Chapter Five: Crying with Christine

”What scares you about surgery?“ asked Christine.

The question seemed out of context. The clarity of it rescued me from the emotional fog of the last question. I snapped into Spock mode. ”Well, I’m not really scared of surgery. I mean I’ve been through surgery before. Knee surgery. Shoulder surgery. I did fine. I don’t think it’s surgery that’s a problem really,“ I said.

”So, what is so scary then?“ asked Christine.

Christine had skillfully lead me where she knew I did not want to go but needed to. She knew there was something I needed to face; something I needed to admit and that unless I did, whether I had surgery or not, my healing would be incomplete. There was no way out.

"Well...a lot stuff. A lot of bad things can happen in surgery like stroke, infection, death, paralysis. It's a big deal," I said. "And, I guess...I don't know...I had surgery on my shoulder and my knee and I felt ok about it. Even though I was told when I had the knee surgery, I would never run again. I knew that was probably not true. I had confidence in the rehab that I stood a good chance of running," I said.

"Yeah, and why is that?" asked Christine.

"Well, I knew that the surgeon was just coming from his perspective, experiences and most of the rehab wasn't designed to make your joint healthier and I knew we could do that so I wasn't too concerned about it. It bothered me when he said it but not like this with my back," I replied.

"So, it sounds like you had confidence in the rehab after the surgeries? Are you not so confident about rehab after back surgery?" asked Christine.

Right about here, I think, things started feeling shaky like I was standing on one of those rope bridges and it started to sway. "I think it's just...I guess losing some bone, losing the muscle, the stabilizers, I just don't think you can take impact, like jogging, after something like that and I don't know if people lose their abilities because that's just what happens after surgery, because of the surgery, or if they lose function at a higher level because they never rehab in a way to get to that level again," I explained. And, as I heard myself say this, at the same time, I had this sense that somehow this wasn't true. I had helped a lot of people return to high levels of function after they had been told they never would. The truth was still hiding.

"Those are all really good points. But, what would it be like for you if you had to give up some things? You might not need to, of course. You're assuming you would but like what happened with your knee, it may not turn out that way. But, what if it did? What would it mean to you to not be able to jog or do some of those kinds of things?" asked Christine.

The truth started stirring, whirring inside me. I pushed it down. What is this? What is this feeling? Why is this....No. I am not going to cry. Not here. Not now. It chugged and churned swelling up until I could no longer hold it. It rolled up out of me; out of my eyes in tears; out of my chest in sobs. I held it as long as I could trying to talk in a voice I no longer recognized. "It's just....it's the start of the end. It's the end," is all I remember being able to say.

I turned my back to Christine and held my head in my hands and cried. I cried for all I had lost. I cried for the pain; the loss of control; the fear; for reasons I didn't understand. I cried and Christine listened quietly with her heart.

She handed me a tissue. As I took it to wipe my eyes, I said, "I'm sorry...I'm sorry."

"I am so glad to see that right now. It's a good thing to cry. It's ok, " said Christine in a soft voice.

I took a few deep breaths. A calmness settled on me. I felt better. I felt oddly better. Lighter. My voice returned. "Well, that's never happened to me before. What was that?" I asked.

"Pain. It's normal to grieve for things you lose and things you loved. It's part of the healing process. It's a really good thing," said Christine.

She stood and hugged me and told me I was going to be ok.

And, I believe I will.

The words, "start of the end" troubled me for a while after this visit with Christine. I had adopted the belief that my active life was over even though, logically, emotion removed, it was likely not over at all. I was otherwise quite healthy. I have a great group of people to help me. I have access to excellent care. I was borrowing trouble from the future and I wondered why. Why with this injury, of all the ones I've had, why is this one so different?

As I thought about this, wrote about it, an image appeared in my mind. It was a vivid, vibrant one of my dad when he was near the end of his life in a nursing home. In a hospital bed, a sterile, cold room, alone, by himself at the end of his life. And, how did he get there? How did my dad end up in this spot? Spinal surgery. He had an operation on his neck and never recovered.

Whether I end up in surgery or not, whether I ever jog again with my buddy Spencer, I'm ok with with the future now. I'm not so scared of it. I realize that some of my fear and troubles with this injury have emotional ties to what happened with my father. Recognizing the connection helps me but the emotional winds will come and go, I know that. I realize that I will have some good days and some days that aren't so good. I'll hurt, and lose some sleep. I'll miss some dinners out, the movies for a while.  I'll have waves of sadness, anger but I will also have days of great joy and happiness.

I found something that day crying with Christine: a beginning.

I believe I'll be ok.

Comments

[Ken Katz MD]

Decrepitude is a great word!

[Eric Fonken]

I’ve been following this blog topic with particular interest, having gone through a very similar injury, as you well know. Your pronouncement of the “…beginning of the end…” really resonated with me, as that is the exact thought/fear that has buffeted me over much of the last 3-1/2 years, exacerbated, I suppose, by the vivid realizations of mortality and limitation that seem to first visit most of us at some point in “mid-life.” Thankfully, I appear to have passed through the worst of that and find myself happier overall than I have been in years. The mourning for the former physical me- the bulletproof basketball fanatic, skier/snowboarder, runner, backpacker, landscaper- has thankfully given way to excitement for the new physical challenges and goals I am making for myself in spite of my injury and the particular physical limitations it has placed on me. I love my newfound long walks (made vigorous by tackling very steep hills), invigorating swims (which I hated pre-injury), interval training on the bike, and weightlifting sessions (and perhaps best of all, my newfound incentive (excuse?) to pay someone else to rake the 50 yard bags of leaves my oak trees produce every spring! J). I no longer feel like I am just “settling” for them in place of my favorite high impact activities, but enjoying them on their own merits.

Another thing I have gained is that taking things for granted is no longer part of my persona. I have found that wonderfully motivating, freeing, and life affirming. Part of what motivates me is to not let my back injury “win”- I have chosen to make the rest of me stronger and healthier than it was before by better tending to my body and diet and I can honestly say I am healthier and stronger overall than I was pre-injury. Those 20-somethings ain’t got nothin’ on this 43-1/2 year old!

In a roundabout way I feel like my injury might also have set me up to be healthier in the long term than I might have been otherwise, not that I wouldn’t undo my injury in a minute if I could. I had a propensity to overdo physical activities, to ignore mild and moderate pain, to not allow for recovery. Had I continued down that path, I likely would have faced additional preventable injuries and an old age tormented by even more aches, pains, and limitations. What you, Christine, and Ryan taught me about my body, about movement, about exercising intelligently, and about the need for recovery have not only made me better now, but should prevent a significant degree of self-inflicted decrepitude down the road, hopefully allowing me to remain active and healthy well into old age. Not to take things for granted, of course! That belief, though- which I have faith is not a delusion- helps me keep the peace with my injury and to keep moving on.

Anyway, I look forward to hearing “...the rest of the story.” You and the Sports Center crew are the best of the best and you know what you need to do, so I have no doubt that you will persevere. As you allude to, the hardest battle will likely be the psychological one, but I am confident you will win that one too. Hang in there!

[Stuart Nichols]

A wise man once said, "Wait to worry." Is this still true?

[Ken Katz, MD]

This is a very common issue in the emergency department when patient's fear, anxiety, angst, etc. seem to be persistent even after intial examinations are unremarkable or not life-threatening. Often, there is an underlying worry about cancer or something that had happened to a loved one who had a similar medical complaint.
It is very satisfying to peel the layers of emotion even in a brief time to see this. Simply addressing it and asking the patient why he/she is worried often relieves the pressure. And then when this is realized, then the real healing and understanding can begin---