014 021 031


UNIVERSAL 012 014 021

031 033 034 039 042 113


VIEWSTAR 019 025 190

ZENITH 058 065 098 212 222




320 321 361

CHAPARRAL 315 316 451


DRAKE 317 318 413

DX ANTENNA 331 352 369


ECHOSTAR 309 319 322

380 395 396 463 467 475

477 483 484 490 493





301 303 311 323 365 403

454 468





HUGHES 306 314 455 480

485 488


JERROLD 367 454 464 468



MACOM 317 365 370 371









PHILIPS 305 375 480 485

487 488 492 494



PRIMESTAR 412 454 464

RCA 307 308 310 465 474

481 482 491

RCA DSS 458 476

REALISTIC 325 349 377

SAMSUNG 313 422 489


331 335 341 353


SONY 304 405 486



TEECOM 330 333 390 391


TOSHIBA 302 426 462 470


UNIDEN 323 324 325 326

332 348 349 350 351 354

355 381 382 383 389 403


ZENITH 371 384 387 394

419 479


APEX DIGITAL 216 233 239




DENON 150 162 201 208



GE 196 197





186 220

JVC 192 199

KENWOOD 151 183 225

KLH 224

LG 198 211 219 226


MAGNAVOX 169 212 234

MARANTZ 169 214



NAD 217

ONKYO 200 207

OPTIMUS 153 183

PANASONIC 163 171 179

181 184 189 203 205 238

240 243

PHILIPS 005 169 188 212

PIONEER 154 160 174 180

221 222

PROSCAN 173 196 197


RCA 159 173 196 197


SAMSUNG 002 003 168 195 209 210

241 244 245

SANYO 004 155 156 182

SHARP 161 166 183 204 230

SONY 156 167 178 187 191 206 223

232 242

SYLVANIA 006 235


THOMPSON 196 197

TIVO 008 009 010 011 014 015

TOSHIBA 169 181 185 190 200 213

227 236

YAMAHA 157 158 205 218

ZENITH 169 194 198 211 219




Posted in Uncategorized | Leave a comment




1. Referring to the DEVICE CODE LIST, look up the 3-digit Code Number that corresponds to the brand and models of your equipment. If there is more than one DEVICE CODE listed under your brand, try the first code with the following instructions:

2. Hold down the Device Mode Button (e.g. TV) until the status LED indicator (located above the “ON/OFF” button) begins to blink. (This takes about 3 seconds) Then release the button.

3. Enter the three digit code of the DEVICE from step “l” above. Upon entry of the third digit, the status indicator will blink a confirmation (3 blinks) if the code was accepted, but will turn OFF immediately if the code was rejected. If rejected, try another code.

4. Try the functions on the BIG BUTTON™. If your device responds to your requested function correctly, you have entered the correct Code. Otherwise, repeat the above setup instructions with the remaining Device Codes until your device (e.g. TV) responds to your requested function. Simply repeat the above procedures to enter the Device Codes for your VCR, CBL/SAT, DVD or TIVO (Remember to press Device Mode Button TV, VCR, CBL/SAT or DVD in step 2 above).


• If you cannot find a correct Device Code for your equipment, see USING POWER SCAN (searching) section .

• It is highly recommended, to write down your Codes on the bottom label of your BIG BUTTON™.


At-A-Glance: MODE (3 sec) → ON/OFF → ARROW UP (▲) or ARROW DOWN (▼) → ENTER

If you cannot identify a correct Device Code for your equipment from the Device Code List, you should try the POWER SCAN method.

1. Manually turn on the device you wish to scan for (e.g. TV)

2. Perform Power Scan by pressing and holding (approximately 3 seconds) the desired DEVICE MODE button TV, VCR, CBL/SAT or DVD until the status indicator light begins to blink.

3. Press and release the ON/OFF(power) button. The status indicator light will stop blink ing and stay ON at this point.

4. PRESS and RELEASE slowly and patiently the blue UP (▲) button to scan forward through the code database. To scan backward through the code database, press and release the blue DOWN (▼) button. Each time you press the up or down arrow, the remote will try and turn off the device (TV, VCR etc) you originally selected.

5. When the device (TV,VCR etc.) responds by shutting off, press the ENTER button. This will store the code in memory and you will see three blinks of the status indicator light to confirm the code input. Be patient, there are over 100 codes to search through.



• Power Scan Model Check is the same as Power Scan, however, other keys may be tested to see if they work with the target device without leaving the scan feature. If the device responds to the other keys pressed, then the current ID will be locked in by pressing the ENTER button. Otherwise, scanning may be continued by pressing either the blue

ARROW UP (▲) or ARROW DOWN(▼) buttons.

At-A-Glance: MODE (3 sec) → ON/OFF → ARROW UP(▲) or ARROW DOWN (▼) → ANY VALID KEY or (ARROW UP (▲) or ARROW DOWN (▼) ENTER


At-A-Glance: MODE (3 sec) PREV CH

1. To see the Code of a device, press and hold the DEVICE MODE button (TV, VCR, CBL/ SAT) or DVD of the selected device until the status indicator begins to blink (approx. 3 seconds).

2. Press the PREV CH BUTTON. Upon release of the PREV CH button, the status indicator will blink the 100’s, 10’s and 1’s of the device’s code.

3. Count the number of blinks to determine the code. A ‘0’ in any location is represented by a fast flicker of the status indicator. A code of 102 will be shown as BLINK <pause> FLICKER <pause> BLINK, BLINK .


At-A-Glance: CBL/SAT or DVD MODE (3 sec) → CBL/SAT or DVD (hold) → TV

NOTE: By setting punch-through in CBL/SAT (or DVD) Mode,. the TV’S volume up/down controls will be accessed by the BIG BUTTON™ when in the CBL/SAT (or DVD) Mode.

1. Press and hold the CBL/SAT or DVD MODE button until the status indicator begins to blink (approx. 3 sec.) Release the Device Mode button.

2. Press and hold the Device button (CBL/SAT) or (DVD) and press the TV button. The status indicator will blink a confirmation sequence of 2 blinks.




1. The Master Power feature is disabled as the default. To enable Master Power, press

and hold any DEVICE MODE button TV, VCR, CBL/SAT or DVD until the status

indicator begins to blink (approx. 3 sec.). Then release the button

2. Press and release the ON/OFF button twice. The status indicator will blink a

confirmation (2 blinks) that Master Power has been enabled.

3. Repeat the process to disable the Master Power feature.


• With Master Power enabled, the remote will send the power code plus 2 additional power codes for each TV, VCR, CBL/SAT OR DVD, in that order. All of the devices should be within the remote’ s operating range so they can receive their power code.


