Today was the first day that I was able to put any significant weight on my foot. How my heart leapt. I hadn't realized how much I missed that feeling of being in balance. Months of leaning unevenly to reach for things and babying one side. Not that I could put a full half of my weight on that foot. No matter, though, because I felt it. I felt the first traces of function, like the first rivulets of snowmelt in the mountains in springtime.
I have tried to feel grateful for progress over these weeks. In fact, I have felt grateful. Still, I had this longing to feel the beginnings of use in my foot. I went through some moments of disbelief, wondering how I would ever walk on this battered limb again. To feel progress in the use of my foot is a joyous occasion. I am grateful, and I think I can be patient now.
Tuesday, September 25, 2007
Musings - Personal Strength - September 25
Some thoughts on what it means to be strong in crisis - Mark.
There is a dimension to injury that is mythical and life-affirming. It is the hero's journey and brings many gifts wrapped in strange packaging. In this light, the injury is a sudden sundering of business as usual, a sudden fall from grace. The journey back to the surface is arduous, and the traveler is forever changed in the process.
Of course, it doesn't always feel this way. Sometimes recovery is just miserable, or worse, boring. However, it seems worth embracing the injury and the journey at least to some degree; it is the only way that I can find to make sense of this ordeal. It is not as though I can press rewind and return to my life before the accident. Therefore, embracing the injury and paying attention is my only recourse. Therein lies the essence of strength; the only way past this injury is through it.
Blase Reardon was the first on scene at my accident. A couple of weeks later, he beautifully expressed his observations and thoughts. Blase commended me for my strength, focus and grace. His words have reverberated in my head since then. I think that embracing the injury at the time was the essence of my strength. Ironically, I had to surrender in order to be strong. Maybe it was wilderness medicine training; maybe it was seventeen years of climbing and thinking about accidents. Whatever the case, my response in the first few seconds after the boulder crushed my leg was to acknowledge completely that this accident had happened. I don't remember even a moment of denial or thinking, "how could this happen?" In that instant, I surrendered my life as it had been a few moments before. The thoughts that accompanied this surrender were the source of my strength in crisis. I remember thinking that my leg was broken, that my life was forever changed and that I needed to stay conscious in order to survive.
We have all heard stories of amazing strength of character. I have wondered how I would have handled the trials of Ernest Shackleton's crew in Antarctica or the close call that brought Joe Simpson a hair's width from death in the ordeal he describes in Touching the Void. We have heard of Nazi officers who refused to execute Jewish civilians. As a result, those officers were executed - murdered, really. Why did I watch the Rambo series or Chuck Norris movies as an adolescent? Undoubtedly, I wished and hoped that I had some of their qualities of strength. I feel sure that this yearning was for something more than physical strength. I hoped for strength of character and some degree of righteousness in pursuing a moral course of action.
Perhaps I am not alone in wondering whether I, too, possess the strength to respond to a crisis. Would I jump in front of a bus to save an endangered child? Would I take a stand against tyrants, though it might mean my downfall? And in this case, how would I respond if I were critically injured in a rock climbing accident? It is a hypothetical question most of the time. I have certainly hoped both that I would be strong and that I would never have to use that strength.
One of the gifts of this ordeal has been that it called forth strength in me. During my rescue, my survival required a very immediate and intense focus. Within a few moments, I pulled off my t-shirt and asked my cousin to wrap my leg. I began to take webbing off of my harness to use to stabilize my leg. I looked in our immediate vicinity for a sturdy stick that my act as a splint. However, I had seen my open fracture with my smooth dark muscle exposed and a jagged bone cocked at a stark angle. I saw my foot flopping to the side like a dying fish in the bottom of the boat. I was able to acknowledge that there was little that we could do medically until the Search and Rescue Team arrived with more materials.
Now, during my recovery calls forth a different kind of strength. It demands a steadiness and patience that alters my sense of time's passage. It requires me to put great effort into small tasks that were once automatic. I have to think carefully as I turn my wheelchair around in the kitchen, collecting the articles for a bowl of cereal from high cupboards, barricaded refridgerators and unforgiving pantries. Each day, I must follow my routine and perform physical therapy, even though I have done it for days in a row, even though I don't feel like it this morning. Embracing this condition, the slow convalescence, can be harder than the intense first moments of injury.
