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GENTLE DREAMS, GRANITE WILL Years of longing, effort are paying off

THE BALTIMORE SUN

When she came to Baltimore from the Canary Islands at Christmastime in 1993, Beatriz Lopez-Perez brought her precious collection of rings tied up in a wine-red velvet bag.

Soon, she will have fingers so she can wear her rings. Soon she will have wrists, so she will no longer have to wear her watch and bracelets around her ankles. Soon she will have arms, so that one day, when she is a wife and mother, she will be able to hold her baby.

These are the dreams of Beatriz Lopez-Perez, who was born to a mother who took the drug thalidomide. To wear rings, bracelets and watches. And to hold a baby in her arms.

"When I go shopping, the first place I will go is to the rings, the watches," said the mischievous 20-year-old, laughing. "Anything for the hands."

For 18 months, a prosthetics maker has worked with surgeons and therapists at Johns Hopkins Hospital, fashioning arms for Ms. Lopez-Perez.

The arms will have skin made of vinyl, bones made of aluminum and muscles made of springs and motors. Sometime in the next two weeks, they will be finished.

The beautiful young woman with soft brown eyes and a granite will doesn't want to think of the arms, attached to a harness, as machinery. She wants to come to think of them as part of her body -- as the hands and arms she has felt, somehow, she has always had.

Even after her arms are finished, she will have at least a month of hard work ahead. Learning to use any prosthesis is hard.

Learning to use mechanical arms, wrists and hands when you have never had flesh-and-blood ones, is very hard.

Therapists and doctors can help her, she said, but she must teach herself.

"They can put on the prostheses," she said. "But they cannot teach you."

Like other thalidomide children born with feet but no arms, Ms. Lopez-Perez grew up learning to use her legs as arms, and her feet as hands. She is incredibly agile and utterly unself-conscious.

She can write on a desk with one foot while standing on the floor with the other. She can feed herself, wash dishes, pull books off shelves, stuff envelopes and do most of the thousand things other people do with their hands and arms.

People always offer to do this and that for her, but help is the last thing she wants. "If they help you, they don't help you, really," she said. "You lose the ability to do it by yourself."

People are sometimes startled by her. In banks, she can cause a stir by putting her foot on the counter to endorse a check. Sometimes, she said, the tellers will nervously tell her that she need not sign it. She will go ahead and sign anyway.

People occasionally stare at her on the street, in malls or in stores. She won't turn away. She confronts them. "I say, 'You like skirt? You like my clothes? I bought it there,' " she said. "They snap out of it. They are embarrassed."

When she came to this country, Ms. Lopez-Perez had a hard time adjusting to some of the cultural attitudes.

She loves to flirt, but American men tend to take this too seriously. While her physical therapist was fitting one of her new hands with a ring, Ms. Lopez-Perez asked him: "Do you want to marry me?"

The therapist, who is married, was flustered.

RF She laughed as she told the story. "I have a fine time!" she said.

No need to be sheltered

One thing she likes about this country is how people with disabilities are treated.

"In a lot of foreign countries, people with handicaps like hers are institutionalized, they're so sheltered," said Cathy Hutton, the former head of Hopkins' international services office. "The one thing that she loves about living in the States is that that's not the case here."

Ms. Lopez-Perez was born near the city of Santa Cruz de Tenerife, on the island of Tenerife. Tenerife is part of the Canary chain, volcanic islands in the Atlantic off Morocco that form a province of Spain.

She knows she was born in early November 1974. But she doesn't know the date. She was abandoned by her parents when she was just a few days old.

It's almost certain that neither her father nor her mother was named Lopez-Perez.

That is the name the government of the dictator Francisco

Franco gave her. At the time she was born, she said, the government gave all foundlings the same last name, changing it every few years. From 1970 to 1974, abandoned infants were all named Lopez-Perez, which is a combination of two very common Spanish names.

'A big mistake'

Her first name, Beatriz, was given to her by a nun at her orphanage. It means "peace."

"That was a big mistake," said Ms. Lopez-Perez, shaking her head and grinning.

Thalidomide was sold as a sedative, sleeping pill and treatment for morning sickness that produced no side effects.

It was banned in most countries in 1962, after pregnant women who took it gave birth to 8,000 children with missing limbs or other deformities.

Ms. Lopez-Perez blames General Franco, who died in 1975, for permitting the sale of thalidomide in Spain when her mother was pregnant.

"He didn't take the drug off the market," she said. Because of him, she said, "no information about thalidomide came out."

She has never met her mother but does not hold her responsible.

"I don't think it was her mistake," she said.

Ms. Lopez-Perez has had artificial limbs before. When she was just 4 years old and living in the orphanage, she was given a pair with hooks. She hated them. She threw them down the stairs and refused to wear them.

At the age of 11, she received a pair of mechanical arms that had hands and fingers. They were crude and heavy, she said, and worked too much like a machine.

She wore them until she was 14, when the harness that held them in place no longer fit. By this time she had been adopted by a family in the town of Firgas, on the island of Gran Canaria.

She wanted a new pair of arms, she said, but there was no way to pay for them.

She has never really felt handicapped, she said. She said she can feel her hands, though she has none. "My doctors say I am crazy, it is impossible," she said. "But my brain thinks I have the hands."

As she grew into a young woman, she was determined to have a permanent, graceful pair of arms. Doctors told her the best place to get such arms is the United States.

