Adaptive Engineering for Musical Instruments James P. Snedeker, M.M. Abstract—Musicians who become disabled may not necessarily need to discontinue music making. This article provides 12 examples of musicians for whom musical instruments were modified to accommodate specific disabilities. Ingenuity, imagination, and flexibility can help individuals with disabilities overcome obstacles to continue music making. Med Probl Perform Art 2005;20:89–98. I f you always wanted to be a hero when you grew up, an ideal line of work might be as a copy-machine repair technician. Most of us know how critical that piece of machinery is to our day-to-day office functioning, and there is no shortage of crisis when it breaks down. The call is made, waiting ensues; finally the repairperson shows up, the machine is fixed, and all is right again with the world. Similar dramas often go on in the world of musical instruments. For a performer, it’s a sinking feeling to start a warmup on your instrument before a performance, only to find that a key is bent or a valve is stuck. But even worse, what happens to people when their ability to perform at all is taken away, not because of a horn problem but because of an accident, malady, or sickness? Fortunately, those who repair musical instruments for a living relish a challenge. Often as musicians themselves, they know how important it is to play and express oneself through music, and through ingenuity in altering the instrument they can return an afflicted musician to playing despite seemingly insurmountable odds. Sometimes, just ordinary folks with an idea, hunch, or simply good will and a knack for tinkering can also turn a fallen musician’s situation around. This article reviews 12 such case histories and shows that ingenuity and perseverance can transform a seemingly dreary situation into a positive one. the saxophone again, which requires two hands. While working with an occupational therapist, the patient realized that if it were possible to sufficiently modify a saxophone, he might be able to play it with one hand. Enter Jeff Stelling, a local instrument designer and repairman. After extensive consultation, Stelling developed a prototype of a “one-handed saxophone” (Figure 1), which enables the player to play all the notes with the right hand only. The instrument, though complicated, truly delivers the potential for playing just as well as a normal saxophone. Indeed, his client performed in a recital with his students in November 2003 (personal communication with player, November 2, 2004). From the beginning, Stelling wanted to build a fully functioning, professional instrument capable of doing everything a normal saxophone could do. Years before, a one-handed saxophone had been built in Connecticut, but it did not have all of the chromatic pitches and was limited in range. All the alternate fingers (such as Bb’s, side F# and C, and so on) also had to be available. The 23 keys normally played by nine fingers now had to be played by only five. ONE-HANDED SAXOPHONE In February 2000, a 37-year-old woodwind player and music professor at the University of Nebraska Kearney who specialized in saxophone had a massive stroke that resulted in left-side paralysis. As he recovered, part of putting his life back together included figuring out how he was going to play Mr. Snedeker currently works as an instrumental music teacher for the Shutesbury Elementary School in Shutesbury, Massachusetts, and teaches instrumental music privately at the Red Barn Music Studio in Amherst, Massachusetts. He is also a copy editor for the Northfield Mount Hermon School in Northfield, Massachusetts. Address correspondence to: James P. Snedeker, M.M., 248 Amherst Road, #E8, Sunderland, MA 01375. E-mail: [email protected]. FIGURE 1. The one-handed saxophone. June 2005 89 FIGURE 2. Sample fingering chart for one-handed saxophone. Stelling and his client considered the fingering system of the saxophone, the basic idea of which is that each finger has a key assigned to it (although sometimes more than one; for example, the left-hand pinky operates four different keys). In contrast, the piano keyboard has 88 keys that can be played by any finger. They then hit on the idea of having one key designed to combine the functions of the left with the right index finger (the good one) and similarly have another key each for the middle and ring fingers, which would combine the duties of these fingers from both hands (Figure 2). After more than 2 years of work, Stelling produced a professional-quality instrument that can play every note a FIGURE 3. The pedal trumpet. 