I have recognized this same strength in others. In Mass General Hospital, an octagenarian kept his spirits up while he underwent procedures for cancer. A diabetic in my rehab center talked about what he might do after his big toe and several others were amputated. A carpenter smiled when he described falling and breaking an ankle that had been smashed the year before. These people were finding strength that blossomed through their trials.
While this ordeal has brought forth gifts of strength and patience, I offer them as testimony rather than as prescription. My accident could have been different in a hundred small ways. The rock might have cut a different swath. Assistance might have been further afield. The elapsed time to surgery could have stretched over days. Moreover, I might have been another person with a different constitution or mindset. It is not for me to judge others' responses to crisis, only to articulate my own as a small data point in comprehending what is possible.
Within a week after my accident, a long-time NOLS instructor and administrator was killed while rock climbing. Despite wearing a helmet, Pete Absolon died instantly when he was struck by a rock trundled by an unthinking hiker. This accident was "the big one." No amount of "personal strength" would have saved Pete. Perhaps I have been most fortunate to have just enough travail to discover this strength.
Sunday, September 23, 2007
The Journey - Some Days Are Hard - September 20
I stood in the shower naked today, crying over my swollen foot. I felt very tender - "it's so mangled," I managed to whisper between tears.
I have been overwhelmed by the beauty in the eyes and hearts and letters of people who care that I heal. I have embraced the silver linings of finding personal strength, of feeling the deep love from Melissa, of finding grace in small interactions with people. But still, some days are hard.
Unwrapping my leg for my daily dressing change is always a vulnerable moment for me. The idea of recovery can feel uplifting; it can feel like a pleasurable challenge or heroic journey. These ideas help me to make meaning out of this ordeal. And yet, when we unwrap my leg, the magnitude of injury chafes against lofty conceptualizations. I can hardly imagine moving from this unsightly appendage to a leg on which I could hike or run. I look at my still swollen heel, as large as a softball. I have little feeling, and the mild discoloration has not faded. I touch the area of my skin graft. There is no fleshy padding, and It feels hard against my tibia. It is warm to the touch, yet I have no sensation. Like waking up when one's arm has fallen asleep, I regard my leg almost as some foreign creature. I have been given permission to start bearing weight - up to 25% - on my right leg. However, my heel won't even touch the ground, as my achilles has tightened up. The outer edge of my foot touches down first; it screams and throbs before the ball of my big toe contacts the ground.
The cry helped. It had started earlier, when I noticed that my other foot and ankle was swollen. I felt mad, taken off guard by this unexpected ailment in my left leg. In all my efforts to be tender, hopeful and loving towards my injured right leg, I have resisted urges to be angry at it. When my other foot started to swell, it bore the brunt of any resentment that might have been brewing. I wasn't cheered even when Melissa reminded me that my left leg lost a whole muscle and a giant patch of skin; a little swelling was entirely reasonable after that trauma.
Finally, getting into the shower, it started. I could feel the tears welling up. I grieved, I felt better, I resolved to continue - to continue believing in the power of humans, individually and collectively, to heal. And when that level of belief isn't possible, I resolved at least to suspend disbelief about being able to stand on top of a mountain again one day.
Strong at the Broken Places - Mark - September 14
I hope that this update reaches all of you in good spirits. Please
know how much your support and contact have meant to me during this
ordeal.
The short version is that I am progressing well, and I should be out
of this rehab center next week. I am a lucky man to have a partner as
loving and committed as Melissa. I am deeply appreciative. The
recovery process will be long, and physical therapy is unbelievably
painful (dangling my leg). However, I'm happy to do it in order to
heal.
Today was amazing! I have been in a rehabilitation center for a week.
At my follow-up appointment with Plastic Surgery, they poked and
prodded and peeled off dried blood and dead skin. They told me that
the graft is stable and that I can bear weight (if ok'ed by
Orthopedics), touch it, stretch, shower, ... They also took out my
last wound drain, stopped my antibiotics and blood thinners and gave
me their blessing.
It is humbling to notice my process. Even though I want to have
normal function, I notice the fear. Subtle thoughts occur to me - Am
I really ready to start bearing weight? Will I stay healthy without
antibiotics? Perhaps I'll wait another week to shower, just in case.
