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Fetal Hand Grasp photo.

Samuel Armas, at 3½, outside his home.
Treating the Tiniest Patients
Dramatic advances in fetal medicine—especially in utero surgery—have changed what we know and how we think about the unborn
By Claudia Kalb
    June 9 issue —  Samuel Armas, a chattering, brown-eyed 3½-year-old, has no idea what “fetus” means. Nor does he realize that he was one of the most celebrated in medical history


AT A MERE 21 weeks of gestational age—long before it was time to leave his mother’s womb—Samuel underwent a bold surgical procedure to close a hole at the bottom of his spinal cord, the telltale characteristic of myelomeningocele, or spina bifida. Samuel’s parents, Julie and Alex, could have terminated Julie’s pregnancy at 15 weeks when they learned about their son’s condition, which can result in lifelong physical and mental disabilities. But the Armases do not believe in abortion. Instead, in August 1999, they drove 250 miles from their home in Villa Rica, Ga., to Nashville, Tenn., where Dr. Joseph Bruner, of Vanderbilt University, performed a surgery bordering on the fantastical. Bruner cut into Julie’s abdomen, lifted her balloonlike uterus out of her body, made an incision in the taut muscle, removed the fetus, sewed up the spinal defect and tucked him back inside. Fifteen weeks later Samuel Armas “came out screaming,” says Julie.
       That scream became a rallying cry for fetal-rights groups, which seized on a stunning photograph of Samuel’s tiny hand emerging from his mother’s uterus during surgery. Since then, anti-abortion activists have posted the image on dozens of Web sites to show just how real human fetuses are—even those that aren’t yet viable. And that’s just fine with the Armases. “We’re very glad it’s gotten visibility,” says Alex. “That wasn’t our fetus, that was Samuel.”





Dr. Joseph Bruner at Vanderbilt is known for his work in fetal surgery, especially on babies with spina bifida, a condition in which the spine does not close properly during development.   Vanderbilt confirms that little Samuel Armus was 21 weeks-old in the womb which makes the surgery very risky because if anything goes wrong, the baby cannot survive on its own.  Dr. Bruner and his colleagues, however, have done numerous successful spina bifida surgeries on fetuses that are not yet viable.  In this particular surgery, the baby's hand poked out of the incision in its mother's womb and Dr. Bruner says he instinctively offered his finger for the baby to hold.  Most versions of the story say the baby reached out and grasped Dr. Bruner's finger, but in an article in USA Today on May 2, 2000, Dr. Bruner says both the mother and the baby were under anesthesia and could not move.  Michael Clancy, the photographer who took the picture and who owns the copyright to it says, however, that out of the corner of his eye he saw the uterus shake and the baby's hand pop out of the surgical opening on its own.  Clancy says that when the doctor put his finger into the baby's hand, the baby squeezed the finger and held on.  You can read Clancy's description of the experience and more about the picture, below this picture and at his website at



From Michael Clancy

A Moment ... From a Child

Fetal Hand Grasp photo. During a spina bifida corrective procedure at twenty-one weeks in utero, Samuel thrusts his tiny hand out of the surgical opening of his mother's uterus. As the doctor lifts his hand, Samuel reacts to the touch and squeezes the doctor's finger. As if testing for strength, the doctor shakes the tiny fist. Samuel held firm. At that moment, I took this "Fetal Hand Grasp" photo.

As a photojournalist, my job is to tell stories through pictures. The experience of taking this photograph has had a profound effect on me, and I'm proud to share this moment with you.

Michael Clancy

Story of the Photo  |  Mission Statement  |  Order a Print  |  E-mail Michael


The photos here are used by Courtesy of Michael Clancy. They are copyrighted and the personal property of Mr. Clancy. Please do not copy or use without his permission.                                                                   Texas Bob





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