90 Medical Problems of Performing Artists normal saxophone can. In July 2003, he and his client presented the instrument to the World Saxophone Congess in Minneapolis.1 Soon after, the father of a teenage saxophonist from South Carolina who had heard about this project was in touch with Stelling; his son had lost his left arm in an airplane crash. Stelling and his client decided to donate the original prototype to the young man, who today is playing as well as ever despite having only one arm.2 THE PEDAL TRUMPET In February 1993, a 57-year-old trumpet player and music professor at the University of Massachusetts Amherst experienced the disintegration of his C5-6 spinal disc with resulting paralysis below that level. The doctors warned him that he would never walk again, much less conduct or play trumpet. But after 3 months of physical therapy, he was able to play a fanfare on a post-horn (a type of straight trumpet with no valves) for the school’s spring graduation. After several years of continued therapy, he regained enough movement in his arms to conduct again but still only had one intact finger on his trumpet-playing (right) hand. He still taught trumpet lessons, albeit haltingly, using his index finger to manipulate all three valves. In 1998, Andrew Forster, a graduate student in music at the same university, devised a solution, the “pedal trumpet,” in which two of the trumpet valves are operated by the player’s feet via cables connected to pedals. He wrote to the Yamaha Corporation and asked them to donate the equipment, which consisted of two pedals used by drum-set players to operate the high-hat cymbals. Yamaha was happy to oblige and sent the pedals (personal communication with Andrew Forster, January 21, 2005). Forster then approached Richard Hansen, a brass repairman from Palmer, Massachusetts, and shared his idea: attach one end of a cable to the valve and the other to a bass-drum FIGURE 5. Air-powered trumpet being played. FIGURE 4. The air-powered trumpet. foot pedal. The trumpet valve would be pulled down by depressing the pedal, while lifting the pedal would allow the valve to pop back up. The first and third valves of this device would be operated by the left and right feet, respectively. The middle valve could be operated by the disabled player’s index finger, which retained sufficient strength to be used normally. Hansen took on the challenge and soon presented the musician with the world’s first pedal trumpet (Figure 3). After learning the system of fingering/pedaling needed to operate the device, the disabled player was soon playing duets with his students, something he had been unable to do for 5 years. AN AIR-POWERED TRUMPET Sometimes the best solutions to problems arise through a series of unrelated circumstances. It was a trip for some fast food I took in 1997 that eventually inspired me to design a second modified trumpet for the same player, one that could be operated by his fingers in normal trumpet-playing position, despite the fact that he still had virtually no range of movement in those fingers. I was a graduate student in music education and applied saxophone at the time. One day, after noting the touch screen on a cash register, I thought, if touching a surface can make a cash register work, why couldn’t touching another surface make a trumpet valve go down?3 I enlisted the help of two engineers on campus, Mike Conboy and Asaph Murfin, both of whom had an interest in adaptive engineering and who took on the project with gusto. After 2 1/2 years of working on their own time, their own expense and with my musical guidance, we designed a trumpet with valves that were powered by compressed nitrogen. A metal shelf sitting just above the valve pearls holds three touch pads, corresponding to each valve. When holding the trumpet in normal fashion, the player’s fingers are situated just above the pads. To activate the system, all that is needed is to touch any of the pads. When a finger comes in contact with the pad, it sends an electrical signal to a processor, which in turn activates a compressor attached to a tank of nitrogen, sending a burst of nitrogen through a flexible plastic tube connected to the bottom of the valve. An actuator connected to the inside of the valve pulls the valve down from inside. The valve stays down so long as the circuit is complete; once the finger is released, the air pressure is reduced and the valve pops back up (Figures 4 and 5). One minor alteration to the normal trumpet posture needed to be made. Due to the complete immobility of the player’s ring finger, which is used to operate the third valve, we transferred the third-valve duties to his thumb. Outside of this, the normal trumpet player’s finger technique remained intact. When he first played the final product, tears rolled down the player’s cheeks and he said, “It’s a miracle.” He debuted