Normal Operation

Once you have set up the BIG BUTTON™ for your equipment, it works like your original remote controls. To operate, just aim it at your equipment, press an appropriate Device Mode Button and then command the desired function by pressing a corresponding button on the BIG BUTTON™. The indicator turns on during signal transmission and as confirmation of button touch. At your button touch, the BIG BUTTON™ illuminates the keypad for 5 seconds. You will see the keypad clearly even when you are in a dimly lit area.


1. To change to “menu” mode, press MENU button.

2. In menu mode, use REWIND ( < ), PLAY (▲), F.FORWARD (▼) , or RECORD ( > ) buttons as a navigation button (blue arrow). Once the menu item is reached, press the ENTER button and your selection will be made.

3. If a button is not pressed within 20 seconds in the Menu mode, the remote control will exit MENU Mode.

4. If any button is pressed except ENTER button in Menu mode, the remote control will exit MENU mode.

5. In the CBL/SAT Mode, REWIND ( < ), PLAY (▲ ), F. FORWARD (▼), or RECORD ( > ) buttons are used for navigation only.


1. Press menu button to enter into navigation mode.

2. Use the blue arrow buttons to navigate.

3. Press exit button to exit TIVO.


1. Do not expose your BIG BUTTON™ to direct sunlight, high temperature, mechanical shock, or liquids.

2. Do not use old and new batteries together as old batteries tend to leak.

3. Do not use corrosive or abrasive cleansers on your BIG BUTTON™.

4. Keep the unit dust free by wiping it with a soft, dry cloth.

5. Do not disassemble your BIG BUTTON™, it contains no user-serviceable parts.



Posted in Uncategorized | Leave a comment

What you should know about fever


What you should know about fever






Just what is fever?  Simply defined it’s a state in which your body temperature has risen automatically.  It’s mainly a symptom, an early warning signal that all is not well with you.  In an adult, it may reflect anything from an infection to some bizarre parasitic disease.

Is 98.6degrees the normal temperature?  Not always. “Normal” temperature differs slightly in various parts of the body.  When a thermometer is placed under the tongue, the red line at 98.6degree F is generally regarded at normal for most people. (Taken rectally, the normal temperature is 99.6degreeF; in the armpit it’s about 97.6degreeF).

Today, however physicians tend to consider a range between 97 & 99degreeF, orally, a “normal” zone.  One reason is that body temperature has its ups and downs during any 24-hour period.  It is lowest (97degrees of less) from 2 to 5a.m., when you’re sleeping.  It jumps to perhaps 99,5 degrees by the late afternoon at early evening.  Also, it is likely to be a little higher after meals.

Beyond this, individuals vary in their natural, customary temperature.  At Northwestern University Medical School, a professor staged a revealing experiment.  Using 276 healthy students as subjects, he took their oral temperature at 8a.m.  One student registered 99,4degrees, another 96.6degrees with the median of the group at 98.1degrees.  The classic 98.6degrees was shown by only 19 of 276 students.

What about children?  Since the heat-regulating system in infants and young children has not been fully developed, they tend to run alarmingly high temperatures, even if only a slight higher averages than adults.  A child may run up a fever 105degrees for a bad cold and not be terribly sick; yet his father would probably be in serious trounce at 105 degrees.

What does a high temperature signify?  Essentially, it means that you are producing heat faster than you are losing it.  Your body’s heating system is not unlike that of your home.  When your food [fuel] is burned, the generated heat is sent through your blood vessels [pipes].  Layers of fat under the skin [insulation] serve to cut down heat loss.  You constantly produce and throw off heat.  When production and loss are equal, temperature is normal.  With fever, your body’s “thermostat” has evidently been pushed too high.

How is body temperature controlled?  Though that thermostat, a complex mechanism governed mainly by the involuntary part of the nervous system.  These cells are believed to be centered in hypothalamus, a thumb-size area of nerve tissue situated on the floor of the brain, behind and above the bridge of the nose.

What sparks a fever?  Dr. David J. Gocke, professor of medicine and microbiology and chief of the division of immunology and infectious diseases at Rutgers Medical School, explains it this way.  “Fever is a sign that tissue or an organ has been damaged.  The body responds with an inflammatory reaction.  In an infection, for instance, the body tries to get rid of the damaged tissue.  White blood cells [leucocytes] infiltrate the area and devour the damaged tissue so that they can be carried out.  In the process, the white cells themselves break down and often die, releasing pyrogens [heat-producing substance], which circulate to the brain and there prod the thermostat into action.  Body temperature rises, and fever results.”

While an infection is the most common cause, a verity of other factors may cause temperature to shoot up.  Fever may be associated with an illness, such as gout or cirrhosis of the liver, which has no oblivious infection.  An injury or burn can send bits of damaged cells into the bloodstream, to be carried to the thermostat.  Certain drugs produce a similar heating-up.

How does fever affect body?  When fever takes over, you may get the shakes, your teeth may chatter.  Your skin is pale and slightly blue, and you feel cold.  Shivering generates more heat and boots the temperature even more.  Generally, with high fever comes loss of appetite, mausea, weakness, and sometimes a stomach upset.

As the temperature rises, your thermostat issues emergency signals to all vital organs.  In the battle to cool your body, blood vessels in the skin dilate, making your face red.  Your heart has to beat faster, and the blood must flow for healthy new cells.  Sooner or later, the chill subsides, inside warm reaches the skin, and you sweat—cooling-off process that drops your temperature.

Is higher temperature always dangerous?  Not always.  Nor is it necessarily true that the higher the fever the graver the illness.  However, a high temperature above 100 degrees can be regarded as significant.  Consequences may depend on the fever’s persistence as well as on the individual’s age.  At temperatures above 103 degrees, various degrees of temporary mental derangements may appear, raging from impaired judgment to complete confusion, restlessness and delirium.  In adults, a temperature of 106.6degrees lasting for a few hours would likely cause brain damage and could be fatal.

Few patients survive a temperature over 109degrees.  Luckily, before it reaches that level, your body ordinarily brings life-saving emergency mechanisms into play, to take command and produce more white cells to attack bacteria, and to create antibodies to kill germs.  Also, since the fevers that accompany various diseases act differently, the behavior of your thermometer can be of great help to your physician in diagnosing and charting the colures of an illness.  The fact that you can work up with fever could be a good sigh—that your body is sound enough to battle infection.

