Can 'Tree Man' Be Saved?

Doctors hope they can cure Dede Koswara from an extremely rare disorder.


JAKARTA, Indonesia, April 16, 2008 — -- Dede Koswara, popularly known across Indonesia as "Tree Man," has been living in a tropical hospital for months, where a team of doctors has been sawing away at the barklike growths that have slowly encased his entire body.

"This is the most remarkable case, the most severe case, I have seen in my career," said American doctor Anthony Gaspari at a news conference in Bandung, about a two-hour drive from capital city Jakarta.

For Dede (who is known by his first name), what started as a simple wart on his knee as a teenager spiraled his life out of control when it became infected. Treelike growths gradually spread all over his legs, arms, chest and face.

He became physically unable to do basic functions and everyday tasks.

As a result of his condition, Dede lost his job, and his wife left him. He moved in with his parents and has been supported by extended family. His two kids often visit him at the hospital.

Doctors have learned that Dede has a defect in his immune system. This defect doesn't allow him to control the type of human papilloma virus -- an extremely common virus that most of us develop an immunity to -- causing the warty growths on his skin. Their treatment plan is to control the tumorous growths and restore his immune system.

Hopes are high for Dede to have a second chance at life.

"What I really want first is to get better and find a job. But then, one day, who knows? I might meet a girl and get married," the 37-year-old told the British newspaper The Telegraph from the hospital.

Gaspari, from the University of Maryland and specializing in immune function of the skin, sat on the press panel with a team of experts. He talked about how he first became involved in helping to treat Dede.

"I was actually asked by The Discovery Channel to join them and to study this patient and confirm what kind of health problem he had," said Gaspari. "I was also interested in this case to see what I could do to help this patient."

Gaspari's initial involvement in this case created a local firestorm. Dede's blood samples were reportedly taken out of the country without the government's permission.

The controversy rose through official ranks and Indonesian President Susilo Bambang Yudhoyono stepped in. As a result, care for Dede was turned over to local specialists.

Under their care, he has completed about half of his eight scheduled surgeries, each one taking hours to complete and several doctors. His family watches the operations by live video feed from a nearby room.

So far, treatment has gone well. In January, Dede, still in a wheelchair recovering from an exhausting surgery, greeted the media. He cautiously held a pen with his left hand, which, with warts cut away, was significantly smaller in size than before. As he wrote he smiled shyly at the flashing cameras.

Several surgeries later Gaspari has returned, it appears, in good grace with the Indonesian government.

Thanking his Indonesian colleagues and Health Minister Siti Fadilah Supari for inviting him back, he said, "There are many challenges that remain in treating his condition, but he's received excellent care and is taking a step in the right direction."

Dede's remaining surgeries and treatments in Indonesia will continue to be a challenge as doctors learn more about his rare situation.

Head local doctor Hardisiswo Soedjana estimates it "may be six months after right now" before surgery will be complete, all depending on Dede's response to treatment.

It is unlikely that he will ever be completely cured of his condition.

"He has an internal health problem that is allowing this to happen," Gaspari said, adding that he has explained this to Dede and his family, "and he's going to be living with that health problem for the remainder of his life and that will be a challenge to keeping him in an improved state."

For now, Dede's family watches as he slowly returns to the appearance of his former self.

His father, Ateng Koswara, told The Telegraph, "You can see the form of his 10 toes now. He can wear flip-flops. He loves doing Sudokos. He is in good condition."