Vavita’s injuries are profound. A severe burn incident that occurred some 15 years ago has impaired freedom of movement of her head, arms, and hands.

My role as Recreation Therapist is to discern how best to provide some diversion that is entertaining, enjoyable, calming, during the wait before surgery. Sometimes it is just ” being there” with a smile, a gesture, an activity. In the midst of a wide age range, and a wide range of actual movement capability. As an expert mime artist, I enter with a perspective about movement capability. We use the concept of the “kinesphere” to refer to a person’s full range of movement, a repertoire of mime possibilities for practice and performance.

When I first observed Vavita, I was not at all sure I had anything in my bag of tricks that she could do within her personal kinesphere. How wrong I turned out to be!

At Nan Madden’s gentle urging, ” I’m sure you’ll come up with something,” I did.

I had brought a set of brightly colored wooden puzzles with geometrical shapes to be placed on a board to form a picture: a flower in a vase, a steamship, a rabbit, a mandala– seven two-sided boards, 14 pictures in all.

Vavita was delighted when I approached her. The smile that she beamed transcended her condition.

When I placed the puzzles there for her, she immediately understood how it worked and set out independently to complete the first puzzle. I stayed to watch. And I watched her do EVERY one of the puzzle designs in the course of the next 40 minutes.

My fascination was with the dexterity of Vavita’s hand.

As a mime artist, I practice articulating hand movements to produce effects on stage. I draw from how we use our hands in life. When by such injury, a person’s kinespheric repertoire becomes limited, it is amazing to witness the resilience of the body and of the spirit to adapt.

Imagine, if you will, articulating your hand to move with the dexterity of Vavita:

• Thumb is free to move.
• Forefinger and middle finger are curled under (as is the pinky finger) able to move side-to-side to grasp and to grasp with thumb and bent forefinger.
• Ring finger has developed the full dexterity that we usually associate with a healthy forefinger, able to grasp finger to thumb.
• From the wrist, the whole hand is thrust downward.

This is the permanent position of Vavita’s hand since her accident. Watching her manage the puzzle gave me insight into her determination. She has had to solve EVERY problem of her life with her hand the way it has become. The verve she showed while doing the puzzle is just a glimpse into a daily struggle that she has managed to succeed at. She’s a mother with two children. Her father earns the equivalent of $100/month for the household.

The operation here will free the movement of her head, and release her arms from being frozen to the sides of her body.

An incremental change. Vavita’s hand remains in the same position, with a bit more range of movement of the arms.

She exhudes determination and perseverance. She clearly experienced delight while doing the puzzles, and I suspect, an added delight that I was watching and celebrating with her every inch of the way.

Assisted by her sister in the yellow, Vavita takes her first post-op walk, having had major surgery to free her head and arm movement. As a parting gift, I gave her the wooden puzzle set to take home. An incremental improvement, which may make a big difference in her everyday life.