No vinegar or brown paper
It is the body that suffers as well as the mind. For part of my soul was shattered that fateful morning in a quiet suburban street.
Hopes on a high with my head in a cloud,
Life upside down with a shattering crash.
Bike skipped a corner with nary a sound.
My eyes open slowly from a dreamless sleep. Prising them open lets in the shuttered light filtering through the closed Venetian blinds. My body aches and is slow to respond. The bottom half of it feels disconnected and stiff.
While I lay there in a daze, my reverie is broken by the nurse coming into the room. She is dragging a wheeled pole and the ubiquitous blood pressure machine. Her cheery good morning, when it feels anything but, challenges my customary good nature. “How are we this morning?” she asks. As if I can work that one out. I struggle even to remember my name and date of birth when she asks before dispensing my pain medication. All part of the routine around here. Slowly my thoughts come tumbling into some sense of order. “How is the pain?”, the nurse asks in an absent yet caring manner. Oh yes, the pain, like a constant companion it is always there. The nurse pulls down the blanket to reveal my left leg swathed in bandages. We can both see it is very swollen and yellow bruising peeks out from beneath the edges of the dressing. That and the skerricks of dried blood still attached to the bandages indicate the trauma recently inflicted on my leg.
The memory of how I came to be like this slowly coalesces in my mind – yesterday’s operation. What was it again? Operation number eight in less than six months. I remember little of it except for an abstract experience of waking in the operating theatre, and peering sleepily over the top of the green and clear plastic screen near my head. Seeing Sanjeev, my surgeon, banging away in the corner with a hammer, at what I later realised was my hip. Then I noticed the anaesthetist sitting near my head. When he saw that I was stirring, he must have tweaked something, as I drifted back to sleep and I remembered nothing more until the nurse woke me in recovery.
Six months after the accident, the break in my shattered femur hadn’t healed. The three infections I picked up in the hospital had retarded the bone’s healing process. The only option Sanjeev had was to replace the metal rod that was running the length of my femur. A rod that had been holding the broken pieces of my leg together. Bugs love metal, so he removed the rod during operation seven two days before. He found the infection was rampant, so he had no other option than to clean out the wound, pump me with even more antibiotics and leave me lying in bed for 72 hours unable to move. Then during yesterday’s operation, he had to break the bone so that gravity would force the two pieces together. Part of the problem was that due to physics, the sharply angled break kept wanting to shear under pressure. Sanjeev replaced the rod with numerous plates and screws.
I remember being in recovery again and of coming out from under the cloak of anaesthetic, waking to find it is a struggle to breathe through the pain. Years of yoga training had taught several breathing techniques; that a long breath out and a shorter breath in will slow your heart rate. This technique, I hoped, would ease the pain. At the same time, the recovery nurses kept asking me to breathe ‘properly’. A so called ‘normal’ breath would do nothing to ease the pain nor reduce the want to sleep forever.
How easy it would be to slip away and not suffer any more. To disappear forever into oblivion. To no longer live in a pain-filled world. At times I just wanted this all to be over. Not just for me but for those around me who were caught in my hurting. But my pleas to get off the horrible roller coaster were never granted. Instead, I had to return each time back into this world of pain.
My world came a tumbling with me in the air.
Levitation that morning just wasn’t there.
I was in the hospital the first time for just over five weeks. For someone who was normally very active it felt like an age. Trapped in a fluoro-lit, air-conditioned cage with the other patients whose lives were equally filled with pain, blood and boredom. During that time, the only occasion I experienced fresh air was when a nursing sister/friend of ours came to visit. Kate asked when I’d last been out of bed. When I said, the furthest I’d been was the bathroom, Kate disappeared, moments later returning with a wheelchair. With my legs wrapped in a blanket, she whisked me to the elevator and out of the building.
Even though we sat only a few metres from the front door of the hospital, it was outside. Out in the fresh air and far enough away from the smokers who hovered near the main entrance. We sat there for almost half an hour. The dappled light drifting through the trees into patches of sunshine while I cried. At first tears of pure joy, because for those precious few moments, I was back in the real world. Away from the smell of death that inhabits hospital wards. Then it hit me what had happened, and I cried for the life that had been shattered to pieces.
