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Divine Reimplantation

We present here the contents of a conversation between Vittorio Messori and Dr. Landini Cugola, the famous Italian traumatologist, a specialist in the field of limb reimplantation and a recent convert as a result of reading Messori’s book on the Calanda miracle.

Among the readers of my book, Il Miracolo, was a man whom I did not previously know, and who wanted to meet me himself: Dr. Landini Cugola. I knew right away that he was someone quite exceptional. Cugola is a traumatologist, a professor of microsurgery in the medical faculty of the University of Verona. Although he is chief surgeon of the university hospital’s Department of Hand Surgery, his competence and practice cover the traumatology of all limbs, both upper and lower. He is a well-known and respected specialist in the new techniques of limb reimplantation. To those of us unacquainted with this field, the results of these techniques — unimaginable just a few years ago — are nothing short of astounding.

After reading a review of my book in a newspaper, the doctor bought himself a copy and “read it at a single sitting,” as he later told me — as much out of professional interest as for other reasons. The book made such a great impression on him that he immediately contacted me and requested a meeting. But before that, he asked me to send him a photocopy of the entire record of the Saragossa inquiry, which included the interrogation of all twenty-four witnesses. After studying these documents, he invited me to his office at the Verona Polyclinic. At the very outset of our meeting he stressed that he considered himself a “sociological” Catholic, meaning that he was Catholic by upbringing only, which was quite common in the Veneto district. Thus, he assured me, he had neither any special interest in religion nor any strong feelings on the subject. Quite the contrary: both his scientific formation and profession as a surgeon — and he had acquired the one and practiced the other at the highest level — inclined him toward a secular view of things. And yet, as soon as we met, he told me: “You yielded to the reality of the Calanda events on the basis of historical research. I think, then, that I too must yield, but in my case as a physician and university lecturer, whose every day is spent in the reconstruction and grafting of limbs.”

Indeed, he explained to me that an examination of the evidence presented before nine judges at Saragossa between June of 1640 and April of 1641 can lead a modern specialist to but one conclusion. Namely: “What those men and women saw and described is in complete accord with all the principles underlying the reimplantation of a lower right limb. What those people swore to — and what was set down and certified by the public notaries — is precisely what we specialists would certify. But we certify this over three and a half centuries after the event. It is utterly unthinkable that those seventeenth-century Aragonians could have thought up (and with such precision!) a clinical picture and post-operational evolution, which for them was altogether unimaginable. The only possible explanation is that they described something they really saw. But this very explanation, though a rational one, opens the door to a mystery!”

Let us try to follow Dr. Cugola’s reasoning. One of the problems that the Saragossa judges had to deal with was the fact that the leg “restored anew” to the young peasant Miguel Juan Pelicer had a wasted look and needed time to regain its full motor functions, and yet in its proportions it was quite like the other. This was no creation ex novo. Rather, as the theologians who studied the case claimed, it was a striking “sign of resurrection,” or rather “life restored.”

Thus, on that happy evening of March 29, 1640, the youth did not “grow back” a new leg. Rather, he “regained” the same right leg, which two and a half years earlier had been amputated “four fingers below the knee” and then buried over a hundred kilometers away in the hospital cemetery at Saragossa. All the witnesses agreed that the restored leg had a number of peculiar visible marks that allowed them to make this identification.

Yet it is precisely this fact that most disturbed the judges who had to comment on the incident and appraise its supernatural character. Let us recall the words of Archbishop Apaulaza, whose verdict concluded the inquiry: “The aforesaid Miguel [Pelicer] and most of the witnesses testified with regard to art. 26: namely, that the said Miguel was at first unable to put his foot on the ground, for the nerves were stretched and the toes were bent down and almost without sensation. He did not feel the normal warmth of the leg, which had a corpse-like color and was not of the same length and thickness as the other leg. All this seems to contradict the nature of a miracle, both because it did not occur in a single instant, and because such an imperfect reality does not seem to come from God, who knows no imperfection….”

In voicing this reservation, the archbishop was mindful of the fact that the Christian God intervenes directly only in instances where nature itself is unable to act — as in the restoration of an amputated leg. Thus, the Creator prefers to allow the laws and forces, which He created, to act in a normal manner. But precisely because of the “gradual” dynamics of this miracle, Cugola was able to make his observations from the point of view of a traumatologist, a professor of microsurgery, and a specialist in limb reimplantation.

