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One gives up Only letters


Translated from Spiegel Online.
(Please forgive the translation)
Special thanks to Tobias Goihl for his contribution.

May 3, 2001, KATJA THIMM

Since a year the Austrian policeman Theo Kelz with the hands of a dead person lives. After 1680 hours(lessons) therapy the feeling returns gradually in the angenähten fingers. Neurologists want to investigate in the exception patient how the brain learns movements again.

The buxom waitress smashes a " Servus, the dominions " and serves the ordered(appointed) Viennese. Theo Kelz winces, lets the small sausages back fall on the plate. They(you) are too hot in order to give a hand. Immediately his(its) Mrs Roswitha pushes back to him a paper-napkin about the clear-varnished jaw table.

Carefully Kelz wraps the napkin around the end of a sausage, then it holds with all five fingers clasps and dips, as if a puppet player pulled the threads, the small sausage awkward in the mustard.

So ponderously the bearded policeman moves his(its) hands in the Innsbrucker hospital-cafeteria also - he is fallen in love with them(her). "Beautifully" he finds them(her) and grants to them rarely more than five seconds peace. Again they must scratch his(its) beard, must gesticulate and, while he tells, the edge of a table touch.

Softly and rosy the hands, a little look rammed and bloated. The gleaming fingernails grow. And in the crossing to the back of the hand there sprout black hairs.

Theo Kelz, 47, carries the hands of a dead person. Under his(its) shirtsleeves hide themselves scars which look, as if he has got stuck as a child in the barbed wire. He says " show ", to his(its) Mrs Roswitha, " my life line goes over in the scar. " Cautiously Roswitha to him pulls the sleeve again in the joint.

On the 24th of August, 1994 a bomb to the policeman and blaster teared into pieces is

Ne hands - right briefly above the wrist, left with some centimeters of lower arm. In the Slovene-German-speaking racer's-elementary school in Klagenfurt local residents had discovered a suspicious tube and had alarmed the police. When the employees wanted to analyze the tube in Gepäckröntgenstrasse on the airport, it exploded.

Again a perfectly contrived explosive charge had risen in Austria, again the psychopath and racist Franz Fuchs had terrorized the country(land). From 1993 to 1995 his(its) bombs killed four people(persons) and 13 hurt(violated) other, among them the Viennese mayor Helmut Zilk; his(its) left hand was mutilated.

When blaster Kelz broke the eyes - left operated on poverty, in the arms instead of hands only thickens groups-, sat his(its) 19-year-old daughter Andrea in the sickbed. " Give up, dad, one does only a letter ", she said. The surly civil servant had this, to the moaning and despondency always Gräuel were, his(its) daughter from an early age drumed.

Half a year later he did not work again - now more than blaster, but as a radio speaker in the application directing center. He used the muscle-steered electronic prostheses he received first, soon virtuoso as others own hands. In the Chinese restaurant he reached to Stäbchen, he twisted baskets, dressed, washed himself, only managed on the toilet(dress). He sat down even on the motor cycle again, fidgeted around with his(its) red-blue squirted 1000th BMW 9200 kilometers straight through Canada and the USA - a policeman with black leather gap and synthetic material hands, daughter Andrea always hintendrauf, and when she dropped off, their(her) head fell on his(its) shoulder.

His(its) wife remained back in the Kärntner a 400-souls-village field churches - as carefree as earlier, when he had taken the steering wheel(ruler) still with hands. " She has always known that she marries an adventurer ", says Kelz.

One with fixed ideas. Since although Kelz mastered the life with prostheses so with the greatest of ease, he did not discharge from him what he names " my brain wave ". Already two months after the assassination attempt, at the night to the 28th of October, 1994, Theo Kelz sat down in the head to be able to feel again: the hair of his(its) woman(wife), the vibration of the steering wheel(ruler) on uneven streets.

" I knew ", he says, " that I needed an uncontrollable will, so that the almost impossible would also become true. "

Immediately in the other morning he wrote letters on a computer, with the first provisional prosthesis which he turned about the right stump and was fastened to which a small rod. With it he lashed out on the keys to convince more than 40 transplant physicians in Europe as his(its) idea: " Sews to me new hands in. "

After ten days came post(post office) from Innsbruck. " With the present state of the medicine ", wrote Raimund Margreiter, " I can do head of department of the university clinic, nothing for you. "

Just four years later other surgeons ventured the pioneer's act: in Edouard-Herriot-Hospital in French Lyons an international doctor's team to the New Zealander Clint Hallam transplanted the hand of a dead person. " From this moment in I had no more reflections ", confess Margreiter. Kelz travelled with his(its) daughter to Lyons. " Shake Hallam the hand ", he asked Andrea. " She Is warm actually? "

May one transplant hands? A risky intervention venture which gets life neither nor extends?

