Lives & Limbs – Ancient History

My series of articles inspired by Nicole Ver Kuilen‘s visit continues.

I noticed over Thanksgiving that a lot of TV channels seemed to be embracing “Throwback Thursday” by airing old but awesome episodes of their most popular shows. I’m a few days late to the party, but I thought that this would be a good opportunity to highlight a couple of fascinating figures from our distant past.

The Original “Iron Man”

Iron artificial arm, 1560-1600.

We have evidence of prosthetics being used by the ancient Egyptians, but the first documented example of a prosthesis being worn to restore function to an amputee was a metal arm worn into battle by the Roman General Marcus Sergius Silas, who lost his right arm while fighting in the Second Punic War, which took place from 218 to 201 B.C.E. We don’t know how it came about, but Sergius managed to obtain an immobile prosthetic arm made of iron, which he attached to his residual limb with leather straps. His prosthesis allowed him to wear his shield again, so he returned to active duty, where he served with valor and distinction in many battles.

He was wounded almost thirty times over the course of his career. At the time, the mortality rate for soldiers wounded once in battle was north of 80%. Sergius not only survived, but he quickly returned to the front lines each and every time. His iron limb and incredible durability made him famous, and people eventually gave him the nickname Ferrous, which is Latin for “made of iron.”

Sorry, Tony Stark. Marcus Sergius was the original Iron Man.

Sergius’ reputation for dedicated military service eventually earned him a place in public politics, where he served as a Roman Praetor. He faced a certain amount of adversity while in office because of his amputation, with several of his colleagues attempting to bar him from taking part in public ceremonies because of his perceived “deformity.” Sergius was apparently quite successful in defending himself against his detractors, which probably makes him the world’s first advocate for the rights and dignity of amputees.

The World’s First Prosthetist Was a Barber

#2 - Pare Prosthetics

If you were unfortunate enough to need surgery in Europe during the Middle Ages, you wouldn’t have gone to see a doctor. Doctors at the time considered surgery to be barbaric practice that was beneath the dignity of their profession. If you needed surgery done, your local barber had the sharpest blades and the surest hands in town and was often trained to use them for medicine as well as shaving. Ambroise Paré, a barber who served in the French military during the mid to late 1500s, is widely considered to be a founding father in the fields of surgery and prosthetic care.

Paré is particularly celebrated in prosthetics circles for his ground-breaking work in the field of amputation surgery. He popularized the use of ligatures to repair severed arteries and developed an ointment that promoted healing in wounds, both of which greatly improved the survival rate of veteran amputees. Unfortunately, Paré’s brilliant new treatment methods weren’t enough to save all of his patients. Many of the soldiers that he had worked so hard to save on the battlefield later chose to take their own lives rather than live without their amputated limbs.

Horrified and saddened, Paré decided that it wasn’t enough to simply heal an amputee’s wounds or fill the space left empty by their missing arms and legs. If he truly wanted to save lives, he needed to restore a sense of wholeness and function to his patients. With this in mind, he was the first to take a holistic approach to managing prosthetic care. He also created the first artificial leg with a working knee joint as well as the first artificial hand with articulated fingers. Many of his designs are actually still in use today.

I don’t necessarily recommend that you let your barber perform your next surgery, but I would invite you to recognize and celebrate the achievements of this one barber in particular. As a surgeon, a scientist, and a humanitarian, Ambroise Paré was a cut above the rest.

Lives & Limbs: A Celebration of Prosthetic Advancement and Amputee Achievement

I recently had the pleasure of being visited in my office by an impressive young woman by the name of Nicole Ver Kuilen. Nicole has been named as the inaugural Health Policy & Advocacy Fellow at the National Association for the Advancement of Orthotics & Prosthetics (NAAOP), having lost her left leg to cancer at the age of ten. As she grew older, Nicole’s desire to be an athlete brought her new challenges. Obtaining a prosthesis that could meet her needs was difficult, as was navigating the financial complexities that often come with seeking prosthetic care in our country.

Nicole found herself asking a lot of questions during her sixteen years as an amputee: Why is prosthetic care so time consuming and expensive?  Why are all but the most basic of prosthetic devices often deemed “cosmetic” or “convenience” items by insurance providers? Why are people who lose their limbs under certain circumstances afforded better access to care than amputees like her who lose limbs to things like cancer? Nicole’s quest for answers led her to take a 1,500 mile jog down the west coast to raise public awareness of the issues facing American amputees. Her journey has been recorded in a documentary called 1,500 Miles, which she has used to take her message to our elected leaders in Washington and demand change.

Nicole’s story, thought leadership, drive, and sprawling list of accomplishments were a great reminder that amputees are often some of the most determined, hard-working, and impressive people around. The history of prosthetic care is packed with fascinating accounts of people like Nicole who overcame tremendous odds to make important and impactful contributions to society. Those contributions were made possible by others who saw the dignity and worth of amputees and developed the technologies and medical procedures necessary for them to live their lives to the fullest.

Inspired by Nicole’s visit, I’ll be presenting a list of people (in no particular order) who have  changed the way we look at amputees and the prosthetic care that they rely on. I’ll introduce you to a couple of people every few days until I make it through my material, so check back often!