Sitting quietly, her left hand in her lap, Fennel tries to grip the piece. She raises and swivels her shoulder to lift and rotate the hand above the disk and bring it straight down to touch it. Her fingers tremble, but she manages to close her forefinger and thumb on the disk and lift it.
She has no sensation yet in the transplanted hand. The nerves grow about one millimeter a day from the connections the surgeons made to her arm, and it will be several more months before sensations develop.
"The hand is connected to me. It's mine," Fennell said. "But until I have feeling in it, it's not going to feel like mine."
She purses her lips with concentration as she loses her grasp of the object and reaches for it again. When she succeeds, she looks triumphantly at Azari.
For The Record
Los Angeles Times Thursday, April 21, 2011 Home Edition Main News Part A Page 4 News Desk 1 inches; 47 words Type of Material: Correction
Hand transplant: In the April 19 LATExtra section, a photo caption with an article about Emily Fennell, who had hand transplant surgery at Ronald Reagan UCLA Medical Center, said she spends eight hours a day in physical therapy. As the article noted, Fennell is receiving occupational therapy.
"The minute you tell me I can't do something, I do it," she said, grinning.
Her therapists encourage her to say "my hand" instead of "the donor hand." It's a psychological adjustment that runs parallel to the physical challenges she deals with.
"I know it's from a donor," she said. To this day, she still has few details about that person. "This is a gift they've given me, and it's such a blessing. But for me to accept it, I have to think of it as mine."
Now, like any 26-year-old, Fennell is eager to get on with her life. On weekends, she sometimes sees friends in Ventura County, where she attended Buena High School. But she fiercely misses her daughter, who is staying with relatives. For now, Fennell lives in UCLA-owned housing and will remain there until May or so.
Once home, she will have regular occupational therapy. Improvements can be expected for several years, and she should eventually obtain about 60% of the function of a normal hand, Azari said. The transplanted hand will always be weaker.
"It's going to be a road of constant rehabilitation, practice, gaining muscle strength, muscle conditioning, nerve growth," said Dr. Sue McDiarmid, medical director of UCLA's hand transplant program, which has begun adding other hand amputees to the waiting list.
"But Emily strikes me as a young adult who loves life. The will to be a whole, functioning mom was a very powerful motivator for her."
Fennell has a mental list of future milestones to celebrate as her hand becomes serviceable. Pull her hair into a ponytail. Cut up meat with a fork and knife. Hug her daughter "with both hands."
"You know," she said. "Little things."