the new trumpet in public in August 2000, performing the theme and variation of Carnival of Venice. A SOLENOID-POWERED TRUMPET Incredibly, soon after completion of the air-powered trumpet, a similar trumpet was designed in another country and for a much younger player with a different story. In early 2001, Russ Brown, a teacher in Saskatoon, Saskatchewan, Canada, heard a student auditioning for the school musical’s pit band. Advancing juvenile arthritis had made it extremely difficult for her to play. It limited her physical strength, finger and hand dexterity, and flexibility and mobility and greatly impeded both fine and gross motor skills. It was very difficult for her to hold the trumpet and depress its valves.4 About 70 million adults and 300,000 children in the United States alone have arthritis.5 After years of training and perfecting their craft, professional and nonprofessional June 2005 91 FIGURE 7. Trombone further braced. FIGURE 6. Trombone on stand. performers are often unable to continue to play due to lack of strength in the arm and hand caused by carpal tunnel syndrome, arthritis, or nerve damage. This teacher felt the urge to find a solution to this problem and, unable to find any equipment on the market that would readily present a solution, resolved to build it himself. After receiving funding from his regional department of learning, Brown used personal time to tinker and experiment. As with the air-powered trumpet, Brown also wanted to make as few changes as possible to the horn. The process of development was one of trial and error; development came by experimenting with parts from auto wreckers, automotive part dealerships, Home Depot, Princess Auto, and Canadian Tire. The final prototype consisted of a 4.3-amp, 24-volt DC transformer, a set of relays on a circuit board, three solenoids, two small cooling fans, and a heat cutoff switch attached under the solenoids. Each solenoid is activated by a touchsensitive key/switch embedded in a custom hand mold. The hand mold was designed to accommodate the atypical shape and form of the student’s arthritically deformed right hand. An exoskeleton supports the key/switches in the hand mold, solenoids, and cooling fans. The trumpet is attached to a stand. The stand allows adjustment of the amount of pressure to the lips (embouchure) with very little left-hand strength; this was accomplished with a spring counterbalance mechanism. The design allows any traditional trumpet to be fitted into the exoskeleton in approximately 5 minutes with92 Medical Problems of Performing Artists out modification to the trumpet design. All of the parts dismantle for storage into a travel case on wheels. A subsequent model improved on this design. It has a unique dual retriggerable monostable multivibrator circuit to reduce the heat generated by the solenoids (thus, no cooling fans are needed). It allows full power to the solenoids’ pistons at the instant the key/switch is depressed. When the solenoid piston is fully engaged, the circuit reduces power just enough to hold the valve(s) down. The new board allows the solenoids to be enclosed, reducing the mechanical action sound. Cables connect the valves to the solenoids, eliminating any vibration to the mouthpiece. The piccolo trumpet, alto horn, baritone, valve trombone, and tuba all use a similar valve system, and the trumpet’s technology is adaptable to these instruments. The rotary valves of the French horn would require a repositioning of the upper cables. Thus, Brown’s trumpet allowed an individual with severe juvenile arthritis to fully participate as a member of a concert band, jazz band, and brass ensemble. For his efforts, he received the Saskatoon Teachers Federation Award for the Integration of Technology for the Disabled in 2002 and the Award of Merit by the local arthritis society (2002). An e-mail from a band repairman indicated that several clients, including professionals, have sought similar adaptations (personal communication with Russ Brown, November 22, 2004). TROMBONE HARNESS/STAND In 2002, I received an e-mail from Carl Bradford of Yarmouth, Maine. He had read about the air-powered trumpet I had developed and was asking for help for his friend, a professional trombonist who had played with Maynard Ferguson’s band in the early 1960s but who was paralyzed on his left side after a stroke. Physical therapy helped, but he remained unable to hold the trombone with his left hand. Moving the slide with his right hand, as normal, was not a problem (personal communication with Carl Bradford, March 2002). Because the trombone is a relatively simple instrument in terms of construction and operation, it might seem that adapting it would be an easy proposition. But, because of