Institutionalization at work - I have only been in the hospital for a
month and have a strong drive to recover. If fear and doubt creep
into my psyche, I can only imagine the experience of people who have
been in this setting longer:
Down the hall is a brain-injured patient. At odd times of the day or
night, he WAILS, calling for the nurse. In many cases, they are right
next to him. He cries, "Nurse, don't be a witch."
Another woman is usually cheerful and dedicated to her physical
therapy. However, she was dispirited yesterday. She had a spinal
fusion (fused vertabrae) in June. She is disappointed because she
still can't walk after three months.
A young man lost the use of his legs 10 years ago as a senior in high
school. He simply lost feeling and the ability to move them--no known cause.
He is here for sores and infection, but he has no place to go afterwards.
He grew up in poverty and doesn't really have skills that could allow
him to work, to contribute, to find worth. Melissa and I have both
talked with him about some possible steps.
In this context, I am incredibly fortunate. I am healing well. I
have resources and a beautiful network of people who have shown me
their support. And Melissa... Melissa is a godsend to me. I can
hardly believe what an incredible partner she is. When the going
wasn't easy, Melissa really stuck by my side. She has massaged me,
stayed late hours, helped me to visualize and brought me treats. How
can I ever thank her enough?
Yesterday, I walked about 75 yards on crutches. Physical therapy
consists of (1) light workouts to strengthen both upper and lower body
and (2) the hugely painful process of letting my leg dangle. When
blood flows into my leg (as in standing or even just dangling it off
the bed), it throbs and swells. I start to get light-headed and
sweaty. I like to think of myself as a pretty tough character, but
after 10 minutes of dangling, I'm crying for mercy.
PARTING IMAGE: Did I mention that I shaved my head? Fun! I've never
done it before - sure makes hair washing easy. Wow, do I have a
widow's peak!
We think our next update in a few days or a week will be a "last"
update as we switch over to writing in a blog on a website
(rockthehealing.com) that a college friend is creating for us. It
seems hard to think of signing off with all of you. Maybe we can plan
a global simultaneous "toast" to healing to appreciate this joyful
vigil.
know how much your support and contact have meant to me during this
ordeal.
The short version is that I am progressing well, and I should be out
of this rehab center next week. I am a lucky man to have a partner as
loving and committed as Melissa. I am deeply appreciative. The
recovery process will be long, and physical therapy is unbelievably
painful (dangling my leg). However, I'm happy to do it in order to
heal.
Today was amazing! I have been in a rehabilitation center for a week.
At my follow-up appointment with Plastic Surgery, they poked and
prodded and peeled off dried blood and dead skin. They told me that
the graft is stable and that I can bear weight (if ok'ed by
Orthopedics), touch it, stretch, shower, ... They also took out my
last wound drain, stopped my antibiotics and blood thinners and gave
me their blessing.
It is humbling to notice my process. Even though I want to have
normal function, I notice the fear. Subtle thoughts occur to me - Am
I really ready to start bearing weight? Will I stay healthy without
antibiotics? Perhaps I'll wait another week to shower, just in case.
Institutionalization at work - I have only been in the hospital for a
month and have a strong drive to recover. If fear and doubt creep
into my psyche, I can only imagine the experience of people who have
been in this setting longer:
Down the hall is a brain-injured patient. At odd times of the day or
night, he WAILS, calling for the nurse. In many cases, they are right
next to him. He cries, "Nurse, don't be a witch."
Another woman is usually cheerful and dedicated to her physical
therapy. However, she was dispirited yesterday. She had a spinal
fusion (fused vertabrae) in June. She is disappointed because she
still can't walk after three months.
A young man lost the use of his legs 10 years ago as a senior in high
school. He simply lost feeling and the ability to move them--no known cause.
He is here for sores and infection, but he has no place to go afterwards.
He grew up in poverty and doesn't really have skills that could allow
him to work, to contribute, to find worth. Melissa and I have both
talked with him about some possible steps.
In this context, I am incredibly fortunate. I am healing well. I
have resources and a beautiful network of people who have shown me
their support. And Melissa... Melissa is a godsend to me. I can
hardly believe what an incredible partner she is. When the going
wasn't easy, Melissa really stuck by my side. She has massaged me,
stayed late hours, helped me to visualize and brought me treats. How
can I ever thank her enough?