How should temperature be taken?  Use a clinical thermometer.  Before each use, sterilize it in alcohol, rinse it in cold water, and shake it down so that the mercury drops below 95degrees.  An oral thermometer should be held under the tongue, with the mouth shut, for a minimum of three minutes.  [A rectal thermometer should first be lubricated, the patient placed on his sue and the thermometer inserted up to the 98.6degree line for three to five minutes.

Proper care must be used in taking mouth temperature.  The reading may be off if the patient drinks hot or cold beverages—or smokes—just before the thermometer is inserted.  And if he breathers through his mouth instead of his nose when oral temperature is being taken, the reading is meaningless.

What can be done to reduce a fever?  Most physicians agree that the following measures are usually helpful:

  • · Keep the body’s water balance high.  Since you lose a lot of water in sweating and in vaporization from your air passages, drink plenty of fluids.
  • · Get plenty of rest and nourishment, rather than “starve a fever,” as some believe, doctors may recommend a high protein diet, fat and carbohydrates.  Hence, it’s generally advisable to increase the intake of solid food [that is easily digestible] so that your body is not weakened further.
  • · For mild fever, aspirin of asprin-containig tablets generally bring down temperature within 30 to 60 minutes.  Adults can take a couple of five-grain tablets every four hours; infants and children, tablet containing a total of no more than one grain per year of age, every four hours.
  • · Use light bed covers and keep your bedroom comfortably cool and humid.  “Sweating is out” by bundling up under blankets in an overheated room is considered unwise.  After all, your body is striving to get rid of heat, not trying to conserve it.  An ice pack may help when the fever mounts over 103degrees.
  • · Let your physician examine you and diagnose what’s wrong.  In your doctor’s hands, the revealing symptom called “fever’ can usually be brought under control, and any underlying cause be safely treated.



Posted in Uncategorized | Leave a comment

The Marvels of the Human Hand

imagesCAERPF2BThe Marvels of the Human Hand


In the darkness of a mother’s womb a tiny, ivory-colored embryo enters its fourth week of life.  Within the tightly curled, motionless organism, scarcely two inches long, millions of new cells are growing at an enormous rate.  From the side of the reck region sprouts a pair of “buds”.  Rapidly they elongate into three segments.  The extreme outer segment assumes a paddle shape.  Five lobes appear on the edges of the paddle.  Muscles, tendons and nerve fibers develop.  By the third month of pregnancy, the little flipper’s miniature fingers flex spasmodically.  A human hand has been formed.

Months later, when the baby is delivered, these little fingers will clutch and pluck at the hands of the obstetrician with startling insistence.  From then on, the hands of this human being, directed by the brain, will chiefly determine how this life differs from the lives of all other creatures on earth.

No other part of the body is so intimately associated with human behavior.  With our hands we work, play, love, heal, learn, communicate, express our feelings, construct our civilizations and create our works of art.  The hand and our emotions are so linked that, for most of the world’s peoples, clasped hands symbolize faith, love and friendship, while the clenched fist is the unmistakable expression of human strength and resolution.

How and when during the immense span of evolutionary time did this extraordinary appendage originate?

Amazingly, the fin of the fish is the forerunner of the human hand.  As fish crept out of the sea and developed into air breathing amphibians, their fore fins developed into instruments for crawling, gripping, creeping; and through millions of years subsequent evolution their basic four-limbed artichetecture persisted.  Watch goldfish in an aquarium.  The delicate motion of the fins just behind its head as they fan the water to regulate its movements is controlled by a set of muscles, which are the rudiments of our intrinsic hand muscles.

Once of the most complex instruments of the entire body, the hand is an intricately engineered mechanical device composed of muscle, fat, ligament, tendon, bone and highly sensitive nerve fibers.  It is capable of performing thousands of jobs with precision.  To make the simplest grasping motion, and array of muscles, joints and tendons all the way from shoulder to fingertips is brought into play.  Taking a spoonful of soup involves more than 30 joints and 50 muscles.

The hand is packed full of bones, eight in the wrist, five in the palm, and 14 in the fingers of one hand.  The ligaments, cords of stringy material, hold all these bones together at the joints.  The tendons, tough fibers that guide hand and wrist bones and link them to the muscles that operate them, control finger motion.

The thumb, operating independently of the other four fingers, is the busiest and most important of all the drifts.  Because of the thumb’s unique ability to cross over and link up with any one of the other fingers, we can get along with one thumb and one other finger, or even the stump of a finger.

The rest of the fingers are markedly different in strength.  The middle finger is usually the strongest, followed by the index finger; the fourth finger is considered by the teachers of music and typewriting to be the less least responsive to training because of an innate muscular weakness; the little finger is weakest of all.

The size of a person’s hand is not significantly related to the strength of its grip or whether it will be fast or slow, deft of clumps.  Among musicians, physicians, artists, athletes and others who depend on their hands to earn living, there is an infinitive variety of stubby fingers, slender fingers, large hands and small hands.

Human fingers can be trained to perform astonishing feats.  The flying fingers of a master pianist can strike 120 notes per second.  With two fingers, a skilled surgeon can tie strands of thread into tight knots inside the human heart.  A circus performer so strengthened the index finger of his right hand by years of patient effort that he can balance himself on its tip.

Every walking moment we obtain a great deal of information about the things we touch by the “feel” of them.  This is possible because the skin of the hand is not like the skin of an other part of the body.  While extraordinary tough, it is also wonderfully elastic and incredibly sensitive.

The skin of the back of your hand actually stretches by almost half an inch when you grip or squeeze something; simultaneously, the palm inside is shortened by half and inch.  Beneath the thick skin of the palm is a buffer of fat which protects the vital tendons and blood vessels of the hand while the outer surface is being subjected to the tremendous friction created by scraping, twisting, gripping and clenching motions.

The palm of the hands, and particularly the fingertips, are equipped with special sensory apparatus.  A piece of finger skin smaller than a postage stamp contains several million nerve cells.  Of the surface of the skin are ridges formed by papillae.  These are dotted with myriad pores and nerve endings, which detect the temperature and texture of anything we touch. [Fingerprint identification is based on the fact that the whorl patterns created by these papillae are never identical in two people]

The greatest natural enemy of the human hand is cold, because bloodless joints in which the temperature drops more quickly than it does in blood filled muscles take up most of the finger.  That is why you can skate of ski all day in zero temperature without covering your face, which is full of muscles richly supplied by warm blood, while without gloves your fingers grow painfully numb in minutes.  Finger joints, like all other body joints, are bathed in a colorless, viscous lubricating fluid [synovia], which provides a smooth, gliding action when we bend an elbow or a finger.  When this fluid gets cold, it thickens and finger joints stiffen.