Transplant patients must swallow for life a medicaments-cocktail with high Cortison-interest. The substances suppress durably the immune system, so that the body does not push off the foreign(strange) organs. The risk to fall ill, with leukaemia, lymph glands cancer or cancer of the skin, rises clearly. And no doctor guarantees that the body does not get rid, nevertheless, in one, two or ten years of the foreign(strange) organ.

Only after hot-tempered discussions Margreiters team positioned itself behind the chief - first of all because Kelz both hands were absent(lacking)., never says Margreiter, he would have accepted an Einhänder whose new, foreign(strange) hand would be defeated daily compared to old, close(familiar). He would also have rejected a psychologically weak patient as an organ recipient. However, Theo Kelz is a personality with iron-hard will: " Somehow he also had the right(law) on new hands. So satanically how they have to him old weggehauen. "

On the 7th of March, 2000, policeman Kelz pushes just night duty, rings at half past three the telephone. In the university clinic Innsbruck lies a brain-dead potential donor. There were two false alarms already; this time everything seems to vote: the donor is a middle 40, has the blood group B and a similar stature. His(its) relatives have agreed to the hand withdrawal.

While Kelz falls in the narcosis, his(its) Mrs Fasching with the neighbors celebrates in field churches. " I have sent them(her) to the party ", he tells. " She had to be silent strict instruction. We wanted no bustle which would have endangered my lifetime dream. "

A few steps of Kelz the donor lies removed in the neighbouring operating theatre. A doctor's team prepares his(its) hands and lower arms, cuts through to muscles, veins, Long and nummeriert them(her). Next door another team prepares the stockings of Kelz.

Longer than 2,5 hours(lessons) the donor's hand should be not without body and oxygen apparatus - in a different way than one kidney which keeps, well rinsed, many hours(lessons). "Fortunately", says the responsible hand surgeon Hildegunde Piza, " the hands did not have to fly only on ice cooled by the helicopter through the country(land). "

The doctors work siebzehneinhalb hours(lessons). They(you) screw the lower arm bones, stabilize inch and spoke with titanium plates. They(you) sew two arteries, two big nerve fibres, twelve Bend and ten Strecksehnen, most time under the microscope. Besides, only the fingers of the operating surgeon move, his(its) wrist lies quietly proped up, he uses threads, finer than hair. Fabrics and blood vessels are absent(lacking) Kelz ' to left arm; the doctors improvise. From a piece bends becomes a Strecksehne.

When the policeman wakes up from the narcosis, he looks at fingertips which tower from the groups. He says " My hands ", immediately - decided, every question after the earlier, him unknown porter from the first moment to verdrän-

Gene. Lose only no thought to the fact that somewhere in Austria people(persons) run around to whom these hands, worked(worked the way up), have raged and have stroked, are familiar.

Fourteen days later Roswitha touches the new hands of their(her) man(husband) for the first time. He senses nothing. His(its) lifetime dream hangs on the lower arms like cold rags, he is more helpless than during the years with the prosthesis. Roswitha must feed him wash, with him on the loo. After a few weeks he can hold at least the spoon, " somehow purely with it in the gullet ". Bread he lies down on the back of the hand and pushes it from there in the mouth.

The recollection of his(its) old hands has no place in the family. " This is seven years ", says Roswitha. " A new life has started with my new hands ", he explains(expresses). Unforgettably the television evening, when the married couple on the sofa sits and paints them(her) to him over the fingers. Frightened he winces. For the first time he senses something again. " Then I have always put the hands under the shoulders ", says Kelz. " I just(exactly) wanted to notice how they take(accept) the warmth. "

To submit to the severe rhythm of the rehabilitation, the both rent a furnished house in Innsbruck. Two therapists are put down, only for Theo Kelz: six hours(lessons) daily, three in the mornings, three in the afternoon.

It is difficult, sometimes humiliating to recapture his(its) feeling to itself. Every day the nerve ends push only a millimeter forwards - to them(her) penetrate into the fingertips, years can pass.

But Kelz has reached already a lot. In the seclusion of the clinic cellar the physiotherapists have their(her) spaces(rooms). Before a small table sits meistumhegter patient of Austria, the right hand lies loosely on the white plate(record). Left, bended, supports his(its) head. His(its) eyes are concluded(closed), he looks highly concentrated.

