A stray bullet can change a life. Or put an end to one. Nineteen years ago, Wilmer Arias was just a boy who liked to play innocently with his cousins in the street. He was an ordinary nine-year-old, who went to school and helped his grandfather in the fields. It was a normal childhood in his country, Guatemala, until one day a stray bullet hit him in his fragile neck and changed everything.
Wilmer Arias appeared in Valencia this week, sitting upright in a wheelchair and with an enormous smile, thanks to the latest 'miracle' performed by Dr Pedro Cavadas and his team. The surgeon's most recent stroke of genius was to reconstruct a complete separation between someone's spinal column and pelvis, and that complex operation has meant that Wilmer, who is now 28, can sit for the first time without suffering pain.
Cavadas and his patient appeared at a press conference at the hospital in Manises to share Wilmer's brave story and explain the complexity of the operation. Thanks to an agreement between the Manises hospital and the Cavadas Foundation, these hair-raising operations are now possible.
Wilmer was wearing a polo shirt over a long-sleeved tee-shirt, jeans over his wiry legs, and highly-polished shoes. Beside him Dr Cavadas, smiling happily, wore old denims, hiking shoes and, as usual, a camouflage tee-shirt. He discarded his white coat years ago because he didn't like "dressing up as a doctor".
It has taken two long operations, one of them involving eight hours of surgery, in order to see Wilmer sitting in a chair. His condition had reached an extreme point; he was desperate; his life was in danger. Dr Cavadas explained that his vertebrae were so damaged that his spine was "split in two". The doctor and his patient took it in turns to speak to the press. The bond they have come to share was obvious.
What about that bullet? "Life is random and uncertain. Some lives are cut short because of bad luck," said the doctor. Nobody knows where the bullet which prostrated Wilmer for life came from.
After exploratory surgery, he spent two and a half months in a coma. Nobody moved his delicate body during that time, and that caused ulcers on his back and a great deal of pain.
"We didn't have money for medical treatment, so I just had to try and bear it," explained Wilmer.
Cavadas said that as time passed the ulcers became infected because they remained open. The infection penetrated the sacral bone and 'ate' it, causing it to deform. The sacrum helps to shape the spinal column and the pelvis.
"The situation was very complicated, because the aorta was just a few centimetres away. It was a wound which would never have closed. He would have died," said the surgeon.
A providential nurse
The operation was so complicated and delicate that some hospitals in the US told Wilmer he could die during surgery, and that it wasn't advisable to try it.
That is when destiny placed Marta, a Spanish nurse who had collaborated with the Cavadas Foundation in Madrid, in his path. They had already met in Guatemala, and Marta immediately contacted Dr Cavadas to tell him about the case.
Wilmer admitted that he had never heard of the reputation or fame of this specialist in plastic surgery, and started to search for information on the internet.
"At first I was sceptical about him, but when I had the first operation, and they removed the ulcer and I didn't have the pain any more, I trusted him 100 per cent," he said at the press conference.
The surgeon explained that two major operations were needed: one to clean up the area where the ulcers were, and the other to insert the bone. He did that with part of Wilmer's fibula, joining the remains of the pelvis with the remains of the spinal column.
"The difficult part is adapting it, knowing what type of fixture to use, how to connect the arteries and the aorta," he said, before quoting one of his favourite sayings: "We weren't trying to invent the wheel; we just needed to find out where to put it".
Wilmer, who at one point suffered severe lack of nutrition and pneumonia, is now starting a new life, one which is full of objectives. He will have to wear a corset for six months, but will gradually notice improvements. His perspective on life is completely different now, however.
He has some short-term ambitions, such as finishing his university studies in Administration and Company Management in Guatemala, and cooperating with the Pequeños Hermanos Foundation, an international organisation which fights for children's rights and helps them in tragic times of their lives.
Wilmer has rediscovered his will to live. "If you want a happy life, focus on a challenge, not on things or objects," he said.
That is a lesson that Pedro Cavadas learned years ago: he is a successful surgeon now, but when he started out money and material things were what attracted him most. Until one day, when he had a change of heart, sold his Porsche and reorganised his priorities. The luxury car was replaced with a very basic jeep and, more recently, a bicycle.
It is likely that no other Spanish doctor is as popular in the world, which is now accustomed to his surgical achievements. Like the arm stitched on to a patient's leg for nine days, the first hand and forearm transplant, the first facial reconstruction in Spain; milestones made possible by a stroke of luck back in 1983.
Because Pedro Cavadas had wanted to be a veterinary surgeon, but that would have meant moving to Zaragoza and he didn't want to leave Valencia. Six years later he qualified in Medicine with honours and an award.
He then specialised in plastic surgery, without really knowing what he wanted to do, apart from the fact that he detested, really detested, cosmetic surgery.
Playing at survival
Decades later, he has become one of the most important specialists in reconstructive plastic surgery on the planet. Where hope ends, Cavadas appears. Those who plead for help, lost cases, find it, even if it has nothing to do with his speciality. And his achievements reflect the bravery of the patients who come knocking on his door.
This 'miracle doctor' devotes his whole life to medicine. Some days he carries out one operation after another, even forgetting to eat. His passion never abandons him, not even when he rests: that's when he reads books on reconstructive surgery.
He only really relaxes with his children, Ruo, 17, and Xiao, 13 - whom he adopted in China - and on his charity trips to Tanzania, where he operates free of charge on dozens of patients with mutilations, tumours and a thousand other problems.
A couple of times a year, in a remote hamlet called Engaresero, he sets up a field hospital with no electricity and water from the river. He doesn't rest from sunrise to sunset, when he puts his scalpel down because the insects start to appear. There, when he has a bit of time free, he escapes with a compass, a rucksack, a box of matches and a bow. It's time to play at survival.
In inland Valencia province he has created a small wilderness of his own, a property in Villagordo del Cabriel, where he raised and bottle-fed Pan, a fawn born on St Pancras' Day.
He is, however, always in a hurry to get back to the operating theatre. That's where he feels most at home, and saving patients like Wilmer is the real meaning of his existence. "We have given someone the gift of life," he said. Another 'miracle'.