For the surgeon, it was a breakthrough; the miner whose arms were restored called it ‘a miracle’
David Glenn Jackson, a 21-year-old zinc miner from Bloomington Springs, Tenn., first met Dr. Harold Kleinert a year ago in Louisville, Ky. It was a day neither will ever forget and one that will live in medical history.
That morning, while Jackson was working at the bottom of a mine shaft, a piece of sheet metal broke free from its rigging 1,000 feet above and plummeted down. As Jackson attempted to push a co-worker out of its path, the sheet sliced through his outthrust arms, cutting both off as if they had been guillotined. Jackson and his severed limbs were airlifted immediately to Louisville’s Jewish Hospital, 175 miles away, where Kleinert and two surgical teams worked for 12 hours. A landmark in the relatively new art of microsurgery, the reattachment operation was but another first for the 55-year-old Kleinert, an exquisitely gifted craftsman who was already widely acknowledged as the world’s finest hand surgeon.
“It wasn’t as difficult as it could have been,” the doctor recalls. “The sheet metal made relatively clean cuts.” His patient, who is expected to regain two-thirds normal use in each arm, is less dispassionate. “It’s a miracle,” marvels Jackson. “I thought they were lost—I figured I’d have stubs, that’s all.”
When Kleinert came to Louisville 25 years ago, he decided to specialize in the then almost ignored practice of hand surgery. Previously it was regarded as a hopeless field and relegated to the least experienced doctors. Kleinert had to develop not only new techniques but also instruments. They were mostly modifications of jeweler’s tools and, as he says, “It’s kind of like fixing a watch. It’s that delicate and exacting.” Reimplantation of digits or limbs can be done only with the aid of a microscope, zooming in on the tiny veins, arteries, muscles and nerves. The sutures—it takes up to 10 per vessel—are done with a thread one-tenth as thick as a human hair.
As the pioneer, Kleinert was on round-the-clock call, operating with two alternating surgical teams. “I would assist him every other night,” recounts a longtime associate, nurse Donna Hobbs. “He was there every night. There was no one else.” Then as now, Kleinert survives the long grind on diluted tea and coffee, snacks forced on him by the nurses, a quick massage by Hobbs and a few winks between operations. He guides his staff with an incredible calm, considering the long hours of relentless pressure. No one can remember his ever yelling or even getting excited. “Long ago,” he says, “I realized that if you got into a critical situation in the operating room, you would need a team that was ready to work, not one you’d gotten emotionally upset.”
So relaxed is the atmosphere that Kleinert and his colleagues even exchange off-color jokes. “You bet it bothered me,” reports one patient, who was under a local anesthetic and conscious during his operation. “Kleinert talks so low I couldn’t hear any of the punch lines.”
That is about the only complaint, and there is an extraordinary mutual respect between the surgeon and his patients, regardless of ability to pay. “What does it matter,” asks Kleinert, “if a patient is rich or poor? If he needs care, that’s all that matters.” For years Kleinert neglected sending out bills “unless the office or I needed money.” Then, at the behest of hospital officials who couldn’t collect from insurance companies unless he made out invoices, he hired a business manager to attend to such mundane chores. “Suddenly,” he exclaims, “I had money.” He invested his funds in farms, shopping centers and other real estate, and personally enjoys raising Black Angus cattle. But the ever-busy Kleinert laments: “I don’t get much farming done. It’s hard to see black cattle at midnight.”
Himself a product of a Montana ranch, Kleinert wanted to be a doctor from the age of 5. After a bachelor’s degree from the University of Michigan, he earned his M.D. at Philadelphia’s Temple University. Currently a professor of surgery at both the Louisville and Indiana medical schools, as well as consultant to a clutch of major civilian and military hospitals (and to the U.S. Surgeon General himself), Kleinert has written 88 research papers and trained 270 surgeons from around the world. Four of his former interns have joined his practice, and he and his teams perform 400 operations a month and see as many as 1,000 patients a week.
Kleinert’s schedule leaves him little time for his wife, Margaret, 54, and five children, 19 to 30, but they understand that for Dad the patient comes first. “There’s no price you can put on this,” says John Molinaro, 32, a former ranking U.S. weight lifter whose now partly restored nerve-damaged hand is one of Kleinert’s triumphs. “It’s the kind of thing you used to see on Marcus Welby,” glows Molinaro. “You don’t think it really exists until you see Dr. Kleinert.”