the finesse a player needs in balancing the horn in relation to the body while playing it, designing a solution proved difficult. Therapists had fashioned a harness that attached to his trombone. This enabled the player to hold the instrument with his left hand enough to steady it, but the harness caused considerable discomfort in the scapular area, including painful cramps. A straight steel brace support was added to the bottom of the horn, which then rested on his chair, between his legs. This transferred some of the instrument’s weight off the shoulder, with another strap in the back added for additional stability. However, the design still lacked enough rigidity to hold the horn in place without sliding from back to front (personal communication with Carl Bradford, April 26, 2002). My solution was to construct a floor-mounted stand that would hold the trombone in place and stand freely. The stand was attached to a piece of plywood that lay on the floor. Not only would this stabilize the stand, but when the player moved his wheelchair in place to play the horn, the weight of the chair would render the entire system stable (Figure 6). Working with two engineers, Mike Conboy and Bob Sabola, this basic design proved more problematic than we first thought. Even though we used a thick steel pipe, the instrument proved unstable when the slide was used and would wobble so much as to render it unplayable. The obvious solution was to add a second brace, but the instrument continued to wobble. We then vertically placed two sheets of plywood to the base, hoping to transfer the energy that was causing the extraneous forces to the floor base. This also failed. We then determined that extra stabilization could be accomplished by adding a third, adjoining brace. When you cross-brace a structure into a second spatial plane, you immediately make it more stable, so we added this third brace to connect the middle two (Figure 7). The resulting geometry proved stable enough so that the trombone lost its wobble. When the player first used the stand, he noted that it not only solved the sliding problem endemic to the chest harness, but it also provided sufficient lateral resistance so that he was able to blow air with greater force, thus enabling him to play in a higher register than he had been able to before. He planned to continue the use of the therapist’s shoulder harness for some of his playing (including gigs, because it is more portable than the stand) and the stand to build up his embouchure (personal communication with player, February 28, 2004). With both aids, the player again has the ability to blow changes with the best of them. FIGURE 8. Trumpet showing attempted left-hand fingering. REVERSE TRUMPET In the late 1990s, a high-school trumpet player from Long Island, New York, came to Jeff Vovakes, a musical instrument repairman in Middlesex, Vermont, for help. The student was in a wheelchair due to the effects of cerebral palsy. Trumpet players hold the trumpet with their left hand and press the valves down with the right-hand fingers. This player, however, while able to grasp with his right hand, had little use of its fingers. His left hand, however, was relatively intact. Vovakes decided to create what he calls a “reverse trumpet”; that is, the player fingers the valves with his left hand while holding the instrument with the right hand (personal communication with Jeff Vovakes, November 13, 2004). While this may seem like an easy solution that wouldn’t involve any adaptation, the problem is that the trumpet’s bell (the open, flared section where the sound comes from) gets in the way of the left hand (Figure 8), keeping the fingers from the valves. Vovakes decided to move this section. He took apart the trumpet’s tubing and rotated the bell section approximately 40° clockwise so that the bell section of the horn was on the right-hand side of the valves instead of the left. Consequently, the lead pipe (the tube that the mouthpiece fits into) was also rotated and was now on the left-hand side of the horn instead of the right. The only consequence of this new setup was that, due to rotation of the piping, both the lead pipe and bell ends were a little lower than normal in relation to the valves. This caused no problems for the player. CLARINET FOR A PLAYER WITH WEBBED FINGERS In 2003, a local high school student with congenital hereditary syndactyly, a condition in which the middle and ring fingers of the right hand are webbed together, approached Vovakes. The student wanted to play clarinet June 2005 93 able to the student. Vovakes decided that he would alter a regular clarinet by adding a key cover, complete with pad, to the third ring. This would eliminate the need for the student