Hero Work

Five stories that will make you believe that, on their best days, doctors really do have superpowers.

August 2013

Freak Accident
A day at the lake ends at the Denver Clinic for Extremities at Risk.

The Front Range isn’t particularly well-known for its lake culture, but on a sunny day in August 2003, 10-year-old Jaime Culley was enjoying a carefree day on Boyd Lake near Loveland. She, her friend, and Jaime’s dad, who was driving, were zipping across the lake on their Jet Ski, heading back from the lake’s tubing area. It was the quintessential end-of-summer day for a kid who was excited about her upcoming birthday and the first day of sixth grade.
As the trio skimmed the surface, their faces wet from spray, the Jet Ski encountered a heavy wake and a gust of wind. The unexpected jolt caused Jaime to lose her balance, and she quickly found herself taking a swim. Jaime had been carrying the group’s inner tube as they crossed the water. When she fell backward, the tube and the rope attached to it came with her. Jaime’s dad realized his daughter had come off the watercraft and let go of the gas. What none of them comprehended, though, was that Jaime’s hand had become tightly tangled in the rope, which was attached to the Jet Ski at the other end. Before anyone could grasp the situation, the forward momentum of the Jet Ski pulled the rope taut—and with it came Jaime’s left hand, which was completely severed at the wrist.

It was a devastating injury, one that the team of physicians at Loveland’s McKee Medical Center was not equipped to repair. Their recommended course of action was to clean the wound and leave Jaime with a stump. But a nurse had seen a poster for a program she thought might be worth checking into first: the Denver Clinic for Extremities at Risk.
The name is a mouthful, but the Presbyterian/St. Luke’s Medical Center–based team of medical professionals has been managing diseases and conditions that place people at risk of losing a hand, foot, leg, or finger for 27 years. It is one of the few clinics of its kind in the country, and people from all over come to see its doctors for limb-threatening diseases like bone cancer or after accidents involving lawn mowers, chain saws, snowblowers, gas explosions, military injuries, and, like Jaime, ugly encounters with ropes.
Dr. William Brown, a plastic surgeon who’s been with the Extremities at Risk team since 1991, met Jaime shortly after she arrived in Denver via air ambulance. Certified in hand surgery and self-taught in microsurgery, about 30 percent of Brown’s patient load sees him not for cosmetic purposes but for reconstructive procedures. “Jaime was medically stable when she reached us,” Brown says, “but she had a significant injury, a life-changing injury. I was limited in what I could do for her, but I believe any replant you can do in a child is worth doing.” That meant Brown wanted to try to reattach Jaime’s hand. Fortunately, the “part,” as Brown calls it, had not sunk to the bottom of Boyd Lake and had instead remained lodged in the inner tube roping. Jaime’s hand had traveled with her to Denver.
During a six-hour surgery that same day, Brown did what he could for Jaime. He attached bones with pins; he re-established blood flow by repairing arteries and veins; and he hooked up as many tendons and nerves as he could. Although he was doing his best to ensure the operation was successful, Brown knew this would not be Jaime’s only surgery. “She was not ever going to have full range of motion,” Brown says. “But with some tendon transfers and nerve grafts at a later date, I thought we could give her a good helper hand.”

This month marks the 10-year anniversary of that day on the lake for Jaime. In that time she has endured five major surgeries, a handful of smaller procedures, and a lot of physical therapy. Her left hand is not normal, but she has better-than-expected function, which she learned how to use well enough to do all the things she ever wanted to do. Her thumb doesn’t function as well as she’d like; her fingers can’t extend as well as they retract; and she cannot bend them at the outermost knuckles or move them independently. “I never really let it stop me,” she says. “I just kept playing like kids do.”
Of course, Jaime remembers the accident well. She recalls her father holding it together admirably in the moment—flagging down a nearby patrol boat for help—but then falling apart later on. She remembers seeing the mangled mess that was her arm. And she remembers that she didn’t feel much pain. She also remembers exactly what she thought when she first realized her hand was gone. “I was getting ready to go into the sixth grade,” she says, “and I remember immediately worrying about how I was going to have to learn how to write with my right hand because I had been left-handed.”
Today, Jaime calls Brown when she has concerns about her hand. But most of the time, she doesn’t think about it. She’s busy being a psychology student at Colorado State University. She’s considering nursing school after graduation and maybe training to be a flight nurse. “If I could make someone else feel better in a situation similar to mine,” she says, “I think that would feel really good.”

The Top Doc

Dr. William C. Brown
Plastic Surgery