Ready or not

With this kind of help it's a wonder anything is ever ready.
With this kind of help it’s a wonder anything is ever ready.

Somewhere around the middle of December those awkward conversations that happen when one meets a casual acquaintance on the elevator start to stress me. I’m sure you know the conversations I’m taking about– the ones that normally revolve around the weather, and start with nice safe statements like “that was some wind yesterday” and “sure hope it warms up for the weekend.” I can manage a benign dialogue on these meteorological subjects for several floors without breaking a sweat. But I have come to realize that there is one elevator conversation-starter that I truly dread.

“Are you ready for Christmas?”

For some reason I feel like I am supposed to provide an actual answer to this question, rather than the usual meaningless elevator small talk. I think way too hard about my response, mentally kicking into overdrive as I silently review the status of my gift-shopping list and my pre-Christmas errand list and the to-do list on my desk of all the things I should really try to get done before I go on vacation. I generally blurt out a lame response like, “Almost.”

I wish I knew why I feel so pressured by this question. I know that the people asking it are just doing it to fill air space– that they don’t really care whether my gifts are all wrapped and my cookies all baked– that they aren’t really judging me on the basis of whether or not the tree is up and the lights hung.

Why then do I catch myself judging myself?

What does it really mean to be “ready” for Christmas? In the Anglican tradition in which I grew up, we spend four whole weeks of Advent getting ready for Christmas. Four weeks in which we light candles and reflect on the significance of the child whose birth we are celebrating. That is, if that is still what we are celebrating.

I admit to being one of those annoying people who starts Christmas shopping in August. I’m not a big fan of shopping in general, so If I can spread it out over a longer period it is less of a burden. Even so, I am almost always dashing out to pick up something at the last minute. This year in spite of carefully buying the various components of Christmas dinner for which I am responsible well ahead, I have still thought of one more thing I will have to go out and buy amidst the throngs of last-minute shoppers.

Even when I’m ready, I don’t feel ready.

I think it has something to do with the fact that the older I get, the more complicated Christmas gets for me– the more I understand that Christmas happens in spite of us. If you are sick or hurting, Christmas doesn’t wait until you feel better. If you are lonely or sad, Christmas doesn’t wait until you feel more like celebrating. Christmas doesn’t care if you are ready. It comes regardless. And, because we have imbued its coming with such significance, with such–dare I say it– baggage, its relentless determination to arrive on schedule despite our degree of readiness can make the things that weigh us down seem all the more weighty.

If you are grieving, the fact of Christmas  can make the grief harder to bear. If you are alone, Christmas can be even lonelier. When you are low, there is nothing like the expectation that we will all be “merry” to make you feel even lower.

You know the song “We need a little Christmas?” It’s a mall and radio station favourite, because it screams Christmas without anything suspiciously religious like shepherds and stars. But do you know where the song originates? It’s actually from the Broadway musical Mame. The song comes at the point in the plot where everything has gone about as wrong at it can go. Auntie Mame has lost her job, and lost her fortune in the stock market crash. If you listen carefully to the lyrics, they aren’t exactly merry:

I’ve grown a little leaner
Grown a little colder
Grown a little sadder
Grown a little older

 

Essentially the song is saying that we need a little Christmas to distract us from the fact that, at this precise moment in time, life sucks.

Since I started writing this post I have put the finishing touches on my 5-year old nephew’s made-to-order Darth Vader cape and reversible Indiana Jones vest. (Yes, I’m THAT aunt. Jealous?) I have wrapped my last gift. Aside from that one last grocery run, I am ready for Christmas.

And for me, at this point in time, life doesn’t entirely suck. But I know people– people I care about– for whom it does. And Christmas is coming whether they are ready for it or not.

That’s why I was delighted to come across a blogging  initiative called C4C– which stands for Company for Christmas. You can read all about it here. It’s being managed this year by a terrific blogger who goes by the handle Rarasaur, and the premise is that bloggers volunteer to spend some time online on Christmas day so that other bloggers who are alone on Christmas have a community to interact with. I continue be amazed at the kinds of connections that happen in the blogsphere. Just when I start to get the cynical feeling that 99% of the blogs following mine are either spammers or out to enlist me in some pyramid scheme, something like C4C comes along and restores my faith in humanity.

Because when it comes right down to it, being ready for Christmas doesn’t really have anything to do with how many tins of cookies are stacked on the kitchen counter, or how overdrawn your bank account is. Remember the Whos down in Whoville? Even after the Grinch stripped their homes of all the gifts and treats and trappings of Christmas, they were still ready. Ready to hold hands and be a community that celebrates together even when times are tough. Now I’m ready.

