Coping with injury. My turn.

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Winter in Edinburgh.  It’s a beautiful time in the city, but walking around the city’s cobbled streets can become treacherous by adding just a touch of ice. After coming to the end of one especially boisterous night out with folks from my gym, I embarked on the short walk back to my home.
I think that the toe of my shoe caught under the uneven terrain of cobblestoned road, and in a flash I tumbled face-first onto the cold, unforgiving stone.  It was a hard landing.  Ouch, my lip.  Ouch- BOTH my lips!  I could immediately feel that my upper and lower lips had deep gashes on the inside of them and I could taste the stream of blood that flowed freely.  I touched my hand to my face and took it away to get a look at it.  Blood.  Lots of it.
I got up quickly, mostly mortified from embarrassment, and walked the rest of the way back home with my hand over my face, hiding my mouth and nose.  I soon became aware that my finger hurt quite a lot too.  Broken blood vessels, swelling, turning black and blue.  Never mind.  I’m not all that precious with my hands, and it didn’t worry me.  The cuts on my lips, however, aligned with cruel accuracy over my embouchure.  This wasn’t good.  I had a Messiaen Quartet for the End of Time rehearsal just hours away in the morning.  What was I going to do?!  How was I going to play?  How was I going to play forte?  No time to get stuck. I swished my mouth out with a big gulp of acrid TCP disinfectant, held a frozen pizza to my face for 5 minutes, and went to bed.  With quick wit, I went back to the freezer and grabbed an ice pack for my finger, too, just to be thorough.  I’d probably be alright in the morning.
1 February, 2015.  I am invincible!  Denial to acceptance.
I woke up around 9am and had a look in the mirror.  I’d become a thing of horror in a few short hours.  Over night my lips had grown and protruded a considerable inch or more away from their usual geography.  I had scrapes all over my face, especially around my mouth and nose. My finger was quite black and blue and, I had to admit, pretty damn sore.  Still, I could move it.  I took some ibuprofen.
People would be arriving to my flat for Messiaen rehearsal in less than an hour.  How would I play?  Nevermind- I’d figure it out!  I picked up my clarinet, still assembled from the day before, and attempted an embouchure.  I could feel the gash on the inner lower lip open like a great chasm of a UNESCO Site.  Hmmm, there had to be another way.  I tried angling the mouthpiece off to the side.  Yes, yes, I could play!  I was making a sound!  With the mouthpiece off to the side I not only looked like a retired Dixieland band member, but sounded like it too. But hey- I was playing.  Phew-  I’d got away with it.
After another half hour of coming closer to my senses, it was becoming painfully clear that I was not going to play this rehearsal.  My friends arrived, one by one, and I couldn’t hide the mess I had made of my body.  As you might imagine, they didn’t hesitate to encourage me to sit the rehearsal out, to which I obliged, but with heavy guilt.  Anyway, I knew I would be ok by our Thursday concert.  After all, it was only Sunday morning.
After the rehearsal finished, my musician friends had to leave to carry on to other jobs.  I might have started feeling even more sorry for myself if it weren’t for the kindness of still more good friends.  Most people kept suggesting that I get my hand checked out, though I really didn’t want to go.  (I famously don’t trust doctors.  Whilst I have no medical training, I obviously know more than they do, and that’s final.)  However, my friend Mike, the husband of our Quartet’s violinist, Aisling, generously offered to take me to the A&E (or ER, for the Yanks) and strongly encouraged me to just let him do this for me.  I agreed, you know- for the sake of others really, that I would get an x-ray just to prove that I was fine.  So, Mike kindly drove me there and patiently stayed with me at A&E, commiserating with me in boredom for several hours while I had x-rays and consultations. Eventually I sent him home while I waited for the x-rays to be interpreted, because I was told it was going to take a while.  Apparently Sundays are famously busy days at the A&E.
Two x-rays were taken of the offending hand and examined.  Woohoo!  Look at that! Nothing on it!  I was fine!  My nurse practitioner, Anna, muttered to herself that it wasn’t quite the kind of x-ray she’d asked for, but that there was no sign of fracture.  She said I’d go home, ice my finger 4 times a day and take over the counter pain meds.  Yippee!  Though after a few more seconds she began doing something I didn’t like. She kept looking behind her toward some of the other doctors.  Then, after an exaggerated intake of breath, she paused.  Anna admitted that there was one more view of my little finger that she needed to see x-rayed before she could responsibly let me go. (Damn. Damn. Damn, Damn!  I made the mistake of telling her I was a professional clarinettist, too.) She ordered one more x-ray.
The image came back.  It looked good to me, alright!  But Nurse Anna kept enlarging it, then shrinking it, and then engorging it again, highlighting one little place on the side of the second bone of the little finger of my right hand.  I didn’t like this part very much one bit.
Nurse Anna seemed to notice someone behind her in the ward. In a flash she vanished with my chart and left me on my own.  After 5 agonising minutes, she returned.  She had been speaking with a fairly high-level orthopaedic surgeon who just happened to be beginning his shift.  She had him look at my x-rays and he confirmed what her instincts told her about that sodding place she highlighted on this last x-ray.
Without giving me even a moments notice (granted, with which I might have become difficult), Nurse Anna abruptly grasped my hand.  In a flash my little finger was being tied up next to its neighbour in tapes and gauze on bent metal.  I begged Nurse Anna for another way to resolve our differences but she invoked the surgeon to come talk to me.  He said that even if the splint was ‘overkill’, if it was rested now it would be a very quick, easy fix as opposed to the risk of needing a more complicated surgery later if I carried on without a splint.  Wait, what?  Did he just say ‘Surgery’???
The blood drained from my face and, with a quiet humility, I accepted my fate.  In this moment I knew there was no choice but to let my colleagues down and admit I couldn’t play these concerts with them.  I would have to pull out of 4 performances of Messiaen’s monumental Quartet which I had been practicing so diligently much of January.  I’d have to sit on the sidelines instead of play music I love, and miss out on collaborating with these lovely people.  I felt truly sad.
19 Feb, 2015 Getting my life back.
After more than two weeks of my hand immobilised in a stinking gauze claw, my splint has finally come off!  I feel as though I have been let out of prison!  I had my finger reexamined on Tuesday, and while this story is not entirely over for me, I can play, and I can have my life back!
I’m going to need some physiotherapy.  The finger is swollen and stiff, and the swelling may persist for months, I’m told.  I have exercises to do that should improve the current range of motion from its current 70% to something better than that.  I am struggling to get my little finger to contribute to making a fist, but as for playing, I would say that even with less range of motion I could play without impairment.  The biggest challenge will be getting used to, and accepting, this finger as it is now, rather than how it might be someday.
All of my musician friends who have had serious injuries have told me of their similar experiences with getting out of the splint/cast/pins and they are all the same.  It is really, really stiff for a while.
I think there is part of me that has always felt invincible, and even capable of controlling my own health, immunity, and healing.  However, this has been a more humbling situation for me.  I got injured, and there might not be any kind of fast track to recovery.  I will have to do my physiotherapy exercises religiously, and even if I do, it will still take some time.  I might not regain exactly 100% of the range I had, ever, and there might not be anything I can do about it.
Acceptance has been a recurring theme for me in the last two weeks.  One of the things I do outside of music is that I am a Body Balance instructor in my spare time (a fitness class mixing yoga, tai chi, and Pilates) and I always end class with a meditation.  I try to help my class members experience acceptance of whatever is going on within them that day and to feel a loving kindness towards themselves.  I realise this week that I am really struggling to treat myself this way.  Instead, I found ways to convince myself that my splint was needless, redundant, over the top.  Now that it’s come off and it’s not the slender, agile, finger I had three weeks ago, I am reminded that I am am just as fragile as anyone else.

