Elena Klionsky


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The Anatomy of Healing
By Elena Klionsky

            For any person to have a hand injury is very difficult; for a musician, it is horrific. It is a real fear that all musicians feel--it is a pianist’s worst nightmare.

            I had spent fourteen years studying at The Juilliard School of Music (first, in the Pre-College Division, then at the undergraduate and graduate schools) and during that time I practiced, on average, six hours every day. I studied piano with some of the greatest pianists and teachers in the world--Irena Orlov, Robert Harris, Nadia Reisenberg, Bella Davidovich, Adele Marcus, William Masselos, Jacob Lateiner, and Vladimir Viardo. My chamber music teachers were knowledgeable and inspiring--cellist Harvey Shapiro and violinists Dorothy Delay and Tossy Spivakovsky. After numerous recitals, orchestral appearances, and tours in the Americas, Europe, and Asia; after giving master classes and lecturing in universities; after playing with singers and being able to transpose any piece into any key at sight--I had a severe hand injury. What followed was a long and arduous process of physical and emotional healing as well as re-evaluations of my practice habits, my priorities, and my life as a whole.

            During the last six years I have learned many things I never thought about before. For example, I learned that one out of every five people has small tears in the cartilage in their wrists. These people are primarily men and the tears are due in large part to some kind of heavy lifting. In my case, I had small tears in both of my wrists, partly from overuse and partly from lifting my two little children. I had many sprains, repetitive use syndrome and even one bout with tendonitis during all the years that I had played the piano (I started at the age of five). But this time it was different…

            I served on the Board of Directors of the American-Russian Young Artists Orchestra and on that fateful night in June 2002 the orchestra had a concert in Alice Tully Hall in New York’s Lincoln Center. My baby-sitter cancelled at the last minute and my husband was out of town, so I decided to take my kids--ages seven and four-and-a-half--with me and put them to work. They did extremely well with giving out flyers, greeting people, and even entertaining. So when the concert finally started, I was glad to see my four-year-old son quietly fall asleep in my arms. Afterwards, while still holding him, I was shaking hands with people and talking for about an hour and had to get in and out of a taxi to get home. My son was not a light kid, and I felt that something was tearing in my right wrist. Not wanting to believe the worst, I tried ignoring the pain. By the next morning I could not turn my right hand palms up. I tried ice, heat, massages, and just leaving my hand alone for the next few weeks, but my hand was getting worse every day. By this time, playing piano was impossible. I finally decided to see a doctor. Thus begins my long journey that I share in this article. I hope to help other injured musicians walk that long and difficult road to playing again.

            My experience, I guess, is typical of a neurotic musician, a person whose hands seem to him more precious than gold. I am lucky that I live in New York and am surrounded by the best doctors. I asked a trusted friend, a cardiologist, to find me the best hand specialist there is. In a few days he recommended Dr. Andrew Weiland from the Hospital for Special Surgery in New York. He is the president of the American Hand Surgeon’s Association, and is known to everyone in his field.

            Dr. Weiland took one look at my hand and said that the cartilage in my right wrist is torn and that I needed surgery. I did not respond well to the word “surgery.” I insisted on an MRI (although Dr. Weiland thought it was useless) and then took the results (again on the advice of my doctor friend) to the chief of hand surgery at Cornell Medical Center in New York. His opinion made my decision easier: “Dr. Weiland is indeed the best there is, the Hospital for Special Surgery has the best equipment, and surgery is imminent.” In the meantime, I was not able to comb my hair, eat, hold a cup in the right hand, or even write. Playing the piano was out of the question. The surgery was scheduled for August 26, 2002.

            Dr. Weiland is very matter-of-fact, to the point, and not much of a talker. I had a thousand questions but could not get much information out of him. All I knew was that he was not sure whether my cartilage could be stitched back together--it was connected by only one millimeter of tissue! If not, the cartilage would have to be removed and playing piano would not be possible ever again. My best-case scenario would be stitched-up cartilage followed by weeks in a cast.

