IN OUR HANDS

A surgeon portrays the versatility and intricate anatomy of the human hand, as well as the terrible things that can go wrong with it.

A hand is “the Rosetta stone of the soul,” according to Arem (Surgery/Univ. of New Mexico; Clinical Associate/Univ. of Arizona College of Medicine). More than 20 years as a hand surgeon have not dimmed his fascination with and awe of this unique appendage, and he shares his enthusiasm here. First, he tells the stories of 11 patients who have come to him for repair of injuries or deformities. In each, the personality of the patient and accompanying family members or friends are as much a part of the story as the hand and its treatment. Rather than the aloof surgeon of stereotype, Arem listens closely to people’s concerns. He is at heart a teacher, making sure his patients understand what has happened to them, what he will try to do for them, and what they must do for themselves. Similarly, as he describes each surgical procedure, he explains to the reader what he hopes to accomplish, what the problems are, and how he will handle them. Cases include creating an opposable thumb for a child born without one, salvaging hands nearly destroyed by gangrene or ravaged by rheumatic disease, and dealing with rattlesnake-bitten or machinery-mangled fingers. Less dramatic but no less interesting are cases involving carpal-tunnel syndrome and psychosomatic illness. In Part Two, “An Informal History of the Hand,” Arem briefly touches on the language of gestures, the physiology of touch, left-handedness, palmistry, phantom limb pain, skin grafting, prostheses, the special significance of the thumb, and the nature of carpal-tunnel and rheumatoid disease.

Thorough, informative, and warmly human.