Momentum

The remains of the mental muck I was lamely trudging through on Friday night were still clinging to me when I left for work this morning. Even though I wrestled my weekend into some order with my trusty list. Even though I slept late (a rare event) and woke to the smell of fresh cinnamon buns my daughter had made for breakfast. Even though I made a real point of taking it easy on Sunday and actually went to bed at a decent hour.

Sometimes I just lose momentum.

If you haven’t experienced it, it’s hard to explain the kind of fatigue that comes with certain forms of chronic illness. In my case, it comes in a package with rheumatoid arthritis. But fatigue is a feature of all sorts of chronic conditions–other forms of arthritis, fibromyalgia, MS, depression.

Everyone gets tired, right? But fatigue is different from tired. Tired is an event. Tired is “I didn’t sleep well last night so I’d better have a nap.”  Tired is “Wow that was quite a workout; I’ll sleep well tonight. “Tired is “I’ve been on my feet too long and I’ve got to sit down for a few minutes.”

Fatigue doesn’t go away if you sit down for a few minutes. Fatigue is waking up from the nap without much more energy than you had before. Fatigue is looking at the dishes on the kitchen counter, knowing that it would take 5 minutes tops to wash them, and not having the energy to do it. Fatigue is staring blankly into a fridge full of fresh ingredients and opting to microwave a frozen dinner to eat on the sofa. Fatigue is staring blankly at the screen and realizing that even stringing together a few coherent sentences is Just Too Much Effort.

Sometimes fatigue is a corollary of chronic pain. Because let me tell you there is nothing quite so exhausting as chronic pain. But even when my joints are not flaring and I am not experiencing significant pain, the fatigue can still wash over me and rob me of my momentum.

It has taken me most of my life to realize that, ironically, the more exercise I get, the less likely I am to be overcome with fatigue. In the weeks following my hip replacement surgery, when I was exercising religiously and walking every day, I had all kinds of energy. I’m still walking when I can, but the reality is that my work involves a lot of sitting. After being back for just two months, I can already feel the reduction in physical activity taking its toll. In spite of my best intentions to the contrary, it’s hard to maintain the momentum of healthy living when there are so many other priorities crowding in and demanding attention.

After my sluggish weekend, I was relieved to find that at some point mid-morning I got my stride back. By mid afternoon I was on a productive roll, and things that looked like huge and daunting tasks on Friday and throughout the weekend were finally getting knocked off my to-do list with ease.

When the fatigue subsides, it’s easy to forget about it. Easy to assume that the momentum will last. Easy to fall into the bad habits that leave me dragging like a old clock that hasn’t been wound. My calendar at work this week is a marathon. I know better, but I let it happen all the same.

First you save a life

I can’t pass up today’s Daily Prompt, which invites bloggers to “Tell us about a bullet you’re glad you dodged — when something awful almost happened, but didn’t.” My biggest challenge is deciding which bullet to write about.

In a previous post I treated you to an excerpt adapted from an unpublished book manuscript. Here’s another snippet from that same manuscript…

030117-N-5996C-003It is never fully night in the Intensive Care Unit. There are always lights, and a steady buzz of human and mechanical activity. If you are in the ICU, it is because you are not stable enough to be entitled to eight hours of uninterrupted sleep. You need frequent checking, and so do all your neighbours.  The classic hospital joke—where the nurse wakes you to say it’s time to take your sleeping pill—is not a joke in ICU.

Although ICU nights consist of catnaps wedged between inspection tours, there is a distinctive rhythm to the 24 hour period that helps to maintain some semblance of day and night. Hospitals in general are very rhythmic. Everything is scheduled—except, of course, the crises.  If you want to see frenzied improvisation at its most improvisationally frenzied, hang out in the adult Emergency Room of a downtown hospital on a Saturday night. Travel up into the medical wards where people with slower paced problems are slowly getting better (or worse), and you will find everything chugging along like clockwork. Mind numbingly boring clockwork.

But in ICU, the two poles of this continuum arc around and crash into one another. This is the reason that, in my opinion, there is no human being—not even the most perfectly disciplined athlete or ballerina—who can embody a more exquisite balance of precision and flexibility than an ICU nurse.

The ICU nurses I encountered were made of tough stuff. They worked 12-hour shifts tending to the sickest of the sick. They were in constant motion—each nurse only focused on a couple of patients per shift, but they kept up a seamless rotation of activity. Check vitals. Clean patient. Change bedding. Calibrate tubes. Chart progress. Repeat.  Competent, efficient, and in the case of the nurse I recall most vividly, in possession of a wicked sense of humour.

You’d have to have a sense of humour to survive a job like that. I think ICU nurses would make good astronauts. They have the patience and attention to detail necessary in a situation where the smallest error could mean the difference between life and death, and when the crisis hits they somehow keep that control and levelheadedness, but at a much accelerated pace.

