JAVS Fall 2000

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j OURNAL OF THE AMERICAl\ V IOLA SOCIETY

be out now on a full disability pension." Like Dr. Paradis, he said he would have no hesita tion in having it fixed by surgery if it were his own, and that the procedure was usually one of the most successful in the field of osteopa thy. He was confident the thumb would emerge stronger or at least no worse than before. On the phone, I checked with my now formidable stable ofOTs and PTs on rwo con tinents. I knew they were all normally biased against the use of the knife. All were unani mous, that in my case, the condition could only worsen without intervention. Those who had the benefit of seeing both x-rays-late 1997 and late 1998-were even further con vinced of the need for surgery. The unanimity greatly eased my mind. When I experienced four days of panic over the notion of arthrodesis- an irreversibly fused second joint-! was further relieved to talk to the surgeon one last time before sur gery, and hear him say he would "try to save the joint" on the operating table if at all possi ble. It would depend on how he saw the carti lage after going in. He would fuse only if he saw the joint by now unworkable. I think medical history was made, as a sur geon actually proposed a solution less radical than that of OTs and PTs, all of whom said, "If you're going to bother at all, then just go the whole route and fuse, so as to avoid hassle later." I went into the operating theater with notes for the surgeon fastened to each thumb. On the left, "Moenie sny nie," which I hoped was correct Afrikaans for "Do not cut!" And on the right, a message for Dr. Liebenberg who would see me only under general anaes thetic: "What's a nice person like you doing in a joint like this?" One must advance, with philosophy and a sense of one's own limits. I could say it was cruel to be struck in that part of the body with which I make music. But there are also lungs, colon, brain, heart, any of which can go awry with far more cruel effect. I am lucky to have made music, without which life would not be recognizable to me. I am equally lucky not to depend on music for my livelihood, as this thumb ordeal would have put quick end or lasting hiatus to that. Proceeding with the surgery was a calcu lated risk, and if you plot on a schema the

viola player, she was naturally drawn to the treatment of musical injuries, which she sensed were rife on the stage around us. She took a look at my thumb and x-ray from Dr. Paradis, and saw problem mixed with hope. She gave me a series of exercises and sent me to Pretoria occupational therapist Corianne van Velze, who made splints for use during the daytime, and even one for use while playing, to complement the larger one Sandy Cooklin had devised in Cleveland. In retrospect, I'm glad I took a year before deciding on surgery. As the knife produces radical and irreversible effect and huge incon venience, one must look at all alternatives before leaping into the hospital gown. With Nicola Naude's caring and inventive treatment over the course of a year, and Corianne van Velze's ingeniously designed splints, I think my chipped bone and torn ligament of over rwenty years did much better than one could fairly expect.

The deterioration however, was discern able. Another x-ray, a year later, and the always frothy Dr. Liebenberg reacted in a moment, "This thumb is a factory defect," and "If you were a manual laborer, you would