Hand of Hope, Warning Shows a graphic picture

This is a pretty amazing story,


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 U.S. paper which published it, you
probably would never have seen it.

The picture is that of a 21-week-old unborn baby named Samuel Alexander Armas, who is being operated on by 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 he 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 Samuel, the little guy reached his tiny, but fully developed
hand through the incision and firmly grasped the surgeon's finger. 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 pregnancy isn't about disability or an
illness, it's about a little person" Samuel was born in perfect health,
the operation 100 percent successful. Now see the actual picture, and it
is awesome...incredible....and hey, pass it on! The world needs to see
this one



Take a good look at this picture. It's one of the most remarkable photographs ever taken. The tiny hand of a fetus reaches out from a mother's womb to clasp a surgeon's healing finger. It is, by the way, 21 weeks old, an age at which it could still be legally aborted. The tiny hand in the picture above belongs to a baby which is due to be born on December 28. It was taken during an operation in America recently. It is a medical development in the control of the effects of spina bifida ... and on a picture which will reverberate through the on-going abortion debate here

Your first instinct is to recoil in horror. It looks like a close-up of some terrible accident. And then you notice, in the center of the photograph, the tiny hand clutching a surgeon's finger.

The baby is literally hanging on for life. For this is one of the most remarkable photographs taken in medicine and a record of one of the world's most extraordinary operations.

It shows a 21-week-old fetus in its mother's womb, about to undergo a spine operation designed to save it from serious brain damage.
The surgery was carried out entirely through the tiny slit visible in the wall of the womb and the `patient' is believed to be the youngest to undergo it.
At that age the mother could have chosen to have the fetus aborted. Her decision not to, however, led to an astonishing test not just of medical technology, but of faith.

Samuel Armas has spina bifida, which left part of his spinal cord exposed after the backbone failed to develop.
The operation was designed to close the gap and protect the cord, the body's motorway for nerve signals to the brain.

So, on an unborn patient no bigger than a guinea-pig, the operation was performed without removing the fetus from the womb.
The instruments had to be specially designed to work in miniature. The sutures used to close the incisions were less than the thickness of a human hair.
An ER-style crash-cart team was on constant standby in an adjoining room.
When it was completed, however, Samuel's battle for survival was only just beginning. Nor would the emotional battle his parents had already endured finish quite yet.

Julie and Alex Armas had been trying desperately for a baby. Julie, a 27-year-old nurse, had suffered two miscarriages before she became pregnant with the child they intended to call Samuel Alexander if it was a boy.
Then, at 14 weeks, she started to suffer terrible cramp. An ultrasound scan was carried out to show the shape of the developing fetus and its position in the womb.

When the picture emerged, it was the moment that every parent-to-be dreads. Their unborn son's brain was mis-shapen and his spinal cord was sticking out from a deformed backbone. He had spina bifida. They were devastated and ``torn apart'' said Alex, a 28-year-old jet aircraft engineer.
At that stage, and even weeks later, the couple could have decided to have the pregnancy terminated. In their home town of Georgia in the US as in Britain abortion is routinely offered. Although accurate figures are not available, many parents accept. For Julie and Alex, who are deeply religious, it was not an option.

That didn't mean, of course, that they were not racked by pain at the thought that the child they had longed for was imperfect.
It also riddled them with guilt over whether they had effectively taken the decision to inflict their son with years of handicap, pain and suffering.
So, this being the United States, they turned to the internet for help.
Julie's mother found a website giving details of pioneering surgery being carried out by a team at Vanderbilt University in Nashville, Tennessee. Although the results have not yet been endorsed in medical journals, they looked encouraging to Mr. And Mrs. Armas.

Their doctor put them in touch with Dr. Joseph Bruner (it is his finger in the photograph). A race against time had begun.
Because it affects the spinal cord, spina bifida can lead to a condition that causes brain damage. Mr and Mrs. Armas were told that if they were to avoid the condition, which was not then present in Samuel, they had to act fast.
``I wasn't concerned about a child who couldn't walk,'' said Julie, ``but I want a child who knows me.''

