Guitarist Recovers From Fingertip Amputation


Background

I began playing guitar in 1965, getting together with friends and playing folk songs on acoustic guitars from various artists' songbooks and "Sing Out" magazines. From late 1965-1968 I was enrolled in the extension program of the Peabody Institute of Music in Baltimore, Maryland, studying the classical guitar for ½ hour on most Saturdays from Roland Rafaelle, a graduate student at the institute, and was a fairly accomplished intermediate student when I discontinued lessons.

The technique that I learned from the institute was sound, but classical music did not help me entertain friends at parties (part of my goal in learning to play guitar) with sing-along favorites like "Gloria" and other popular tunes playing on the radio. A friend helped me learn to 'play by ear' (a whole other story) and use a flat pick. My friends enjoyed listening to and singing along with my song list which grew to include many favorites, standards, and even some jazz.

By 1980 I had a good grip of both plectrum and finger-picking right hand techniques, and

...using movable chords (no longer locked into the first position) though my understanding of the complete fret board was still lacking. My left hand was firmly rooted in the classical technique of efficient positioning and movement, which suited all of my playing quite well.

Losing fingertips

In 1983 I was working in a production woodshop, cutting parts from 1” pine planks to mass produce bee hive boxes. One day, while working at a goodly pace in a smooth rhythm, I made the mistake of clearing a jammed piece of wood from the saw that I was using with my hand, and in the process amputated ½ of the middle finger and 1/3 of the ring and little fingers on my left hand.

At the hospital an effort was made to reattach the amputated segments from the middle and ring fingers through the miracle of micro-surgery – only the ring finger segment was able to be reattached, slightly askew, with only 1/3 sensitivity restored, and no use of the first joint. Further surgery was needed on the little finger to regain motion lost due to scar tissue that formed in the sheath that the tendon glides through.

To see a picture of my left hand as it is today, click here.

Rehabilitation

Once I was released from the hospital, the real work began. My left hand, arm, and shoulder had atrophied from lack of use during the healing process. Even considerable effort trying to make a fist produced no more than a ¼ inch of movement in any of my fingers, with my hand remaining mostly flat. My reattached tip and nubs were extremely pressure and temperature sensitive. I began several months of physical therapy, involving hand massage, immersion of the hand in warm sand, grip strengthening exercises, practice picking up and manipulating various sized objects, and motion maintenance of my finger joints (even passively with the other hand if necessary). During this process I regularly treated the scar tissue from the surgeries with vitamin E oil to maintain what suppleness I could to those areas of my hand.

Playing the guitar

Even before I'd completed the physical therapy and the 'clinical' rehabilitation, regaining functional use of the left hand, I began experimenting with the guitar.

I tried playing left handed; since I am right hand dominant it seemed that chording with the right hand would give me maximum fret board capability, and my left hand would be more than able to use a flat pick. For me, this was not an option; my left hand had no sense of rhythm and to teach the right hand the position and technique for chording would have been like starting completely over… there was a real kinetic memory in each hand that could not be denied or easily overcome.

The next effort was using various open tunings, and I had great success with this. Even with only one usable finger on the left hand (at the beginning, during therapy) I was able to play chords with melody and make music again. This was encouraging; I knew that I would still be able to play guitar, (I had considered never playing again) just not exactly as I had in the past. The challenge now was to find out how to use the newly configured left hand to my best advantage – I had options for coping with the physical changes.

The psychological challenges were another thing, and caused me much more distress than the loss of the fingertips.

After 18 years of playing, I had become fairly proficient (repertoire included "Take Five", "Masquerade", "Stormy Monday", and some Pavanas by Luis Milan [classical compositions], and much more) and playing guitar was mostly a lot of fun; now playing guitar was not fun, but hard work to achieve even minimal results. Fresh in mind was how smooth and entrancing my music used to sound, not that long ago, and now my best results when trying to play even simple songs from my past were far from fluid, rife with gaps and buzzing strings. Some often used chord forms (1st position B7 and C7, for example) were impossible to execute, and the inversions and other-position replacements not easily incorporated with the chords previously used in most of my songs. Following other players' fingerings at an informal jam session was not possible, either, so the joy that came from impromptu jams was torn away, also.

My friends were understanding and supportive, but the disparity between their skills and mine, and my inability to quickly adapt, was so frustrating that I withdrew, and only rarely played with other musicians. What had been my most enjoyable social activity was now a thing of the past, and I missed it tremendously.

...but I continued to build a new vocabulary of chord forms and adapted my material to them. Most songs had to be completely reworked and relearned to use the new chord forms, inversions, and positions effectively. I edited the classical pieces by dropping out some of the harmony notes, keeping the melody line and enough of the harmonizing notes to retain the overall sound of the composition.

I found that my right hand technique was developing to compensate for some of the difficulties caused by my new left hand. Some chords that I could no longer strum I played effectively by plucking only the strings necessary to sound the notes of the chord without the doubled notes that a strum would sound.

I gradually moved away from using the flat pick, and now rarely use one (the exception being when playing songs that were written using a flat pick. I’ve found that having written a song with a flat pick, sometimes a pick is needed to get the same effect that I intended originally, in which case special compensations in the chords must be made to accommodate the use of the pick.)

In conclusion

Recovery and rehabilitation was a challenging process that took a concerted effort and quite a bit of time, but was ultimately accomplished. My technique and ability have progressed far beyond the level I had attained at the time of the 'accident'. To hear MP3 files of songs from my CD, "These Magic Words", recorded after rehabilitation, click here, and click on any title to hear the track.

I’ve covered the down side of this incident in the above paragraphs, but in retrospect, after recovery, there have also been significant benefits from this journey. My right hand technique has now advanced to the point where I can not only pluck strings, but also strum in various ways that work quite well. The left hand developed also – I was previously 'locked into' a classical guitar technique/methodology, which was restrictive and became only marginally useful. Now the left hand is free to find a sound that I need rather than a chord that will do. Combined, the new vocabulary of chord forms that I've found most useful and the advanced right and left hand techniques have given my songs and playing a unique sound, something that I was hoping to attain from the very beginning of my infatuation with the guitar. The rehabilitation process also greatly advanced my understanding of the entire neck of the guitar. It is now possible to follow other musicians at tempo, translating the chords they use to the ones in my vocabulary without affecting the flow of the songs we are playing, so impromptu jams with other musicians are again a joy to share in when the opportunities occur. My playing has advanced way beyond where it was in 1983.

I hope that you've enjoyed this article. If you have any questions about any stage of this process, or would like more specific information, feel free to contact me at techknights2@gmail.com with any questions. Please include "guitar rehab" in the subject line of your e-mail.

David