At first, he thought it must be a hoax.
The man in the picture didn't have hands at the ends of his arms; he had what looked like tree branches - two masses of tangled, overgrown bark.
In more than 20 years of practicing medicine, Dr. Anthony Gaspari, chief of dermatology at the University of Maryland Medical Center, had seen terrible skin conditions, but he'd never seen anything so incredible or so bizarre.
FOR THE RECORD - A photo caption in yesterday's You & Your Health section should have identified the physician examining Dede Kosawa as Dr. Rachmat Dinata, head of the Indonesian medical team treating Kosawa.
THE BALTIMORE SUN REGRETS THE ERROR
"It was just so outrageous, so unusual, I wasn't convinced the hands were real," the doctor remembers. "I thought maybe they were somehow taped on."
A crew from Discovery Health, part of the Maryland-based Discovery Communications, had sent Gaspari the pictures along with an invitation. Would he be willing to fly to Indonesia and help them make a diagnosis?
Despite his doubts and concerns about Indonesia, a country in Southeast Asia known for terrorist activity, he boarded a plane in June 2007, beginning an odyssey that would take him to the other side of the world, drop him into diplomatic negotiations with his peers in another country, spawn two television documentaries and introduce him to a man who's fostered a sense of hope in the face of the most extreme adversity.
Just getting to the patient was an adventure.
Gaspari, who is also chairman of the department of dermatology at the University of Maryland School of Medicine, had to travel 10,000 miles. It started with a flight from Baltimore to Chicago and then on to Beijing. From Beijing, he flew to Jakarta, Indonesia. From there, he had a three-hour drive to the city of Bandung, the closest large city to the crew's rural destination.
After a night's rest in Bandung, Gaspari and the Discovery film crew drove for an hour to a lakeside village, took a half-hour boat ride across the lake and then hiked up a long, dirt hill in tropical heat to finally reach the patient: Dede Kosawa, a 35-year-old known as the "Treeman."
"You couldn't tell the top of his hand from the bottom," Gaspari says. "Warts carpeted his body. From his elbow to his fingertips, you couldn't see a spot of skin."
Kosawa's life had changed after he scraped his knee as a teenager and warts began to appear around the wound. The warts then spread across his entire body, turning, after 20 years without much intervention, into a disfiguring, debilitating condition. He lost his job and his wife and he depended on his family to dress him, feed him - even carry him.
