Editor’s note: George Hampton worked in Carville as part of the United States Public Health staff from 1963-65 and then again from 1974-77. In his second tour of service he worked with Dr. Paul Brand as Department Head of Orthotics and Prosthetics. He recalls his period working with Dr. Brand as one of the most memorable of his career. He shares here some of his recollections of Dr. Brand. This vignette is part of George’s as yet unpublished manuscript, Remembering Carville. I regret never meeting Paul Brand or his wife as so many mention them fondly. George’s vignette gives us an insight on Dr. Brand’s impact on HD care.
PAUL WILSON BRAND: A LIFE WELL LIVED SERVING HD PATIENTS IN INDIA AND AMERICA
Twenty years older than me, Paul Brand was, internationally at least, part of that "greatest generation" that saved democracy when they prevailed in the Second World War and later tackled problems on the home-front with the same intensity. Born of missionary parents in Tamil Nadu, India in 1914, years later he completed medical training in London as the war began. Some of his surgical qualifications were earned while working as a trauma surgeon in the London Blitz.
After the war, Paul and Margaret Brand (they had met and married while in medical! school) returned to India to teach surgery and to practice at the Christian Medical College and Hospital in Vellore. He became a pioneer in the budding specialty of reconstructive hand and foot surgery. Margaret, an ophthalmologist, did eye surgery. Together they improved the lives of countless HD patients.
Many physicians treating HD in the 1940s and 50s in India and other countries, including some in the US, considered deformities, infections and loss of hands and feet to be a direct and inevitable result of the effects of the HD bacillus. After documenting loss of protective sensation in large numbers of patients, Dr. Brand realized the bacillus didn't "weaken" the tissue and lead directly to foot or hand infection and amputation. But It did damage some motor, sensory and autonomic peripheral nerves in the extremities.
A keen observer with a sharp, analytical mind, Dr. Brand saw that some of his patients did not experience skin damage and ultimate loss of digits, feet or hands. This led to his conclusion that it was the caregivers' failure to adequately protect the patient's skin from the stress of rubbing or friction that led to this loss, and just as important, the patient's failure to follow the caregivers' directions. These observations revealed that achieving long-term benefits from reconstructive surgery required surgeons, nurses, PTs, OTs, Orthoptists, Prosthetists and patients to work closely as a team to overcome the loss of protective sensation and prevent amputations.
Numerous awards for his outstanding achievements and contributions to professional and lay literature were given to Dr. Brand. The most unusual one came in 1961 when Queen Elizabeth II knighted him a CBE (Commander of the British Empire) and bestowed the title of Sir Paul Brand in recognition of his promotion of good relations between the Republic of India and Great Britain. A gifted but humble man, Dr. Brand inspired me to do my best. He continued his service at Carville after I left. Nine years later he retired from his position as Rehabilitation Branch Chief and senior surgeon. He and Margaret lived in Seattle near children and grandchildren until his death in 2003. My dose professional association and friendship with Dr. Brand was one of the most rewarding times of my life. It was the first and only time my boss had been knighted by the Queen of England. The reader is encouraged to look online or in the library for additional information about this remarkable man.