The ICU doctors too, were a different breed. As the head of ICU, succinctly put it: “first you save a life.”

His colleague explained this philosophy in more depth to my mother: “When someone is as sick as Anna is now, our priorities shift. Priority number one is to keep her alive. Priority number two is to save her kidneys. Priority number three is to get the bleeding under control.  While her eyesight is important, at this point, it can wait for another day.”

Of course controlling the bleeding would have been easier if they had known where I was bleeding from— they still couldn’t explain why my haemoglobin kept dropping.  The doctors were now tossing around terms like “multi-organ breakdown”—as always more descriptive of what was happening than of why. One doctor admitted to my husband that the entire medical team was “baffled” and they were considering the option of transporting me to the Mayo Clinic.

But by the next day it was decided I was too unstable to transport, so the Mayo Clinic was out.

Unstable I was indeed. An MRI confirmed that the fluid was now collecting in my head—putting pressure on my brain and messing with my perception and cognition. Sometimes I had double vision, and sometimes my vision was clouded. I was vomiting blood, and the diarrhoea continued unabated. Pressure on my lungs from the fluid in my abdomen made it difficult to breathe. Dialysis made me dehydrated, but they were afraid to give me fluids because they still couldn’t explain why I was retaining so much fluid.

I was anchored to the bed by an impossible spaghetti-tangle of tubes. I had IV tubes to keep me hydrated. Stomach tubes to deliver the liquid food substitute on which I was subsisting.  Oxygen tubes clipped to my nose. And the nasty intra-jugular tube, in my neck, through which I received hours and hours of dialysis for my failing kidneys as well as transfusions of whole blood and plasma.

Shortly after my arrival in the ICU, one of the nurses decided it was warranted to bend the rules and allow my five-year-old daughter in for a visit. Much later my husband confessed that the staff agreed to the visit on the grounds that, at that point, the odds of me making it out of ICU alive were looking pretty slim.

I was too weak to interact with her. She just stared down at me from her father’s arms, wide-eyed and silent. Back at daycare, after what must have been a truly horrific experience for a 5-year old, she made an attempt to express the inexpressible in a drawing. On a tiny scrap of pink paper she drew a meticulously detailed depiction of me—in a bed—surrounded by a tangle of tubes. Her caregiver recounted to me later how she laboured over the portrayal of each tube. When she was satisfied that she had captured the scene fully, my daughter sat back and stared at the portrait in silence for a long time. After this period of reflection, she picked up her pen again and scribbled a heavy “blanket” over the figure in the bed—effectively obliterating the tubes from view. If only.

The ICU was a big room with patients arranged in a ring around a sort of “command centre.” The beeps and hums of the machines busily keeping me alive blended into the beeps and hums from everyone else’s machines, and the result was an oddly comforting white noise.  I didn’t mind the machine noise, but the endless talking of the staff irritated me and kept me awake. Each bed had a curtain for when privacy was called for, which didn’t seem to be often. The fact that I was too sick to care about my surroundings meant that I equally didn’t care about being “on display.” If I wasn’t noticing my neighbours, they sure as heck weren’t noticing me. Although it was possible to see other beds, they seemed to be arranged so that, open curtains notwithstanding, I was never really aware of what was going on with the other patients.

Except once. On one of the not-quite-nights when I was at the lowest of the low, I had more trouble than usual sleeping. In my disoriented state I was having trouble making sense of what was happening around me. I remember feeling irritated throughout the night by the lights from the neighbouring bed shining in my eyes. I was vaguely conscious of a commotion that deviated from the usual slow dance of night-time activity. I recall a curtain being sharply drawn—enough to obscure my view, but not enough to mask the lights and sounds. Still, I didn’t put it together, even in the morning when I could see that the bed next to me was vacant. It was evening again before my husband explained to me that my neighbour had gone into cardiac arrest in the night and had died.

            It felt quite plausible that I would be next, so I started mentally planning my funeral.

Body and Soul: of mundane miracles and secular sacraments

Like all good little cradle-Anglicans of my day, when I reached the age of 12 I signed up for Confirmation class. We met crammed into a too-small but oddly symbolic “upper room” off the church balcony. I remember exactly two things from my weeks of Confirmation prep. The first is the lesson where we read and discussed the miracle of the feeding of the five thousand. The minister who taught the class took it upon himself to challenge us with some liberal theology, and pressed the point that perhaps there was more than one way to make a miracle. Perhaps Jesus didn’t conjure extra loaves and fishes out of thin air after all. Perhaps when the members of the crowd observed one person sharing the provisions he had brought, they were inspired – or shamed— into digging into their packs and bringing out their own secret stash of snacks to share. It had never before occurred to me that people might be invited to participate in the making of miracles. Indeed that we might be expected to participate. That perhaps that was how miracles really happened.

