GRAIN VALLEY — Curtis Aubuchon had trouble getting the leech on his reattached finger.
Setting the worm on the chosen spot, it sat for a moment before curling up and dropping off. But with a monk's patience, Curtis carefully plucked up the worm with a pair of tweezers and set it on a pool of freshly drawn blood.
"There..." He paused, working steadily. "Come on."
His wife, Anita, looked on quietly. She had moved from the stool in front of him to the chair beside him a little further away.
"Is he on?"
Curtis nodded his head.
It's been a rough stretch for Curtis and his family. On a recent Saturday, he was out back mowing the lawn when his son, Zach, began asking him if he was going to work on his tree house. Finally Curtis agreed and set to work.
While laying down the floor, the power saw he was working with slipped and, as quick as a lightning strike, he cut off his index finger up to the knuckle.
"It was just one of those things not paying attention," he said with impossibly calm resolve. "It just happened."
When Zach told his mother what happened, she didn't believe it until she was forced to: Her husband holding his bloody hand and telling her through an impossibly calm voice what had happened.
"He wasn't freaking out or anything," she said. "He was calm, but I think that was for Zach. He didn't want to scare him."
Curtis nodded his head. The leech, meanwhile, remained where Curtis had placed him. Look close enough and one could see it pulsating.
Because the finger was still partially attached by a thin piece of skin, Curtis was spared having to look for it, which oftentimes creates more tension and more blood loss. Holding it up to his hand and pressing as hard as he could, the couple sped off to St. Mary's Medical Center six miles from their home in Grain Valley.
As with all amputations, negativity loomed. Most who lose a finger have about 13 hours to reattach it, but the concept of reattaching something as small as a finger felt impossible. While he waited in the emergency room with his finger placed on his stomach, nurses and residents stopped in to see him. One resident physician, Chris Halphen, stopped by, looked at it, and felt positive that the finger could be reattached.
Staff continued to search for a hand surgeon, but because it was the weekend, it was difficult.
Eventually they located Dr. Robert Paul, a general orthopedic surgeon. He listened to the story and visitors' impressions.
"They all felt there was still a good blood supply to the finger, and most everyone thought it could be reattached," Paul said.
X-rays were taken and sent to the University of Kansas Medical Center. Staff and physicians there determined the situation was dire and that reattachment was futile.
"I just knew I didn't want to lose my finger," Curtis said.
He was in the hospital for a total of six hours, three of which were spent in surgery. When he emerged, all signs pointed positive. Paul set the bone with a metal pin, sewed the tendons and repaired as best he could the digital nerves.
And the waiting game began.
Meanwhile, talk among hospital staff centered on post-op therapy and the most efficient means to get the finger back to health. Eventually, conversation focused on leeches and their ancient medicinal benefit, stretching back centuries.
Historians believe Egyptians used leech therapy 3,500 years ago to treat headaches, ear infections and swollen tissues. During the Middle Ages, leeches made a comeback before fading out. They found popularity again in the 1800s.
Paul said the practice isn't regularly used at St. Mary's, and few know to ask for it.
"Every 10 years or so," he said, adding that leeches are used more commonly following plastic surgery operations. "This time we felt we needed to."
The leech is useful for those reattached small parts of the body that contain many blood vessels. Blood clots can form easily in the veins that serve as a drain, and severe blood clots can cause the tissue to die because of oxygen and vital nutrient deprivation. Leech saliva is also a natural blood thinner and provides pain relief.
It was absolutely crucial, in Curtis' case, that blood flow from the tip of his severed finger be unobstructed.
"You hear about it in medical school, about people as far back as 800 B.C. using them for bloodletting," Halphen said. "I'd heard about it and seen it while I was on a plastic surgery rotation."
In 2004, the Food and Drug Administration classified both maggots and leeches as the first live medical devices, effectively restoring the reputations of both that had fallen in and out of favor throughout the centuries.
The process is simple: using a diabetic needle, Curtis pricks the skin on the finger and sets the leech down. It can be difficult getting the worm to stick in the right place, but once set, the leech remains there for anywhere from 20 minutes to eight hours. Once engorged, it falls away.
"In laymen's terms, the leech reduces pressure in the finger to allow blood to come in and out," Paul said.
Sitting with his arm on a pillow, Curtis grinned.
"It's not very pleasant," he said, looking down at his hand. "I'll be glad when it's over."
He recently had his last day of leech therapy and later met with Paul. All signs pointed positive. The next day, Curtis said Paul and staff were encouraged by what they had seen.
"It's going well," Curtis said. "(The finger's) doing what it's supposed to be doing. The leech worked."