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In every town in every part of this sprawling country you can find a faceless sprawling strip mall in which to do the shopping.

Rarely though do would you expect to find a medical miracle working behind the counter of the mall's hobby shop.

That however is what Lee Spievak considers himself to be.

"I put my finger in," Mr Spievak says, pointing towards the propeller of a model airplane, "and that's when I sliced my finger off."


I think that within ten years that we will have strategies that will re-grow the bones, and promote the growth of functional tissue around those bones
Dr Dr Stephen Badylak
University of Pittsburgh

It took the end right off, down to the bone, about half an inch.

"We don't know where the piece went."

The photos of his severed finger tip are pretty graphic. You can understand why doctors said he'd lost it for good.

Today though, you wouldn't know it. Mr Spievak, who is 69 years old, shows off his finger, and it's all there, tissue, nerves, nail, skin, even his finger print.

'Pixie dust'

How? Well that's the truly remarkable part. It wasn't a transplant. Mr Spievak re-grew his finger tip. He used a powder - or pixie dust as he sometimes refers to it while telling his story.

Mr Speivak's brother Alan - who was working in the field of regenerative medicine - sent him the powder.

For ten days Mr Spievak put a little on his finger.

"The second time I put it on I already could see growth. Each day it was up further. Finally it closed up and was a finger.

"It took about four weeks before it was sealed."

Now he says he has "complete feeling, complete movement."

The "pixie dust" comes from the University of Pittsburgh, though in the lab Dr Stephen Badylak prefers to call it extra cellular matrix.

Pig's bladder

The process he has been pioneering over the last few years involves scraping the cells from the lining of a pig's bladder.

The remaining tissue is then placed into acid, "cleaned" of all cells, and dried out.

It can be turned into sheets, or a powder.

How it works in detail

It looks like a simple process, but of course the science is complex.

"There are all sorts of signals in the body," explains Dr Badylak.

"We have got signals that are good for forming scar, and others that are good for regenerating tissues.

"One way to think about these matrices is that we have taken out many of the stimuli for scar tissue formation and left those signals that were always there anyway for constructive remodelling."

In other words when the extra cellular matrix is put on a wound, scientists believe it stimulates cells in the tissue to grow rather than scar.

If they can perfect the technique, it might mean one day they could repair not just a severed finger, but severely burnt skin, or even damaged organs.

Clinical trial

They hope soon to start a clinical trial in Buenos Aires on a woman who has cancer of the oesophagus.

The normal procedure in such cases is often deadly. Doctors remove the cancerous portion and try to stretch the stomach lining up to meet the shortened oesophagus.

In the trial they will place the extra cellular matrix inside the body from where the portion of oesophagus has been removed, and hope to stimulate the cells around it to re-grow the missing portion.

So could limbs be re-grown? Dr Badylak is cautious, but believes the technology is potentially revolutionary.

"I think that within ten years that we will have strategies that will re-grow the bones, and promote the growth of functional tissue around those bones. And that is a major step towards eventually doing the entire limb."

That kind of talk has got the US military interested.

They are just about to start trials to re-grow parts of the fingers of injured soldiers.

Skin burns

They also hope the matrix might help veterans like Robert Henline re-grow burnt skin.

He was almost killed in an explosion while serving in Iraq. His four colleagues travelling with him in the army Humvee were all killed.

He suffered 35% burns to his head and upper body. His ears are almost totally gone, the skin on his head has been burnt to the bone, his face is a swollen raw mess.

So far he has undergone surgery 25 times. He reckons he has got another 30 to go.

Anything that could be done in terms of regeneration would be great he says.

"Life changing! I think I'm more scared of hospitals than I am of going back to Iraq again."

Like any developing technology there are many unknowns. There are worries about encouraging cancerous growths by using the matrix.

Doctors though believe that within the so called pixie dust lies an amazing medical discovery.

The missing finger that never was

* Ben Goldacre
* The Guardian,
* Saturday May 3 2008

This article appeared in the Guardian on Saturday May 03 2008 on p15 of the UK news section. It was last updated at 00:09 on May 03 2008.