Before the surgery, the doctor offered to have me watch what he was about to do on a TV screen and thought that it would take about an hour. Luckily, I opted for heavy sedation because the surgery took around two-and-a-half hours. When I woke up and saw the doctor, I asked him the only question that was on my mind: “Will I ever play again?” His response made me laugh and cry at the same time: “You owe me ten percent from every concert you play!” First I cried from happiness, which very quickly turned into tears of pain. Never in my life have I experienced such pain--not even the pain of having two kids via C-sections. I was on heavy painkillers for the next few days and cannot recall much from that time. After a while I realized that all the little things like brushing my teeth, eating, getting dressed and many others are not such “little things” after all. I was completely helpless with a bandage from my elbow to the tips of my fingers. I was eager to get back to life but did not know how.

            In the meantime, I had to cancel concerts, figuring that even though the surgery went well I had a long recovery period. For a person who loves to play and lives for it, it was extremely painful to realize that every cancelled concert was devastating to my future bookings. People’s reactions threw me off balance also. Some people never responded at all, some wanted to start planning come-back concerts, some wrote encouraging letters saying how they knew that I was strong and would pull through. Mostly, though, I got many “sorry” notes. I guess people were politely erasing my name from the roster of professionals. Among the cancelled concerts was one with my closest friend, conductor Vakhtang Jordania. I wrote him a long e-mail how scared I was that I would never play again, how much pain I was in, and, basically, that I was lost. His response, short and to the point, I will treasure forever: “I have two new dates. Please pick one today.” I did, and felt that this short note was the most heartening and reassuring endorsement of all.

            After two weeks, I went back to the hospital to get my stitches out and get a real cast. When the bandages came off, I felt sick to my stomach – my hand looked tiny (all the muscles shrunk from just two weeks of not using them), it was all yellow and blue from inner bruising, completely stiff with dark brown strings and iodine marks. My hand looked as if it was paralyzed and it scared me half to death. My fourth and fifth fingers were not moving at all. Seeing my hand look that way was a real psychological trauma. After three tries, the cast was finally set and I had to wear it for six weeks. I drove everyone crazy in the hospital because, having the mentality of an ordinary musician, everyone was bothering me and everything was scaring me. I made them put extra cotton between my skin and the cast; I made them give me more space; I made them give me less space. I was panicking…

            Once the cast was set, I began contemplating what to do next. I don’t have many close friends, and definitely not many musicians whom I can turn to for advice. One of my true friends--my confidante, as well as my first piano teacher from Leningrad, is Irena Orlov. Luckily for me, this tiny, pipe-smoking woman, who always had answers to all of my questions, had moved to Washington DC many years ago. Her suggestion was to start practicing immediately with the left hand. Anything that I ever played with both hands in parallel motion was the best thing because while playing with only one hand, your brain is still wired to play with both. So, although I did not play with my right hand, in my mind it was still playing. I went through all scales and arpeggios and Hanon’s exercises over and over again and then added the last movement of Chopin’s b-flat minor Sonata as well as Chopin’s Etude in E-flat major (Opus 25 no. 12). I played with my left hand very, very slowly while imagining that the right hand was also playing. My teacher also suggested just lying in bed and reading music. After all the years of experience, when you play something in your mind, your hands subconsciously are playing also. That, I discovered, was great advice. During these weeks, I was still on painkillers almost all the time but practiced with my left hand as much as I could.

            My life changed when the cast finally came off in late October. It was a day I anticipated with excitement and horror. I never had a cast before and had no idea what to expect. When the nurse took an electric saw to saw off the cast, the view was not pleasant. Although the blue marks had faded and the stitches almost dissolved, the hand looked lifeless. The skin was yellow and dry, and practically none of the fingers moved. The hand was so weak that I could not hold a piece of paper. My hand had no muscles, no ability to move and no energy in it. I was told to start therapy as soon as possible, but because I was not used to trusting anyone with my hands, I decided to go home and start practicing. That was scary… and wrong… My hand had no rotary movement--palms up and palms down, my wrist was as stiff as a rock. My friend from Juilliard came over that night--she was probably horrified by what she saw but instead encouraged me to keep trying.

            On my first visit to the Physical Therapy department at the hospital, I was evaluated and my “bad” hand was compared to the “good” one. I found out that day that my left hand rotated 180 degrees; my right hand, only 2 degrees. I discovered then that I had a very wrong idea about therapy--I thought I would take painkillers and then stretch and turn my hand as much as possible. Instead, I was only allowed to exercise while I could tolerate the pain. Being a stubborn and self-assured musician, I had to realize then the painful truth that I could sometimes be wrong, that I do not know everything--even if it had to do with my hands--and that other people know many things better than I do.