Because of its intricate arrangement of nerves and muscles, the hand is highly vulnerable to injury.  Injuries to wrist, fingers and hands account for almost one half of the total casualties in industrial accidents.  All lacerations of the hand are potentially dangerous because holders of virulent organisms swam over the things we touch daily.  The thick skin of the hand provides an impregnable barrier to these bacteria.  But if a scratch of puncture permits then to gain entrance, infection may follow swiftly.

Our hands deserve careful treatment.  As tools of learning, working and communicating, they can be considered the fundamental vehicle of human thought—partner with the brain in forever separating man from the rest of the animal kingdom.

Posted in Uncategorized | Leave a comment

It Won’t Hurt, Cause You’re My Brother

“It Won’t Hurt, Cause You’re My Brother”



Football was the most important thing in 14-year-old Todd Conner’s life, until his brother Allen was born, on October 7, 1975.  The squirmy nine-pound infant charmed the would-be grid star, and soon Tood was vying with his sister Lori Ann, 15, for opportunities to help their mother with the new arrival.


One afternoon in November—less than six weeks after the baby’s birth—Todd was holding Allen in the crook of his arm, natural as football.  As he lowered the baby into the bassinet, he noticed that the infant’s head was wet with perspiration.  Todd held out a finger and five tiny fingers twined around it.  Then, suddenly, the chubby hand tightened convulsively and the baby’s body went limp.


“Mother!” Todd shouted.  “Something’s wrong!”


Unable to revive, her infant son, Carolyn Conner rushed Allen 20 miles from their home in Conyers, Georgia, to Henrietta Engleston Hospital for Children in Atlanta.  Their doctors shaved off his blond ringlets and punctured the soft spot on his head with intravenous needles attached to tubes.  Physicians probed, palpated and X-rayed; technicians pricked the tin fingers, drawing blood, and left with pipettes filled, slides carefully smeared and labeled.  Nurses collected urine samples recorded his fluid intake, blood pressure and temperature.

Two days later, the diagnosis showed that Allen had suffered permanent kidney impairment.  The two vesico-ureteral valves on the tubes leading from the kidneys to the bladder did not function properly.  Thus, urine flowed back into his kidneys, severely damaging them.


To repair the valves and stop the backup, Allen needed surgery.  But he was too young and weak for such an intricate operation.  Instead, the surgeons opened Allen’s abdomen and made an incision in his bladder to excess urine could drain through a catheter.  The major surgery would have to wait until he weighed at least 16 pounds.


The first time he saw his baby brother with the needles inserted into the veins beneath his scalp, Todd turned away.  “Does it hurt him? He asked weakly.  Though his father, Perry Conner, and his mother and the nurses assured him Allen couldn’t feel the needles, Todd’s own head hurt sympathy.


Seven weeks after entering the hospital, Allen was allowed to go home.  The interim surgery had put life back to him.  He learned to sit up and crawl.  However, at seven months, he still weighed less than his birth weight.


One day Tood found him asleep in the family room and saw that his skin was white as talcum powder.  Todd’s yell immediately brought his mother.  She grasped the skin of the baby’s abdomen between her thumb and forefinger.  Instead of being supple and falling back in place, the pinched-up ridge remained.  “He’s dehydrated,” Carolyn said, gathering Allen up and heading for the hospital.

This time it was five weeks before doctors let the boy come home, and after they did there was a family council.  “The nephrologist says Allen will probably develop kidney failure-possibly before he’s a year old,” Carolyn explained, her voice shaking.

But during the following weeks, with diet and heavy meditation, Allen’s condition stabilized.  His birthday came and went: Tood organized a party for him, with cake, punch and balloons.  He learned to walk, stand on his head, whistle, and pull off his clothes.  His favorite pastime was galloping around the house on Todd’s back, shouting, “Go, horsy!”

By December 15, 1976, Allen weighs 16 pounds and the Atlanta nephrologist told Carolyn Conner that he could now withstand the valve-reimplantation surgery.

Allen knew from his earlier hospitalizations that “losing” his shoes, meant pain would follow.  When his parents had their tiny son ready for the hospital, Todd bent down and tied a double knot in his brother’s shoelaces.  “Hang on to these shoes, boy,” he said with affection.  Then prayed: ‘Dear God, please let him come back.’

The operation went smooth and Allen returned home on Christmas Eve, weighing 13 pounds.  His favorite Christmas toy came from Todd—a big green frog he could ride, even when he felt so bad he couldn’t walk.  Once again the toddler commandeered Todd for his horse and made him his general slave.

Allen’s well being lasted until July 1977.  Then he lost his appetite.  Nothing, not even Todd’s coaxing, could get him to eat enough to maintain his weight.

Doctors suggested garage—force-feeding through a tube inserted in Allen’s nose and running into his stomach.  With a high-calorie formula and four daily feedings, the boy gained a little weight and grew an inch.  Meanwhile, his blood tests, taken every other day, indicated stable kidney function.

Then suddenly in January 1978, the tests showed further deterioration.  By mid-January he walked unsteadily he walked unsteadily, and by mid-February he stumbled occasionally.  Again the Conners took him to a specialist in Atlanta.  The doctor said he had a bone disease that goes with kidney failure.

By March, Allen could hardly walk.  So Todd carried him the burden of his knowledge far heavier than his little brother.  Every time the child was taken to the doctor, Todd insisted on a complete report.  Twenty-five times Allen’s head had been shaved for intravenous feeding.

Now came new word from the specialist: Allen must go to the University of Minnesota Hospital for hemodialisis, a blood cleaning process—called dialysis for short.

“The hospital is world-famous for its success in treating kidney diseases in very young children,” Carolyn Conner assured her family.  Then after a long pause she added, “Allen will have to have a kidney transplant this summer.  If it’s successful it will cure the bone disease too.”

For a moment Todd could not speak.  Then he lifted his eyes to his parents.  “Mine,” he said.  “I want to give Allen one of my kidneys.”

“Todd, your mom and I thought you’d volunteer,” his father replied.  “But we’re against it.  If either you or Lori give a kidney and it didn’t work, and then something happened to you…” He chocked over the words.  “Besides, with only one kidney, you might not be able to play football.”

“I don’t care about that!” Todd blurted.  “Allen needs a kidney, and when that plane leaves Minneapolis, I want to be on it with him.  You’ve got to let me be tested.”

