It was only for a few moments, but it was enough: Little Lakshmi Tatma showed the world that she is doing OK.
The 2-year-old Indian girl who had extra arms and legs removed last week in a marathon surgery made her first public appearance since the operation at a news conference this afternoon at Sparsh Hospital in Bangalore.
Lakshmi is out of the intensive care unit and, doctors say, on her way to a long and slow recovery.
"She is coping very well, and she is stable," said chief surgeon Sharan Patil. "Lakshmi is safe at the moment."
Patil barely left the hospital for five days last week to ensure the health of the girl who has captured the world's attention. Patil led the team of 30 surgeons who separated what was essentially a headless parasitic twin joined at the girl's pelvis.
Parasitic twins differ from conjoined twins in that they are not fully formed and they depend upon the body functions of the twin's complete fetus.
During the surgery, the spine was cut to remove the extra limbs and the wide gap between Lakshmi's pelvic bones was closed using bone grafts. The closed gap was a significant accomplishment for the surgeons, who had thought they may have to close it over the course of several surgeries.
"We still have things to do, but so far, so good," Patil said.
Lakshmi's father, Shambhu, carried the girl whose legs were in casts but whose arms were free to the news conference. But the scene was so frenzied that she became uncomfortable and was removed almost immediately.
Lakshmi has begun eating solid food again and has been off her respirator since Friday. She has months of rehabilitation ahead of her, including potential surgery to fix her club feet, as well as an additional surgery due to the repositioning of her organs. But doctors do not expect to do these surgeries soon.
Small, Significant Progress
Since the marathon 27-hour surgery to remove extra limbs from little Lakshmi's body, her progress is now being measured in small but significant increments. After coming off the ventilator over the weekend, she also drank some milk and wiggled her toes. On Sunday she ate three pieces of bread. These steps of progress indicate that the 2-year-old is recovering very well.
The biggest concern right now is the possibility of infection due to the enormous wounds from her surgery. Patil said that perhaps the most significant indication that Lakshmi is making progress is that she appears to understand what has happened to her.
"Maybe it's my imagination, but I can see her. … She just gives one stare down her limbs and I can see she is saying, 'Where have they gone?'" said Patil.
During the surgery satellite trucks and local media filled the red dirt driveway outside the hospital, which is surrounded by palm trees, awaiting news on the little girl who has captured worldwide attention.
"She's a fantastic child in terms of the speed with the tissue recovering now and she's withstanding the procedure well," said Patil. "She might surprise all of us with making an attempt at walking within the next six weeks."
A Long Trip to Touch Many Lives
In late September, Patil traveled to the family's village in the remote and poor Indian state of Bihar after receiving a call from a social worker seeking help for Lakshmi's condition.
Sparsh Hospital, which has only been in operation for two years, was created to help the middle and lower classes of India to receive quality care. The hospital has taken unique approaches to execute this concept by cutting costs, including opening a facility on the outskirts of Bangalore, instead of the high-priced downtown. The hospital's foundation donated the cost of the surgery, estimated at $625,000.
Shambhu and Lakshmi's mother, Poonem, had tried to find medical help for their daughter, but were told surgery was not possible. The family struggled financially, particularly because only one parent could work while the other cared for Lakshmi, who was constantly running a fever. Survival rates for conjoined twins can be as low as 5 percent; doctors believed that Lakshmi would likely die in her teens without surgery.
In their village, which has just 150 homes and no electricity, Lakshmi's parents tried to give her as normal a life as possible. But in the region, villagers considered her to be the reincarnation of Laxmi, the multilimbed goddess of wealth. Some people even tried to buy Lakshmi to put her in the circus.
When Patil met the 2-year-old, he said he was unprepared for what he saw.
"Even though I'm a medical man and having seen the most grotesque things, it was quite shocking. I'd never seen anything in life like it before," he said. "The way she was moving around with that body, it was quite difficult and it was quite touching. Her older brother was running around and she was envying him."
About a week after the doctor's visit, the family traveled to Bangalore to prepare for the surgery.
For Lakshmi and her parents the trip to the hospital was the longest of their lives. When they arrived in Bangalore, they rode in a car for the first time. And Poonem, who is six months pregnant, received her first ultrasound, which indicated that her unborn child is healthy.
"We have tried to touch their lives, but it's been reversed now. We have become much enriched by having Lakshmi in our hospital," said Patil. "This is probably the best thing that's happened in my career. I'm able to reach out and help somebody who needed it most, and nothing could have pleased me more. It's a very nice feeling."