            My first day with my physical therapist was October 22. My therapist knew that I was a pianist and so ours was a job to “fine-tune” my hand for playing. The first thing we did was a “contrast bath.” It simply meant that I had two bowls of water in front of me--cold and hot. I put my hand in one and tried to make a fist and then did the same in the other bowl. I had to do this ten times. I also had a scar massage (that is done so that I would not get scar tissue on either side of the scar--it is especially bad on the inside because scar tissue can put pressure on the muscles). I had to “desensitize” the scar--simply put, I took a terry towel and rubbed the scar with it. This was necessary because the scar was over-sensitive and even the lightest touch made me jump. I also had to do thumb opposition (pressing the thumb against the second finger, third, fourth, and fifth fingers in sequence); thumb extension (stretching the thumb with the other hand); and tendon gliding (a massage along the tendons to slowly stretch them out). Then we started with “real” exercises: I got three that day and had to do them for the next seven months twice a day. I had to flex and extend my wrist (leaning my arm on a table or even on my thigh with the wrist hanging over the edge, I had to try to pull my fingers up towards me and then down away from me); then came radial and ulnar deviation (making a fist with the thumb facing up, and slowly stretching the wrist towards the thumb and towards the pinky); and then pronation and supination (with elbows touching your sides and making a fist, rotating the fists up and down). Each exercise had to be repeated ten times (one set) and in the middle I was supposed to hold the hand in a stretched position for five seconds. With time, I did two sets and even three and then with weights, eventually getting up to holding five pounds in each hand. Most of this therapy was not so much because I had surgery, but because I had eight weeks in a cast. I am describing it all in such detail because most of us at some point of our lives have a broken bone or an injury. In my mind, the cast does the most damage for a musician because you completely lose flexibility and range of motion.

            I had a problem that I would imagine all musicians have--I thought that by doing more of what they gave me, I could play sooner. All I ended up having was more pain and actually less progress. When my therapist said I should do each exercise ten times, I did it twenty-five. I thought I was smarter. I had to learn to trust others, and this is something I had never done before. I always thought that I knew better when it came to my hands. On top of all of their exercises, I made up my own. Back in college, I studied massage techniques and they all came in handy (literally). At the same time I was attempting to start practicing. I stretched my fingers and tried to put them on the keyboard one at a time. I was extremely diligent--therapists at the hospital were laughing at me because while most of their patients wanted to stay on disability for as long as possible, I was the only one eager to get back to work. I went to the hospital every day for therapy and repeated the whole session at home at night and worked by myself twice a day on weekends.

            Irena told me not to start playing without her--I could not understand why. The truth is that when I started studying with her as a small child, she started me off with certain exercises, but being a child, they came so naturally that I had not thought about them since. Irena wanted me to go back to the first lessons that we had together. It was a little weird at first, but because she now was able to explain to me why they are so important, in a strange way it felt good to start once more from the very beginning.

            The first three exercises we did away from the piano. They seemed simple, but at the time very important. We started by standing with our arms spread out and just feeling the weight of the hands while trying to relax the biceps and the triceps muscles. This was to start feeling each muscle and its functions, one at a time. For the second exercise, we put our arms forward in front of us and relaxed our wrists completely (my right wrist, of course, was still very stiff but still I tried to let it just hang down as low as it could). We then relaxed our biceps and triceps muscles and allowed our hands to fall back with wrists still “hanging.” We then dropped our elbows to our sides and practiced tightening and relaxing the muscles of the entire hand. The third exercise away from the piano was to stand straight with shoulders down and relaxed with arms in front of us. Then we tried to swing the wrists twice down and twice to the sides, repeating as many times as we could (again, very slowly). Because my entire hand and back were very stiff from the cast these small exercises were invaluable.