to have to cover the third hole with the finger alone. He then added a metal tab to the top of the key cover, offset toward the second hole (middle finger). Thus, by a combination of rotating the wrist clockwise, the ring finger, although attached to the middle finger, still had enough movement to lean over and press down on the tab, which would in turn lower the cover on the third hole, thus covering it (Figures 9–11). Vovakes also created a replacement set of keys so that it could be turned back into a normal clarinet if desired. FIGURE 9. Removed normal clarinet rings. RECORDER FOR A PLAYER WITH ARTHRITIS FIGURE 10. Clarinet rings with added adaptation. Another central Vermont resident came to Vovakes with a recorder problem. This woman had osteoarthritis (degenerative joint disease), one of the most common types of arthritis. She had diffuse involvement, including the fingers of her right hand, which were severely deformed. The recorder is a simple wind instrument in that one changes the notes by either covering or uncovering holes with the fingers (Figure 12). While Vovakes’s client was able to move her fingers independently, she was unable to cover the finger holes. She had played recorder all her life and, according to Vovakes, told him she wasn’t going to give up now, asking him to adapt her instrument so she could keep playing. To solve the problem, Vovakes decided to approach the instrument as a saxophone. The fingering system of the saxo- FIGURE 11. Clarinet with adapted rings in place. but, due to the condition, was unable to cover the third hole on the bottom stack (personal communication with Jeff Vovakes, November 13, 2004). On the clarinet, not only do you have to press down key rings with your fingers, your fingers also have to cover the holes inside the rings. One immediate solution was for the student to use a plateau clarinet, an instrument that, instead of having key rings above the holes, has cupped pads like a saxophone. The fingers push down on the cup and the leather pad inside the cup covers the hole. The Leblanc Corporation currently makes a plateau clarinet; however, because it is a specialty item, it was not afford94 Medical Problems of Performing Artists FIGURE 12. Normal recorder. FIGURE 13. Recorder with added keys. phone is quite similar to the recorder, the main difference being the way the holes are covered. As noted in the clarinet case history, the player pushes down on a cupped key situated above the hole, which then covers the hole itself. Vovakes constructed an entire key mechanism out of brass for the three holes of the right hand (bottom) and one for the third finger of her left hand (top). He designed tabs on top of the hole covers customized to match up to where the player’s finger pads fell when playing the instrument. (The instrument she played, an alto recorder, already had a low C key in place, as seen on the bottom of the instrument; Figure 13.) In the meantime, the pads that completed the seal between the key and the finger holes were made out of cork rather than leather. This was done to make it easier to find the exact seal; if the seal didn’t quite work, Vovakes ran sandpaper between the lowered key and the body. In this way, the cork sought its own tight seal. The instrument worked perfectly, and the woman was able to keep playing her beloved instrument with her friends until she passed away a few years later (personal communication with Jeff Vovakes, November 13, 2004). FINGER-GUIDED TUBA In 2002, a tuba player in his 60s from St. Johnsbury, Vermont, came to Vovakes. He had diabetic neuropathy and although he had sufficient finger strength to press down the valves, he was unable to maintain lateral control. As he pressed the valve down, his fingers tended to slip off the top of the key pearls. Vovakes saw what he hoped would be an easy fix and found it in a trumpet. When holding a trumpet, the player’s right-hand thumb sits in a “saddle,” which can be moved from front to back to aid in keeping certain notes in tune. Vovakes removed three such saddles from some old trumpets. After machining off the valve pearls from the tubaist’s Besson tuba, he soft-soldered the trumpet valve saddles to the top of the valves (Figure 14). FIGURE 14. Tuba valve with saddles. FIGURE 15. Sketch of flute apparatus. The saddles kept the player’s fingers in place, on top of the valves, and he was now able to play the tuba without any problems (personal communication with Jeff Vovakes, November 13, 2004). COMPUTER-OPERATED FLUTE The possibility of a flute player who had lost use of normal finger dexterity occurred to Rosemary Metcalf, a student at Worcester Polytechnic Institute in Worcester, Massachusetts. She designed a system that would be