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The Surgeon Who Helped Revolutionize Hand Transplants

Dr. Kodi Azari. Azari performed a hand transplant on Emily Fennell, 26, after she lost her hand in a traffic accident. (AP Photo/Reed Saxon)

Dr. Kodi Azari has traveled the U.S. as a lead surgeon in five hand transplants. Hand transplant recipients have usually lost their hands before surgery, but Azari laid the groundwork for a new kind of procedure:

The doctor had some hypotheses he wanted to test, provided he could find a patient with the ideal requirements: excellent health, enormous self-discipline, a positive attitude, and—rarest of all—a limb that needed to be replaced but had not yet been amputated.

Azari knew he was hoping for a long shot. Most hand transplant candidates have been injured in accidents or in battle, when a catastrophic event forces an emergency amputation. These procedures are aimed at minimizing suffering and are usually carried out to facilitate future prosthetic use. Generally that means the arm is severed closer to the elbow than the wrist, and the nerves and tendons are trimmed back and tucked inward to lessen discomfort. That creates challenges, however, if a transplant is attempted later. All those tucked-in nerves and tendons tend to merge over time into a jumble of tissues that is difficult to connect to a new hand with precision.

Wouldn’t it be great, Azari thought, if a transplant recipient’s arm could be amputated in a way that prepped it specifically to receive a new limb? How much more quickly would a patient recover if each tendon, nerve, artery, and vein were left in place and marked—labeled, like so many colored speaker wires, to be hooked up to a matching apparatus? How much more functionality would the patient gain, and how rapidly would he or she gain it? Azari believed this fantasy patient would awaken post-op, look at the new hand, and be able to move the fingers right away.

Azari found the ideal patient in Jonathan Koch, a television executive who experienced full-blown septic shock and needed several limbs amputated. Amy Wallace tells his story in Los Angeles Magazine.

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Building In the Shadow of Our Own Destruction

"A Vision of Sir John Soane’s Design for the Rotunda of the Bank of England as a Ruin," by Joseph Gandy, 1789 (Sir John Soane Museum)

Colin Dickey | Longreads | April 2017 | 12 minutes (3,060 words)

 

In the opening pages of Austerlitz, W. G. Sebald describes the Antwerp nocturama, a zoo enclosure of simulated darkness designed to allow visitors to watch nocturnal animals in their natural environment. Sebald finds himself fixated on a raccoon compulsively washing a piece of apple, an animal whose work goes “far beyond any reasonable thoroughness,” he writes, as though this “would help it escape the unreal world in which it had arrived.” In the same way, perhaps, I’ve been reading Sebald compulsively for the past few months, as though through this act I might find the means to escape the unreal, topsy-turvy world of this grim winter.

Sebald is often called a Holocaust writer—all his major works deal with the Nazi genocide, some more explicitly than others. But his writing is often more concerned with a crisis in European modernity, one that can be traced back as far back as the Napoleonic Wars—a crisis in which the Holocaust was a horrifying, but nearly inevitable by-product. No historical tragedy arrives, ex nihilo, like Athena from her father’s forehead. Rather, Sebald traces and patterns that are laid out decades, perhaps centuries in advance, often in plain sight. They ostentatiously draw attention to themselves, though we have no desire to recognize them. Rather than focus on cartoonish depictions of Nazism as some anomalous evil, Sebald looked for the ways that fascism grew from the innocuous and banal aspects of European culture—from textile manufacturing, to psychotherapy, to architecture.

It was in architecture that Sebald saw the most telling indicators of the inevitability of the camps, often in the most unlikely of places. In Austerlitz, Sebald’s narrator meets up with the novel’s eponymous protagonist in Brussels’ Palace of Justice, reputed to be the largest courthouse in the world. Built in the 1880s, the Palace is a massive accumulation of stone organized haphazardly, such that many of its corridors and stairways lead nowhere. Sebald sees a paranoid logic in such a building, meant as an awe-inspiring monument to justice,  yet containing a lawless rabbit warren of hallways—a belief that marble and brick can forestall death itself. There was an anxious psychosis in the late-nineteenth century that led to greater and greater structures, each trying to outdo the last, further exacerbating a death drive. “At the most,” Jacques Austerlitz tells the narrator about this palace, “we gaze at it in wonder, a kind of wonder which in itself is a form of dawning horror, for somehow we know by instinct that outsize buildings cast the shadow of their own destruction before them, and are designed from the first with an eye to their later existence as ruins.”

