Magisterial, as always. Thank you. Can you predict the future for us? There are some departments such as Penn and Stanford that have just started living donor hand transplantation programs. And I'm sure you're familiar with it. You must have been consulted about it. Can you give us your view of where that potentially very exciting work may be going? Thank you. Yes, I think it's going. Hold on one second. We're recording for posterity. So if you could come to the microphone. Can I set that down there? Yes, absolutely. I'll take that with you. That's a great question. And of course, I hear about these things. I don't read the literature like I used to, OK? Because I do many volunteers. volunteer things, particularly in North Carolina, and I'm more interested in why something's not growing at Daniel Boone Native Garden and what I've got to do to make it grow, or what's going on at my church, or at Listening Post in ASU, or something. But to answer you, I think that's wonderful, avant-garde thinking. It's not here yet, and you know it's going to take a lot, because transplanting a portion of the limb, the repairs of nerves are still not as good as they need to be, in spite of what you may think. They're really terrible, and Sir Sidney pointed out at the very end. Why is this? Because there's some basic processes here that you need to understand, and until you correct them or make them better, you're not going to be as far ahead as you'd like. Should a flail arm, should it be amputated and a prosthesis put in, and then some nerves like descending cervical plexus, or phrenic, or God only knows what, maybe a branch of the hypoglossal be brought down and implanted into what's left of the pectoralis major, if that's still there, maybe de-enervated, and have little spots where you can put electrodes and pick up from the patient thinking about it, especially if they're retrained, to make something work on that prosthesis that works better. Yes, yes, yes, but that's where I think a lot of the future lies, and there are now six, I think, in our country, heavily funded places that are doing that type of research. I was just telling you about some of the University of Michigan work because that's what I'm most familiar with since I lived and worked there for some years, but even there, I think you'd have to look ahead maybe 20, 30 years before you're getting much, and I wish, you know, I wish less of the brachial plexus injuries were due to high-speed stretch, head one way, neck and arm another way, in a way I wish they were all gunshot wounds because you can do a lot more with those, believe it or not, or I wish they all had tumors that you could take out and preserve the plexus, but that's not life. That's not how it is, you know. So I, you know, I like my colleague in England who, you know, wrote so extensively and so well. He was the second author now that took over Seddon's textbook, Ralph Birch, and he devoted the whole last chapter to the English health system and the English system of providing grants and the English system of providing rehabilitation and the English system of providing support for people who need secondary help with nerve things, and he felt, I'm sure he still does, that this was atrocious, and until or unless that got changed, no matter else what was done, we weren't going to have things where we needed them to be. So he was a seriously injured patient with serious nerve loss, but great question. Thank you. We're going to—thank you, Dr. Klein. We're going to move to our session.

living donor hand transplantation programs

challenges

repairing nerves

advancements

brachial plexus injuries