cognitively familiar to someone who had already played flute but who could, for any number of medical reasons, use only one hand. A normal flute without any modifications would be held in the air by a floor stand. Nine fast-response, pushtype solenoids would be configured in such a way that when the flute were attached to the stand, they would be fitted over the nine main keys of the flute (operated by the left hand’s thumb, index, middle, ring and pinky fingers and the right hand’s index, middle, ring and pinky fingers) (Figures 15 and 16).6 This system existed as a design only and was never actually fabricated. While there are more than nine keys that are somewhat important, this device covers the range of most beginning to intermediate flute repertoire. Two full octaves are covered in the user interface design. In this way, the solenoids would act as mechanical fingers, which press down the keys. The player would control the finJune 2005 95 FIGURE 16. Mounted solenoids diagram. Doctors were able to reattach all but his pinky and replaced his knuckles with plastic ones. All of the fingers responded to some degree, with the exception of his ring finger. But, despite this relatively good news, the doctors also pronounced that he would never play the flute again. Undeterred, he contacted the Emerson Corporation, a maker of flutes, and asked if they could help him. He needed something that would give him an alternate option for playing his G/G# keys (played by his ring finger and pinky, respectively) and the C key (played by the index finger). Although that finger had been reattached, it flexed abnormally, veering off to the side. His thumb and middle finger functioned normally. Building an extension that allowed use of the tip of the index finger to depress the key solved the C key problem. The solution for the ring finger was to build extensions off both the G and G# keys that are played using the pinky stump. The player can rotate his pinky around an axis enough to be able to play either the G key independently or both the G and G# keys simultaneously (Figure 18). Due to the new attitude of this hand, holding the flute normally in the crook between his left thumb and index finger was no longer an option. However, inspired by an 18th-century flute that had a crutch built for just this purpose, he had Emerson add such a crutch, which rests between the thumb and index finger (Figure 19). Due to some continuing pain in the player’s upper neck and shoulder, the flute’s head joint was bent to a 30° angle, FIGURE 17. Sample fingering chart for computer-operated flute. gerings via a handheld cylindrical controller fitted with buttons. A new system of fingerings was devised for someone with only one hand. The fingerings would be cognitively similar to the normal flute fingerings so as to make this part of the transition as easy as possible (Figure 17). A computer program would then be written that would interface between the buttons and the solenoids; when a particular combination of buttons is pressed, the combination of solenoids that corresponded to that note’s fingering would be activated, thus pressing down the correct keys for that note. Performers would either stand or sit near the device so that they could place their lips on the lip plate and blow air normally across the tone hole, thus producing the note that was fingered. FIGURE 18. Flute with G and G# key extensions. MODIFIED FLUTE A 25-year-old man in Colorado had played flute for about 6 months when he had an accident while working in a sawmill that would have appeared to end his flute playing. In the accident, he severed the thumb, index, middle, and ring fingers of his left hand, and leaving only a one-inch stub of his pinky. 96 Medical Problems of Performing Artists FIGURE 19. Flute hand crutch. which promoted dropping of the shoulders, thus relieving pressure in the scapular area. Today, 27 years after the accident, the player enjoys playing his flute for friends and family. He noted that, “There’s nothing like the moment when you realize that you’ve been given back what has been taken away” (personal communication with player, November 20, 2004). ADAPTED DRUM-SET PEDAL In 1999, a professional drummer who had played with Elvis Presley, Sonny and Cher, and Bette Midler was stricken with pneumonia. Complications developed that forced doctors to perform an above-the-knee amputation of his right leg, thus preventing him from using the bass drum pedal on his drum set. Medical people attempted to build a device that would permit him to play again, but their lack of understanding of the mechanics of drum pedals and what is required to lay down a strong beat was reflected in their prototype, which failed to do the job. He continued