I also recall learning about the sacraments. I learned that Roman Catholics recognize seven sacraments, but that Anglicans observe a sort of “sacraments light”—zeroing in on Baptism and Eucharist. Mostly I can still hear the priest repeatedly intone—“a sacrament is an outward and visible sign of an inner and spiritual grace.” Kind of like sharing your picnic lunch with your neighbors to show that you are a community.

After Confirmation I promptly stopped attending church for most of my teen years. There was no noisy rebellion on my part—mostly I just had lots of other ways to spend my time that seemed far more relevant and interesting than my parents’ church. As a young adult I found my own way into a faith that was mine, not just a parroting of my Sunday School and Confirmation lessons. And I grew to appreciate more and more what it meant to do things that were visible and external as a reflection of what was going on invisibly and spiritually within.

When I turned 40 I had a huge celebration. Forty is a milestone birthday at the best of times, but it is often celebrated with a wry sense of doom and despair. (“Oh no I’m getting old…”) For me, 40 was a really big deal because I wasn’t dead. I had, by contrast, spent my 38th birthday in galloping kidney failure, being readied for what was very nearly a one-way transfer into intensive care. Through a series of miracles supported by the participation of various members of the medical profession, I did make it back out of intensive care and into the world, but not before I had battled temporary vision loss, taught myself to walk again, and recovered from brain trauma.

Catastrophic as that particular illness was, it was not the first time my body betrayed me. The truth is my body has a long and tiresome history of betraying me. I was diagnosed with Juvenile Rheumatoid Arthritis at the age of two, and spent most of elementary school sidelined in gym class with painfully inflamed knees. After a teaser of a remission period during my teens, the arthritis came back in full force just as I was poised to graduate from university and start a teaching career. As if my bodily betrayal was not enough, one of my professors heaped coals on the fire of my frustration by musing to my face that “perhaps I should consider a less physically demanding profession” than the one in which I had just invested five years of preparation.

Then, in a whole new set of bodily betrayals, my attempts to have a child were thwarted by repeated failure. My first two pregnancies ended in early miscarriage. Surgery for an ectopic pregnancy went wrong, and I nearly bled to death from an internal rupture. My fourth pregnancy ended in fetal death at 12 weeks, but I didn’t miscarry. Apparently my body couldn’t even get miscarriage right. While I did eventually succeed in carrying two children to term, my eldest was born after an extraordinarily long and difficult labour that resulted in a caesarean. The technical term for this particular bodily betrayal was labour that “failed to progress.”

So by the time I hit 40, my relationship with my body was strained at best. But in spite of all the trouble it had caused me, I was still alive. That seemed worth celebrating. I wanted to make peace with this body that had failed me so many times, but that had also rallied from so many close calls. Like an old Timex watch it took a licking and kept on ticking.

So I got a tattoo. I had been contemplating the notion of a tattoo for about three years, but took a while to decide when, what, and where. Having decided on my milestone birthday as a perfect “when,” I found the “what” while gazing around my living room one evening are realizing that ALL the artwork on my walls bore the images of loons—a creature that has always held significance for me. I chose the image of the adult loon with its baby riding on its back—an image that reflected for me the extent to which my body—and my life—had been marked by my journey to, and through, motherhood.

legAs to “where,” I opted for a spot halfway up the side of my right calf. I reasoned that in this position I could show off the tattoo without getting half naked, but could keep it hidden if that was appropriate in a professional context. I assumed, in fact, that I would want to keep it hidden at work. It oddly didn’t dawn on me at the time that hemlines might rise.

To my surprise, I gradually became less and less concerned with when it might be “appropriate” to let my tattoo be visible. I started wearing shorter skirts to work and not caring who saw the tattoo. Somehow, making my body a canvas for this work of art made me more comfortable in my own skin.

I didn’t think about the tattoo as a sacrament at first. Over time I began to realize that what had felt at first like an act of belated adolescent rebellion held a much deeper significance to me. Curious about what motivated other tattoo bearers, I read and heard deeply touching stories—tattoos marking the death of a loved one, tattoos marking a significant life event or choice, tattoos remembering a lost friend, tattoos marking a battle with disease or addiction, tattoos enshrining a powerful memory. I came to understand that I had marked my body in this way as an outward and visible sign of a truth that I couldn’t really put into words, but that I carried deep within me.

Between my 40th and 45th birthdays, my inner truths underwent a profound transformation that culminated with the outward sign of divorce. Searching for the right ritual to mark this transition, I knew it was time for another tattoo.

