Nuts and Bolts

Picking up small objects—especially when they’ve dropped on the floor—has been a challenge for decades. Keys and coins are particularly difficult. Because my finger tips have resorbed and I don’t have much in the way of nails, it’s really tricky to grasp narrow edges and flip the object into my palm. This has prompted some creative problem solving over the years, such as using a piece of scrap paper to slip under the offending item, or pressing on its edge with my toe to leverage the other side.

It’s become all the more challenging since my hand surgery. I’m now missing several finger tips altogether, which makes it that much harder to grasp little stuff.

Or so I thought, until I underwent a fascinating OT assessment last Thursday. I had scheduled this appointment to help determine how much sensitivity is left in my hands. I met with one of my hand surgeon’s occupational therapists, accompanied by two students, who politely asked if I minded their participation in the assessment. I’m always glad to teach, and I certainly provide a rare case study, so I welcomed their involvement.

And here’s what I had to do: I sat across from one of the students, who served as time keeper and recorder. She emptied a box of small objects on the table—a wing nut, a large and small hexagonal nut, a small square nut, a washer, a key, three coins (penny, nickel and dime), two sizes of safety pins, and a large and small paperclip. My task, using first my right hand alone and then my left, was to pick up each object and place it in the box. If I couldn’t do it, I would slide the object off the table into my other hand, but this reduced my score. The test was timed.

This was tricky. I completed both tests in under two minutes, but I couldn’t pick up everything with my left hand. Still, all were impressed by my dexterity. I was surprised, too.

The next step was to repeat the test on each hand—with my eyes closed. To my amazement, I actually did better on this round with my left hand, picking up every object, and doing it faster than when I had my eyes open! Clearly, the fact that I know I’m right handed and assumed that I couldn’t do as much with my left hand affected my approach to the puzzle when I was able to see. Very interesting proof of how expectations can affect what we think we can accomplish.

The final test involved closing my eyes and having the student place each object in my palm (right hand first, then left). I had to identify the object and place it in the box. By now I knew what each item felt like, but manipulating without being able to grasp it involved some juggling, and sensing contours was not so easy without my fingertips, which I can’t bend enough to form anything close to a fist. Nonetheless, I got all the answers right with each hand.

The team was very enthusiastic. I certainly exceeded their expectations, as well as my own. The conclusion? Despite all the damage to my hands over the years, reduced sensitivity and significantly reduced dexterity due to my recent surgery, I can still sense quite a lot. I may have to approach the process of grasping things with new strategies, but the basic information is still transmitted accurately from my hands to my brain.

Thank goodness.

Evelyn Herwitz blogs weekly about living fully with chronic disease, the inside of baseballs, turtles and frogs, J.S. Bach, the meaning of life and whatever else she happens to be thinking about at

Image Credit: Konstantin Olsen

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