Brander and Dr. S. David Stulberg, an orthopedic surgeon, see patients at a plush office on Lake Shore Drive.
But for about 10 days every year, the co-directors of Operation Walk Chicago willingly throw themselves into the most primitive conditions, performing free surgery along with educating local health care workers in advanced surgical and rehabilitation techniques.
The Chicago team has fixed knees and hips in China, Ecuador and India and, in 2011, in Humboldt Park, restoring the gift of mobility to disadvantaged Chicagoans. But the limitations during previous trips were nothing compared with those in Nepal, where threadbare resources force patients to improvise to get around. It's not uncommon to observe amputees relying on old skateboards or tree branches as wheelchairs and crutches.
"Once you see these things, you can't unsee them," Brander said. "The seed has been planted."
Operation Walk was founded in 1994 by Dr. Lawrence Dorr, a Los Angeles surgeon. There are now 11 chapters nationwide, including in Chicago. Typically it takes about $200,000 to fund a mission, with each organization soliciting its own donations of cash and equipment.
Destinations are selected based on several criteria, including whether a country has sufficient clinicians willing to provide follow-up treatment and officials with enough clout to circumvent the bureaucrats demanding bribes before releasing tons of medical supplies shipped in advance.
Electricity often is erratic, water contaminated and air conditioning nonexistent. Two patients frequently occupy a single bed, while their families sleep on the floor, allowing them to feed and care for their loved ones, Brander said.
Despite all the stumbling blocks, the organization has plenty of volunteers, who often pay their own expenses and use vacation days for the privilege of putting in 14-hour shifts.
"It's a test of how good you are, the sharpness of your skills, your stamina, everything," Brander said. "It's a chance to get back to some basic medicine. Even the most jaded surgeon is moved."
Dr. Lalit Puri was part of the Nepal mission, his first. Being part of the team — which performed 35 joint replacements — was a transformative experience, the orthopedic surgeon said. "I knew right away that this was going to be a part of my life and my career."
In many developing countries, the disabled are outcasts, often relegated to a life of begging. It's another reason that so many Nepalese traveled for days to be seen; why tears, hugs and gifts of almonds or fruit were daily offerings from grateful locals, the doctors said.
Still, no matter how hard the physicians floored the accelerator — the usual 45-minute Chicago office visit was reduced to a two-minute assessment overseas — the patients never stopped coming.
"Sometimes that means making difficult choices," said Brander, closing her eyes. "Do you save the 20-year-old or the 70-year-old? You have to decide."
Surgery and recovery
About 18 months after that first examination in Katmandu, Team Sajina, as they called themselves, was poised for her arrival in Chicago this summer.
Transportation, visas and housing details had all been ironed out. Operating room time was reserved and an elite roster of physicians had been assembled. Even members of Chicago's Nepalese community — about 10,000 strong, concentrated in the Uptown and Rogers Park neighborhoods — were alerted.
On the morning of July 18, team members walked over to Worcester House, an apartment building near the hospital, to retrieve the skittish patient. With the curtain about to go up on this carefully calibrated ballet, Tamang was having second thoughts. Perhaps the surgery could be postponed?
"Think about having an operation, which is already scary," Brander said. "Then add that you're far from home, in a strange city, where you don't know the language or have any family. It's understandable."
The usual one-hour surgery stretched into 31/2 hours, much of it devoted to repairing work done by doctors in Lebanon, who used screws and bolts to hold her shattered pelvis together.
When she arrived at Northwestern, the initial X-rays looked like someone had emptied a toolbox into her midsection. While the Lebanese physicians did their best, they lacked the expertise to tackle such a complicated procedure, explained Puri, comparing Tamang's injuries to a shattered urn.
"When her pelvis was put back together, some of the pieces were missing," said the surgeon, who later handed the patient a fistful of hardware as a souvenir.
Three days later, Tamang moved across the street to the Rehabilitation Institute of Chicago, where she spent two weeks learning to walk again with daily sessions of physical and occupational therapy. She's still grappling with the challenges — both to the body and the spirit — of an arduous road to recovery, but if all goes according to plan, she'll return to Nepal early next month.
"Stand tall, push through it, can you take a quicker step?" said physical therapist Nicole Williams, watching her patient on the treadmill. "How's your pain? Two more minutes, then we'll take a break."
Tamang grimaced, but kept going.
Operation Walk Chicago is a not-for-profit volunteer medical group that provides free hip and knee replacements for impoverished patients. To learn more or make a donation, go to operationwalkchicago.com or contact Jane Scanlon, Operation Walk Chicago administrative director, at 312-475-5613.