Most of the time, I tried to stay positive. While in truth, I am like a Pollyanna on the outside but inwardly gripped by fear. For all my hopes had come crashing off the rails on that fateful corner.
No one likes hospitals. Once you enter as a patient, all your dignity goes out the window. After the operation there was a catheter draining my bladder, and when I need to do a number two, I couldn’t just go to the bathroom even though it was only a few steps away. Instead, I had to arch my body, bracing with my right leg to lift my bare arse enough to slide a bedpan underneath. Then I literally shat in the bed.
Hospitals are also de-personalising places; you need to rely on overworked nurses for your most basic needs. Even though they see you several times a day, they still ask for your name and date of birth whenever you are given your medication. When I first asked why they asked this question every time, even when I was on a first-name basis with them, the response was in part, “to prevent me from selling the drugs on the street”. As if!! I couldn’t even walk two paces unaided let alone legging it down the road to some strange street corner to meet an ever-waiting drug dealer. Then selling the drugs I so badly needed to dull the constant pain.
A hospital ward is a challenge to your sanity. While I was struggling with my personal drama, there were three other people in that room and all the other patients on the orthopaedic ward who were dealing with their individual dramas. One night a man down the corridor kept the entire floor awake for hours with his blood-curdling screams.
Then there is the food they serve; which is never the best. As anyone who has spent time in hospital knows it varies from mediocre to inedible; overcooked, grey vegetables and omelettes that could be used as frisbees. It was always going to be a challenge trying to stay gluten-free and vegetarian inside a system that works on conformity. For those first five weeks, I survived on the green smoothies that my partner Vern brought to the hospital every day. In the first five weeks I lost nearly 10kg; who needs to diet. Simply break the largest bone in your body, and you’ll lose weight in no time.
Nor the place for inhibitions; modesty quickly goes out the window. Once as the physiotherapist and I hobbled up the corridor, my hospital gown was split down the back with my arse uncovered for all the world to see. A kind nurse sidled up and re-fastened the back of my gown as a small nod to modesty.
Nor are hospitals the place anybody wants to be, even those just visiting. Our visitors disappear as quickly as they politely can leaving us alone with our often negative thoughts. Blood, pain and suffering and death are etched into the walls in an atmosphere that even the antiseptics cannot completely cover.
Throughout those long days, even while surrounded by caring family and friends, I have felt frustratingly alone. No one else can carry my burdens; each of us has to heal our wounds.
How fluid our priorities, nothing is firm,
All that’s important is in another’s hands.
A challenge to self that’s without a term.
There is no point in trying to understand what went wrong, although it all started with desire. For several years I had been lusting after something that always seemed out of reach. Then fate took a hand.
I needed to replace the bicycle which I had ridden for twenty plus years. My bike and I had covered so much territory, and now it was no longer fit to ride. A minor service at the bike shop revealed a significant stress fracture in the frame, left unchecked it could have resulted in a disastrous accident. Little did I know what was in store. I replaced my old bike with a brand-new, custom-fitted Cervélo worth several thousand dollars. I proudly took possession of it on the Friday before the following, fateful Monday morning.
For a couple of days, I felt that all the world was finally running in sync, but that wasn’t the case. It had drizzled during Sunday night, and on Monday morning I was determined to ride my new bike on the 20-minute commute to the office. Then on a slippery left-hand corner, in the back streets close to home, my bike went out from underneath me, and I crashed heavily to the ground.
I knew things were not good when I saw the considerable divot in my left thigh, plus I couldn’t stand up. I lay there in the middle of the street, wondering what to do next. A kind stranger called an ambulance and helped me crawl to the kerb. I lay in the gutter making phone calls to work saying I’d be late and to Vern that I was being taken to hospital.
