Hands healing hearts—and bodies

Buried in the middle of Mark N. Perlmutter's curriculum vitae, in the section labeled "Medical and Scientific Societies," is a line that reads, "Hands Healing Hearts, Medical Director." It doesn't sound like anything extraordinary, wedged as it is between his memberships in national and state medical societies-until you understand what the organization represents, and the great lengths to which this Hazleton, PA, surgeon has gone to foster its mission.

The remarkable part of Perlmutter's life story-the part that doesn't leap out from his CV-starts in 1992, when he and his wife, Karen, traveled to Mexico to adopt a child. In fact, Perlmutter performed surgery on the boy he later adopted. "It cost 35 cents for plaster to fix his club foot," he recalls.

Seeing the tremendous need, Perlmutter founded "Hands Healing Hearts International" (HHH), an organization whose volunteer medical teams travel to Ecuador, Mexico, and, recently, Peru to correct overwhelming congenital, traumatic, and developmental deformities of the face, hands, and feet. Karen Perlmutter had been a fundraiser for the American Heart Association and her expertise was invaluable when the couple decided to structure Hands Healing Hearts International as a nonprofit organization. This expedited fundraising since donations are tax deductible.

For the first few trips, Perlmutter and his team of physicians, nurses, and nonclinical support people operated on about 20 children and adults. Now, they operate on 275 people during the same one-week period. The size of the team varies from the teens to nearly 30, depending on the surgical focus of the trip and the volunteers available. HHH teams have returned to Mexico many times since 1992, and Perlmutter added trips to Ecuador after operating on several Ecuadorians during his hand fellowship in Miami. "I asked one patient, 'Why did you come here?' She replied, 'There's no one there who can do it.' I saw that as an opportunity."

Perlmutter did some research and discovered that there are many congenital deformities among Ecuadorians, few of which are corrected surgically. Contributing to the problem, generations of consanguineous marriages have produced mutations and birth defects with such penetrance that even people who aren't related carry the genes for birth defects. "I've amputated at least 10,000 accessory digits," Perlmutter says. "I've fixed 50 radial club hands. I've operated on more birth defects in any one day in Ecuador than I'll see in three years of practice in the US."

Training local doctors is a primary goal

Teaching local surgeons orthopedic and plastic surgery techniques is as important to Perlmutter as the surgical procedures he and his HHH team perform. "We're their CME," he says. In addition to surgeons, the team also trains local nurses and physical therapists. This way, much-needed care can continue well after the HHH team departs. Their goal: to "put ourselves out of business" at any given hospital within five years.

Besides the training, "we provide them with computers, Internet access with digital cameras, fax machines, and textbooks," says Perlmutter. He spends hours answering e-mails and looking at faxes. "There isn't a night that goes by that I don't have tracings of a hand or a laceration and a drawing of an advancement flap with comments as to how the surgeon would close it. Or, I might receive a photo of a defect asking me what surgical approach I'd use and the appropriate timing of it, given the patient's history.

"What's really rewarding: Now I'm getting secondary faxes from some doctors, saying 'No, I disagree with you. I think I'm going to try this instead, because it has worked better for me in the past.' "