This time I approached the tattoo more consciously as sacrament. This time I also knew immediately and intuitively what the image would be. Another loon, but in the aggressive stance—wings upraised—of a loon that is charging an enemy. I’ve been charged just so by a loon, while inadvertently canoeing too close to her nest. They are powerful creatures—and bigger than you think—especially at close quarters in their threatening “don’t mess with me and my babies” posture. This tattoo is quite large, and is centred between my shoulder blades. I have to twist and crane in the mirror to see it myself, but I am always conscious of it—always sensing that it pushes me forwards and gives me strength.

Someone once remarked that the image reminded them of a phoenix rising—an apt coincidence, since the inner transformation that the image was crafted to represent was very much a rising from the ashes of my failed marriage—an emergence of new life in the wake of grief and loss.

Now into my 50’s, I continue to negotiate a tenuous truce with my unreliable body. Most recently, my left hip joint has betrayed me utterly, and for its troubles been banished from my body once and for all in favour of a slick new titanium and ceramic replacement.

It’s hard not to call the outcome of this surgery a miracle. After taking painkillers day and night for I don’t know how long, within two weeks of being rolled out of the operating theatre I no longer needed any pain medication. None. Is it a miracle that the research has produced a prosthetic hip that works and an effective process for inserting it? Is it a miracle that my surgeon was skilled, or that his team provided me with such a comprehensive preparation?

I went into the surgery knowing exactly what I would need to do to contribute to my healing: I would need to haul out my own resources and apply them to my healing process. Provide my own loaves and fishes. Perhaps it’s enough of a miracle that after all the times my body has said “I quit,” those resources are still there.

Maybe I should get another tattoo.

back

Honestly Daily Prompt, I sometimes feel like you are stalking me. This is not the first time you have posted a prompt just AFTER I have posted something relevant to that prompt. So although this was originally posted on November 23, I am linking it to the December 1 Daily Prompt: “Tattoo…You?”

Soup Day

The theme of today’s Daily Prompt is: “Food for the Soul (and the Stomach ).”  That’s convenient, because in addition to being Remembrance Day, which in my part of the world is a statutory holiday, today is Soup Day in my household.

Twice a year I cook a turkey.  Roast turkey is the default menu for my family’s Thanksgiving and Christmas dinners. And, although my mother and sisters are all very competent cooks, somewhere in recent history a secret vote was taken when I wasn’t looking, and it was decided that Anna Always Cooks the Turkey.

I don’t mind, really. Cooking a turkey is about the easiest contribution to make to one of our communally prepared meals, and I have gotten quite adept at transporting an enormous roaster full of steaming bird to whichever house is hosting the event in question. And to be honest, my daughter and apprentice turkey roaster deserves all the credit for the most recent turkey. (That had something to do with my index finger being in a splint.)

Now the whole point of turkey is the leftovers, as far as I’m concerned. And the best part of the leftovers is the carcass. (Apologies to any vegetarians who are starting to wish they hadn’t started reading this. Feel free to get out now!)

Since mid-October the Thanksgiving turkey carcass has been stashed in plastic bags in the bottom of my freezer– waiting for a time when we could count on being home all day. Days like that are rare in my household.  Most of our days are characterized by much frantic-running-about.

Today, however,  is a perfect Soup Day.

soup potA whole day at home is necessary to see the process through. It takes a good 4 hours to simmer the carcass into a rich stock. Then it takes a while to cool it down enough so that the meat and bones can be handled. We painstakingly pick out all the tidbits of meat that have fallen deliciously off the bones and set them aside. Then we strain the broth and add the meat back in, along with vegetables, seasonings, and finally noodles.

I have a recipe, but I don’t really follow it. In fact I’m not sure why I even bother opening the book except out of some sense of ritual.

If you start the process right after breakfast, the soup is ready to eat right around the time you are starting to contemplate supper. All that you need to add is a tray of hot baking powder biscuits, thrown together at the last minute while the noodles cook.

soup bowl

After supper we portion the soup into containers  for freezing. In the coming weeks we look forward enjoying a home-cooked meal, even on the frantic-running-about days. Or rather, especially on the frantic-running-about days!

Mmmmmmmm.
Mmmmmmmm.

Not so fine

Today’s Daily Prompt states: “Describe the last time you were surprised by the intensity of a feeling you had about something, or were surprised at how strongly you reacted to something you thought wouldn’t be a big deal.”  This one was easy, because I’d already written it.

Excerpted and condensed from a chapter of an unpublished book manuscript.

Source: Besthealth.bmi.com

In October 2012 I arrived at my rheumatology appointment planning to ask for a surgical referral. We had been discussing hip replacement surgery for some years, and I felt the time had come. It had, in fact, been coming for 13 years, since 1999 when a critical illness left me with damage to the cartilage in my left hip joint. The joint had been steadily deteriorating ever since.