At that stage, there was no real pain. It waited until the paramedics moved me onto the trolley to put me in the ambulance. That was when it truly hit. Pain like I’ve never experienced in my life. Brain searing agony that literally took my breath away. Pain that all the morphine the emergency department doctors pumped into me did little to alleviate. Pain that caused my leg to cramp, such that I had to brace myself when its relentless onslaught struck. Squeezing the bed railings in a vain effort to tackle the rolling onslaught of agony. Pain that came with every small movement of the shattered bones in my shattered leg.
For the next 48 hours, after the accident, while the doctors and nurses tried to make me as comfortable as possible, the cramps kept coming in nauseous waves. The opioids they injected made little inroads into the pain. Eventually, they put my broken leg in traction which lessened the cramps, before what became the first of a dozen surgeries.
The first was reasonably successful in that my surgeon was able to pin the shattered pieces of my femur together with a steel rod. All would have been well if the gash that ran from my hip to my knee had not become infected. A week later, when they removed the bandages, the pus oozed through the stitching soaking both the sheets and the bed. The unremitting flow of blood and pus necessitated another operation this time to clean out the wound.
Unfortunately, the three infections in my leg took control of the situation, and another three more washout operations followed over the following fortnight. Then because I had been five weeks in bed without moving my left leg, the muscles had frozen. This necessitated another procedure called an MUA (manipulation under anaesthetic). A simple term for a torture like treatment. My frozen tendons were forced to move under anaesthetic, so I didn’t feel a thing, however once awake, I was attached me to a machine. For the next 24 hours, an electric-powered pedal-device that kept my leg continually moving at increasingly greater angles. All the while, I kept pressing the morphine button to the point when I could no longer stand the drugs or the pain.
Days, nights, pain beyond what I’d ever know.
Without those around me, hope lost long ago.
Anecdotal evidence supposes that a patient’s survival chances depend heavily on their attitude to the illness, and their determination to fight. Almost regardless of the condition, survival rates are proportionately higher the stronger the support network. Vern, picked up the pieces after my accident. He collected my bike from the supermarket manager who had made the initial emergency call. It was Vern who came to visit every day, morning and night. Plus some of my good friends called or came to visit when they could. For those brief moments, they brightened long and terrible days. Some bought books, some bought food but all of them brought moments of distraction. Like a prisoner, they all were my lifeline to the outside world.
It is said that patients receive on average six weeks of caring by those around them. After that, the friends, family and even loved ones drift back to their lives while you are left with yours. I’ve met friends in the street who are surprised that after nearly three years I’m still on a walking stick. I’m greeted with, “I thought you’d be better by now”. What can you reply? Nothing. Each day is a struggle, I don’t want to dwell but cannot help ruminating, while life continues.
Long term illnesses are as tough on the patient as it is on their carers. Vern has been a constant. He has been here throughout this drawn-out drama; however, this has changed us. We are both exhausted by it, and I feel our relationship is balanced on a knife-edge. I saw how completely worn down my father was before my mum passed away after years of her ill health.
This journey has highlighted that the world has become very specialised. Doctors and nurses are very good at what they do but are at times limited by their specific skills. I’ve realised that my wholistic, Vedantic beliefs often conflict with a western medical system. While the constant pain and uncertainty make it a struggle to remain mindful; at times meditation and breathing helps with the pain. However, this thinking runs contrary to a system that is about prescriptive medicine and proven science. That said after two and a half years Sanjeev recently mentioned that we had moved beyond the realm of science into the realm of common sense. This is in line with the Hippocratic principle, ‘what works and doesn’t cause harm, is the correct course of action’.
Along the way, there have been times when I just wanted to surrender. I understand now what my mother used to say after her final operation. Why she wanted to end all the pain and suffering. Yet somehow, we grit our teeth and continue on regardless. We don’t get to escape the suffering. We keep going believing that things will get better. That it’s only going to be a couple of more months, a few more weeks or in the next moment that the pain will finally go away. But it never does.
