Alumni Profile: David Chiu’73

By Julia Hickey González

In June 2015, “The Tonight Show” host Jimmy Fallon tripped on his kitchen rug and flailed to the floor, while his wedding ring caught on the countertop and stuck there. The resulting injury, which stripped his finger of its flesh, landed him in Bellevue Hospital’s intensive care unit in New York City for 10 days. He returned to the late-night stage visibly humbled, with his left hand bandaged to tell the tale: “This amazing doctor—Dr. David Chiu—he comes in. He has a bow tie and cowboy boots?! THAT’S my doctor. That’s my guy,” Fallon marveled.

David Chiu’73, NYU Langone’s chief of hand surgery and founding director of its New York Nerve Center within the plastic surgery department, exudes a maverick elegance through his choice of accessories. But he knows better than to wear rings. Four out of 10 such “ring avulsion” injuries nationally result in amputation, he said, and of the fingers that survive, only 20% regain movement.

“Jimmy Fallon can play guitar with that hand,” Dr. Chiu explains in a more grave than boastful tone. “It was a fortunate and gratifying outcome.”

Fortunate are the patients treated by Dr. Chiu because he premiered the techniques that can revive ghostly digits and even entire severed limbs. Using autogenous vein graft as nerve conduit (AVNC), he removes a vein from “more convenient and less expensive real estate” on the body, such as the foot, and threads the injured nerve stumps from both ends into it. The patient’s vein serves as a covered bridge to keep out scar tissue while the delicate, cable-like nerve strands grow toward the end-organs. The “nerve conduit” concept, coined by Dr. Chiu, inspired bioengineering companies to seek synthetic variations.

“I’m kind of the senior statesman of hand surgery in New York,” says Dr. Chiu, whose professional life has paralleled the development of microsurgery and peripheral nerve surgery in New York City. “All the difficult cases they refer to me.”

Chosen by Dr. Jerome Webster, Dr. Chiu was the first VP&S student to become a sub-intern in Columbia’s plastic surgery service. Because he is ambidextrous, he is able to sew stitches in one continuous, alternating motion. While a Columbia resident in 1978, he treated a handyman’s saw injury by completing the school’s first successful finger replantation. When television crews arrived to interview the surgeon, Dr. Chiu declined to take credit, hoping not to eclipse the attending supervisor, who had not been present.

Dr. Chiu would go on to help establish the replantation team at Bellevue Hospital throughout the 1980s after completing a fellowship there. Returning to Columbia in the ’90s, he pioneered challenging transformations in which second toes were replanted onto hands to act as functioning fingers on babies with amniotic band syndrome.

Always seeking to preserve harmony in form and function, he also began preserving subcutaneous fat under skin grafts to create a smoother, more natural appearance. He named the technique adipose tissue-preserved skin graft. And while Dr. Chiu takes great satisfaction in the aesthetic aspect of plastic surgery, he continues to feel that his highest duty is to those in dire need of vital reconstruction and preservation of movement. On a trip to Morocco, he observed halal slaughtered chickens running headless through a courtyard. This sparked research into the powers of the spinal cord, as opposed to the brain, to direct motion. Collaborating across cell biology and anatomy departments, his lab used a rodent model to identify his hypothesized “spinal brain” when a proximal spinal nerve was cut and implanted into this specific area of gray matter (Lamina 7-9). For developments including AVNC and the concept of re-entry spinal cord innervation, Dr. Chiu received the prestigious Hanno Millesi Award in Vienna in 2010 for achievements in peripheral nerve regeneration. He was the second American to receive the honor.

A Benevolent Path

As a 5-year-old patient in his pediatrician’s waiting room, David Chiu approached each of the other children to ask how they were feeling. “Are you sick? Do you have a sore throat?”

The nurses delighted in the boy’s desire to mimic his pediatrician. He was a soloist in his school’s chorus in Hong Kong, and he had fallen ill just before a competition. His pediatrician filled a porcelain bowl with water, heated it with an alcohol lamp, and had the boy inhale the steam to clear his nasal passages.

“I sang, and we won. He became my biggest hero,” says Dr. Chiu. He saw that the practice of medicine came down to one fundamental and benevolent reality: Doctors make people better. It became his life goal.

Dr. Chiu’s parents were initially dubious about his choice to pursue medicine, because they had never seen him touch anything dirty.

Dr. Chiu’s last memory of Sunwui, China, where he was born and from which his family fled after the Communist revolution of 1949, is an image of his servants weeping before him on their knees. He was 4. Dr. Chiu was his father’s only son and, he explains, the 31st generation descendent from the second emperor of the Song dynasty. After the new regime condemned his family, they escaped to Hong Kong. His aunts would die by suicide. He wouldn’t return to China until traveling with a medical delegation in 1984. When he looked out of the plane upon China’s coastline, he was surprised when his eyes welled with tears.