           Then we moved on to the piano. Irena told me to imagine that my fingers were like hooks and my arms were like ropes hanging from the shoulders. The key was to properly connect the shoulders to the fingers. My goal at this point was to consciously learn how to relax each muscle--without that I would be in constant pain from tight muscles. She gave me six exercises that could be played on any scale with hands going in contrary motion. These looked very easy but were very difficult to do; to produce the right results we had to achieve slow, controlled relaxation of the arm. We started by just putting each finger on the keyboard slowly using the full weight of the arm coming from the shoulder. To pick up the finger, we used the entire arm, especially the elbow. The wrist had to always feel relaxed. Then, with one hand supporting the other on the bottom, and without forcing, we practiced light staccato with “sweeping motion.” This is only for active finger motion, with the entire arm relaxing on the other hand and the wrist not moving. The third exercise is nicknamed “push and fly.” This time you combine exercises one and two. Shoulder pushes the finger forward and finger is catching the notes very quickly. Afterwards the arm goes back to the next note slowly. This teaches the shoulder muscles to tighten and relax quickly.

            The next two exercises are to teach the wrist to control and sound. With the wrist down and comfortably relaxed, you start with two-note slurs which are played very slowly with correct smooth upward hand motion. When this is comfortable, you do three-note slurs, four-note slurs, etc. You can play as many as you want as long as the hand movement is very slow and relaxed, and the notes are evenly divided with the hand movement (think of a bow and how many notes you can fit evenly on one bow).

            For the next exercise (again to relax the wrist) you play a note (first note of a scale), then rotate the entire arm--elbow out, up, inside, repeat. Repeat this rotation on every note of the scale. To take this exercise further, when the hand permits, you can start practicing Chopin’s A-flat Etude (Opus 25 no. 1).

            The last exercise consists of dotted rhythms: you start by rotating the arm four times like in the previous exercise, then play a very fast (grace note-like) note and the third note is again long with four arm rotations. Afterwards you can do two grace notes, three, four, up to two octaves. (Because you are playing scales in contrary motion, you have a range of two octaves.) This teaches you relaxation together with speed with active fingers. In time, I played arpeggios with the same rhythms.

            The thing that shocked me most is that I lost all sense of distances. I could no longer sight-read without looking down at my hands. Just like string players remember their notes by distances, pianists – although they can see the keys--still have muscle memory of distances on the instrument. I felt that I remembered my old repertoire but could not play it because I did not know “how to get to the notes.” It was a very awkward feeling and my doctor thought that it was all in my head. Irena said that it was common for musicians to lose their sense of distances after wearing a cast. I could only play if I looked down at my fingers.

            I could not do the easiest things away from the piano also. One of my very close friends had a concert in New York and I did not go because I could not get dressed! I started “slightly” over-dosing on painkillers because without them I could not practice or live at all.

            By the middle of November, I was practicing one hour each day. My wrist rotated 43 degrees and I was doing the same exercises but already with one pound weights. My therapist added two new exercises--theraputty gripping and theraband stretching. Putty is just like the clay kids play with, and I had to squeeze it as long as I could tolerate the pain. Theraputty squeezing emphasizes the intrinsic muscles of the hand as well as finger flexion. I was also given a “theraband”--a thick rubber band that I had to attach to a doorknob and then pull down to my sides and behind me. (It came in different colors, depending on the thickness of the band.)

            I guess I pushed myself too hard too fast: I had a setback. My wrist became very stiff and I had a problem with my thumb (again stemming from the cast) and had to get a cortisone injection. I did not realize that weather was also a factor. After any surgery your inside trauma is always painful when it becomes cold or it is raining or snowing. I still could not practice more than one hour a day – and it was still not a continuous hour; I had to stop every ten minutes or so to take a break. I was still improving: I got a stronger putty to squeeze and got new exercises to do--biceps curls, triceps stretching and strengthening, and a device that looks like a gun with rubber-bands of different thickness which you pull with a “trigger.” By early December, my wrist was so stiff that I could not play piano at all and had to cut back on exercises.

            Therapy was grueling and at the same time it made me feel that the progress was far too slow. All this was more painful psychologically than physically. I was told to be patient, but sometimes I would just break down in tears and think that my days of piano-playing are over. However, I had to pull myself together and keep going. By the middle of December, my wrist rotated 79 degrees and although I had “hand fatigue,” I kept pushing myself to do more.