To add to my stress, I crashed on a Monday and on the Wednesday, we finally settled on buying the design studio where I’d been freelancing. The grown-up decision to buy an existing business in many ways was a saving grace. While the plans I had for the business have been shelved, pushed aside by the challenge of just keeping a new business going while balancing work, doctors, physio and pain, all on one good leg.
After just five weeks in a hospital and five operations, I had to drag myself out of bed and back into the office. During the negotiations, the previous owner claimed he’d be happy help out if needed. He lied, all he wanted to do was take the money and retire. The way things worked out, he charged us through the nose to stay on until I could get back to work – not the most auspicious start for a new business.
That said I wouldn’t have been able to keep the business alive if it wasn’t for my colleague Bill. Small businesses are about teams, and Bill, Vern and myself have worked together to keep the business going.
Pollyanna outside, despair my inner view,
Once was invincible standing on my head.
Walking for now on three legs instead of two.
Six months after the initial operation, we found out that the infections in my leg had retarded the bone’s healing. I had to go back again under the surgeon’s knife, not once but twice more. This time not under a general anaesthetic but with an epidural, as I’d already had six in less than six months. Rather than drifting off to sleep, I couldn’t feel a thing from my bellybutton down. Which in itself was a weird feeling, I remember making a joke as they wheeled me into theatre that this must be what an out of body experience feels like.
Operations seven and eight were performed at a private hospital, where the risk of reinfection was lower. I spent a lot of time staring out the window, which overlooked the hospital’s multi-storey car park. My 86-year-old father flew down again to look after me. He is good company, yet his presence only reinforced my lack of independence.
It’s said that all things happen in threes. Although I don’t necessarily hold to that thinking, it does seem that one event creates ripples in the universe. While my leg was still healing from operation number eight, a wound developed on my left shin and it refused to heal. Sanjeev eventually exorcised it from my leg. It turned out to be a skin cancer. In the process, a fourth infection made its way into the wound, this one E. coli ESBL. This bug and the non-healing of the wound resulted in two more operations on my shin. Then just for good measure, another skin cancer was excised from my left shoulder, which also required a second dig.
Because of these secondary infections and the slow-healing wounds, it was a year and a half before Sanjeev could even contemplate removing the plates and screws from my femur. I had nicknamed the metalwork Perseus – my praying mantis. The drive to remove Perseus was that by the time of operation number twelve I’d spent over two years on the highest dose oral antibiotics available. As if what was going on in my leg wasn’t bad enough the antibiotics were slowly destroying my gut, I also suffered from tendonitis in my joints (a side effect of the antibiotics), and the pain-relieving opioids were screwing with my brain.
Life a different state of being, a reversal.
Chance, suffering, joy: each a rehearsal.
Finally, after the twelfth operation in February, we saw a light at the end of what has been a long, dark tunnel. The operation was a success, the patient survived and Perseus had stayed long enough for the bone to heal. We had turned the corner to recovery. This journey has been like a marathon – never-ending, exhausting and long. While at other times like a glacier – a slow, inevitable wearing down of everything and leaving nothing of what was, left.
After the last operation and a week in the hospital, I was transferred to rehab for a week of intense physio. This was the same rehab hospital I had been attending as an out-patient for the previous six months, so I was on a first-name basis with most of the staff. These sessions were intense and painful, not least of all because I was still recovering.
While at rehab, I often felt like a faker. I was there with other folk who were generally in a far worse place than myself. Some were coping with the effects of a stroke, MS, Parkinsons, or had lost a limb. A few of them could only hope to recover some ability to walk or speak and some were never going to fully recover. They might improve, whereas I’ll eventually return to some sense of a life.
The best part of physio was the hydrotherapy sessions. Once you’re in the water, you are roughly half your body weight: this dramatically reduces the stress on my leg, making movement easier and less painful. The way different health insurers operate is confusing. With mine, I have to spend a minimum of three hours in any session, and after a procedure they only allocate twenty sessions to recover. After my one week stay, I dutifully went to rehab every Wednesday morning. Those three hours were in my case, divided between physio, occupational therapy (OT) and hydro or gym. While two were hard work and challenging the OT session was a doddle. It mostly entailed walking around the block for an hour with the physio. Rehab helps, but the real work is done every morning at home on my yoga mat. There I would repeat every morning what I’d learnt the previous Wednesday. These physio sessions also meant I was out of the office for half a day. I needed to make up those missed hours and often ended up working late at night as well as over the weekend.