“China is always part of me. I am very proud of my Chinese cultural heritage and my family legacy. One thing I’m very proud of is that my ancestor became emperor of the Song dynasty without spilling one drop of blood. And we never produced a tyrant,” he says.

Dr. Chiu studied in England and the United States, where he attended the University of Missouri before arriving at what is now VP&S. In medical school, he developed a passion for the mess of surgery. “I wear gloves,” he told his parents. “It’s all fun.”

Dr. Chiu found medical school relatively easy. First of all, although he has dyslexia, he could speed read his textbooks. “So when I read, I don’t read words. I don’t read lines. I read pages,” he says.

A remarkable auditory memory also helped. After attending a lecture, he would have the content memorized. His classmates, incredulous, demanded to see his notebook, only to find illegible scribbling that he did to pass the time.

Because the medical student found himself with an unusually flexible schedule, he focused on elevating the extracurricular activities of the VP&S Club to meet his princely standards. He had attended movie nights with black-and-white projections on a torn screen and the occasional bedsheet toga party but felt the students deserved better.

“I like to see things in good order. I wanted it to be well organized. If you have some good idea, well, do it. Do it right. Do it the best,” he says.

Dr. Chiu became president of the club, fired its director, hired an executive secretary, began charging for events, and revitalized the organization’s finances. For the Christmas party in 1972, he put out a sign-up list for student volunteers to rearrange the dining hall at 50 Haven Avenue into a dancing room. Only one person signed up, under the name “Rudolph the Reindeer.”

As dinner was concluding, Dr. Chiu took to moving the furniture by himself. One by one, other students joined in until everyone had prepared the hall for the musical guest: the psychedelic rock band from the Broadway production of “Joseph and the Amazing Technicolor Dreamcoat.”

“It was electrifying!” Dr. Chiu remembers. The booming show greatly moved the young associate dean, Dr. Donald Tapley, who became the club’s greatest benefactor and advocate. The club expanded its activities and professionalized its theatrical performances, such as full musicals with VP&S student actors and the spectacular singer and saxophonist Yvonne Thornton’73.

“No one mocked me anymore,” Dr. Chiu says. “You know, those four years were some of the most beautiful of my life.”

Dr. Chiu met his wife, Lilian, on her first day of medical school at Columbia. He was a fourth-year student walking the halls to ensure all was in good order when he saw a young woman who appeared lost. He offered assistance and showed her to the dean’s office. Later that morning, he sat beside her on the bus to her first-year picnic upstate. When he commented on what appeared to be an ornate engagement ring, he was pleased that she told him it was only a disguise.

That night, at a party Dr. Chiu had organized through the VP&S Club to welcome first-year students, she kissed him on the dance floor in front of everyone. 

What Plastic Surgeons Do

After refusing the limelight for the first finger replantation at Columbia, Dr. Chiu finally agreed that TV cameras could enter his surgical theater in 1992. The Learning Channel would televise, live, parts of the attempt to create a functional hand for a 1-year-old girl who experienced amniotic band syndrome in utero. Strings of scar tissue had wrapped around her developing hand, and she emerged with only a pinky finger at birth.

As director of Columbia’s plastic surgery service, Dr. Chiu devised a plan to replant the baby’s second toes onto her hand, in addition to cleaving her fused digital stump into two additional fingers. The hope was to create a thumb and two fingers in addition to the pinky and, therefore, the ability to grasp. He didn’t anticipate the crowd of people jammed into the OR, that students would be watching the surgery live streamed from a filled auditorium, or the disbelief he would encounter.

“Sir, what gives you the right to experiment on a child?” he recalls a BBC producer asking.

“I’m not experimenting. I am developing a new way to do things. That’s what plastic surgeons always do. I base my design on the things I can do well with confidence,” he explained.

“But if it doesn’t work, that would cause you a tremendous amount of embarrassment,” the producer added.

 “What kind of doctor do you think I am? The chance to give the child a lifetime of function and productivity is worth the risk. Do you think I should not do it because I may fail?” he told her and got to work.

More than 10 hours later, the lights on the stage were so bright that the tiny new finger looked transparent. He removed the clip that would open the connecting artery and waited for the blood to flow. The finger turned a lively pink—a sign that all was in good order.

He would go on to complete 16 successful surgeries in eight babies with amniotic band syndrome, with every patient gaining a functional hand. Thirty years later, his first patient has grown into a thriving nurse practitioner and mother to two children, he says. 

He shares the adage of his longtime Columbia mentor, Dr. Jerome Webster, who summarized a plastic surgeon’s gift: “We cannot undo all damages, but we can help someone rebuild a life. And the results of that newer life could be perfect.”