May 05, 2014

The Sound of One Hand Healing

After breaking his hand, a physician gets a dose of present moment medicine Robert J. Abramson

I broke my hand last year. I knew immediately it was broken by the exquisite, searing pain. I have experienced my fair share of pain, from kidney stones in rural India to joint pains from 40-plus years of long distance running, but never a fracture. So when the edge of my hand hit the corner of the wall as I catapulted forward off the last step down the hallway in my house, I knew by the rapid elimination of my many previous causes of pain that this was fracture pain. An integral, internal bedrock structure had snapped like so many trees after a strong storm.

I knew I had broken a bone but went into a state of denial, waiting two-and-a-half days before seeking medical treatment. (And I am a physician.) The x-ray provided clear, irrefutable truths: a clean, nondisplaced fracture of my nondominant hand. I was given a custom-made thermoplastic ulnar gutter splint, velcroed in place, to be worn at all times except while showering. Apparently showering is a sacrosanct time when no harm can befall you.

A gutter splint refers to the edge of your palm, to the hand bone between the pinkie and the wrist that looks like a little gutter. Looking at it, I was reminded of another one: the Meridian Gutter, the acupuncture point located on the inner surface of the forearm, slightly above where the wrist creases. This point, when used properly, has the ability to clean out and carry away debris from the body, mind, and spirit, just as the gutters on a house or on the street carry away rubbish. Inspired, I asked myself what obstacles were blocking my path now and what obstructions were blinding me to new insights.

How I fell was perfectly choreographed by myself: I was walking downstairs in a hurry, carrying books in both hands and bending down to pick something up in mid-step. What was I thinking? Am I Nureyev? Of course I was going to trip. I was doing what I always caution my patients not to do. “Be present in the moment,” I tell them. “When you walk, just walk.”

I am clearly not alone in dealing with the subtle perils of modern life. The back room of the hand physical therapy department of the hospital was like a military rehab unit for those of us returning from the front lines of a skirmish with the 21st century. We recognized a kinship, comrades in arms, as we set about to heal from our injuries caused by our contemporary lifestyle: carpal tunnel, Blackberry thumb, repetitive stress, and perhaps most dangerous of all, inattentiveness. My fall was a harsh reminder that multitasking only allows me to do multiple things less well.

So here I am, at the eve of a one-week planned vacation with my hand in a splint, all my plans and projects suspended. Life can be a hard taskmaster. But it can and does go on—even with just one hand.

Unfortunately, I am far more comfortable and familiar with doing than with not doing. Action, using my both hands, is what I think I do best. And resting, contemplation, meditation: they all require not doing. My insightful wife, keenly aware of my growing restlessness, encouraged me to explore the sound of one hand, a reference to the koan by Hakuin, an 18th century Zen monk. This koan, “Listen to the sound of the single hand,” implores us to contemplate the unity of stillness and action. With my one hand in a splint, my other hand is free to function without opposition. It has nothing to push up against—nothing but the void.

This new space, brought to me by my overdoing and inattentiveness, gave me the freedom to explore my fear of not doing. What am I afraid of by being unopposed? Do I need conflict to assert my being? Can I let go of my past reflections and my future projects? This was the gift set before me: not a quick resolution but an immersion in the present process.

What is the sound of the wind when it silently moves through leaves, or the sound of the sunlight as it illuminates the world? What is the sound of one hand healing? It is, as I came to hear it, the sound of myself. It is my true self, a merging of my ceaseless and seemingly all-important physical activities with a quiet contemplative presence, bringing activity into stillness and stillness into activity with only a single hand.

Robert J. Abramson, MD, is a physician practicing Five Element Acupuncture and Integrative Medicine in Manhattan and Wainscott, New York.

Image courtesy of Flickr/yincrash.

More at Tricycle:


While meditation is often identified as the
central practice of Buddhism, the majority of Buddhists throughout history have not meditated. Only in the 20th century did meditation become considered an appropriate practice for laypeople.


In this issue: The manmade obstacles female practitioners face; strengthen your awareness and keep your life simple; and the prison diary of a Chinese dissident poet. Plus: A frank chat with the Dalai Lama’s translator.

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Nimrodscott's picture

Ouch! This story sounds painful, and is a reminder of my experience. Not broken bones, but a small set of stitches on the pinky finger inexpertly bandaged by the radiologist let to a "dead finger" on my dominant hand. Two surgeries later and the finger was saved, but ulnar gutter bandages and a hand splint requires months of therapy. Many lesson opportunities presented themselves here.
1) forgiveness meditation, embracing the radiologist in the heart of forgiveness, 2) relearning inter dependence and the gratitude that can accompany it, 3) patience opens the heart for others, and impatience closes others off.

Ach! The lessons of life :)


Wanderer33's picture

As a person whose "What was I thinking?" moments have also landed me in orthopaedic doctor's offices, I enjoyed, and related to, this article. Thank you, Dr. Abramson! Now the question is this. How can one find a physician with your sensitivity and sensibility if we are not in Manhattan?

chrishazzard41's picture

I broke my back some years ago while on a surfing holiday. Fortunately the nerve damage was very slight, (loss of some sensation in my legs and genital area) but the fear was great. The forced inactivity turned out to be a wonderful opportunity for me to practice meditation. The technique I used was tonglen. Whenever the pain or fear arose I moved closer to it, really feel it. Realizing that all around me were others with similar fears, I would ask for these fears to be transferred to me. The result was that my suffering diminished rather than increased and I believe that quite possibly my healing was accelerated. The one proviso I advocate for anyone contemplating tonglen is not to do it in order to reduce their own suffering. It neeeds to be selfless.'s picture

Me too! Broke a hand bone in exactly that way and received the same treatment (from myself and from others) including the 2 ½ days of denial the author mentioned. Learned a lot about fear/denial and how to generously take care of my own body from that little adventure.