One week later, Todd and Lori Ann—who had also countered a kidney and insisted on being tested—sat with their parents in the office of Dr. John Najarian at the University of Minnesota Hospital.  “Rejection is the major concern,” Najarian said, ‘so we check for tissue compatibility.  Tissue typing is done through four genetic makers called antigens.  For a donor and recipient to be compactable, at least two antigens must match from a sibling, there’s a 90 to 95 percent change of success.  It’s a 70 to 75 percent chance if the donor is a parent, and 50-50 if it’s some other family member.”

Perry and Carolyn Conner, and Lori, all proved two antigen matches.  Todd showed a four-antigen match—so close to Allen’s tissue that only an identical twin could be more compactable.  His parents consented to the transplant.

While 2 ½ -year-old Allen continued dialysis as an outpatient, Todd began the psychological testing required before such surgery.  One day the topic was sports.  The psychologist asked, “You think you’re a pretty good football player?”

“Fair,” Todd muttered.

“Ever dream of being the fasted back, the highest-scoring end?”

“Yeah, I’ve thought about it.”  Todd’s voice was high, tense.

When the session was over, Todd dent to the dialysis section of the hospital and stood outside the door listening to the soft whir of the machines cleaning his brother’s blood—a four-hour, three-times-a-week process.  He scuffed his toe, the way he’d do for an onside kick.  How did that doctor guess about those dreams”?  Yes, he would miss sports, especially football.  But he’d have something better to take its place: the finest little brother who ever lived.

On May 10, 1978, Todd woke early, long before the scheduled 6:30 a.m. surgery.  Despite the pills meant to calm him, butterflies churned in his stomach the way they did before a big game.  A hospital orderly bumped opens his door with rolling bed.  The 16-year-old climbed abroad and was wheeled off toward surgery.

“Todd!”  He heard his brother’s voice, shaky with tears.  An attendant pushed another cart toward him with a tiny lump under the sheet—Allen.  The little boy looked white and afraid, but his right arm wiggled out from under the sheet, and he waved and smiled.

The orderlies pushed the carts into the same elevator.  Allen kicked his sheet off, exposing red shakers—laced and tied in a double knot!  He climbed over on Todd’s cart and locked his skinny arms around his brother’s neck.

“After today,” Todd said huskily, “you’re not going to hurt anymore.”

“ Know,” said Allen.  Suddenly his chin began to quiver.  “Todd, when they give me part of you, will you hurt?”

Hiss little brother had suffered so much, yet here he was worrying about him.  “Nope,” Todd said, pulling Allen close.  “It won’t hurt me, because you’re my brother.”

The elevator door slid open and the attendants rolled them toward adjoining rooms.

A dozen green-clad doctors and nurses clustered around Allen.  An incision was made down the middle of his abdomen, and his shriveled kidneys were removed.  Then Dr. Najarian went into next room where another surgical team had opened Todd halfway around at the waist on one side, to remove the right kidney.  Dr. Najarian returned almost immediately, cupping in his big hands something that looked like a shiny wet potato.  He placed it in a basin of sterile solution to wash away the blood and cool the kidney for a better take.  Meanwhile, Todd’s incision was closed and he was whisked to recovery.

Allen’s abdominal cavity looked far too small to accept his brother’s kidney, nearly three times the size of his own.  It was a tight fit, but doctors knew that soon after the operation the kidney would shrink to the size Allen needed.  Then, as he started to grow, it would grow with him at a normal rate.  Six hours elapsed before Dr. Najarian, grinning with relief, reported to the Conners that Todd’s kidney was functioning in Allen.

The next day Todd asked to be wheeled down to Allen’s room.  Through the bed railing the two brothers kissed and repeated each other’s names over.  For the next two weeks, Allen received interjection serum—administered via tube inserted in his neck during surgery.  Then, 14 days after surgery, Allen and his parents flew home to Georgia. [Todd had left a week later].

Today, nearly three years later, with his doctor’s approval, Todd is working as a landscaper in his father’s business.  Allen is in kindergarten and has achieved the normal height and weight for a child of his age.  Once a month his mother takes him for blood tests at a nearby clinic; the results are phoned to Minnesota for monitoring.  For the rest of his life he will take ante rejection medication.  But thanks to Todd’s precious gift, the lively 5-year-old now has a future, a chance for a full and happy life.

Posted in Uncategorized | Leave a comment

I’ve Lived With Cancer

I’ve Lived With Cancer



One morning I stretched in bed and felt a pain in my right breast.  I touched the spot with my fingers; there was a tiny lump, about half the size of an olive.  I lay there for a minute thinking.  I was 37 years old.  What a terrifying coincidence.  Mother had been 37 when she had her operation for breast cancer.  I wasn’t sure my lump was anything serious, but I remembered how it had been with Mother.  She was the sort of person who believed it a disgrace to be ill.  She waited too long to see the doctor.  Ger operation hadn’t cured her; the cancer recurred in the uterus, and the second time they didn’t operate.  They treated her with radium, but that didn’t work either.  She died when I was 19, a senior in college.

With these memories crowding in one me, I wanted to see a doctor right away.  My husband Hod (a nickname for Horace) and I, with our two little girls, had just moved to Seattle, and we didn’t know any doctors there.  After a bad experience with obstetrician who diagnosed the lump as “just nerves,” I went eventually to an internist.  He felt the lump and send me immediately to a surgeon.  The surgeon told me the lump ought to come out the next day.  He would have it examined on the spot by a pathologist.  If it turned out to be cancer, he would go right ahead and do a radical mastectomy; remove the breast and all surroundings tissue likely to be invaded by cancer, including some muscles and the lymph nodes under the arm.  He knew about my mother and wasn’t about to take any chances.  I was pretty sure it wasn’t cancer.  I may have prayed about it.  Raised a Presbyterian, I had married a Mormon.  Not wanting a house divided, my daughter and I had studied Mormon faith and been baptized the preceding year.

I knew the bible quotation: “Is any sick among you? The prayer of faith shall save the sick,” we asked some of out Mormon friends, elders in the church, to come to the hospital and pray.  They came, put their hands on my head and asked the Lord’s blessing, and prayed for my recovery.  It was a simple, spontaneous act, not words read out of a book.  But in this time-honored ceremony.  I knew I had been blessed—that there had been communication with Our Lord.

The next day, when I was taken to the operating room, both Hod and I were quite calm.  When they didn’t bring me out after a few hours, he knew that they must have found cancer.  He says he didn’t worry, and I believe him.  He has a calm faith in God, and he trusted our doctors—and he has always made me feel the same way.

