By Tokio Kasai, MD

One day, while relaxing on the sofa at home, I was flicking through Collection of Hand Sketches, which features drawings by the great masters of the world. The book includes various sketches of hands drawn by the great French masters Ingres and Delacroix and the titans of the Renaissance, namely, Michelangelo and Raffaello. It also comprises a young man’s strong hand and possibly an eligible woman’s soft hand. Because each hand had a gender and an age, I felt they had a somewhat realistic purpose. I found myself transfixed by the sketch of a hand drawn by a particular genius on one page. The hand, which was extremely abstract, had no age or gender. It should be noted that it represented the very notion of a hand itself, arising from an emptiness of space without a background. It was Da Vinci that sketched the hand in its purest form. Was he not the ultimate master who was able to express an idea itself, which is something that no other great master was able to do?

We know, understand, and memorize the patient and the individual characteristics of their condition. This, as a matter of course, is extremely important and useful in actual clinical practices. Hand surgeons also first start from impressionism. While accumulating experiences, the memorized impression changes to the subject itself with a clear outline. Possibly one day, as our vision is enhanced, every phenomenon will become transparent so that we may see things-in-themselves that should perhaps be called models? This is what I am made to imagine. However, I must state that I am not a master. I am always indecisive with the choice of treatment as well as in life.

The great swordsman of the 17^th Century, Miyamoto Musashi, revealed in The Book of Five Rings, a military text that he wrote at the age of 60 during his final years, the state of emptiness as the destination of swordsmen. He stated, “There is only good in what is called emptiness (pronounced “kuu”), it is not evil. An emptiness with not a shred of indecisiveness, that rightly, clearly and firmly grasps the general situation is itself the ultimate way of war.”

I have not completed my journey yet.

Tokio Kasai, M.D.
Department of Orthopaedic Surgery
Takamatsu Red Cross Hospital
Takamatsu, Kagawa, Japan