Ephemeral is nature, more oft clothed in nonsense.
White and dark thoughts hide behind false pretence.
Six weeks after the operation, and with the holes in my bones healed but still green, Sanjeev told me to no longer consider myself a patient. He said to get back to ‘normal’, whatever that meant. My question was what was normal; eventually, I resolved that there is no such thing. Besides, what was once normal no longer applied. The life that I had was gone. Before the accident, I always active whether it was swimming, yoga, cycling, walking or painting. Once never still; for the last few years, I’ve had to be just that.
Everything was finally moving ahead. I was at physio once a week as well seeing an exercise physiologist two mornings a week to rebuild my muscles. The finish line was now in sight – so we thought.
Then two months ago I was back in the RPA’s emergency department late one evening. I had flown up to Queensland the previous weekend. A family lunch on Saturday to celebrate my father’s 87th birthday. We did nothing strenuous just sitting, talking and eating with my family. As Mother’s Day was the next weekend, we visited Mum’s grave in the afternoon and laid fresh flowers.
By that evening, I was in agony. Panadol made no difference, and I hadn’t brought any stronger painkillers with me. Over the past few months, I’d weaned myself completely off of them. I spent the rest of the weekend on my bed which put a dampener on my visit. Monday morning my sister dropped me at the airport for my flight back to Sydney. By the time the plane landed back I was struggling to walk even with my stick. Plus the aircraft it seemed had perversely parked at the far end of the terminal. I went straight from the airport to work, did what was needed then that evening, Bill dropped me home. I struggled into the house and went straight to bed but not before downing a couple of Endone.
The next morning, I felt a little better. The following day, Tuesday, I went to work though by the end of it I was again struggling. When a passing stranger asks if I needed help getting into our front door, just confirmed something was wrong. Later that evening, when the pain hadn’t eased, I convinced Vern to take me to the hospital. Then I spent the next twelve hours waiting in the emergency department.
Vern left around 11pm just as they finally took me for an x-ray. The attending emergency doctor thought that I may have pulled a muscle or trapped a nerve. After spending a sleepless night on a vinyl recliner chair, my surgeon arrived around 6 o’clock the next morning. The first thing he asked was “What have you done?” Tired beyond reckoning, I facetiously remarked, “You tell me, you’re the doctor”. It seems a stress fracture had developed in one of the screw holes where Perseus had been and the fracture had cracked halfway through my femur.
Usually, a surgeon would pin a fracture in a weight-bearing bone. That would have meant yet another operation which none of us wanted. The next option was several weeks in a hospital with absolute bed rest. As I needed to run my business, the alternative was to spend six weeks in a wheelchair and have weekly x-rays to check the healing process. Several times I was told not to do anything stupid.
Dad flew down again for another month to help out, and Vern was able to borrow a wheelchair from a work colleague. As we live in a Victorian terrace, the wheelchair was impractical, so when in the house I was back on crutches. At first, we used the wheelchair everywhere outside the house then later, just in the office. This gave me a different view of the world and felt it keenly when people looked down at me. Slowly the pain subsided enough for me to transition out of the wheelchair, off the crutches and back to only a walking stick. Each step tentatively forward.
This journey has severely tested my beliefs and my faith. I don’t know whether I’ve passed, still taking the exam or if I’ve still much to learn. I do know that I’m more physically, mentally and spiritually exhausted than I’ve ever been in my entire life. It is said that what doesn’t break you; makes you stronger. I’ve learnt it is a platitude, not a truth.
