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Monday, June 04, 2007

amazing in the worb on fetal surgery

A picture began circulating in November. It should be "The Picture of the Year," or perhaps, "Picture of the Decade." It won't be. In fact, unless you obtained a copy of the US paper which published it, you probably will never see it. The picture is that of a 21-week-old unborn baby named Samuel Alexander Armas, who is being operated on by a surgeon named Joseph Bruner. The baby was diagnosed with spina bifida and would not survive if removed from his mother's womb. Little Samuel's mother, Julie Armas, is an obstetrics nurse in Atlanta. She knew of Dr. Bruner's remarkable surgical procedure. Practicing at Vanderbilt University Medical Center in Nashville, he performs these special operations while the baby is still in the womb.

During the procedure, the doctor removes the uterus via C-section and makes a small incision to operate on the baby. As Dr. Bruner completed the surgery on little Samuel, the little guy reached his tiny, but fully developed, hand through the incision and firmly grasped the surgeon's finger. In a Time Europe article highlighting new pregnancy imagery that show the formation of major organs and other significant evidence of the formation of human life but a few days after conception, Dr. Bruner was reported as saying that when his finger was grasped, it was the most emotional moment of his life, and that for an instant during the procedure he was just frozen, totally immobile. The photograph captures this amazing event with perfect clarity. The editors titled the picture, "Hand of Hope."

The text explaining the picture begins, "The tiny hand of 21-week-old fetus Samuel Alexander Armas emerges from the mother's uterus to grasp the finger of Dr. Joseph Bruner as if thanking the doctor for the gift of life."

Little Samuel's mother said they "wept for days" when they saw the picture. She said, "The photo reminds us a pregnancy isn't about disability or an illness, it's about a little person." Samuel was born in perfect health, the operation 100 per cent successful. Now see the actual picture, and it is awesome ... incredible.

Origins: The image accompanying the text quoted above is real in the sense that it is indeed a photograph taken during a revolutionary fetal procedure undertaken on 19 August 1999
to fix the spina bifida lesion of a 21-week-old fetus in the womb. The operation was performed by a surgical team at Vanderbilt University in Nashville which developed a technique for correcting fetal problems in mid-pregnancy by temporarily removing the uterus, draining the amniotic fluid, performing surgery on the tiny fetus, then restoring the uterus back inside the mother. The patient shown above, Samuel Armas, was the 54th fetus operated on by the surgical team; Dr. Joseph Bruner, the surgeon whose hands are pictured above, alleviated the effects of the opening in Samuel's spine caused by the spina bifida, a congenital disease that often leads to paralysis and other problems. Pictures from the surgery were printed in a number of newspapers in the U.S. and around the world, including USA Today, and thanks to the remarkable surgical procedure performed by the Nashville team little Samuel was born healthy on 2 December 1999.

However, it is not true, as described in the accompanying text, that these photographs were taken as Samuel's hand "emerged from the mother's uterus to grasp the finger of Dr. Joseph Bruner as if thanking the doctor for the gift of life," or that Dr. Bruner said "when his finger was grasped, it was the most emotional moment of his life." This misinformation has been propagated by many different sources, including the Michael Clancy, the photographer who snapped the pictures:
As a doctor asked me what speed of film I was using, out of the corner of my eye I saw the uterus shake, but no one's hands were near it. It was shaking from within. Suddenly, an entire arm thrust out of the opening, then pulled back until just a little hand was showing. The doctor reached over and lifted the hand, which reacted and squeezed the doctor's finger. As if testing for strength, the doctor shook the tiny fist. Samuel held firm. I took the picture! Wow! It happened so fast that the nurse standing next to me asked, "What happened?"

"The child reached out," I said.

"Oh. They do that all the time," she responded.1
What actually took place, as described in news reports of the surgery, was that:
[J]ust as surgeon Dr. Joseph Bruner was closing the incision in Julie Armas' uterus, Samuel's thumbnail-sized hand flopped out. Bruner lifted it gently and tucked it back in.2
(The dubious veracity of the photographer's version of events is highlighted by the disclaimer he appended to it on his web site, stating that it represented his "opinion of the events as they took place during the surgery for Samuel.")

The surgeon, Dr. Bruner, later elaborated on some of the exaggerated and false claims made about the photograph:
"It has become an urban legend," says Bruner, the Vanderbilt University surgeon who fixed the spina bifida lesion on Samuel. Many people he hears from wonder whether it's a fake.

"One person said the photo had been reviewed by a team of medical experts and they had determined that it was a hoax," Bruner says with a laugh.

More commonly, people want to know how the photo came to be.

Some opponents of abortion have claimed that the baby reached through the womb and grabbed the doctor's hand.

Not true, Bruner says.

Samuel and his mother, Julie, were under anesthesia and could not move.

"The baby did not reach out," Bruner says. "The baby was anesthetized. The baby was not aware of what was going on."3 Read more...
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