At my previous appointment I had expressed frustration at repeatedly being cautioned that 50ish was “young” for hip replacement. But my doctor’s response had been encouraging: “Ultimately, Anna, what matters is what you are experiencing—how much pain you’re in, your loss of mobility, and how it is impacting your ability to live your life.”

So I spent six months soul-searching. I researched the surgery. I talked with a colleague who has undergone a hip replacement about her decision and her recovery journey. I tried to rest and exercise a little more and eat a little better. I (grudgingly) traded in my heels for sensible shoes.  And I made a concerted effort to monitor what aggravated my hip—what it could and couldn’t do. I gave a lot of thought to how it was affecting my ability to live my life.

The routine at my appointment is that an assistant — a doctor in training– sees me first to update my file and do a preliminary examination. I don’t know the assistant all, and he doesn’t know anything about me beyond the technical details in my chart. He doesn’t know my story. He begins to ask the usual questions:

“What medications are you currently taking?”

I recite my laundry list of pharmaceuticals.

“Are you experiencing any problems?”

Here, I think, is my invitation. “Yes, actually. The pain in my hip has been getting significantly worse. The acetaminophen is not managing the pain. My mobility is also getting worse…”

I don’t get very far at all into my carefully rehearsed speech before I realize that he has stopped looking at me. Instead, he is paging carefully through my file. He lands, triumphantly, on an X-ray report from roughly a year ago. “It says here,” he declares in a tone that is clearly intended to be encouraging, “that the hip wasn’t that bad.”

A dark cloud blows over my psyche and I feel myself begin to fold inward. Suddenly, I desperately need him to stop talking. I don’t want to be told my hip looked OK in last year’s X-ray when I have just told him that today it is not OK. The X-ray does not tell him that my hip hurts now. That it wakes me up in the night and makes me walk with an uncomfortable limp. That it has become a barrier to basic daily activities like tying my shoe and trimming my toenails. That it stops me from enjoying things I want to enjoy. But I am suddenly unable to articulate any of these things to him. Instead, I feel a wave of panic rising and can no longer fight back tears. My capacity for rational thought falls away as I sink into the overwhelming despair that no one cares about my lived experience. I fear that I am just going to be told that I will have to put up with the growing deterioration of my hip until I am much, much older or completely unable to function—whichever comes first.

I am too distressed to be able to explain to the assistant why his attempt at reassurance has affected me this way.  In the moment, I don’t even fully understand it myself. All I can do is blurt out, “I just want to talk to my doctor!” I have to repeat this request three or four times, before the assistant finally scurries out of the exam room in search of her. When he arrives back with my doctor in tow, I am still in a state of high agitation and barely able to articulate why.

It takes me 48 hours to process for myself why I fell apart so completely in that moment, and to recognize my reaction as a post-traumatic stress response.

This was not the first time a doctor had glibly told me that I was“fine” when I knew that I was not. And the last time that happened…well actually the last several times that happened…

Are the subject of the rest of my book.

A healthy dose of disagreement

I have to confess that, while I find the Daily Prompt from WordPress can be a great seed for growing a new post, I often experience a disconnect between the prompt title and the question being asked. Sometimes I just ignore one and focus on the other. Sometimes I write about my own topic. And yeah, sometimes life explodes and I don’t write at all. Today’s Daily Prompt is creating so much cognitive chaos for me that I am compelled to address it here. The prompt, titled “Placebo effect,” asks: “If you could create a painless, inexpensive cure for a single ailment, what would you cure and why?  Photographers, artists, poets: show us HEALTH.”

pillsThere is so much about this prompt that doesn’t sit right with me, I hardly know where to start. I’m going to have to deconstruct it one piece at a time.

In the first place, as a title to the rest of the prompt, “placebo effect” doesn’t make sense. The question is about curing an ailment, but I wouldn’t necessarily equate “placebo” with “cure.” That’s not to say that a placebo can’t play a role in curing disease. The placebo effect is an observable phenomenon that has been extensively researched.  But there is no consensus about what causes it, except for some acknowledgement that it has something to do with the complex way the human mind and body interact. By that token it would seem be a stretch to say that a placebo could “cure” a particular disease. If the effect of a placebo is in some way linked to the workings of the mind, then I don’t see how it could ever cure a specific physiological disease in patients who were psychologically and cognitively diverse.