The Palais de Justice in Brussels, Belgium was begin in 1866 and finished nearly twenty years later. It is said that Hitler admired it as one of his favorite structures, but during the liberation of Brussels, retreating German troops set it on fire, heavily damaging the building. (Wikimedia Commons)

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The Top 5 Longreads of the Week

This week, we’re sharing stories from Peter Waldman, Garrett M. Graff, Rachel Aviv, Catrin Einhorn, Jodi Kantor, andd Eric Boodman.

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We’re Living in the Golden Age of the Corporate Takedown

Elizabeth Holmes. Photo: AP Images

Miki Agrawal, co-founder and “She-EO” of menstrual underwear phenom Thinx, raised eyebrows when she stepped down from her role in the company in early March. Agrawal had long been infamous for her company’s boundary-pushing ads and her well-publicized hesitance to use the word “feminist.” Within days of Agrawal’s announcement, Racked published a gripping article examining corporate dysfunction and alleged sexism at Thinx, and Agrawal struck back with a lengthy post on Medium that detailed her “incredible ride” with the company. “I didn’t put HR practices in place because I was on the road speaking, doing press, brand partnerships, editing all of the creative and shouting from the rooftops about Thinx,” she wrote. Less than a week later, Agrawal was accused of sexual harassment by a former employee.

Such is the power of the corporate hit piece: Fueled by eyewitness accounts, scorned ex-employees, and juicy tidbits about a CEO’s bad behavior, a corporate identity that took years to build can unravel in days. These piquant stories might smack of a slow-motion trainwreck, but they satisfy more than our inner gossips and gawkers. Today, the myth of a CEO is often of their own making—once minted by years of climbing the corporate ladder, now CEOs are made in weeks or months. CEO, we are told, is less a work status than a state of mind.

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Seven Stories About the Science Behind Fast Food

(AP Photo/Sunday Alamba, File)

I am a pizza apostate. Not only do I use a fork and knife whenever I eat pizza, I also sometimes bypass my normal slice joint for the siren call of deliciously buttered-and-garlic salted crust that only Dominos can deliver.

According to Bloomberg, I am not the only one who can’t resist the Michigan chain’s pies: the company is now worth a staggering $9 billion—its share price has risen more than 2,000 percent since 2010 (outpacing the likes of Google and Apple)—and Dominos has not only been brought back to life, it is now the leading force in the intersection of fast food and technology. As Susan Berfield writes,

Domino’s has always understood the importance of not having to go anywhere. Although you can still walk into a restaurant if you must, there are at least a dozen ways to order a Domino’s pizza in absentia. Some are self-explanatory: mobile apps, Apple Watch, Facebook Messenger. Others need some explanation. To order via Twitter, you must create an online account, save a pizza as your favorite (known as your Easy Order), and connect it to your Twitter account. Then tweet a pizza emoji to @dominos. “We’ll know who you are, what pizza you want, your default location and payment,” Maloney says. “We send a ‘Sounds awesome, are you sure?’ You send a thumbs up.” But if you want to order something other than your favorite, you’re out of luck.

Maloney clears away the remains of our lunch (Pacific Veggie, thin crust) to show me option 12 on his phone: zero-click ordering. “This will freak you out,” he says. “What’s the easiest way to order? When you don’t have to do anything.” One day Maloney and Garcia were in the car with their ad guys, dreaming of how to one-up Amazon’s one-click ordering. Three months later they had their zero-click app, which does require one click to start. “Tap the Domino’s icon to open it and find my Easy Order,” Maloney says. That’s it. “I have 10 seconds before it automatically places the order.” A big countdown clock appears on Maloney’s screen. If he does nothing, his Easy Order, a 12-inch hand-tossed pizza, will be on its way to his home.