My friend thought when I woke up after the operation was that there was a ten-ton truck on my chest.  This was the pressure bandage put on to keep fluid from accumulating.  “We’re sorry,’ a doctor said, “but we had to do the radical.”  I was pretty groggy from the anesthesia, but even so I was shocked.  Remember, I was only 37—that seems very young to me now, 16 years later—and I was proud of my body.  I knew what the alternative was, though, and the doctors cheered me by saying that they had got out all the cancer in one piece of tissue.  As far as the surgeons could tell, I was free of disease: “You might as well worry about being hit by an automobile,” he said.  “As to think that you will die of cancer.”

But what really convinced me that I was going to live was a peculiar experience I had a day or two after the operation.  I was lying in bed, quite alone, when I heard a voice say, “You are going to be fine.”  It’s possible that I was still feeling the effects of drugs, but I heard that voice as clearly as I’ve ever heard anything in my life.  It dramatically renewed my faith, gave me strength and tranquility.

After nine days I was able to go home.  Hod came and got me.  He acted as though I had just got over a bad cold, or something equally trivial.  That night we watched a television verity shoe with a line of chorus girls wearing low-cut gowns.  I began to cry.  Hod turned to me and said, “and what are you crying about?”  It made so mad that I quiet crying—and I’ve never cried since.  What he said may seem heartless, but he was under doctor’s orders: tender, loving care was great, but sympathy would only get me feeling sorry for myself.

I was very touchy at first.  The doctor said, “You must have something to help you bathe; otherwise you might lose your balance and fall.”  When I protested, “You don’t mean you want me to let my husband see me!” he just laughed and said, “Of course I do.”  And Hod was so unconcerned about the scar that I began to get over my embarrassment.  About four weeks after the operation, I went to a department store for my prosthesis—a false breast worn in a brassiere.  The woman in the lingerie section was merry understanding, and the prosthesis was quite comfortable.

After a radical mastectomy you have to work to recover the use of your arm.  It is painful, because the muscles have been cut; but if you don’t exercise they heal in a stiff and awkward way.  So I did what the doctors ordered: walked my fingers up the wall, waved my arms, everything to get the motion back.  I love golf, and was especially anxious to get back to it.  There were some twinges as I began swinging a club, but I kept at it.  When I first went out to the course, I was rather nervous.  But I took a full swing and something tense me relaxed as that white ball flew into the sun.  It was a nice drive, straight done the fairway.

I was even more nervous the first time I put on a bathing suit at a friend’s pool.  Would my scar, which went rather high in my neck, embarrass the others?  Well, nothing risked, nothing gained.  It was hot, and I wanted to swim.  So I walked out, trembling a little inside, and dived into the pool.  Nobody even noticed.

As the years passed, the operation receded from by thoughts.  The girls grew up and married.  Hod and I had a wonderful time.  Of course I had the checkups the doctors ordered, including chest X-rays and the Pap test, every six months at first and then every year.  But there were no further problems.  I had long ago considered myself cured when I discovered a lump in my left breast as I was taking a shower.  I reported directly to my surgeon.  “I don’t know what it is.” He said, “So we’ll operate and find out.  With your history, even if the lump is not malignant, I will remove the breast.  But I’ll not do a radical unless the lump is malignant.”

Two days later they operated.  The lump was not malignant—but underneath he did find a spot of cancer.  When I came out of anesthesia, the doctor told me this—and that he had had to do the radical.  I wasn’t feeling so flippant, but my retort was, “Hurray, now I match!”  I now felt that my troubles were behind me.  The pathologist’s report was negative, meaning that the cancer had been confined to the one spot.  So I was concerned more about regaining use of the left arm as soon as possible, and seeing my new grandson, than about the threat of future disease.  Actually, the second operation was easier to take, both emotionally and physically, than the first—and I was playing golf within two months.

After moving from Seattle to Salt Lake City, I went to see dermatologist about a lingering ear infection.  He took a biopsy and told me there was local cancer-cells involvement.  “Please don’t be alarmed,” he said.  “It’s not metastasis [spreading] of the breast cancer, just a basal cell skin cancer,” But it had got into the cartilage, and needed some plastic surgery so, I entered the hospital.  As a precaution, the surgeon ordered a regular checkup, including chest X-ray, before we went to the operating room.  While I was still unconscious, he told Hod that the X-ray had disclosed a walnut-sized lump in my right lung that would have to come out.  “How are we going to tell her? He asked.  Hod said, “Just tell her.  She can stand the truth as well as I can.”

They gave me five days to recover from the ear operation, and then we went back to surgery for the lung.  It was a much longer and more difficult operation than the mastectomies, and more painful afterward.  For three days I was in intensive care.  But there was good news from my doctor.  The pathology report showed that the cancer—it was definitely metastases of the breast cancer—had been confirmed to that single tumor which he’d removed with the middle lobe of my right lung.

Nevertheless, I began to feel resentful.  I knew I’d been lucky, but I was getting a bit tired of being so lucky so many times, perhaps because I was older, 51.  But after six weeks—a month at hoe—the doctor said I was recuperating perfectly and could go with my husband to a convention in Coronado, California.  It was beautiful there, sunny and warm, and I began to feel strong again.

For a year I was fine, traveling with Hode, playing golf, visiting our grandchildren.  And them I had an attack of pneumonia.  During a series of sputum tests, cancer cells were found.  This means that there is cancer in my chest.  They’ve been giving me radiation treatments to reduce fluid accumulation, and now chemotherapy has been started.  The situation is not good, but I know that I’ve been helped before I believe my doctors when they say there is a good chance of arresting the spread of the cancer.

People often ask me if my cancer is hereditary.  The doctors say no, although they think there may be a hereditary tendency in some families for some forms of cancer.  Since my mother and I both had breast cancer, this is clear warning to my daughters, one doctor told me.  They should be extra careful as taught by the American Cancer Society.

Another question that comes up shy, after all I’ve bee through; I’m not angry or depressed.  My answer is: if the doctors give you every chance to live a normal life, well, why not does it?  They’ve always been honest with me.  They’ve said frankly in the past that they don’t know when or if another form of cancer, of another metastasis, will show up.  But I can’t see sitting around the moping.

I’ve lived a full, happy life through three major cancer operations.  I’ve watched my daughters grow up and seen three grandsons born since the first tumor.  And I’ve not been living in fear.  On the contrary, I’m more fearful about getting abroad an airplane than I am about undergoing anesthesia.  Hod and I have had a good life together; I feel we’ve had a present of 16 marvelous years—more than some have in their entire lives.  As for the future—nobly knows that except God.  And I have faith in Him, just as I have always had.

