In good hands: RGGGH pushes language barrier to renew hopes of a Bihar worker

CHENNAI: It was a race against time for a team of doctors at the Rajiv Gandhi Government General Hospital (RGGGH) for a rare and complex cross-hand replantation surgery. And, one of the main hurdles to overcome was the language barrier, as the patient was a migrant worker from Bihar with no one to assist him with translation.

The groundbreaking achievement was a masterclass on innovation, communication, compassion and most importantly, dedication. The surgery was the first instance at a government facility and just the fifth time it has been performed globally.

When 28-year-old Dharmendra Raj, a migrant worker from Bihar, was rushed to Rajiv Gandhi Government General Hospital (RGGGH) after a train accident near Park railway station on September 26, he had lost both his arms, one crushed beyond repair and the other severely mutilated. With no family member or attendant by his side and unable to communicate in Tamil or English, it was a race against time for doctors not only to save his life but also to help him understand an extraordinary surgical decision that could give him back one functioning hand.

The hospital's Plastic and Reconstructive Surgery Department, led by Dr B Rajeshwari, decided to attempt a cross-hand replantation, attaching Dharmendra's amputated left hand to his right forearm stump.

"As both hands were damaged, we couldn't reattach them in their original positions. The left arm was crushed near the shoulder, while the right had lost all fingers. So, we decided to use the undamaged parts from the left hand to restore the right," said Dr Rajeshwari, HoD (in-charge) of the department.

However, before proceeding, the doctors faced an unexpected challenge — language. "He was from Bihar, didn't have an attendant, and couldn't speak Tamil. We needed to explain the complex procedure, take his consent, and ensure he understood every detail," she told DT Next.

With the help of postgraduate students and residents from Hindi-speaking states, the team managed to communicate the entire surgical plan in Hindi.

"As he couldn't sign due to the amputation, we obtained oral consent, later documented with the approval of the Dean and Medical Superintendent," Rajeshwari added.

The 10-hour marathon surgery, conducted by a 14-member multidisciplinary team, involved intricate skeletal fixation, tendon reconstruction, and microsurgical repair of arteries, veins, and nerves. Once blood flow was re-established in the replanted hand, the team witnessed immediate signs of success.

Under the guidance of Dean Dr Shantharaman, the surgery was carried out by a team of skilled surgeons, including Dr U Rasheedha Begum, Dr V S Valarmathy, Dr V Swetha, and residents Shonu, Annapoorani, Vigram, and Santhoshini.

"This is the first-ever cross-hand replantation in a government hospital in India and the second reported in the country. We are proud that our hospital has achieved this milestone without considering the cost or coverage limitations," she said, noting that Dharmendra was not eligible for either the CMCHIS or PMJAY insurance schemes.

Despite initial depression and trauma, Dharmendra is now recovering well. "We provided psychiatric counselling, and physiotherapy has already begun. Anatomically, the continuity has been restored. With consistent therapy, functional recovery will follow as his brain reorients to the new hand," she explained with pride.

The hospital's humanitarian approach has drawn appreciation from across the medical fraternity. "We didn't think about expenses. He came to us for help, and it was our duty to give him the best possible care," said one of the surgeons.

Now, as Dharmendra regains strength, he holds a new story of survival, one shaped by science, empathy, and the power of understanding beyond words.