While Dominos is at the forefront of our fast food, it isn’t the only company to have paired food science and tech to deliver a product that is utterly craveable. The following are some of the best pieces in the past several years to capture this culinary shift. Read more…

Revisiting the History of the Oakland Raiders Courtesy of Hunter S. Thompson

Credit: NFL/Twitter

The Oakland Raiders have been a thorn in the NFL’s side for decades. From pugnacious owner Al Davis to the team’s raucously rowdy fans and years of mediocrity, the Raiders reveled in being the league’s black sheep. And on the rare occasion when the team was competitive, like during the late 1970s and early ’80s when the franchise won three Super Bowls, the Silver and Black still seemed to thumb its collective nose at the league’s Brooks Brothers-outfitted executives on NYC’s Park Avenue.

Well, those execs enacted their own form of revenge: thanks to a league vote this week, the Raiders will leave the Bay Area for Las Vegas. Much like the neutering of Cleveland’s Dawg Pound (when the Cleveland Browns left for Baltimore in the late 1990s), the vote was put to the NFL owners, and only one—the Miami Dolphins—voted against the move, marking the third team in the past 14 months to relocate. While the Raiders’ new stadium won’t be ready until 2019 (at the earliest), the Raiders will have a two-year memorial for the city that loved them like no other.

It’s worth revisiting when the Raiders were weird and good. In 1973, Rolling Stone sent Hunter S. Thompson to embed with the AFC West team. Thompson was deep into gonzo journalism by this point, and as an avid football fan, he desperately wanted to chronicle a season with what was arguably the NFL’s strangest team. Trouble was, Davis didn’t entirely trust Thompson, and neither did the Raider players, who the Rolling Stone writer plied with cocaine in order for them to open up (according to Robert Draper’s history of the groundbreaking magazine, Thompson then tried to write the coke off as a business expense).

What follows is Thompson’s first interaction with Davis as reported in Fear and Loathing at the Super Bowl: No Rest for the Wretched:

…the other was a small wiry man in a tan golf jacket with a greasy duck-tail haircut who paced along the sidelines of both fields with a speedy kind of intensity that I never really noticed until he suddenly appeared very close to me and I heard him ask a sportswriter from the San Francisco Chronicle who I was and I was doing there…

The conversation took place within 10 yards of me, and I heard most of it.

“Who’s the big guy over there with the ball in his hand?” asked the man with the DA.

“His name’s Thompson,” replied Chronicle sportswriter Jack Smith. “He’s a writer for Rolling Stone.”

“The Rolling Stones? Jesus Christ! What’s he doing here? Did you bring him?”

“No, he’s writing a big article. Rolling Stone is a magazine, Al. It’s different from the Rolling Stones; they’re a rock music group… Thompson’s a buddy of George Plimpton’s, I think… and he’s also a friend of Dave Burgin’s-you remember Burgin?”

“Holy shit! Burgin! We ran him out of here with a cattle prod!”

I saw Smith laugh at this point, then he was talking again: “Don’t worry, Al. Thompson’s okay. He wrote a good book about Las Vegas.”

Good god! I thought. That’s it… If they read that book I’m finished. By this time I’d realized that this strange-looking bugger named “Al,” who looked like a pimp or a track-tout, was in fact the infamous Al Davis-general manager and de facto owner (pending settlement of a nasty lawsuit scheduled for court-action early this year) of the whole Oakland Raider operation.

Davis glanced over his shoulder at me, then spoke back to Smith: “Get the bastard out of here. I don’t trust him.”

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Leave Them Alone! A Reading List On Celebrity and Privacy

Todd Williamson / Invision for JDRF / AP

I read Alana Massey’s essay collection, All The Lives I Want: Essays About My Friends Who Happen to be Famous Strangerswith a pencil in hand. I read it behind the counter at work when it was quiet and customer-free. I read it in bed, long after my partner and cat had fallen asleep. I read it in Starbucks when I should’ve been writing but needed inspiration. Massey is a writer I’ve followed since I became interested in journalism. I admired her incisive blend of pop culture and literary criticism. I especially loved when she wrote about religion—Massey spent time at Yale Divinity School—because I went to a conservative Christian college and I was yearning to see how I could translate my weird, vaguely traumatic religious background into beautiful sentences. I bought her book as a reward for myself for meeting a writing deadline.