The theory behind the surgery is that attention to he spine disorder before the baby is born prevents or limits brain damage, and gives a better chance of healing. It does not cure spina bifida, but it is said to provide a strong chance of limiting the damage through early intervention.
The risks, however, are enormous. Controversy surrounds the use of such surgery because it goes against the general medical rule that the risk should not outweigh the benefit.

Mr and Mrs Armas were fully aware that if anything went wrong, no attempt would be made to deliver Samuel by Caesarean section.
Medical science does not yet have the capability to keep a 21-week-old fetus alive outside the womb. The crash-cart was on standby for Julie, not Samuel.
``If he dies, that's horrible for me and for us,'' said Julie before she went into there. Wiping tears she added: ``But not for him. The worst thing might be if we don't do this, and this is standard treatment when he's 21, and he says: ``Why didn't you know about that?'' And we say: ``We did, but we didn't do it for you.''

The other major dangers were turning him in the womb to get his back in line with an inch-long cut in the wall, through which Dr Bruner would operate, and that the surgery might involve releasing the fluid around Samuel.
The movement posed the risk of sending Julie into labor contractions, which would have been fatal for Samuel.

Thus, one morning at the beginning of last month, Dr Bruner could be heard urging his team to keep quiet. ``Shh!'' he said. ``You'll wake the baby!''
Robert Davis, who reported on the operation for USA Today newspaper, said the lesion that exposed Samuel's spine was found low on his backbone, decreasing the chance of nerve damage.

Although Samuel is believed to have been the youngest patient for such an operation, it was apparently routine enough for Dr Bruner and pediatric neurosurgeon Noel Tullpant to talk about the weather during the operation.
An hour later, the womb is gently eased back into place. ``Beautiful,'' said one of the technicians and relief swept the room.

Julie was allowed home with Alex within days. The baby is due on December 28.
He has not yet felt the touch of his mother's skin against his own and he knows nothing of life outside her womb. But perhaps Samuel Alexander Armas will be able to shake Dr Bruner's hand again.


Update

Many people have written asking what happened to Samuel. Happily, both Samuel and his mother are doing well. Below is the letter that Samuel's mother sent out after his birth.



Dear Friends and Family,

Samuel arrived on Thursday, Dec. 2 at 6:25 pm at Northside Hospital weighing 5 lbs 11 oz and 20 1/2 " long. He was born at 36 weeks but came into the world screaming his head off! He did not have to spend any time in a neonatal unit and came home with us on Monday, Dec. 6. After viewing an ultrasound of his brain, Samuel's neurosurgeon was very optimistic as he does not have any hydrocephalus and the brain malformation has resolved. He is moving his legs very well from the hips and some from the knees. He was frank breech (folded in half) in the womb and the orthopedist feels that he has a good chance for walking. He will begin physical therapy next week in order to work out some of the stiffness in his legs that was a result of his being folded in half in the womb. He is also nursing very well.

Thank you all for your prayers and support. We are happier than we ever dreamed possible!

All our love,
Julie, Alex and Samuel Armas

[littleoldman2]

Very touching

[MisterTommyH]

Amazing.

That's quite a story and quite a photo. Hats off to that surgeon.

[dizzyblonde]

The picture is very touching indeed, but for me, although an amazing story, its also a little disturbing, looking at it from a maternal view.

Having surgery to 'perfect' a child with the risk of dying? Or going ahead with a normal pregnancy and the baby not have a particularly normal life.....a very very difficult decision indeed.

[littleoldman2]

Originally Posted by dizzyblonde

The picture is very touching indeed, but for me, although an amazing story, its also a little disturbing, looking at it from a maternal view.

