Clint Hallam used to dream. about the day limb transplants would be possible. An amateur piano player and former truck driver, the New Zealand native had lost his right hand in an accident in 1984 while serving time in prison for fraud. Years later, in a groundbreaking operation, he would gain a new hand, but in the process, he almost sacrificed everything else. "I've lost perspective," says Hallam, 50. "I put my family through hell."
Hailam had become instantly famous in September 1998, when an international team of surgeons in Lyons, France, grafted the hand of a 41-year-old accident victim onto Hallam's forearm, making him the world's first successful hand-transplant recipient. But that medical triumph ended with a whimper of defeat on Feb. 3, when, at Hallam's urging, the hand was amputated in London. "It was putting the patient's life at risk," says Dr. Nadey Hakim, a member of the team that connected the limb and the one who removed it. "It had to come off."
The hand had functioned well enough in the first year that Hallam could perform such routine tasks as writing firmly, using a fork or holding a glass. But his body continually rejected the foreign tissue, causing severe pain. The cocktail of immunosuppressant drugs meant to stave off rejection also caused intermittent diarrhea, abdominal pains, heartburn and headaches. In recent weeks, the arm had grown so infected and swollen that it oozed puss and the skin came off in layers. It didn't help that Hallam often missed doctor's appointments, failed to attend physical therapy sessions and finally, last December, fed up with the side effects of the drugs, ceased taking them at all. "I just hope that the removal of my hand does not hurt medical science,' he said after the operation. "I doubt any other recipient would be as stupid and reckless as I have been."
The physical toll was only part of an ordeal that began in 1984 when Hallam severed his hand on a chain saw. Though doctors were able to reattach it, an infection developed, and in 1988 it was removed. Hallam says he was convinced that someday surgeons would perfect hand transplants. His search for those medical pioneers took another eight years, during which Hallam would leave his family for months at a time to meet with doctors and urge them to make the attempt. "Daphne had to be mum and dad, and the children had only a part-time father," Hallam says of his wife of 14 years and their daughters Stacey, now 10, and Sarah-Marie, 12.
Everything seemed to change when he awoke on Sept. 24,1998, with a new hand. "I looked at my bandages and saw fingers peeking out, and my tears flowed," he says. "It felt amazing to be able to put two arms around the ones I love." But problems quickly developed. Because of pending charges in Australia on a scheme involving prepaid cards used to buy gasoline, he had to apply for a special permit to rejoin his family at their home in Perth. Even then, he was not allowed to work. Also, the media said that as a felon he was unfit to have been given the transplant. "They wrote that the doctors had chosen the wrong person to help," says Hallam.
His one-time dream was devolving into a medical nightmare as well. The hand's condition grew worse, until even his wife wondered if it was worth it. "This is the most pain I have ever seen him in," Daphne, 38, said Feb. 1, "and to be honest, I can't handle it." Just as he had once sought out doctors to give him a hand, Hallam spent much of last year trying to find one to remove it. Finally Dr. Hakim agreed. "Of course I wanted the hand to stay on," he says. "But in the end, the health of the patient had to come before any research."
Although it had taken over 13 hours to attach the hand, it took 90 minutes to sever it. Hallam recalls how he had been able to play ball with his daughters and worries now that he has failed them. But Sarah-Marie is reassuring. "Dad will be the same person, with or without his hand," she says. "We just want to be normal kids and a normal family."
Michelle Coffey in London
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