Cugola observes that, given this “divine economy,” this will of God not “to do too much,” it is only logical that the restored limb should have been the youth’s amputated leg, and not another — a new one, for this was the only way to avoid adding one miracle to another, i.e. overriding the forces of transplant rejection. The phenomenon of rejection is well known to physicians specializing in the transplanting of organs and limbs. It is no accident that many doctors (including Cugola himself) refuse to perform operations such as the one recently performed in Lyons, France, where an Australian patient received a dead man’s hand and forearm. As a result, such patients are forced to take ever-increasing doses of powerful drugs, known as immunosuppressors, so as to prevent the organism from rejecting the foreign limb. There are, however, surgeons who will transplant organs such as the heart and kidney, for without these the patient would die. But they will not agree to transplant arms or legs, which one can still live without, albeit imperfectly, but perhaps less so than if one had to take anti-rejection drugs.

In short, Professor Cugola’s view is that in Calanda God did not wish to perform a miracle (restoring a new leg) that would require another miracle, namely its normalization (by miraculously suppressing the organism’s reaction), which would also be contrary to the laws of nature.

But let us turn to the clinical picture presented to us by the witnesses, for there the modern specialist can see characteristic features of reimplantation that are in complete accord with natural principles.

The witnesses at the Saragossa tribunal expressed their amazement at the sight of the right foot’s toes, which, immediately after the event, were “corbadas hacia abajo,” i.e. bent downwards, while the “nerves” (the modern specialist knows that here we are talking about tendons — Cugola qualifies) appeared “encogidos” or contracted. “That is exactly as it should be,” observes Cugola, “for the flexors, or the muscles that end in the sole of the foot, are dominant, that is to say, they have a great capacity to stretch and are stronger than the extensors, the dorsal muscles located in upper part of the foot. Today, after reimplantation surgery, we can observe that for a period of time the toes of the lower limb are bent downwards, while the tendons are contracted, for they are under tension.”

At dawn, on the day after the miracle, the grateful people of Calanda accompanied Miguel Juan Pelicer in a procession to the parish church for Holy Mass and the singing of the Te Deum. Here too the witnesses were in complete agreement. The youth left his wooden leg, which he had used until now, in the house, but continued to walk with a crutch, since, as the witnesses observe, “he was unable to put his right leg on the ground.” But then, upon leaving the church after the long liturgy and several hours had elapsed, the situation gradually improved, as the “muleta” (crutch) was no longer needed. “This is also perfectly normal to us specialists,” remarks Cugola. “This is circulation, this is life, which needs time to return to a reimplanted limb.”

Among the witnesses there was also Miguel Escobedo, the mayor of Calanda. He alone recalled one interesting detail. The following is an excerpt from his testimony contained in the inquiry report: “The witness (Escobedo), after being present at the church, and again later, was told by Miguel Juan that he felt the warmth returning to the said right leg, so that the witness touched it and tickled the sole of the foot, and he stated that Miguel Juan felt it. And he saw him move his foot and toes. This too the witness testified under oath.” A modern physician practicing Cugola’s profession has no need to swear an oath, for he knows all too well that this too conforms to the normal clinical picture observed after a reimplantation.

The appearance and clinical evolution of the leg as unanimously described by other witnesses also fall within the parameters of the normal. Miguel Juan’s “restored” limb had an appearance described as “mortecino,” i.e. it had the livid look of death, and in places was violet in color (“morado”). Some witnesses speak of “marbrures,” which can be rendered as “dark patches.”

“This is unbelievably exact and precise!” observes Professor Cugola. “We know from experience that after a reimplantation there is an appreciable difference in appearance between the lower and upper limbs, between legs and arms. Arms have a more or less natural pink color. Reimplanted legs, on the other hand, have a pale, corpse-like color, with violet patches, especially when the “rejoining” takes place after an extended period of time, for example several hours after an accident. But in this case almost two and a half years had elapsed since the amputation!”

Several witnesses testified that the leg was “gangrenada” (gangrenous). Our specialist does not buy this diagnosis. “Between the time of the fracture of the “canilla” (shin bone) at Castellon de la Plana and the leg’s amputation at the hospital in Saragossa, two of the hottest months of the year had passed — August and September. In addition, there was the incredibly arduous journey from Valencia to the capital of Aragonia. If gangrene had really set in, the patient would have died of septicemia long before the operation. In my view, what probably happened was that there had been an inflammation of the bone marrow in the area of the fracture, which was almost certainly a compound fracture, that is, the broken bone had pierced the skin. As a result, blood circulation would have stopped and the leg undergone a process of mummification. This would explain how the amputated leg was preserved after over two years of being buried in the ground. Perhaps, also, this is how God’s realized His plan. This way He did not to have to “reconstruct” a new leg because of the old one having decomposed, but could “restore” the one buried in the hospital cemetery. Not only the bones but also the flesh must have been preserved, although a smaller amount of it owing to the mummification.”