Having surgery to 'perfect' a child with the risk of dying? Or going ahead with a normal pregnancy and the baby not have a particularly normal life.....a very very difficult decision indeed.

Must have been a lot of soul searching and sleepless nights

[dizzyblonde]

Originally Posted by littleoldman2

Must have been a lot of soul searching and sleepless nights

I can only draw from my own experiences of two difficult pregnancies, especially the second, that the womans life would have been tipped upside down and back to front.

But dizz, they weren't trying to make the baby perfect just healthy, either way they had a whole heap of luck that day.

[dizzyblonde]

I think you miss my point BFM. To have surgery to give your child chance of survival, is a form of 'perfecting' to me. In days gone by people were left to hope for the best, technology today gives couples 'hope', and a diffcult decision to make. I'm not sure what I would do in the situation. Being given the choice of emergency C section or Oli would possibly die, was flippin gut wrenching.

They had a whole load of luck, and someone was watching over them.

It was taken during an operation in America recently. It is a medical development in the control of the effects of spina bifida

It shows a 21-week-old fetus in its mother's womb, about to undergo a spine operation designed to save it from serious brain damage.
At that age the mother could have chosen to have the fetus aborted. Her decision not to, however, led to an astonishing test not just of medical technology, but of faith.

Samuel Armas has spina bifida, which left part of his spinal cord exposed after the backbone failed to develop.
The operation was designed to close the gap and protect the cord, the body's motorway for nerve signals to the brain.
Julie and Alex Armas had been trying desperately for a baby. Julie, a 27-year-old nurse, had suffered two miscarriages before she became pregnant with the child they intended to call Samuel Alexander if it was a boy.
Then, at 14 weeks, she started to suffer terrible cramp. An ultrasound scan was carried out to show the shape of the developing fetus and its position in the womb.

When the picture emerged, it was the moment that every parent-to-be dreads. Their unborn son's brain was mis-shapen and his spinal cord was sticking out from a deformed backbone. He had spina bifida. They were devastated and ``torn apart''

That didn't mean, of course, that they were not racked by pain at the thought that the child they had longed for was imperfect.
It also riddled them with guilt over whether they had effectively taken the decision to inflict their son with years of handicap, pain and suffering.

It is absolutely amazing what surgeons can do now and of course the operation, like all operations, was a risk to the baby and mother and this one particularly high risk for both. My sister was born in 1963 at 23 weeks weighing just 2lb, a week or so after the test for both spina bifida and hydrocephalus but the results were not known at the time of her very early birth. The doctors really didnt hold out much hope that she would survive the night, with the permission of my parents, called in the hospital Chaplin to have her christened. My sister survived and took life in her stride, having a major operation each year due to complications of her condition until the age of 16. After that she enjoyed many years of a normal life, learned to drive, moved out of the family home into her own adapted flat, finding love (short-lived sadly) and was co-founder of a small, local charity to assist disabled adults to enjoy outings, bbq's and other social events. Partly due to being wheel chair bound and her condition, my sister kidney's were a constant worry with stones and infections and it seemed that the visits to hospital were again taking up much of her life. 20yrs ago, after renal failure, she was lucky to receive a kidney transplant which transformed her life immensely - life for her was normal again. In November 2009, her renal system began to fail again and the only option was dialysis followed by a transplant. She called me a week before her 46th birthday to say she had won the lottery, another donated kidney - the family were so pleased. The second transplant went well, all working fine. We received a call on NYE from the hospital that my sister had been rushed into hospital with renal failure. Sadly, following 12wks of tests and operation, my sister passed away.

Sandra would have marvelled at the operations that can be done on pre-birth children, especially if their lives can be made more normal and fulfilling and I know if she was put in the same position, she would have permitted the operation in the knowledge that her life was great and full, but could perhaps offer a greater life and more fulfilling.

Sorry for the life story, its the first time I have mentioned it outside the family and I am very proud of the battles she fought, the work she did and the people she made happy. RIP Sandra.