BALTIMORE // A soldier who lost all four limbs in a roadside bombing in Iraq says he is looking forward to driving and swimming with new arms after undergoing a double-arm transplant.
"I just want to get the most out of these arms, and just as goals come up, knock them down and take it absolutely as far as I can," Brendan Marrocco said.
The 26-year-old New Yorker spoke at a news conference at Johns Hopkins Hospital, where he was joined by surgeons who performed the operation.
After he was wounded, Mr Marrocco said, he felt fine using prosthetic legs, but he hated not having arms.
"You talk with your hands, you do everything with your hands, basically, and when you don't have that, you're kind of lost for a while," he said.
Mr Marrocco said his chief desire is to drive the black Dodge Charger that has been sitting in his garage for three years.
"I used to love to drive," he said. "I'm really looking forward to just getting back to that, and just becoming an athlete again."
Although he does not expect to excel at soccer, his favourite sport, Mr Marrocco said he would like to swim and compete in a marathon using a handcycle.
He joked that military service members sometimes regard themselves as poorly paid professional athletes. His good humour and optimism are among the qualities doctors cited as signs he would recover much of his arm and hand use in two to three years.
"He's a young man with a tremendous amount of hope, and he's stubborn - stubborn in a good way," said Dr Jaimie Shores, the hospital's clinical director of hand transplantation. "I think the sky's the limit."
Dr Shores said Mr Marrocco had already been trying to use his hands, although he lacks feeling in the fingers, and he was eager to do more as the slow-growing nerves and muscles mend.
"I suspect that he will be using his hands for just about everything as we let him start trying to do more and more. Right now, we're the ones really kind of holding him back at this point," he said.
The procedure on Mr Marrocco was only the seventh double-hand or double-arm transplant ever done in the United States.
The infantryman was injured by a roadside bomb in 2009. He is the first soldier to survive losing all four limbs in the Iraq war.
Mr Marrocco also received bone marrow from the same donor to minimise the medicine needed to prevent rejection. He said he did not know much about the donor but "I'm humbled by their gift".
The 13-hour operation on December 18 was led by Dr WP Andrew Lee, plastic surgery chief at the hospital.
Mr Marrocco is to be released from the hospital but will receive intensive therapy for two years at John Hopkins and then at Walter Reed National Military Medical Centre in Bethesda.
After a major surgery, human nerves regenerate at a rate of about 2.5 centimetres per month, Dr Lee said.
"The progress will be slow, but the outcome will be rewarding," he added.
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ESSENTIALS
The flights
Emirates flies direct from Dubai to Rio de Janeiro from Dh7,000 return including taxes. Avianca fliles from Rio to Cusco via Lima from $399 (Dhxx) return including taxes.
The trip
From US$1,830 per deluxe cabin, twin share, for the one-night Spirit of the Water itinerary and US$4,630 per deluxe cabin for the Peruvian Highlands itinerary, inclusive of meals, and beverages. Surcharges apply for some excursions.
if you go
Getting there
Etihad (Etihad.com), Emirates (emirates.com) and Air France (www.airfrance.com) fly to Paris’ Charles de Gaulle Airport, from Abu Dhabi and Dubai respectively. Return flights cost from around Dh3,785. It takes about 40 minutes to get from Paris to Compiègne by train, with return tickets costing €19. The Glade of the Armistice is 6.6km east of the railway station.
Staying there
On a handsome, tree-lined street near the Chateau’s park, La Parenthèse du Rond Royal (laparenthesedurondroyal.com) offers spacious b&b accommodation with thoughtful design touches. Lots of natural woods, old fashioned travelling trunks as decoration and multi-nozzle showers are part of the look, while there are free bikes for those who want to cycle to the glade. Prices start at €120 a night.
More information: musee-armistice-14-18.fr ; compiegne-tourisme.fr; uk.france.fr
When is VAR used?
• Goals
• Penalty decisions
• Direct red-card incidents
• Mistaken identity
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
The specs
Engine: 3.0-litre six-cylinder turbo
Power: 398hp from 5,250rpm
Torque: 580Nm at 1,900-4,800rpm
Transmission: Eight-speed auto
Fuel economy, combined: 6.5L/100km
On sale: December
Price: From Dh330,000 (estimate)
Election pledges on migration
CDU: "Now is the time to control the German borders and enforce strict border rejections"
SPD: "Border closures and blanket rejections at internal borders contradict the spirit of a common area of freedom"
Biog
Mr Kandhari is legally authorised to conduct marriages in the gurdwara
He has officiated weddings of Sikhs and people of different faiths from Malaysia, Sri Lanka, Russia, the US and Canada
Father of two sons, grandfather of six
Plays golf once a week
Enjoys trying new holiday destinations with his wife and family
Walks for an hour every morning
Completed a Bachelor of Commerce degree in Loyola College, Chennai, India
2019 is a milestone because he completes 50 years in business
Skewed figures
In the village of Mevagissey in southwest England the housing stock has doubled in the last century while the number of residents is half the historic high. The village's Neighbourhood Development Plan states that 26% of homes are holiday retreats. Prices are high, averaging around £300,000, £50,000 more than the Cornish average of £250,000. The local average wage is £15,458.
