The International Literary Quarterly

May 2008

Click to enlarge picture Click to enlarge picture. Fingertips by Jill Dawson  

The young woman in my consulting room tells me that she lost her hand in a childhood accident involving a lawn mower. It was not so long ago, l991 in fact, – but even so, no one in her family thought to preserve the hand and it did not accompany her in a bag of ice to the Casualty department. The result: this sealed, blunt-ended flesh stump and this peachy hard prosthetic hand, lying in her lap with its straps and cuff abandoned beside it.

She jabs her stump towards the paraphernalia.

“I mean, I ask you,” she says with a sniff.  “As if that bloody thing would fool anyone.” 

“Quite,” I say.

I am not an especially sympathetic man.  You couldn't do my job if you were.

What she does have, this young woman, Emma, as do so many of my limbless patients, is a ghost hand. 

I try not to show my excitement when she tells me this. She must know that she has been sent to me because it”s my area of particular expertise but I have trained myself to hold very still indeed when these people first begin to talk of their phantom limbs. I have become skilled at controlling the knocking in my knees, the breathless desire to pump them for information, to rush at once to my computer and my books, to add their details to my statistics. I've perfected a tone that I believe sounds concerned, warm and quietly encouraging.

“How long have you experienced this phantom hand, Emma?”

“Since I was three.  Since the real one left.  It does things, you know.  It's tapping the chair beside me right now.”

“Why is it doing that?”

“It's irritated, I suppose. It's waiting for your pearls of wisdom.”

I ignore her challenging tone and launch confidently into the explanation I suspect she really longs for. “It's not at all rare,” I tell her, “to experience a ghostly limb when one has been lost. The part of the brain that we suspect is creating this – illusion – lies in the frontal lobes, particularly the strip of cortical tissue called the motor cortex.”

She has large eyes, this Emma, and she blinks more often than most people, or rather: she is blinking rapidly right now.

“You're the doc,” she says. “When do I get to go in the space tube?”

I say that her appointment for the brain scan is fixed for next Tuesday evening. I smile  widely, trying not to feel piqued that such a slip of a girl is so little impressed by the sum of my twenty years of research and my track record of highly consistent publication in The Lancet.



Emma arrives promptly the following Tuesday and seems unfazed by my bad news: my assistant, Anna, a single parent, has had to rush home for some emergency (there is always some tiresome emergency) involving her three year old son. I will operate the scanner and stay in the room with Emma for the twenty minutes or so it will take to do the scan.

“Fine,” she says, taking a piece of bubble gum from her mouth with her good hand and looking around for somewhere to put it. I leap forward with a tissue.

As she takes her shoes off she says: “I had a funny dream last night. It was about my brother – he was the one who caused the accident with the lawn mower. He lives in the States now, but in the dream, I sent him my ghost hand in an envelope. When he opened it, it leapt out, took hold of his hand, and clutched it tightly. I could feel his hand in mine.  I mean, in my sleep, I really could.  It was weird.  It was like I was trying to tell him  - it's okay. You were just a kid. It wasn't your fault.”

“Yes, yes,” I say. I'm used to the sentimental warblings of my patients.

I remind Emma that it can be noisy inside the brain scanner and she assures me she brought her personal CD player (as suggested) and has something that sounds like “Limp Biscuit” to listen to.

“Great,” I smile. “That will be very relaxing.”

I've instructed Emma to think about her phantom hand while in the scanner as I hope to record some changes in the parietal lobe whenever the hand is sent a message to move. I don't know if she even hears this instruction: she barely acknowledges it. She is wriggling into the “space tube”, her headphones already on.

Once she's inside, I sit on a chair beside her, and try to switch off from the metallic humming sound that fills the room. It is an eerie space with its silvery light and airless feel. Emma”s space analogy – predictable though it is – has some truth. The curious thought occurs to me for the first time that I do indeed feel, in this room, so separate from the rest of the world, exactly like an astronaut lost in space.

After a moment I regret my rudeness on the phone to my assistant Anna. I have been courting Anna for several weeks. My intolerance of her son, Tommy, is the only sticking point, I believe, to our relationship progressing.

As I muse on this, a few other terminated relationships float into my mind. Patsy, a student doctor in med school.  She called me – I remember it with a stab  – she told me I was the Coldest Bastard She'd Ever Met.

And then I feel them. Fingertips. Four small warm fingertips and a thumb – I hadn't realized it would be the hand of a child! I was picturing an adult hand! I glance towards the scanner where Emma's legs in jeans are as inscrutable as ever. The room tightens, and the silver blue light contracts around me.

Without doubt, there is a little hand crawling across my face, like a spider. The fingers stumble, exploring. A pause. Then they wipe tenderly at my cheeks. 

If I were a fanciful man, (which obviously I'm not), I'd say it was exactly as if a child, a small, supernaturally forgiving three year old child, was trying her best to make me feel better.