April (Web-only) 2000

ARTICLE TOOLS

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Isaac Newton said, "In the absence of any other proof, the thumb alone would convince me of God's existence." After 40 years as a surgeon specializing in hands, I am tempted to agree. Nothing in all nature rivals the hand's combination of strength and agility, tolerance and sensitivity. We use our hands for the most wonderful activities: art, music, writing, healing, touching.

Some people go to concerts and athletic events to watch the performance; I go to watch hands. For me, a piano performance is a ballet of fingers—a glorious flourish of ligaments and joints, tendons, nerves, and muscles. I try to sit near the stage to watch the movements.

Unless you have tried to reproduce just one small twitch of the hand mechanically, you cannot fully appreciate its movements. Often I have stood before a group of medical students or surgeons to analyze the motion of one finger. I hold before them a dissected cadaver hand, with its trailing strands of sinew, and announce that I will move the tip of the little finger.

To do so, I must place the hand on a table and spend about four minutes sorting through the tangle of tendons and muscles. Seventy separate muscles contribute to hand movements. But in order to allow dexterity and slimness for actions such as piano playing, the finger has no muscle in itself; tendons transfer the force from muscles higher in the arm. (Body-builders should be grateful: imagine the limitations on finger movement if the fingers had muscles that could grow large and bulky.) Finally, after I have arranged at least a dozen muscles correctly, I can maneuver them to make the little finger move. Usually, I give this demonstration to illustrate a way to repair the hand surgically. In 40 years of surgery, I have personally ...