I do know that the human spirit is tougher than many of us believe. That we are capable of coping with levels of pain and grief beyond reckoning. The truth is exposed when pain wipes away the thin veneer with which we coat our lives. I don’t know if this experience has any clear meaning. Yet how come I can say the right things to other people to soften their suffering, when no words can ease my own.
Life is just an illusion and change the only constant. My psychologist Dr David and I recently discussed death from a psychological point of view. Most of what has been written about dying talks about what happens either before or after we die, yet very few thinkers explore the actual process of dying.
There is a legendary story in the Katha Upanishad of a little boy, Nachiketa, who meets Yama (the Hindu deity of death). Their conversation evolves into a discussion into what lies beyond death and what if anything remains. The point is nobody knows what exactly happens when we die; usually, we completely disregard the fact until it is inevitable. Death is relegated to a final option, not something that might occur with the very next breath.
It is only with the right attitude that we see the reality of death and conversely our lives. I was never afraid of dying. That didn’t mean I wasn’t scared at times. It is difficult not to be with death all around. For almost a month after I crashed, because it happened so fast, I was not aware of the seriousness of shattering the most substantial bone in my body. According to my surgeon, the only other patients he has seen who had a similar break were all cyclists in their 40s and 50s.
I don’t know how the accident happened, and I may never know. I don’t even remember the crash; those two minutes of my life are entirely blank. I remember riding through the back streets of Redfern and knowing I needed to turn left at the next corner. The next thing I remember was finding myself on the ground.
The accident did literally throw me; I will get back on my bike – even if only to ride around the block once more. I will get back to a ‘normal’ life. When that is, I’m not sure. I do know that life will never be the same again. We can never step in the same river twice, however we can as my grandfather used to say – get back on the horse that throws us.
It is the pain that truly breaks you; the problem with pain is that it eats into your soul.
At some point, before the leg broke again, Sanjeev told me to stop acting like a patient. Now since I am taking a daily injection of a bone growth protein. It is normally given to osteoporosis patients, even though my bones are not that brittle, I was able to meet enough of the criteria to join the program. Another year of medicine, another year of being a patient, another year of having to cope with what life has thrown at me.
Anger and frustration are constants. I am not the person who crashed nearly three years ago. I don’t like who I’ve become, nor do the people around me like the change. I am often angry at the world and frustrated beyond belief. People who use platitudes when they haven’t experienced genuine pain are just kidding themselves. That or they are trying to sell you something.
I sometimes indulge myself in what-ifs, what if I hadn’t bought the new bike, what if I hadn’t been on that road, at that time of day, what if I had headed Vern’s hints at disaster, what if I had listened to the tiny voice inside my heart that I used to ignore. What if….
At the end of it, all what-ifs are a waste of space, I can’t rewind the clock, I just need to be present. I am trying to face the truth with all the strength I can muster. I know this is all greater than myself, while meditation, writing, and painting help exorcise some of the demons, but it doesn’t ease the fear and pain. At times I cry for what I lost in that gutter, but know it is all just part of my journey. Now you know that I’ve been on one hell of a roller coaster ride to what I trust will be ultimate understanding.
Even though I’ve written the story of what I’m going through, there is still much that is too raw to describe. Long-term illness creates loneliness and depression. As much as I’ve felt supported, in the end I am left alone with my pain. Nobody else can understand how it feels. Such is the truth and the realisation that the life I once had is gone forever. All this creates a layer of depression that is hard to shake. The fact is with all these ever-present realities I cannot see myself or my life as being whole. What is past is no more, nor can I see the future.
To be present at the moment is really tough, for these moments change so slowly. As high as my thinking goes, I’m still dragged back into the reality of the moment. We have to get back on to conquer your fears. Otherwise, pain and fear will drag you down so far in the darkness that there will never seem like a way out. The human spirit is one of survival in the face of inconceivable uncertainty.
Jack and Jill went up the hill
To fetch a pail of water.
Jack fell down and broke his crown,
And Jill came tumbling after.
Up Jack got, and home did trot,
As fast as he could caper,
He went to bed to mend his head,
With vinegar and brown paper.