Kelz should feel surfaces(environment) without seeing them(her). The therapist Carla Kaiser drives pasted panel with his(its) right forefinger about a quadrangular, with a blue carpet rest. " This is a surface(environment) 1, Mr Kelz ", says the therapist. " What you feel? " He answers: " Softly, from fine structure. "

Carla Kaiser is satisfied. She holds out to the patient the surfaces(environment) two to five: parquet, sisal, a wood piece with baby powder, Noppen. Kelz considers: " Hardly, coarser structures, surface(environment) 3. Here this is soft and slippery, surface(environment) 4. " Then she outsmarts him and moves his(its) finger about a square with emery paper with which he has not practiced up to now. Kelz answers quickly: " carpet, surface(environment) 1. " She says no laughing, he hums disgruntled: " There they have put to me a cuckoo's egg in the nest. "

Kelz erfühlt five differently firm(fixed) éponges, ertastet the size of Bauklötzchen and recognizes the distance between thumb and forefinger while taking different subjects.

" How you have recognized it? ", asks Clara. " By the stretch of the thumb folds ", grummelt Kelz.

At the beginning, when Kelz still sensed nothing, also no pain, the therapists moved his(its) fingers only with the biggest caution. " We could not estimate whether the Immunsuppression has an effect on the nerves and Sehnentätigkeit ", says senior physician Marina Ninkovic, the leader of the physical medicine. " We could only anticipate how strongly we might move the joints without tearing longing. "

The brain of the patient must only rediscover his(its) hands. During six years it conceived and sent no signals to steer movements of the hand. How a computer is programmed again. Kelz must learn step by step to plan his(its) movements in the detail - and at the same moment the impulses in the lower arm musculature suppress with which he steered for years his(its) prosthesis.

" If Mr Kelz liked to take a mug, he must introduce himself exact, when the finger meets the mug border what he must do with arm and hands to lift vertically the mug where the hand is, his(its) shoulder and his(its) elbow ", explains(expresses) the therapist Maria Barbach. If he wants to hold the hand before the belly, he must plan the movement in a different way, as if he reaches on the right or to the left of the body for the mug.

For the neurologists in the university clinic the unusual patient is a present. With his(its) help they want to investigate what happens in a brain, before movements run off(expire) as automatically. With a picture-giving procedure which makes the activity of nerve cells visible with magnet waves, they could show that two zones grow in Kelz ' brain since beginning of the therapy. They(you) are evident for the movement image and movement execution responsible. Already four weeks after the operation the "image zones" were visible again - although Kelz could not move his(its) fingers yet.

Meanwhile, after 1680 hours(lessons) physiotherapy, Theo Kelz can serve again independently a telephone. He can write E-mails, itself with a nail snapshotter the nails cut, money of the purse sort out. He has enclosed enough force to drink from a full half liter-glass, if he it with both hands.

He must also not shave any more as awkwardly as still a few weeks ago, when he to be able to scrape strong, with which a hand the other led which held the razor. And since he can distinguish again warmly and coldly, he does not burn himself any more so quickly. He notices if he has reached the deepest point with the doorhandle, and does not press farther downwards. If it hapert, he knows himself to help: in the grasping of the pants zipper he has attached a keyring - he is fine-motor light to serve.

" The Innsbrucker patient ", the doctors name him, is considered(applies) as a sample man. His(its) videos circulate on congresses and conferences. 56 days after the operation he fought successfully against a repulsion reaction. He himself lays, quickens by the unexpected rehabilitation, the slat much higher: instead of forecast 60 to 65 per cent he wants to recapture at least 80 per cent of the natural functions of his(its) hands.

Since beginning of April the policeman sits again in his(its) desk in the Klagenfurter application place. He continues his(its) finger exercises: he coaches every day with two physiotherapeuts who have prepared with Carla Kaiser and Maria Barbach in a fast course for the case Kelz.

The first motor cycle trip with new hands should go to Innsbruck - as a present to his(its) doctors and therapists. He would like to carry a ring again in the rights(laws), to the silver wedding feels able next year, with the Kelz, up to now only state-official, his(its) woman(wife) to the altar wants to lead. Roswitha, he says, this has really earned itself. And then he wants to travel to Australia, to the single continent on which his(its) BMW has not rolled yet.

And if his(its) body wants to get rid of the foreign(strange) hands somewhere between koalas and Kängurus? " I can not live with the subjunctive ", he says.

The New Zealander the Hallam which had done so many hopes as the first person with a transplanted hand to the assassination attempt victim Kelz, has visited him some months ago in Innsbruck. Shortly after Hallam the hand was taken again. The man(husband), his(its) doctors criticize, has been an unreliable patient who has not swallowed his(its) medicaments regularly.

Hallam, a condemned swindler, and policeman Kelz went eating pizza in Innsbruck. " He was terribly unhappy ", says the Kärntner. " Which person with intact hands can already understand his(its) pain? He has not got to outwit his(its) immune system. Perhaps he simply lacked wills. "

The policeman considers. " I, anyhow, ", say he, " does not want to direct about him. "






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