Posted in Uncategorized | Leave a comment

The Right Arm of Eddy Knowles

The Right Arm of Eddy Knowles



Everett “Eddy” Knowles, Jr., a merry, freckled, red-haired boy of 123, stood just off the roadbed and watched the Boston & Marine gravel train grinding slowly past Gilman Square in Somerville, Massachusetts, a suburb of Boston.  It was about 2:20 p.m. May 23, 1962.  Eddy was on his way home from Northeastern Junior High School, and had decided to have a fling at forbidden fruit—hooking a ride on freight.

As a gravel-laden gondola car moved slowly past him.  Eddy pulled himself to the steel step and grasped the handrail.  He hung there in triumph, all five feet and 90 pounds of him.  The spring breeze eddied through his jacket and cotton shirt as the freight groaned eastward.

A few seconds later the world went black for Eddy.  His leaning body slammed full force into a stone abutment supporting the Medford Street overpass.  His right arm cracked, and he dropped into the roadbed, crushing his thumb and the first two fingers of the left hand.  For a minute he laid there, a small-bewildered heap, until the train passed.

He was sure he had broken his right arm, the arm that had so far earned him a 3—1 winning record as a Littler League pitcher.  A smear of blood spread on his shirt just below the shoulder where the jacket had been torn.  Supporting his right arm with his mangled left hand, he struggled to his feet, climbed a steep bank and started home.

As Eddy shuffled past the back loading platform of the Handy Card & Paper Co., Norman Woodside, the foreman saw the bloody, bedraggled figure and shouted to Richard Williams, a press operator, ‘Grab him!’ Williams laid Eddy on the wooden platform while Woodside phoned the Somerville police.  Woodside returned with Mrs. Alice Chmielewski, a clerk, who tried to put a rag tourniquet on Eddy’s arm.  Suddenly, she felt faint.  At the place she sought to apply the tourniquet, there was nothing but space.  Eddy Knowles had walked more than 100 yards, mostly uphill, clutching an arm that had been severed from his body.

Mrs. Chmielewski pushed some rags against the shoulder stump in an effort to stanch the bleeding.  “I got to get out of here,” moaned Eddy.  She held him gently and wiped the sweat from his forehead.  Eddy didn’t cry.  Indeed, he was not to shed a tear for the entire day of his ordeal.

A police squad car arrived in two minutes, and by 2:40p.m Everett Knowles, Jr.,had the good fortune to be wheeled into Massachusetts General Hospital, one of the finest in the United States.

As emergency ward administrator Ferdinand Strauss and his assistant, Michael Hooley, wheeled Eddy toward the emergency operating room, Hooley, asked Eddy his name, address, phone number, religion.  The boy replied clearly.  Hooley now put a complex system into operation.  One call went to the Knowles home; another to the patient-index center in the basement where 1,500,000 names are filed, luckily, Eddy had been a patient there before.  Within five minutes his medical record with his blood type reached the operating room.  Eddy already was receiving 250 cubic centimeters of plasma through a ‘cut down’ in his leg.  Now, the first of the six pints of whole blood he would receive flowed into him through the transfusion tube.  “My arm hurts.” Eddy told the doctors.  “Is it going to come off?”

Nurses Mary Brambilla and Francis Brahms lifted Eddy from his litter to the operating table.  Nurse Brahams cut away Eddy’s clothes with scissors.  Then, they all saw it: Eddy’s right arm lay three or four inches from the shoulder stump.  Not a single thread of skin bridged the gap.  “Will my arm be all right?”  Can you save it?”  Asked Eddy.  Dr. S.B.Litwin, a duty surgeon, nodded.  “Yes, son,” he said.  But at that moment nobody knew.

Dr. L.Henry Edmunds, Jr., the duty surgeon in charge now gave brisk, routine orders: tetanus shot, atropine, injections of penicillin and streptomycin, a sedative shot, pulse taking, blood pressure.  Eddy’s pressure was low, his pulse 120, and he was cold, sweaty—all indications of shock.  Hank Edmunds noticed on encouraging detail.  Eddy’s right-arm artery protruded almost an inch from his damaged flesh and, with each pulse, it throbbed and dilated—but no blood emerged.  It is one of nature’s miracles, this self-sealing quality of a severed artery.  In a young person especially, the vessel’s elasticity is so great that it closes within few seconds of rupture.

Dr. John M. Head, staff surgeon, and Dr. John F. Bruke consulted with Edmonds.  They all noticed that the lone arm, while bruised and damaged, was fairly clean.  Edmunds ordered Nurse Brambilla: “Put that arm on ice.”  Mary Brambilla filled two basins with crushed ice from the ward kitchen’s ice-making machine and placed the arm on them, then packed ice-filled bags around it.

At Edmond’s side now were a number of doctors, including 30-year-old Dr Ronald A. Malt, the resident in surgery and perhaps the most important man Eddy Knowles was to see that day.  These physicians conferred in the corridor.  Never in medical literature had they read of a case of a major limb successfully reattached to the body.  But Eddy and his severed arm appeared ideal for am attempt.  Each step that would be necessary—rejoining veins, arteries, bone, muscle, skin—had been performed routinely for years.  Could they all be done atones?

As the doctors talked, Father L. Chanel Cyr, duty chaplain at the hospital, administered extreme unction to Eddy.  Then Eddy’s father, a meatpacking employee, who worked nights and had been asleep at home when the phone rang, arrived.  Physicians explained the situation.  Would Mr. Knowles send to a reattachment operation?  Knowles signed the release.

Dr. Malt asked Dr. John Herrmann, his assistant in surgery, to take the arm upstairs to Operating room No 5.  There Dr. Herrmann scrubbed, donned a surgical gown, and wet to work.  First he fished out the arm’s three major nerve trunks and the torn blood vessels.  They appeared reasonable intact.  Placing a syringe in the artery, he flushed the blood channels with heparin, and anticoagulant, with antibiotics and with a solution approximating the body fluids.  The antibiotics severed to kill any grantee of lockjaw bacteria that might be starting.  There were no lacerations on the arm.  The bone was broken and jagged, one side longer than the other, but it was not crushed.  Then Dr>Herrmann injected a radiopaque solution into the artery.  A technician took X rays to determine whether there were any blood-vessel blocks.

Eddy Knowles, meanwhile, was wheeled into the “White 3” anesthesia induction room.  Here at 3:40p.m. Dr. Joan Flacke injected a muscle relaxant into Eddy’s leg and gave him an intravenous dose of thiamylal, a sedative.  “I just thought of something,” said Eddy to her.  “My family was going on a vacation in a couple of weeks, and now I guess I’ve spoiled it.”

