JAVS Fall 2000

49

A THUMB's DECLINE: To FusE OR NoT To' FusE?

by Dan Whimuzn

I was in the doctor's office with a problem thumb, injured much earlier when the steering wheel of a car smashed into it while I was driv ing. An unseen rut in Boston's snowy streets had been the culprit. I had evaded the conse quences for over twenty years; now the digit was weak, painful at rimes, and generally suc cumbing to rime's depredations. The question was, whether to muddle through as things were, operate and "clean" the damaged second joint, or just move in and fuse it in a fixed posi tion to guarantee a problem-free (bur musically imperiled) future. With scientific confidence, tracing the filigrees of irs muscle and ligament, Dr. Freddie Liebenberg said, "Let's rake this claw of yours and make it into a hand. " I was on a four-year assignment with the U.S. Embassy in Preroria, South Africa. On free evenings, I practiced SevCik, Kreutzer, and Bach on viola . . . and joined the student orchestra of the University of Pretoria down the street. A clever osteopath in Cleveland, Ohio, had been the first ro note the ligament damage and chipped bone only in late 1997, when I was back home on a short leave. The first signs ofarthritis-humankind's most banal disease- had begun to set into the weakened structure of the second joint. "Musicians are the athletes of the hand," Cleveland hand specialist Dr. Carmen Paradis had averred. Noting the slow deterioration of my now complaining rhumb, she said that if it were her own, she wouldn't hesitate ro have surgery. The "trigger finger" condition (sinew seized inside a sheath-something like a frozen piston in a car engine) might be allevi ated by a cortisone injection, bur surely it would come back to haunt me. Dr. Paradis proved ro be right. Her very witty and inventive colleague, occupational therapist Sandy Cooklin, fixed me up with an elaborate splint I could wear at night, molded closely ro the form of my individual hand. The contraption did irs best work and

achieved some dressage, bur my thumb weak ened further over the following year to the point that even the best splint would not cor rect lt. My playing over the course of 1998 was, shall we say, enthusiastic-bur the thumb of rhe bow hand roo often "collapsed," coming up short on the support needed for both long phrases and spiccaro. Teachers puzzled over what ro do with the thing, when trying to fix my rhumb and second finger into a comple menting arc. More often, the rhumb curved backwards like the spout of a manual water pump, as soon as we all stopped payi ng atten tion for a moment.

Whitman's rhumb bifo" rurgrry

There was no acute pain as that which had taken me to Dr. Paradis in Cleveland, bur the bow was simply not elegant and I noted when I went to the washroom at work that I avoided d rying the thumb, because it was just chroni cally sensitive. In irs perverse way, arthritis had crept in ro rake over the vulnerable joint. T he technical term for this cascading, downward spiral is "thumb kaput," or as one Texas col league put it, "thumb-a-no-workin-itis." Blessings sometimes come from nearby. My stand partner in the orchestra, Nicola Naude, had just spent four years studying physical therapy at the university. As a fellow