These two stories come from the book “Gift of Pain” by Dr. Paul Brand that I had quoted earlier…I am putting them in here because they help to illustrate the extent of the damage to parts of the nervous system in patients with leprosy.
“ A woman in a village near the leprosarium was roasting yams over a charcoal brazier. She pierced one yam with a sharp stick and held it over the fire, slowly twirling the stick between her fingers like a barbecue spit. The yam fell off the stick, however and I watched as she tried unsuccessfully to spear it, eac jab driving the yam farther underneath the hot redcoals. Finally, she shrugged and looked over to an old man squatting a few feet away. At her gesture, obviously knowing what was expected of him, he shambled over to the fire, reached in, pushed aside the hot coals to retrieve the yam, and then returned to his seat. As a surgeon secializing in human hands, I was appalled. Everything had happened too fast for me to intervene, but I went immediately to examine the old man’s hands. He had no fingers left, only gnarled stubs covered with leaking blisters and the scars of old wound. Clearly, this was not the first time he had thrust his hand into a fire….
A few days later I conducted a group clinic at the neighboring leprosarium. My visit had been announced in advance, and at the scheduled time the administrators rang a loud bell to summon patients. I stood with other staff in an open courtyard, and as soon as the bell rang a crowd of people emerged from the individual huts and barracks like wards and began to move towards us.
An eager young patient caught my eye as he struggled across the edge of the courtyard on crutches, holding his bandaged left leg clear of the ground. Although he did his awkward best to hurry, the nimbler patients soon overtook him. As I watched, this man tucked his crutches under his arm and began to run on both feet with a very lopsided gait, waving wildly to get our attention. He ended up near the head of the line, were he stood panting, leaning on is crutches, wearing a smile of triumph.
I could tell from the man’s gait, though, that something was badly wrong. Walking toward him, I saw that the bandages were wet with blood and his left foot flopped freely from side to side. By running on an already dislocated ankle, he had put far too much force on the end of his leg bone, and the skin had broken under the stress. He was walking on the end of his tibia, and with every step that naked bone dug into the ground. Nurses scolded the man sharply, but he seemed quite proud of himself for having run so fast. I knelt beside him and found that small stones and twigs had jammed through the end of the bone into the marrow cavity. I had no choice but to amputate the leg below the knee….”
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