Malt looked at the X-ray plated of Eddy’s arm.  The limb appeared to be fine.  No blood clots, no obstructions appeared.  It was 4:05p.m. When Malt reached his crucial decision: they would try to sew back the severed arm of Eddy Knowles.  Malt ordered Joan Flacke to begin anesthesia.  Then he phoned Dr. Robert S. Shaw, an expert in vascular surgery who was working in another hospital building.  “Bob,” said Malt, “there’s a boy here with his arm off, and I think we’ve got a chance to put it back on.”  Shaw came, on the run.

Under great overhead light in OR 5, Dr. Flacke fitted a mask over Eddy’s face. The boy began to breathe a mixture of halothane, nitrous oxide and oxygen from three tanks.  He fell quickly into a sound sleep.

Judy Moberly, the scrub nurse, felt queasily for the first time in months of watching operations.  The sight of an arm on one table and a boy on another had strangely upset her.  “Do I have to watch?” she asked.  But then, as soon as the arm was brought close to Eddy, she was no longer disturbed.

Around the boy now stood three doctors, two nurses, three anesthetists and two orderlies.  The glassed balcony above them was crowded with a score of doctors and nurses, drawn there as word spread through Massachusetts General that a limb was to be reattached.

Eddy’s right side was propped up, the bloody stump irrigated with salt water and draped with gray linens.  The Shaw directed the initial step, the sewing of the veins.  These had to be connected first, so the blood would have a way to get back to the heart when the artery was repaired.  The arm has two outer veins and one deep plexus entwined about the artery.  Ignoring the outer veins, Shaw selected two veins from the intern network.  With forceps, he gasped the minuscule curved needle attached to green but hardly visible Dacron 6-0 thread. Through a vein he pushed the needle, let loose, picked it up on the other side and pulled.  He did that again and again, 30 stitches to the vein.

It was painstaking work.  Save for the occasional asides of the doctors, muttered though their gauze masks, the room was hushed.  Malt’s job required excruciating patience.  He had to hold Eddy’s arm so firmly that not the slightest movement would occur.  Occasionally, Herrmann helped with this.  One little tilt, and the delicately stitched veins would rip.  When the two veins were reunited, the doctors joked a bit, to crack the tension.

Now Shaw tackled the brachial artery, still self-sealed and throbbing with each heartbeat.  This task was easier, for Eddy’s artery was large—about two-thirds the size of a lead pencil.  Still, the procedure was complicated and took 45 minutes.  Anatomists, of the suturing of blood vessels, were completed just three and a half hours after Eddy fell form the train.

And now came the moment of truth.  While Malt still held the arm tightly, Shaw removed the artery clamp.  Blood rushed down the arm.  People in the balcony stopped talking.  Not a word was spoken around the operating table.  Everybody watched.  Slowly, the waxen limb began to regain its flesh coloring.  A glow seemed to envelop the arm.  The doctors wanted to cheer.  In the balcony, there were exclamations of joy.

“My,” said Malt, “its nice and pink, isn’t it?” Judy Moberly, the scrub nurse, felt the hand.  It is warm.

In the huddle of surgeons now were Dr. Bradford Cannon, a plastic-surgery specialist, and Dr. David C. Mitchell, an orthopedist.  Now it was time to repair the bone.

Consulting with other bone experts and with Malt, Mitchell decided the bone would have to be reinforced.  If not held securely in place, it might snap and tear the blood vessels again.  There are many shapes of stainless-steel rods for intramedullary fixation, as the profession calls it.  Mitchell tried several of these, forcing them into the marrow of the bone, but wasn’t satisfied.  At last, he and Malt settled on the Kuntscher nail, which in cross section is roughly the shape of a cloverleaf and grumps firmly.  They measured the length required—six and a quarter inches.  Malt drove the nail part way up the marrow of the stump bone with a stainless-steel mallet.  Then Mitchell held the arm and forced it onto the rod.  It was 8p.m.

Next job: nerve suture.  The doctors struck a snag here.  They couldn’t find all the nerves in the stump, and they couldn’t be sure how badly damaged the located nerves were.  The smallest scar on a nerve end could thwart full healing, giving Eddy a lifelike but useless arm.  With an eye on the clock, because Eddy already had been on the operating table four hours, Malt made another one of the scores of decisions made that day.  He decided to postpone nerve rejoining for a later operation.

Malt now removed dead tissue to block infection.  Normally this would have been done first, but the doctors postponed it because, until circulation was restored, they couldn’t be sure how much would ultimately be dead.  Next: the muscle.  Malt jointed the muscle with 12 large stitches of catgut.

A skin graft was clearly called for now, since a large, raw wound showed.  But Malt, in still another decision, ruled against an immediate graft.  A graft would take 45 minutes, and there was little time.  It was now past 10p.m., with much work still to be done.  A dry dressing was placed on the patched arm.  Then Eddy was fitted with a spica cast covering both his shoulders and down to the hip tops and holding the rejoined arm firmly, crooked at the elbow.

Eddy’s left hand still had to be cared for.  Dead tissue was cut away from the smashed thumb and two fingers, and a skin graft taken from Eddy’s right foot was applied.

It was almost 1 a.m. when Eddy was wheeled into the recovery room, eight and a half hours after the operations started.  As he emerged from unconsciousness, Eddy smiled at Joan Flacke.  “How’s my broken arm?” he asked.  Then he thought something.  “Next time,” he said, “just give me the gas.  I don’t like those needles.”

Eddy stayed in the recovery room until daylight, and then was wheeled into a private room on the 12th floor.  Although Eddy and his arm were one again, the doctors’ vigil had just begun.  When days passed with no sign of infection, they breathed more easily.  On the fifth day they took a large piece of skin from Eddy’s right thigh and grafted it onto his arm in two places.  On the 12th day they changed the cast, and again on the 15th day, June 13, Eddy went home to his family’s two-story frame house on Dell Street in Somerville.

Eddy Knowles, at age 30, is doing well.  His recovery has been good, and his hobbies include weight lifting and tennis.  He has held various jobs, among them, delivering 200-pound slabs of meat and cross-country truck driving.  All in all, a very remarkable, productive life for Everett Knowles, jr., once a brave little boy who never cried, and who helped to blaze a new trial in medical science.  Suture of Right upper Extremity.” Ronald Malt called it in his laconic one-page official report.

Posted in Uncategorized | Leave a comment