to teach but doubted whether he could ever play again. In September 2000, one of his students learned of the Lemelson Center for Assistive Technology Development at Hampshire College in Amherst, Massachusetts, and arranged for him to visit and tell his story. There, Julian Groeli, a student and drummer, became involved in devising a way for the client to play the bass drum again, which he called Project UpBeat. At first he tried to imitate the shape of a leg to achieve its function. Along with fellow student Matthew Lorenz, Groeli built the first round of prototypes around this concept. Although the client was able to use the device well in the controlled environment of the workshop, it was too bulky and awkward to fit onto a real drum set. Groeli abandoned the leg concept in favor of a cable system for more flexibility. He also noted that it would be beneficial to make the design usable from a wheelchair, so the player wouldn’t have to transfer every time he wanted to play for brief periods. Groeli and Lorenz began to picture a solution that could be used on its own or from a wheelchair. It soon became obvious, however, that drumming from a wheelchair was uncomfortable. The new prototype worked well on an electric bass drum, which consists of a simple pad connected to an amplifier; any beat on the pad is greatly amplified to produce a “techno” style drum sound. However, they were anxious to attach the system to an acoustic kit. An acoustic drum absorbs more energy than an electric pad, and the prototype was still absorbing too much energy, making it hard to get enough volume. Groeli realized that moving the pivot point to line up with the drummer’s hip joint would bring the added leverage they were looking for. They had finally arrived at the root of the problem. Before finishing this last version, Groeli modeled his design in SolidWorks, a state-of-the-art CAD program. This helped in visualizing unfinished sections of the prototype (Figure 20). FIGURE 20. CAD representation of adapted drum pedal. From tinkering with possible solutions—watching them fail and starting over from scratch—to finally listening to his client play again was an incredibly rewarding experience for Groeli. His client has been playing ever since, building up his chops and giving his bass drum a good beating. Groeli and Lorenz presented a version of their adapted drum pedal at the Smithsonian Museum of American History at an exhibition of similar projects organized by the National Collegiate Inventors and Innovators Alliance, March Madness for the Mind in March 2001, where they were interviewed by the Discovery Science Network (personal communication with Julian Groeli, February 6, 2005). Other examples of their adaptive engineering can be found at http://www.julian.groeli.com. CONCLUSIONS What a gift it is to be able to make music, and what a luxury to be able to enjoy it. The joy of music making never diminishes; what may change, however, is one’s ability to do so. As seen here, life’s pleasures can be denied by cruel twists of fate. But as long as the spirit remains intact, and talented friends and technicians are available who can contribute their time and talent, affected musicians can often look forward to retaining their station in the world and to continue to contribute their own certain amount of joy as they did before. This article demonstrates that with collaboration between people with different kinds of expertise, and a little imagination, individuals with disabilities may continue their music making. This is surely but a small sampling of other similar stories that have happened over the years. As those with medical training and musical knowledge can help heal musicians, so instrument builders and repair experts can June 2005 97 modify instruments, enabling disabled musicians to continue to perform. 3. 4. REFERENCES 1. 2. 98 Nabb D, presenter: Introducing: a one-handed saxophone by Stelling Brass & Winds (program pamphlet). World Saxophone Congress XIII, Minneapolis, MN, July 12, 2003. Duggan J: Kearney prof plays a special saxophone. Lincoln Journal Star, April 6, 2004. Medical Problems of Performing Artists 5. 6. Snedeker J: Walter Chesnut and the Chesterhorn: bringing trumpet fingers back to life. International Trumpet Guild Journal 2001;25(3): 45-55. Bernhardt D: Invention hits right note for teen trumpet player. The Saskatoon Star Phoenix, March 18, 2002. UVaHealth Topics A to Z. University of Virginia Health System. Available at: http://www.healthsystem.virginia.edu/uvahealth/peds_ arthritis/stats.cfm; accessed 6 Feb 05. Metcalf R: Mechanical assistance for a one-handed flutist. Worcester Polytechnic Institute, February 19, 2004.
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