This is the left hand of a patient with amniotic band syndrome.
Strands develop in the amniotic fluid and wrap around the developing fetus. These bands can cut off the circulation to body parts and cause indentations and amputations.
This is the patient’s right hand. All of the bones of the wrist and fingers are present and have developed, but the skin over them was fused together. The surgeon was able to free up the patient’s thumb on this hand giving him better function.

One of the anesthesiologists pulled these separates off the scrub rack and scored fashion points today.

All 19 of today’s patients are all tucked in for the night. This baby who had a cleft lip repair is wearing no-no’s. They keep the baby from bending the arms at the elbow and putting their fingers or hands in the mouth and damaging the surgical repair.


The ruins of San Jose.
Tomorrow is our last day of surgery. There were fireworks in the central plaza tonight in anticipation of tomorrow, July 25th, St. James’s Day. He is the patron saint of Guatemala.

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About Lisa M. Asta, MD
Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University.
Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at WebMD.com, Rx.com, and MyLifePath.com. She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. BabyCenter.com currently has two how-to videos for parents in production which feature Dr. Asta.
For more on Dr. Asta’s writing, visit www.LMAsta.com