One of the most important witnesses at the inquiry was Miguel Barrachina, a neighbor, whom, on the night of March 29, the Pelicers had invited along with his wife Ursula for a simple country meal. Living next door, he was the first neighbor to come running over, after his friends had discovered what had happened to their son.

Barrachino’s testimony contains a normal description of the foot and the color of the leg (“mortecino, algo morado”), which, as we have seen, our modern specialist considers to be signs of a real reimplantation. But there is yet another detail. I cite again from the inquiry records: “The witness (Barrachino) states that he touched the right leg and felt that it was considerably harder than the other, and very cold; and that three days after the incident he heard the said Miguel Juan tell him that all the natural warmth was returning to the right leg. And he saw that he could, and still can, move the foot and the toes.”

As the Verona professor remarks, the observations made by the witness Barrachino (that the leg felt hard and cold to the touch) suggest that the leg, which had been amputated and then buried in the ground, must have undergone the process of mummification. This is confirmed by other witnesses, who testified that immediately after the event the youth’s leg “seemed dead.” Observes Cugola: “The blood vessels of a reimplanted limb are half-paralyzed, and the “reattached” part seems colder and stiffer to the touch. The only exceptional thing in this case was the speed with which the leg regained its full motor functions. Concerning the color and stiffness of the limb, the witnesses mention three days. From a perspective of faith, could not these three days — the believer might ask himself — be a sign of resurrected life, just as Jesus rose from the dead on the third day?”

Among those who appeared at the inquiry and swore to every statement they made (both then and later) were two surgeons from Calanda: young Jusepe Nebot and 71-year-old Juan de Rivera, who was retired. The latter’s testimony is typical of a professional physician who is able to provide a detail overlooked by the others, namely, “el tobillo enchado” — a swollen ankle, which he observed while feeling the restored leg on the morning following the event. Observes Cugola: “Even here, everything is in complete agreement with our experience. Slow blood circulation resulting from the difficulty of the veins to return the blood causes blood stasis, which in turn causes the ankle to swell.”

One more aspect of this extraordinary case remains. All the witnesses observe that Miguel Juan continued to limp for a time, even after he was able to put his foot on the ground. The fact is that that the restored leg was shorter than the other “by three fingers” (all were agreed on this). Some historians of the Miracle have advanced the hypothesis that although the youth was already twenty-two years old at the time of the amputation, he had not yet stopped developing physically. When his leg was restored to him two and a half years later, it would have been shorter than the other, which had continued to develop normally. I too found this hypothesis convincing.

Professor Cugola is of a different opinion: “The three fingers represents the amount of bone tissue, which must have been lost as a result of the fracture, plus the amount removed by the surgeon, who, on observing the inflammation of bone marrow, would have looked for some undamaged tissue.” In any case, all the witnesses agreed that after several months the right leg attained the length of the left one. “Natural growth!” states Cugola. “Today, after a reimplantation, we assist in the lengthening of the bone with the use of an instrument called an “external stabilizer,” which keeps the limb under tension.”

There was yet another part of Miguel Juan’s leg that was smaller than in the other; in time it too acquired the same size — namely, the “pantorrilla” or calf. Observes Cugola: “The calf had shriveled, since the muscle had undergone mummification. With the return of blood circulation, movement, and life, the nerves regained their normal function.”

In short, after examining the dozen or so pages of the witnesses’ statements contained in the inquiry records (the archbishop closed them with the verdict that “it was the work of God with the intercession of the Madonna of Pilar”), the Verona university professor has no doubts. “There is nothing else I can do than repeat my conviction — and this, not as a believer, but as a physician who relies on his own clinical experience. What those seventeenth-century Aragonians saw and described was simply a reimplantation of a lower right limb. Everything is in accord with what we observe today. We must remember that at the time of the Miracle of Calanda, people could not have had the slightest notion of what a surgical operation of this kind entailed. The first — unsuccessful — attempts were made in the 1960s. That is why (apart from the many other reasons adduced in your book) it seems obvious to me that these witnesses could not have thought up a situation that was totally unknown to them. It is simply inconceivable.”

Vittorio Messori

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