            The best tips, again, came from my teacher. She suggested that I start with the easiest Czerny etudes (Opus 261). She suggested that I play these etudes using all elements of the exercises we did together – especially rotation, paying close attention to the elbow supporting fourth and fifth fingers. We then went on to transpose each of these etudes into every key. It was a great exercise and I took hours doing it every day. It was not so easy to transpose, so my mind was busy with that rather than thinking how awful my hand was. The transpositions were also very important to get my hands comfortable in all the keys. I started playing Hanon’s “The Virtuoso Pianist in Sixty Exercises” every day. I put my metronome at sixty and that equaled an eighth note. I moved the metronome up a notch every few days as I got comfortable in that particular tempo but it still felt like it would take forever to get into playing shape. At first I played through the first thirty-one exercises non-stop with each hand separately because I wanted to build stamina. When it became too time-consuming, I memorized all the exercises in order, so that I could play with both hands at the same time and not have to stop to turn the pages.

            I did scales and arpeggios every day--I played all major scales one day and minors the next (playing scales in thirds, sixths, tenths, and octaves). I spent hours playing “trill” exercises, especially for the fourth and fifth fingers. I stretched and bent all the joints and muscles in my hands. I even went as far as transposing Hanon’s thirty-one exercises into every key! All of this took months during which time there were more setbacks. As the weather got colder, my wrist got stiffer. I could not get off painkillers. There were days when I felt things would never improve; there were days when I felt I could achieve anything… I was at the piano or doing physical therapy every waking moment of the day. I became obsessed, neglecting everyone and everything in my life.

            By January, I was practicing two-and-a-half hours a day, although I was going through extreme thumb pain. My therapist made me a thumb splint to be worn all the time except when practicing. It was, like most medications, good and bad for me at the same time. It was helping my thumb but it was also making my wrist stiffer, which meant that I had to go back to basic thumb exercises when it was removed. My head knew that I had to follow instructions and do what the doctor and therapist were telling me to do, but my heart was truly breaking. As time was passing and I was canceling more concerts, I could not see the light at the end of the tunnel. It seemed that I was fixing things and at the same time new problems were coming out.

            During this whole time, I had to work both of my hands with the same exercises because otherwise I could ruin my back. Now that I look back, in a way, this was a wonderful experience, where I was starting everything from the beginning and could do right whatever I did wrong before. It kind of gave me a feeling of renewal but at the same time stress was building up. I was extremely tired--probably from wanting and doing too much too soon.

            I had to seriously learn how to be patient. I took up crocheting blankets--it was therapeutic for my hand and because it is so boring, it was teaching me patience. Imagine doing the same tiny hand movement thousands of times, knowing that at the end (in many months) it would be a blanket. While doing this, I was imagining that I was going through the same process on the piano--that through tiny movements and exercises repeated thousands of times, in time (again, in many months) it will result in a healed hand.

            By February I was regularly practicing three to four hours a day with five minute breaks every hour. My thumb felt better--it was only uncomfortable with radial deviation (stretching the palm of the hand towards the thumb). I had deep friction massage to help my thumb. I was “upgraded” to squeezing putty of a different color. I got a new exercise, putty-stamping, to strengthen a different set of muscles. My scar site was rarely painful. I continued with endurance, strengthening and stretching exercises on and off the piano. My palms up/palms down motion was by now 90 degrees each way, my extension/flexion was 54/59 degrees and my radial deviation (towards the thumb) was 23 degrees and my ulnar deviation (towards the pinky) was 23 degrees. I was doing well except for shoulder and back pain. That, I was told, was left-over discomfort from having my casted hand in a sling for so long.

            Eight months after the surgery, on April 19 (which is my birthday), I gave myself a present--I started sight-reading Mozart’s Sonatas. They were great for my hands as well as for my spirit. The sound of this familiar music was most soothing. By the summer of 2003, I reached my goal of 120 beats on the metronome for every quarter note (the tempo recommended by Hanon, himself) for all scales, arpeggios, Hanon’s Thirty-Two Exercises, and stretching exercises and I was finally able to practice my old repertoire. I realize that this “goal” sounds terribly mechanical, heartless, and unmusical, but at that moment physical strength and endurance of my hand, especially of my pinky, and the agility of my fingers was all that mattered. The time had come when I could go back to practicing the way I was used to with real recital repertoire. I added a new set of Czerny Etudes--Opus 740 (which comes in six books, each with a set of eight or nine etudes), playing a different set every day. I decided not to start learning anything new, but rather go back to my old repertoire. I still felt “disoriented” on the piano--my fingers still did not recover their sense of distances on the keyboard, but I just kept practicing. Irena kept encouraging me that it just takes time…

