When Gehane Guirguis set out for a short vacation on a bus from Cairo, Egypt, to the Red Sea in July 2012, she could not have foreseen how the trip would change her life in unthinkable ways.
Guirguis, now 37, was traveling with her mother, aunt and two young daughters when the bus driver briefly stopped in a wooded area. When he returned, fueled by drugs, he began speeding down the precarious roadway. Passengers were yelling for him to slow down, but he did not.
When the bus flipped, Guirguis was holding her 2 1/2-year-old daughter tightly. Moments later, her daughter was killed in the crash, and the arms that had tried to protect her were smashed beyond repair.
Guirguis had both amputated above the elbow, rendering her unable to care for herself in any way. With a major skull injury as well, she went into a coma.
But she survived.
Her husband, Essam, has been her constant companion and caregiver, closing his travel business to feed, bathe and dress his wife and care for their 5 1/2-year-old child, Carole.
But from that tragic trip has come an unexpected journey. From the moment Guirguis was critically injured by the side of the road, she has seen the hand of God guiding her, she said. That divine hand led her to a Bay Area entrepreneur who would help her receive prosthetic arms.
Dozens of local medical professionals at Stanford University Medical Center and in Palo Alto, Mountain View and surrounding communities have donated their time and facilities at little or no cost to help Guirguis and her family. After three weeks in the U.S., she can play with her daughter again.
On Tuesday morning, occupational therapist Natalie de Leon hung nearly a dozen colorful plastic rings on pegs in a corner of the therapy room at Covenant Care's Palo Alto Sub-Acute and Rehabilitation Center on Bryant Street. Guirguis, sporting new mechanical arms, reached for the rings with the hooks that now serve as her hands. Using shoulder movements to extend the elbow joint of her new arms, which are moved with springs and pulleys, she hooked a red ring and dropped it into a plastic basin.
Guirguis smiled with each successful effort, often laughing.
"I want to learn," she said.
A year and eight months after the accident, Guirguis is still being treated for a severe head injury and infection, despite skin grafts from her thigh. She wears a knit cap to cover the head wound where her hair is still missing and to keep the area clean as it heals. When she first arrived, her arms were like jelly, rehab specialists said. Now she can open doors and perform other daily living activities.
Sameh Michaiel, co-founder of a software startup, Mobilque, watched as Guirguis has learned to use her new arms. Her journey has been his too, with God's guidance, he said.
For him, it began with a phone call from his brother-in-law, a volunteer at St. Mary of Zeitoun hospital where Guirguis was treated in Egypt. He felt immediately moved to act, he said. He began raising money through the nonprofit St. Samuel the Confessor, a Coptic relief organization in Egypt, and he phoned all over the U.S. to find a place to get her arms.
Few organizations work with bilateral amputees. People with bilateral amputations above the elbow comprise less than one-tenth of 1 percent of the amputee population, according to prosthetic professionals involved in the project.
Michaiel contacted the Rehabilitation Institute of Chicago, which could help, but the estimated cost was $200,000. "Obviously, it was extremely out of reach," he said.
But looking closer to home, he found Norell Prosthetics Orthotics in Mountain View, where Charlie Kelly volunteered to help. He worked with Campbell-based company Hosmer, which manufactures prostheses. Hosmer supplied the prosthetic arms at low cost, he said.
Kelly and Guirguis worked from 5 p.m. until 1 a.m. to properly fit and work the arms, he said. When the family and Michaiel insisted on paying him, he made up a bill and instead wrote they should make the check payable to Carole's college fund, he said.
"My mom was a trauma nurse. I grew up in a trauma ward and in the emergency room. I've seen a lot of bad things happen to good people," he said.
Kelly said he will remember this project for the rest of his career and his life.
"She had nothing but gratitude. There was just a fire in her that you could see was driving her," he said.
Michaiel saw Guirguis for the first time through Skype during her interview with Kelly. Recalling that moment brings him to tears.
"I asked her what she would like to be able to do, and she said she wanted to comb her daughter's hair again," he said.
Michaiel called Deirdre Ruvolo-Walker, housing coordinator at Stanford Medical Center Social Work & Case Management, to find affordable accommodations for Guirguis and her family. Through the Assistance League of Los Altos, she arranged a $35-a-night stay in an apartment the organization owns across from the hospital, she said. Barbara Ralston, the vice president of International Medicine at Stanford, assigned an Arabic-speaking representative, and the primary-care clinic got the Santa Clara Valley Medical Burn Center to treat her head injuries, Ruvolo-Walker said.
"When I met her, I was just blown away. ... I expected to meet a very sick, depressed person. This beautiful spirit came out of her, and you could see it come out of her eyes.
"This whole community came together on this. It was a remarkable communal effort that demonstrates what I like to think of in life: that people are basically good," she said.
Ruvolo-Walker called Heidi Stone, area director of sales and marketing for Covenant Care.
"Heidi helps us a lot. We call her when we have very sensitive issues and difficult cases," she said. The company's board immediately offered Guirguis all care and treatment free of charge, she said.
Guirguis can soon leave with her family for home, perhaps in a few weeks, said Jonathan Fusilero, facility rehab coordinator. She can read a newspaper and use the computer to look at her Facebook page something that has given her great pleasure, she said. She is thankful for all that Americans have done for her, and faith that has made it all possible, she said.
"This looks as if this is an extremely difficult life experience. Since the very, very beginning, we have felt God's presence. It doesn't feel as difficult because this is the act of God, and we are handling it with peace and resilience," she said.
Carole sat beside her mother and pressed inward, holding the hook that is now her mother's hand. Guirguis reflected on what the new arms have given her family after so much loss.
"One of the first things I wanted to do is to hug my daughter and comfort her, and now I can hug her. And I am looking forward to comforting her," she said.