This reading list is partially inspired by Massey’s excellent writing about the way our society honors and rejects celebrated women—and also about society’s inclination, if not blatant desire, to know every little detail about our favorite celebrities and judge them according to our own arbitrary moral standards. (I’m not immune to this: I spent ten minutes in bed Googling potential paramours of one of my favorite YouTube stars, even though I know it’s none of my damn business.) Why do we feel like we own celebrities—not just their art or their products, but their images and their personal lives? What do celebrities owe us, if anything?

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‘Every Watch Geek Has an Origin Story’

watches and watch parts, on a black background
Photo by Kozuch, via Wikimedia Commons (CC BY-SA 3.0)

Novelist and memoirist Gary Shteyngart has an essay in The New Yorker about his growing obsession with high-ticket mechanical wristwatches, a fixation that escalated throughout the 2016 Presidential race and peaked around the inauguration. Something about the reliability and precision of German and Swiss ticking timepieces helps quell Shteyngart’s growing anxiety; delving into his expensive new hobby, he’s able to divert his attention away from his growing fears and the residual unrest from his childhood as a Jewish refugee from Russia.

Along the way, he visits watch factories in Germany, the offices of the online publications Hodinkee and TimeZone, the Horological Society of New York, and other exclusive halls where his fellow watch enthusiasts gather.

As the election approached, I started going to meetings of the Horological Society of New York. On the streets of Manhattan, I never have any idea which celebrity is which—they all seem to be Matt Damon—but at the Horological Society I could identify all my new heroes, many with full, Portlandian beards, across the vast hall of the library of the General Society of Mechanics and Tradesmen, in midtown, while they waited in line for their free coffee and Royal Dansk butter cookies. There was the nattily dressed Kiran Shekar—yes, the Kiran Shekar, noted collector, author, and proprietor of the independent watch purveyor Contrapante. I ran over to introduce myself and a few moments later he gave me his watch to hold, and a few weeks later he arranged for me to attend the secret RedBar, a meeting of the watch elect, at a bar in Koreatown. You need a regular to invite you to a meeting, and the idea that I could be welcomed into this exclusive world kept me from sleeping. I lay in bed practicing what I might say about “perlage,” “three-quarter plates,” and the rare lapis-lazuli dials on some seventies Rolex Datejusts.

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Want To See a Polar Bear? Just Follow the Bones

a polar bear walks on the ice
A female polar bear near Kaktovik, Alaska (photo by rubyblossom via Flickr, CC BY-NC-ND 2.0)

In Kaktovik, Alaska, dozens of polar bears take advantage of the bone pile—the remains of this community’s yearly quota of bowhead whales, which locals butcher right on the shore—to supplement meager summertime hunting. The bone pile is also a bounty for locals like hunter and guide Robert Thompson, who’s booked solid through 2017 taking hopeful wildlife photographers on polar bear tours. Michael Englehard tells the story in Hakai magazine.

The juncture of lingering bears waiting for freeze-up, the windfall of a bone and blubber cache, and a nearby community eager for economic opportunities, has resulted in a burgeoning bear watching industry in Kaktovik. Thompson, one of seven coast guard-certified tour boat captains, makes a good living from the castaways at the bone pile between September and November. A popular captain who is already fully booked for 2017, he can get so busy that he rushes to work without breakfast, grabbing a fistful of coffee beans to chew on his way out the door. His boat Seanachaí, Irish for storyteller, is aptly named—the man who can see bears making a beeline to the bone pile from his living room chair and who once got charged by a marauding male right on his doorstep regales visitors with tidbits about life in the North. A favorite is the technique for how to prepare a polar bear skin. “You stuff it through a hole in the ice and let shrimp pick it clean,” he says, adding that he’s also seen bears steal from set fishing nets and once watched one pull a net to shore. Thompson’s porch is a still life of body parts and implements: a pot with chunks of unidentifiable meat chilling in the frigid air; a caribou leg for his dogs; snowmobile parts; a gas tank; and, like a cluster of fallen angels, a brace of unplucked, white-phase ptarmigans. On a driftwood stump near the shed grins a mossy polar bear skull; it’s not a scene for tender romantics.

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The Top 5 Longreads of the Week

This week, we’re sharing stories from Amy Wallace, Katherine Laidlaw, Lisa Miller, Porochista Khakpour, and Lauren Schwartzberg.

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