            On May 16, I was discharged from physical therapy. My therapist thought I could go on from there on my own; that I was knowledgeable enough to know when I needed “upgrading” on my putty to squeeze or rubber to pull (I was allowed to return to the hospital to upgrade materials to continue with my own therapy). My insurance refused to pay for more therapy also, and in a way, I felt “grown-up” and ready to be on my own and face the world. I was still feeling very uncertain of how I would ever go out on the stage, but somewhere inside I felt secure and comfortable, thinking that all the years of practice and stage experience left me with a knowledge that was invaluable: I knew exactly how to practice and how to prepare myself for the stage. Now I was practicing extremely slowly, thinking that what I do now will stay with me for a long time. For example, I was relearning the distances on the piano, and I knew that if I practice any wrong notes, they will be remembered by my brain.

            As the hours I spent at the piano increased, so did the pain and swelling in my wrist. My first concert was scheduled to take place seventeen months after the surgery. I was scheduled to play Grieg’s Piano Concerto in Korea. It was now a few months away. Technically, I felt stronger and even sometimes felt that my playing was at this point better than it was before my surgery. I felt more confident (although more nervous) both technically and emotionally. I felt that my playing gained new substance, new color, and better control. I was happy but the pain and swelling in my wrist was getting stronger and stronger.

            By the New Year I could not stretch my fingers to play an octave. I called Dr. Weiland in a panic. When he took one look at my hand, he just said: “Let’s try it again.” I freaked out for a moment but knew I had to trust him again. Dr. Weiland explained that because the sutures in the wrist were made of thick silk and non dissolvable, that he might have made them too tight for me to play piano for such long hours and that was causing the pain. I would have been perfectly comfortable if I did not have to play but with so many hours of straining and stretching, it was too tight. The sutures were not allowing my hand to stretch to play an octave. That day was really the turning point of my life: if ever I doubted whether I should continue playing. Like most of us, I was at times torn between spending more time with my husband, my kids, relaxing, enjoying life--or continuing the life of grueling practice schedules that knew no weekends or holidays, and that very often hurt my family. I knew that I could live a very comfortable life without another surgery but with no music. I also realized that this kind of life was not an option for me. I called Dr. Weiland in the morning and scheduled surgery later on in that week – on January 19, 2004.

When I saw Dr. Weiland on the morning of my surgery, he asked the usual “How are you?” Expecting the usual answer how nervous the patients are before surgery, he was surprised to see me grinning from ear to ear and saying, “Totally excited!!!” He looked at me like I was crazy… I knew that this was the beginning of my new life, no matter how difficult. I could not imagine the second set of problems lying ahead.

            Dr. Weiland promised that I would not have a cast or anything constraining after this surgery and he thought the recovery time would be much shorter. I was shocked to wake up with a huge bandage on my hand again. The nurse said that surgery was a success, that Dr. Weiland removed all sutures from my cartilage and that I should call him the following day and the bandages will come off then. When I called the doctor the next day, his nurse said that the bandages could only come off in two weeks. To me, it felt like eternity and that the whole nightmare was coming back. I knew that the most damage was done by the cast, so in panic I took off all the bandages by myself. As I found out later, this was just an “ordinary” panic or anxiety attack--it was a reaction to all the stress, hard work and fear of going through it all again. I started practicing two days after the surgery. I was back on painkillers and practicing from scratch. Although this time progress was much faster, my mental state became very fragile. As I cancelled the concert that I was preparing so hard far, I felt sick.

            In the coming months I was put on an anti-depressant medication as well as on a mild sedative. I guess that all the hard work and emotional stress finally took its toll on me.

            As I said in the beginning, during this whole time I learned many things that I never knew before. I learned that the most important thing in life is to be honest with myself. I had to face the fact that musicians (as well as most artists) have a fragile nervous system. I learned that there is nothing embarrassing about taking medication--in my case, anti-depressants--to get stronger emotionally. I also learned that whatever happened to me was not a rare case, but a common occurrence. Although in certain parts of my life I can be extremely tough, when it has to do with my music (whether it is my hands or the condition of my instrument) I can break down. I realized that there is nothing wrong with that but it takes courage to face it and deal with it.