Feb 20, 2015 Lessons

The first lesson from this experience nearly goes without saying: best to reconsider my footwear on Edinburgh’s wintery cobblestones. The next lesson moves into the area of gratitude. It’s important to appreciate what we’ve already got- whether it’s health, family, steady work, or the use of all ten fingers.  I’m more and more convinced that gratitude for what we already have is the key to happiness.  I realise I have always taken my physical robustness for granted, not appreciating often enough everything that my body can do for me so well.  It is well worth remembering that if you are healthy and fit, that you have tremendous wealth.  This experience has also heightened my compassion and empathy for those who have been injured or who are unwell, rendering them unable to work or do the things they love. I have also had to reexamine my own sense of value to others outside of the ability to play my instrument.  Self-esteem based on applause is no such thing, and it is how we care for ourselves and each other that really matters.    Finally, I am reminded that I am as vulnerable as anybody else.  Sometimes I have delusions of invincibility.  You’d think by now I’d have learned that that couldn’t be further from the truth.
March 13, 2015.  Gratitude.
This accident is starting to feel more and more behind me now.  I have had a couple of successful performances which were great for getting my confidence back.  My once grossly swollen finger joint capsule is slowly shrinking down and resembling its original size.  The bead of scar tissue in my lower lip also seems to be diminishing.  I am currently preparing for chamber work next week and recital work at end of March without any complications from my injuries.  There’s much to be thankful for, and it’s worth remembering that there would be no matter what the outcome might have been

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