Traditionally on May Day the fool plays at pratfalls and buffoonery around local morris dancers, brandishing his fool's bauble, an inflated pig's bladder on a stick, with which he bewitches and controls the crowds. To the uninitiated it looks like chaos, but for his own safety the fool must know the dances as well as anyone, so that his weaving tomfoolery meshes perfectly with the intricate pattern of kicks, handkerchief waving, and stickbashing.

In the newspapers on May Day, meanwhile, journalists were earnestly reporting the news that pig's bladder extract had been used by scientists in a major breakthrough allowing one man to magically regrow a finger. "'Pixie dust' helps man grow new finger," squealed the Telegraph's headline. "'Pixie dust' makes man's severed finger regrow," said the Times. "Made from dried pig's bladder," they explained, this magic powder "kick-starts the body's healing process".

Now firstly, if you look at the pictures accompanying this column, you will see from the "before" image that there is no missing finger, so we might naively intuit that there is no "missing finger grows back" story to be written. In fact, from the grainy images and scant descriptions available - despite blanket news media coverage, including television interviews - it seems this bloke lost about 3/8 of an inch of skin and flesh from the tip of his finger, and the nail bed is intact.

Make no mistake: I'd be whingeing a lot if it happened to me, but injured fingers do heal, sometimes badly, often nicely, just like gouges and scrapes on the rest of your body. "Nerves, tissue, blood vessel, skin" regrew, said the BBC. Yes. Up and down the country as we speak. The body is an amazing thing. If your experience of rollerskating injuries is not enough, Simon Kay, professor of hand surgery at the University of Leeds, saw the before-and-after pictures, and says: "It looked to have been an ordinary fingertip injury with quite unremarkable healing. This is junk science."

Where did this miraculous story come from? Dr Badylak is the scientist quoted in all of these stories. He told me: "This story came to the media not through us, but rather through the patient. I would just as soon it had not gone out until we complete our pilot study." That is unfortunate. I asked how this patient was recruited, what consent was obtained, how safety was assessed, whether this work has been published, and whether it will be published. He did not answer. Fair enough. He agrees that scepticism is understandable. I'm grateful.

The patient is Lee Spievack. He was given the powder by Acell, a large and longstanding biotech firm founded by Alan Spievack. He is Lee Spievack's big brother. Dr Badylak is Acell's chief scientific adviser, and he can be seen bravely making the best of all this unwelcome media attention by showing TV cameras around his labs and giving lengthy interviews, both now and in February 2008, when this story made the US news, and also, interestingly, in February of 2007, when it made the news for the first time, in exactly the same form, with exactly the same characters, and many identical quotes, verbatim, in the Wall Street Journal, MSNBC, and more. The injury itself, meanwhile, apparently happened (and healed) way back in 2005.

Reconstructing the media frenzy, it all seems to have kicked off - this time around - with BBC New York correspondent Matthew Price doing a very credulous set of interviews that went live on the BBC site on Wednesday at 3pm.

He nods endlessly and says "that's astonishing" when the company founder's little brother tells him that the tip of his finger healed. In the computer animation used by the BBC, a finger miraculously grows back more than half its length, at least two joints worth. At 11:30pm that same day the Press Association put out a story, but the newspapers must have had it sooner for the next day's papers, so I guess they lifted it from the BBC, too. By May Day 3:30pm the story was on Fox news (their morning), and by 11:30pm it hit ABC Australia. All used the same quotes in different permutations. And that's how news works.

Meanwhile, Dr Badylak now tells me that the entire nail bed was missing. This contradicts various previous news reports and apparently the pictures. He also says half the distal bone was missing. Confused? You should be. I've asked him for more pictures. I guess that just goes to show that the media is a confusing and inappropriate place to communicate new and unpublished epoch-making scientific breakthroughs (from 2005).

But we can console ourselves with the thought that one lucky company has had plenty of international media exposure. On three separate occasions. Over two years.