            To be honest, the medication took a good year to work. Although my anxiety and panic went away, very slowly I started weaning myself off the medication. I learned patience when I had to practice only so slowly and get faster gradually, and this was exactly what I did with my medication. Very meticulously I got off the sedatives and only then I was able to practice and live again. After a few months of feeling “normal” (emotionally comfortable), I started lowering the doses of the anti-depressant. It was an uphill battle to pull myself together and to prepare myself for performing both physically and emotionally. But I knew I had to do this or I will never again have the life that I truly want.

            After my second surgery I basically did everything that I did after the first, but it took far less time. I never went back to the hospital for physical therapy – I did it all at home by myself. I knew how to start at the piano, I knew what to expect, I knew my goals and I knew everything I had to do to achieve them. This time, I did not go to see my teacher, either. Instead, I locked myself in my practice room for the following months and repeated the entire process… I am very glad that a friend suggested right after my first surgery that I should keep a diary. I thought that this diary could one day help a fellow musician with the same problem; I had no idea that this diary would actually become my best friend after my second surgery. It kept me from losing my patience, it kept me focused, and it showed me the exact road to follow. I wish I had an article like this one in front of me during my recovery--I would know what to expect, when not to panic, and, most importantly, to push myself towards my goal of performing and not give up. Although I would see the long road ahead of me, I would see that there is a light at the end of the tunnel. I hope this will never happen to another musician, but I am afraid it is inevitable…

            One day I watched the Olympics on TV and was inspired forever. I saw quite a few biographical segments about athletes that participated in the games and I realized that I am not alone--that a number of people have injuries that seem to be impossible to overcome, but where there is a well, there is a way… I saw an aerial ski jumper who fell during a practice session at the previous Olympics and broke both of her legs, pelvis, and back, only to be told that she could never walk again. However, after numerous surgeries and her own determination she was back competing at the next Olympics. There was a Croatian skier won three gold medals after eleven knee surgeries! A diver broke her back while jumping into the pool only to win the gold at the next Olympics! I saw that people can make miracles happen and I started believing that I could make a miracle happen also… I realized that when you really love what you do and are facing the possibility of a life without it, you find that you have the strength and determination within yourself to make it happen again.

            After these long and difficult years, I am back to work and appreciating it more than ever. I am working on recording projects. I am working with a brilliant young composer--editing, recording, and premiering his music. I am back to teaching, which has become much more satisfying both for me and for my students because now I have so much more valuable experience and can give them so much more. And I have started playing concerts again. A huge endorsement came from the wonderful people at Steinway, who invited me to join their roster of Steinway Artists. Great words of wisdom and encouragement came from Maestro Neeme Jarvi, who told me that any musician is a hero, but for me to become a musician for the second and then again for the third time, makes me three times of a hero in his eyes! Every minute I spend at the piano making beautiful music makes me the happiest person in the world.

            My physical trauma took me on a long journey of self-exploration where I learned much about my own limits and capabilities. I was lucky because I had my very first piano teacher walk the road with me together with my closest friend, Maestro Vakhtang Jordania. I had my most patient, kind, and loving husband, my great parents and my wonderful children walk this long road along with me as well. At this point, like never before, I realized the value of my family. I have learned through this very painful experience what friendship means, and, most importantly, I figured out that I truly want to make music not because I never went to a normal college and do not know anything else--but because I cannot live without it.

            I have walked myself through every motion and emotion fully conscious and aware, and, although the journey was much longer than I (or my family!) anticipated, I now do not think my time away from performing was wasted. It probably sounds corny, but I truly experienced and learned honesty (with myself), trust (in doctors, therapists, and teachers), loyalty (from family and two best friends), patience (the process of gradual practicing or weaning myself off medication) and courage to face it all--all very necessary ingredients for being a true musician. Now I feel that although this physical trauma took six difficult years to overcome, I came out of it a stronger person and a better musician.

            At this time, I am back to practicing my usual four to six hours every day and performing regularly. I do all this now with much more appreciation!