Paul Wilson Brand

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Dr. Paul Brand (1914 - 2003) was a pioneer in developing tendon transfer techniques for use in the hands of those with leprosy, now known as Hansen's Disease. He was also the first to appreciate that it was the insensitivity of the tissues in those with Hansen's Disease that made them susceptible to injury. He contributed extensively to the fields of hand surgery and hand therapy through his publications and lectures,

He was the son of missionary parents (Jesse and Evelyn "Granny" Brand) and lived in Southern India until he was sent home to the United Kingdom for education. In his books he gives vivid descriptions of his time in India as a boy with its regular bouts of dysentery and malaria. His father died in 1928 of malaria after Paul's return to the UK in 1923. Paul trained in Medicine at University College Hospital during the Second World War, and later gained his surgical qualifications whilst working as a casualty surgeon in the London Blitz.

In 1946, he was invited to join the staff of the Christian Medical College & Hospital in Vellore, India. After a visit to the Leprosy Sanatorium at Chingleput, a government institution that was at the time under church management, Dr. Brand was motivated to explore the reasons for the deformities developed in those with Hansen's Disease. After careful observation and research, he came to understand that most injuries in Hansen's Disease patients were a result of the pain insensitivity they experienced and not directly caused by the Hansen's Disease bacilli. In 1950, with a donation from a missionary woman, Dr. Brand established the New Life Center, Vellore, as a model rehabilitation center for Hansen's Disease patients. The center was a village environment located at the residential area of the Christian Medical College campus. This helped dispel the stigma that was so prevalent even among medical professionals. Correcting deformities to restore the self-respect of patients and to integrate them into society was his cherished goal.

In 1966, after 19 years of service in India he moved to the U.S.A. on invitation to take up the position of Chief of Rehabilitation Branch at the National Hansen's Disease Center at Carville. He worked there for 20 years and established a well-equipped and well-staffed research unit to study the complications of insensitive hands and feet, their prevention and management. His methods for prevention and management of plantar ulcers are now extensively used for treatment of patients with diabetes mellitus who have similar problems. Dr. Brand also popularized the technique of serial casting for the finger deformities (flexion contractures) that often result from Hansen's Disease, a technique that is now widely used by hand therapists to treat contractures due to many different hand injuries and conditions. When he retired in 1986 from the U.S. Public Health Service, he moved to Seattle and continued his teaching work as emeritus professor of Orthopedics in the University of Washington.

During his career, Dr. Brand received many awards and honors. He was awarded the Hunterian professorship of the Royal College of Surgeons in 1952, and the Albert Laskar award in 1960. Queen Elizabeth honored him with a title of the Commander of the Order of the British Empire in 1961. He served as President of the Leprosy Mission International based in London and was on the Panel of Experts on leprosy of the World Health Organization. He was one of the main architects of the all Africa Leprosy Rehabilitation and Training Center in Addis Ababa, Ethiopia, and the Schieffelin Leprosy Research and Training Center at Karigiri, India. He was an honorary member of the American Society of Hand Therapists, in recognition of his many contributions to the field. A biography was written on him entitled, "Ten fingers for God," by Dorothy Clarke Wilson.

His appreciation of the importance and value of pain is well described in his book Pain: The Gift Nobody Wants. He saw pain as vital for the preservation of healthy tissue in anyone leading a normal life and he gives horrifying descriptions of the results of insensitivity in those with Hansen's Disease or congenital absence of pain. He goes on to question the pursuit of pleasure in Western Society and offers practical ways to ameliorate the effects of pain.

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