Imagine for a moment that you are journeying along a fairly narrow pathway, which at one point you find to be totally blocked by a huge boulder. Just one glance suffices to convince you that it is beyond your capacity to so much as move, much less clear. Then imagine that quite unexpectedly, people begin to emerge with lump hammers and steel stone chisels (including of course, one for you to use). Need I say more? But even in the light of all of the above and of all the many sources of encouragement and inspiration out there, what can I say that possesses true merit and meaning, to a man or woman who somehow feels scarred in a permanent kind of way and – yes – as I have had it put to me by patients many times, “mutilated”?

One of the greatest aids to my thinking in this regard has its origins now far back in time for me personally; to in fact my childhood days. It happened that living at the other end of the block of houses in which I grew up, there resided (as he seemed to me to be) an elderly man who shared house with his daughter and son-in-law. Everyone knew him as “old Mick” and in their different ways, appreciated him for the genial character he undoubtedly was. Apparently his left leg had been ‘blown off’ in the Great War and one always now saw him with his trusty walking stick, taking a daily constitutional and limping his way, one hand invariably tucked behind his back, to a public seat set back at the junction of a main road nearby. There he would sit quietly for a spell watching the world go by and then return home again.

One day, I was helping my father in the garden as “Old Mick” passed by on the outside pavement. As I recall the occasion, he and my father entered into a brief but seemingly amicable, if fairly casual conversation before moving on. I simply cannot recall after all these years the context of what followed between my father and I. However, it seems that I must have made some reference to the fact that Old Mick had only one leg. The one thing that I shall never forget was my father’s prompt and pointed response as follows: “Maybe one day” he gently chided, “you’ll come to see that where people have lost a limb or a part of themselves, the normal practices of counting are suspended”; adding, “In my experience of them, far from taking from them, it contributes to what they are and what they have to offer”. Happily, that day did indeed dawn for me several years ago now, just as my father had clearly hoped that it it would.

In the course of my clinical activities, I once had occasion to visit the home of a patient who had been diagnosed as suffering from Paget’s disease• and an Osteosarcoma••. Donald was now in his mid-50s. Back in the days of youth and early manhood he had apparently been both a fine cricket and rugby player. Until the onset of his illness, Donald had continued to ‘work out’ and run in charity marathons and the like. Unfortunately, it had been necessary to amputate the lower and later, the entire left leg. Donald’s wife had telephoned to tell me that he was becoming more and more depressed and unwilling to go out or even meet close friends who had visited the home for years.

But it was Donald’s wife who on the occasion to which I am here referring, said what I have always considered to be a stunningly beautiful thing and one which I was indeed able to later ‘plug him into’ to good and enduring effect. Just before I left their house that day, she exclaimed, with patent spontaneity and sincerity, “He keeps saying he’s no’ a man anymore. I tell him; he’s more of a man now than he’s ever been over all the years I’ve kent him”. It is, I suppose just another interpretation of other memorable and telling words, “To him that hath, shall be given…”