Secondly, I’m put off by the emphasis placed on the fantasy cure being “painless,” as though a cure that isn’t painless would be less desirable. How do you measure pain? Which pain is worse– a low grade pain that goes on, day in and day out, for years — or a few days of acute pain managed medically? Surgery is a cure that always causes some pain, but I jumped at the opportunity to cure my chronic hip pain with hip replacement surgery. Would it have been better if there had been no post-surgical pain at all? Given that I didn’t need pain killers of any kind two weeks post-operation, I have to say that the fact that there was any pain at all was pretty much inconsequential to the big picture. And I believe that what bit of pain I did experience served an important purpose. Pain is a warning– it is our bodies telling us to take it easy. If my post-surgical pain is my body’s way of telling me to slow down and rest while my system recovers from the trauma of surgery, I am not sure I want to wish that away.

And then there’s the complicated matter of “inexpensive.” As a consumer of the Canadian heath care system, I experience most of my health care as relatively “inexpensive.” But as a citizen who is aware that a massive percentage of my provincial government’s budget is dedicated to that health care system, I know that it is, in fact, very expensive. I’m not at all qualified to comment on the brouhaha going on south of the border with regards to paying for health care, but I know that people everywhere would dearly like to find more inexpensive approaches to medicine. But “inexpensive” can be a just as relative a term as “pain.” My surgery was probably more “expensive” than several years of daily acetaminophen, but I don’t know how the equation works out if you factor in the improvement to my quality of life and general productivity level.

And while we’re at it, let’s talk about “cure.” Or rather, do we only want to talk about “cure?” What about “prevent?” If we decide that “painless” and “inexpensive” are both desirable, I suggest that the odds of achieving both are much greater if our goal is not to cure the disease once it happens, but to stop it from happening in the first place. And what about the third option: “manage.” In the musical Rent the characters, many of whom are grappling with HIV-AIDS, sing with hope about “living with, not dying of, disease.”

There are many diseases that, while we have not cured them, we have learned to manage to the extent that people can live long and productive lives with conditions that were once a death sentence. My great-uncle died at age 12 of diabetes, a few months before Banting and Best discovered insulin. Today it is possible to manage diabetes into old age.

Which brings me to the utter and complete impossibility of choosing one ailment to which I would apply this fantasy cure. Because really how would you choose? Would you base your choice on the number of people afflicted? On the amount of suffering caused? On the cost to the medical system for the treatments that are currently available? Or would it be an emotional decision based on your own experience? I have arthritis. I lost my dad to cancer. I have loved ones with heart disease, depression, diabetes,… the list goes on.

In the end, my biggest beef with today’s prompt is with the implication that curing a disease means the same thing as “health.” Because one thing I have come to know with absolute certainty is that heath means a great deal more than the absence of disease.

thistleFor me, health is an integration of mind/body/sprit. It is wholeness, in the sense that all the parts of me are complete and complementary. It is, to use the familiar words of the serenity prayer, about changing (“curing”?) the things that can be changed, accepting the things that can’t, and having the wisdom and self-assuredness to know the difference.

Which means that I can be completely free of disease, and not be healthy. And likewise, I may be living with all manner of incurable disease and be healthy in the way that I choose to live with and through my physical realities. True health is personal. It is mysterious. It is full of contradictions.

Kind of like writing a thousand words about why I can’t write about the Daily Prompt.

The needs of the many

I got thinking about Star Trek on the walk home from the bus stop yesterday. To be specific, I got thinking about a single line uttered by Spock in The Wrath of Khan. Chances are, even the non-trekkies will recognize this one (make sure your speakers are on!):

I haven’t come across many Spocks in my lifetime. That is, I haven’t come across many people who are genuinely able to set aside their own self-interest and sacrifice themselves completely for the sake of the “many.” I’m not saying that people can’t be altruistic, but I think there is a lot of pseudo-self-sacrifice–a  lot of “doing for others” that, if we really dug down deeply and honestly into our underlying motivations, we would have to admit was serving a personal need as much as, and sometimes even more than, it was helping others.

Because we want to feel that we are doing good, it’s easy to get caught up in busily doing what we think is needed, without stepping back to figure out whether the real needs are actually something quite different. I’ve seen this phenomenon in every organization I’ve belonged to. At some point in time, someone comes up with a solution to a genuine problem. The solution becomes codified into policies and procedures. And eventually it becomes that mighty monolith: THE WAY WE DO THINGS HERE. And no one considers that maybe there are new problems to be solved– different needs to be met–  emerging realities that warrant different actions.

manyPart of the problem is that the “many” are a rather abstract lot, and they are notoriously bad at coming to any sort of consensus about what exactly their needs are. It’s difficult for a faceless and nebulous set of communal needs to compete with the compelling and concrete needs that I truck around with me daily.  The logic goes something like this: I know what I need, because I need it, and therefore everyone must need the same thing. So I’m going to assume that I know what you need and knock myself out giving it to you, whether you all need it or not.

