Warning: This Casual contains details that the squeamish may find disturbing. Reader discretion is advised.
On the night of December 4, 1970, I tried to open a wooden swinging door that contained glass panels. Because the wood was slightly swollen, the door required a vigorous push to open. I shoved with the requisite vigor—but on a glass panel, not the wooden frame. The upshot was that, while the door swung open, my right hand succeeded in shattering the glass, and my little finger was very nearly severed.
The bone, of course, remained intact, but the flesh was nicely lacerated and the finger hung by some tendons and other unidentified viscera. Fortunately, there were people around to witness this extraordinarily thoughtless action on my part; I recall remaining comparatively calm while pandemonium broke out. The sight of blood is not especially bothersome to me, and there was plenty to see as I held my traumatized digit on the ride to the emergency room.
The finger was reattached by the surgical resident at Bryn Mawr Hospital—I can still remember his German name and accent—and over the next two years I underwent two operations in an effort to connect the nerves and tendons and restore the pinkie to some semblance of life. Unfortunately, nothing worked; and in both cases scar tissue formed, leaving my finger frozen in a tightly bent posture. In the end, I opted to have the bone surgically broken and the joint fused so that the finger would remain straight, more or less, allowing me to slip my hand in and out of pockets without resistance, wear gloves, and salute.
Accordingly, I cannot make a fist with my right hand, but, in the miraculous way the human body works, I have otherwise adjusted to this minor mutilation. I am left-handed, so writing was unaffected; but I have long since grown accustomed to playing nine-fingered piano (jazz, mostly) and watching helplessly as coins fall from my palm onto the floor. The surviving nerves remain in some sort of twilight condition, so the finger is exceedingly sensitive and painful to the touch, but I’m used to it.
And so life has proceeded for the past four decades. My comatose finger swiftly withered and is now about half as long as my other pinkie. But until a few weeks ago I had never noticed any particular change in its status until, one Friday afternoon at my office, I observed that it was considerably more painful than usual and, ominously, turning a deep shade of blue.
The next morning, concerned that this might be some sort of staph infection or version of gangrene, I telephoned my stalwart son the medical student, who observed that the symptoms sounded more like bruising than infection, but advised a trip to the emergency room. The ER physician—a former military doc with recent wartime experience—enjoyed my recitation of the finger’s history but was stumped (so to speak) by its condition. After some quick research, however, and comparison with a case she had seen earlier, she announced her verdict: paroxysmal hand hematoma, or Achenbach syndrome.
Andrews’ Diseases of the Skin (2006) defines Achenbach syndrome as a condition characterized by “spontaneous focal hemorrhage into the palm or the vocular surface of a finger, which results in transitory localized pain, followed by rapid swelling and localized bluish discoloration”—all of which happened to my pinkie. It’s a medical mystery, by the way: No one knows what causes it or why, weeks later, the hematoma obligingly dissipates. The ER physician did point out that women suffer from Achenbach more commonly than men. And my aforementioned son, wielding the sarcasm that is a family hallmark, promised to find me an Achenbach support group in the Washington area.
I am pleased to report that the symptoms have, in fact, diminished, although the finger remains more painfully sensitive to the touch, and the hematoma seems to have permanently disfigured it. Still swollen, it bends curiously to the starboard side.
Which leads me back to a conversation, 40 years ago, with one of the hand surgeons who attempted to repair the initial damage. He suggested, at the outset, that the finger be amputated—to which I responded with appropriate horror. But as time goes by, and I seek to adjust to a life blighted by Achenbach syndrome, I can’t help but wonder if that might have been the wiser course. The little finger on my right paw is, now more than ever, a misshapen appendage, and more trouble than not. If it ever is surgically detached from my hand, by the way, I intend to plunge it immediately into plexiglass and add it to my paperweight collection.