THE first time I operated on a hand, I remember the thrill of fear. I was a recently qualified doctor in my new white coat, proud to be out on my own in the hospital Emergency department. The patient, a young butcher, had cut his palm at work. He was terrified that the injury would prevent his returning to work.
With the confidence of inexperience, I reassured him that I was a surgeon and I could sort it out. I injected anaesthetic, cleaned the wound, and saw a white structure glistening among the blood. A senior surgeon glanced over my shoulder, had a quiet word with the patient, and whisked him away for a reconstructive operation to his divided tendon. I realised then that the patient was right to be worried, and I should have listened to my fear.
Repairing and reconstructing hands requires experience and expertise. It is, sadly, quite possible to lose the function of a hand through injury or inept surgery; and hands matter, because, like sight and hearing, they are the way in which we interact with the world. My second and even more important lesson was that surgeons need humility.
For a medical student assisting in the operating theatre, the suspense of exploring the abdomen of a patient with abdominal pain was like opening a Christmas present. We would handle the living bowel with respect, using touch to diagnose the problem — a knot, or lump, or discoloured area. We would cut away the diseased area and then carefully repair the bowel. But that was all we could do.
Even as students, we recognised that surgeons can’t actually heal anything. We could remove disease and stitch everything back together, but God does the healing.
But, that day in the Emergency department, I realised that hands are even more complex than bowels. The anatomy of a living hand is a different world. The primary function of the hand is to move. Everything glistens because of the lubrication necessary for structures to glide. Tendons (the strings that bend the fingers) slide around and through each other, accommodating themselves to the contours of their fellow tendons. Even nerves move as the fingers and elbow bend and straighten, and every single structure has a fine web of blood vessels keeping it alive. I was astounded by the beauty and vulnerability of hands.
AS I trained, I recognised that hand surgery is about careful cutting and stitching, often under the microscope. The more precise one is, the less damage surgery does to an already injured hand. But the outcome doesn’t depend just on the quality of the operation. As the hand heals, scar tissue is laid down, and the lubricating fluid can set hard like glue.
There is a window of a few weeks after surgery for the crucial work of the physiotherapist to help the patient to move their hand. If they won’t or can’t move, then the hand will become stiff and useless. Perhaps that was the nature of the “withered hand” Christ healed.
Hand surgeons try never to lose sight of the fact that the hands on which we operate are the limbs of living human beings who raise children, use laptops, and play football or guitar. If our hands are damaged, our livelihood and relationships are endangered. But the human spirit can triumph over devastating injury.
In the course of making a meditation for Radio 4, I came across Mark Butler, a violinist with the Chilingirian Quartet, who suffered a serious infection of his tendons. It could have been career ending. He required an operation and spent two weeks in hospital; but, with intensive therapy, he recovered to play as well as ever. I also remember and honour the patients who chose not to have surgery, who live with damaged, scarred, or absent hands, and function with confident elegance, using their toes or teeth.
As our complex, vulnerable hands mediate our interaction with the world, so Christ is God’s unique interface with the world. His hands feed the five thousand, heal the man with the withered arm, take children into his arms, and bless and break bread at the last supper. His hands share our vulnerability.
In Holy Week, as Christ accepts his Passion, he allows himself to be handed over to be crucified. W. H. Vanstone points out that it is no coincidence that, in all four Gospels, the word used literally means “handed over” or placed in the hands of others. Christ allows himself to be manhandled. Human hands whip him, push him, and place the purple robe on him. Pilate symbolically washes his own hands of guilt, and human arms hand Christ his cross to carry.
AT GOLGOTHA, nails will be hammered through his hands and feet. In 1970, archaeologists in Israel discovered a heel bone with a seven-inch nail hammered through it. It was of a victim of crucifixion. Each Roman nail, including those that pierced Christ’s hands, was hand-made.
A journeyman, perhaps a slave, hammered each one to produce the four sharp right angles of the square shaft. The top was hammered to form a head. A human hand drove the nails through Christ’s palms. After a working lifetime of preserving and repairing hands, I know how much damage that would have caused.
As the nail pierced the skin, it will have made it bleed. The tip would pass into a layer of muscles so delicately slim and pink that some of them are given the Latin name for earthworms, lubricals. Each muscle has a precise function in the smooth working of the hand. The nails would pass right through them.
They would graze the nerves, causing excruciating pain. It would damage the blood supply and their gliding layer so that, if he were to survive this crucifixion — and he won’t — they would never glide again. The tip of the nail might jar on the slender metacarpal bones of the hand, but would, perhaps, glance off them to pass between the narrow bones.
Archaeologists have found three examples of heel bones of crucifixion victims transfixed by nails. But no hands. So, the nails may have missed the bones. The beautiful muscles would be destroyed instead, and God’s hands in the world would be broken.
Preparing for the Radio 4 meditation, I came across a painfully real depiction of Christ’s crucified hands in a crucifixion scene by Matthias Grünewald, painted for a church in Isenheim, in the early 17th century. Associated with the church was a hospital for those with “St Anthony’s fire”, which causes blood vessels to narrow and areas of skin, or even a finger, to become painful and gangrenous.
Grünewald painted Christ with the sores of St Anthony’s fire with hideous realism; and he depicted Christ’s hands nailed to the cross with huge Roman nails. He wanted patients who were in agony to be comforted by his depiction of Christ suffering with them.
While human hands caused Christ’s suffering, human hands also tried to help. Hands raised the sponge with vinegar to his lips; and hands took down the body from the cross and, according to tradition, placed it in his mother’s arms, before other hands hurriedly prepared his body for burial before sunset.
In Jewish tradition, preparation of the body for burial is still a solemn ritual. The Chevra Kadisha (Holy Society) of the Edgware and Hendon Reform Synagogue is a group of people who prayerfully wash and dress a body ready for burial. I was moved both to hear one member, Andrea Lucas, speak of her sense of calling to this work, and by her use of the prayer “Strengthen our hands” before the work is undertaken. Perhaps we can find an echo in Andie’s work of the care with which Christ’s body was honoured.
And so Christ is laid in the tomb. The hands that drew children to him, stroked mud on to a blind man’s eyes, healed a man born deaf, took the hand of a little girl’s corpse and raised her and gave her to her mother, and took bread and blessed it are finally still.
When he rises to resurrection life, his hands will still bear the scars of the nails. His wounds will be honoured in heaven, and, after his forty days of resurrection appearances, there will be a man in heaven with scars on his hands, a man who, like us, has been wounded and altered by life on earth.
At the ascension, we, the Church, were charged with being Christ’s body in the world. Two thousand years later, we are still here. We — that is you and me, all of us — are Christ’s hands, wounded, scarred, but still the precious interface through which God chooses to interact with the world.
The Revd Lore Chumbley was a consultant hand surgeon in the Mersey Regional Plastic Surgery Unit of Whiston Hospital for 17 years. She is now Priest-in-Charge of Christ Church, Bath. The Wounded Surgeon: A meditation for Good Friday will be broadcast on BBC Radio 4 at 3 p.m. on Good Friday