She decided to come to Hopkins, where her orthopedist on Gran Canaria, Dr. Hani Mhaidli, once studied. Hopkins' orthopedics department is considered one of the best in this country.

'A lot of guts'

She would not say exactly how the arms are being paid for. But she did say that the Spanish government has taken responsibility for her disability and agreed to pay for her medical care for the rest of her life. Friends say she lobbied officials in Spain to permit her to come to Hopkins.

"She's got a lot of guts," Ms. Hutton said. "She gets people moving and doing things."

Her new arms are being built by Charles H. Dankmeyer Jr. of Dankmeyer Inc. in Linthicum. The company is the state's largest maker of artificial limbs and braces.

Soon after he started working with her, Mr. Dankmeyer realized that satisfying Ms. Lopez-Perez would be a difficult task.

Before she left Spain, she saw the movie "Terminator," in which Arnold Schwarzenegger plays a robot built to resemble a human.

In one scene, skin is torn off the robot's arm, revealing the machinery underneath.

"Look!" Ms. Lopez-Perez said. "They can move the fingers!"

Ms. Lopez-Perez brought a videotape of the film with her to the United States, and showed it to her doctors at Hopkins. They shook their heads. Those arms, they said, are a Hollywood fantasy. Prosthetic arms can't move as smoothly as real arms. Prosthetic fingers can't flex and move independently like real fingers.

"Those are the arms that I want," she insisted. She said she was "very upset."

Mr. Dankmeyer and her doctors, meanwhile, worried about more practical matters. How much weight could she tolerate? She is a slight woman. One of her shoulders was broken years ago, and is still sensitive.

Months of physical therapy

Mr. Dankmeyer set out to design arms that weighed no more than 12 pounds. But even that proved too heavy.

Her shoulders needed strengthening. She spent months at Hopkins in exhausting, painful physical therapy.

"There were good days and bad days," said Dr. Carl A. Johnson, an orthopedic surgeon who runs Hopkins' prosthesis clinic. "She did not give up. She would not give up. There were days when anybody else might have given up."

Mr. Dankmeyer made a plaster model of her upper torso. He designed arms, switch mounts, control mounts and a battery pack, and then made mock-ups, fitting them to the torso.

When the vinyl skin covering was made, it was dyed to match Ms. Lopez-Perez's skin color.

The matter of rings

Artificial hands are generally not custom-made. They come in several sizes. Ms. Lopez-Perez chose a pair about the same size as those of her friend Brenda Almenas, 22, of Puerto Rico, who plans to graduate next year from the College of Notre Dame of Maryland.

Then, of course, there was the matter of her rings.

"The rings were a multitude of sizes," said Mr. Dankmeyer. "We took the hands and asked Beatriz, 'Now, which ring on which finger?' " Then he gave the rings to a jeweler in Ellicott City who adjusted them so they would fit the fingers on Ms. Lopez-Perez's new hands.

"She's very, very determined," he said. "She certainly is expressive about her likes and dislikes.

"Strong-willed," he said, "may be an understatement."

Her new arms weigh just 9 pounds. In the coming months, she will learn to use muscles in her shoulders to move six switches in the harness, three on each shoulder.

Of the three switches, one controls motors that will bend the arm up at the elbow. The other two switches control the rotation of her wrists, and the opening and closing of the fingers of her hands. (The fingers open and close together. They cannot move independently, as Ms. Lopez-Perez would like).

The new arms will not replace Ms. Lopez-Perez's feet, Mr. Dankmeyer said. "She'll have the ability to reach out and grab a cup," he said. "But she can't feel the cup. Prostheses are helpers. Tools. There will be times when she will not want to wear them, and there's no shame in that."

Ms. Lopez-Perez did not want to discuss the cost of her new arms. Mr. Dankmeyer said that, in general, a pair of prosthetic arms can cost between $7,000 and $45,000, depending on their sophistication.

Helping friend 'Dieguito'

Shortly after she came to Baltimore, Ms. Lopez-Perez received a letter and phone call from a 24-year-old student from northern Spain, Diego A. Femia-Godoy, who had seen her on Spanish television.

Mr. Femia-Godoy lost both his forearms while playing on power lines as a child. He wants to come to Hopkins to get a new, more advanced pair of prosthetic arms similar to Ms. Lopez-Perez's.

She became his champion. She spent long hours in the Loyola-Notre Dame library researching prosthetics makers. She lobbied Mr. Femia-Godoy's parents to permit their son to come to the United States. She pushed and prodded, and spent long hours on the phone with Mr. Femia-Godoy, whom she calls "Dieguito."

'I believe'

She cried, she said, when his parents agreed. When he arrives in a few weeks, he will have a fierce and loyal advocate in Ms. Lopez-Perez.

"I bring all that I have to another person," she said. "I believe in another person."

In December, Ms. Lopez-Perez plans to return to her home in the Canary Islands. "When I go back to my country, I will have a big problem," she said. "Everybody will want to know, 'What happened to Beatriz?' "

She will have arms, of course. She will be more independent. And she will have new goals. She wants to work with the children at the San Juan de Dios school for the handicapped, which she attended, in Las Palmas, Gran Canaria.

"I want to give back what I have received," she said.

Such are the dreams of Beatriz Lopez-Perez. To have arms. To raise a family. And someday to help others grow to be happy and whole.

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