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April 12, 1975. Wong Yoke Lin was new to the plywood factory, having moved from her hometown of Ipoh several weeks before to earn better wages in Singapore. The 17-year-old was just getting accustomed to the large, noisy machinery. On that morning, everything seemed normal as the plywood planks rolled down the chute to the conveyor belt. Then a plank got caught. Yoke Lin reached for the plank and pulled it from the whirling machine. In an instant her glove and hand were sucked into the machinery. The machine yanked her arm ferociously and Yoke Lin fell back upon the floor. She screamed in horror and pain at the sight of her arm torn off at the elbow. Her supervisor rushed to wrap her bleeding limb, ordered that her severed arm be removed from the machine and sped off with her in a lorry. At Alexandra Hospital Yoke Lin was rushed into the resuscitation ward for a blood transfusion. The severed limb arrived and Mr Leong Hin Seng and registrar T.R. Achuthan began to clean it. The Medical Director, Mr Sung Wing Heun, and Dr Ng Boon Keng meanwhile began work on Yoke Lin's upper arm. "First," said Mr Sung, "we perfused the arm with heparinised saline solution to prevent the blood from clotting by inserting a tube in the artery. Next, we cleansed and removed dirt and devitalised tissues of the disjointed areas." |
The four surgeons battled for five exhausting hours. They shortened the bones on both sides in order to reduce tension on the stitching. They identified vessels, tendons, nerves and muscles on both sides and wedded them together. They transplanted a vein from Yoke Lin's leg. Finally, they took turns to suture the arm together.
Recalling those first hours and days after the surgery, Mr Leong said, "She looked well. Everything was okay. Everybody got very excited. The press got excited. The TV got excited. We got excited." However, according to Mr Leong, the danger is that changes can take place in the tissues of the re-attached portion which could cause permanent damage, like kidney failure.
"The next night," said Mr Leong, "the nurse called me at home saying that the limb looked white, pallid. So I quickly ran over and looked at it with Mr Sung. The muscles had gone into spasm. They became tight like a rubber hose. The blood was not flowing in adequate amounts. If there was no 'good blood' going in by the arteries, there would be no 'bad blood' coming back by the veins.
"We knew this was called vascular spasm, but how to overcome it? What the book said, we tried. But nothing worked. Then I suddenly got an inspiration. I asked the nurse to get me a pail of warm water and some towels and I just wrapped the warm towels around her limb. That local heat opened up the vessels. The nails became pink. You could see it immediately."
Mr Leong attributed much of the success to Yoke Lin's "tremendous motivation to recover." But Yoke Lin saw it differently. "I owe it all to the surgeons and hospital staff who have treated me so kindly," she said.
Several months later Yoke Lin underwent another operation to join up the three severed nerves. Within four months of the first operation, Yoke Lin could hold a pen. Soon after that, she could write with it. Yoke Lin spent three more years in Singapore working at the factory before she returned to Ipoh. Today she is married with three children.
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