But as Spock would be quick to point out, that logic is faulty. I’m not you, and if I really want to “do good” in the world, I need to look outside of myself long enough to see what “the many” really need.  And that’s hard, because as soon as I do that, I find myself in all sorts of uncomfortable territory. It might mean that I have to do something new. It might mean that I have to let go of something I like. It might be risky. Perhaps not quite as risky as locking myself in a room with a melting down reactor core. Perhaps it just feels that way.

oneI want to believe that in the moment of truth I can set aside my own self interest and do the right thing, even when I know the right thing might cause me, or someone else, some short term pain. Even when doing it violates my own singular need for comfort and safety. Even when it would be so much easier to seek refuge in the status quo.

Because when you get right down to it, the status quo only seems easier because it’s familiar. The truth is, the one (or the few) stubbornly clinging to the status quo in the face of inevitable change is expending a lot of effort to stand still.

Happy Hip Day

Today’s Daily Prompt posed the question: You get some incredibly, amazingly, wonderfully fantastic news. What’s the first thing you do?

My “supercalifragilisticexpialidocious” news was not a single moment in time. Rather, it unfolded gradually over the past year.  Last October my doctor sent a referral letter to an orthopaedic surgeon. In March I met the surgeon. And three months ago today I traded in my left hip for a newer model.

Unemployed
Unemployed

My cane still sits in the front hall, but I haven’t used it for weeks. The scar from my incision has flattened out, and feels just like a mild bruise if I poke it. I can climb the three flights of stairs to my daughter’s apartment.

I went to hear Margaret Atwood (!) speak at a local mall a couple of days ago. There were no chairs left when I arrived, so I stood. For over an hour. Before the surgery, I might have lasted 15 minutes. On a good day.

Now that I’ve reached the three-month mark, I can officially dispense with the “hip precautions” and work on increasing my range of motion. But already it’s easier to pick things up off the floor. Easier to get in and out of the car. Easier to get things out of the bottom of the fridge.

Everything is a little easier when you are not in constant pain.

It really is incredible.

Me, now. (sort of)
Me, now. (sort of)

Slow Down

Today’s Daily Prompt poses: Your entire community — however you define that; your hometown, your neighborhood, your family, your colleagues — is guaranteed to read your blog tomorrow. Write the post you’d like them all to see.

bank 1Although, as this blogger observes, I thought that’s what I was doing already, this one did give me pause. And here’s why—

This morning I decided to check out another walking venue that I haven’t  seen in many years. South of the city, along the same wiggly Seine River that winds past the old monastery, is a wooded area called La Barrière Park. It’s at least 25 years since I last set foot in this park. Then, I was a young teacher supervising a school picnic, surrounded by noisy teenagers. Today, aside from the maintenance crew and a couple of dog walkers, I pretty much had the place to myself.

But before that I got lost. To get to the park I had to drive through a new development that has been going up in the south end of the city. There are roads that are so new they aren’t on my map. And there are no meaningful landmarks—just acres and acres of huge, beige and grey boxes. At one point I ended up on a brand new stretch of road that ended abruptly in a massive dirt field. I came very close to just giving up and backtracking my way to a more familiar haunt, when suddenly I found myself on what I knew to be the right road, going in the right direction. Phew.

When I finally found my way into the park, I left my car alone in the parking lot and set out along  a rough maintenance road, past the picnic shelters and the baseball diamonds, over a solid footbridge, and into the woods.

pathThe forest was quiet. The sound of fallen leaves crunching softly beneath my shoes was occasionally punctuated by the rustle of a bird or squirrel moving through the branches above. The path was wide and well-maintained, but in such a way that it didn’t feel like a human construction. The only litter on the forest floor was the natural forest litter of fallen trees and broken branches, many of which were thick with moss. In one spot someone had perched a split log atop two adjoining tree stumps to fashion a primitive bench.

Something about the forest felt safe. Safer, I realized, than I felt driving around lost in the new subdivision.

Tomorrow is the last day of my leave. Monday I will be back at work. Back in the “real world” after many days spent walking and thinking and writing. It’s time to go back; the muscles around my new hip feel strong and my leg feels stable. When I step on the bus on Monday morning I won’t be carrying a cane.

forestBut I’m going to miss the slow rhythm of these days. I know I am going to have to fight to maintain the sense of equilibrium that I have found with all this time to squander. I’m going to have to be very intentional about making time to walk in the woods. Time to think. Time to write.

And the thing that bothers me most is that as a community we seem to accept that that will be the case. We accept that life is hectic. We accept that “busy” is the norm.

I want to continue to challenge that notion as my own “busy-ness” ramps up again in the coming weeks. I am determined to keep wandering in the woods, and not to get lost among the boxes.

And I want to challenge you, my community, to slow down. And go for a walk in the woods.

seine 2