Yesterday, I walked about 75 yards on crutches. Physical therapy
consists of (1) light workouts to strengthen both upper and lower body
and (2) the hugely painful process of letting my leg dangle. When
blood flows into my leg (as in standing or even just dangling it off
the bed), it throbs and swells. I start to get light-headed and
sweaty. I like to think of myself as a pretty tough character, but
after 10 minutes of dangling, I'm crying for mercy.
PARTING IMAGE: Did I mention that I shaved my head? Fun! I've never
done it before - sure makes hair washing easy. Wow, do I have a
widow's peak!
We think our next update in a few days or a week will be a "last"
update as we switch over to writing in a blog on a website
(rockthehealing.com) that a college friend is creating for us. It
seems hard to think of signing off with all of you. Maybe we can plan
a global simultaneous "toast" to healing to appreciate this joyful
vigil.
Strong at the Broken Places - Melissa - September 14
Greetings from the North End of Boston, a hip part of town with tiny
cobblestone streets just big enough for horse and buggy--streets more
than just a touch scary for a guy in a wheelchair! Our outing to a
park 2 blocks away was a memoralbe adventure--adrenaline surges over
every treacherous stone!
Had we lots of time and money, we'd be wining and dining at fancy and
boisterous Italian restaurants and bakeries here in the North End. As
it goes, instead of red wine and eggplant parmesan, we're hanging out
with a crowd of people with ailments and issues much more tragic than
a superbly healing gracilis flap. The level of suffering in a place
like this (not everyone heals so quickly, not everyone will leave this
rehab center and go home) is profound, further fueling the gratitude
that Mark and I have been filled with every step of the way through
this injury.
Mark continues to heal so very well, but I'll let him tell you about
that directly. He is up and about and wanted to be in on the writing
of an update to our circle of healers and supporters.
As for me, I'll share just briefly. These wonderings I find truly
fascinating. First, a few weeks back, I was struggling to keep check
on replaying images of the accident over and over again in my head
(even though I wasn't even there...). Then after a couple weeks, my
mind switched it up--from Mark being in the image to ME being the one
to have my leg crushed. Wow. Second, I have caught myself, when I am
getting dressed or getting out of the shower and toweling off, to be
especially careful around touching my lower right leg---and then I
realize that I actually don't have a wound there---Mark does. Another
wow. I've had a passing glance at thinking of this as a pathological
level of involvement, but then I've just become very intrigued by
these responses. I've marveled at the ability to empathize, and to
truly share difficulty, to be deeply present with someone elses
healing. It also seems to me to be symbolic of the fact that it is not
just Mark's life that suddenly changed last month but that mine has
too.
And what else? Last spring, Mark and I had been talking about doing a
re-committment ceremony this fall on our 7th wedding anniversary in
October--a time to renew our vows. I'm not sure if we'll get around to
a ceremony now, but the last few weeks have been a ceremony of a
different kind. Seven years ago, Mark wrote in to our vows "I vow to
tend this union in times of ease and hardship that it might grow in
abundance and strength...." This whole ordeal makes for an interesting
relationship to hardship. Not that I would ever choose to have my
partner's leg crushed, or my own, and yet as we look at the event from
the distance of more than a month of healing, there is growing
"abundance and strength". In thinking about the transformation that
comes out of hardship, I turn to a line from Hemingway that I've held
close to my heart long before this injury. In working with trauma,
these words have been solace:
"The world breaks everyone
and afterward
some are strong
at the broken places." ----Ernest Hemingway, A Farewell to Arms
cobblestone streets just big enough for horse and buggy--streets more
than just a touch scary for a guy in a wheelchair! Our outing to a
park 2 blocks away was a memoralbe adventure--adrenaline surges over
every treacherous stone!
Had we lots of time and money, we'd be wining and dining at fancy and
boisterous Italian restaurants and bakeries here in the North End. As
it goes, instead of red wine and eggplant parmesan, we're hanging out
with a crowd of people with ailments and issues much more tragic than
a superbly healing gracilis flap. The level of suffering in a place
like this (not everyone heals so quickly, not everyone will leave this
rehab center and go home) is profound, further fueling the gratitude
that Mark and I have been filled with every step of the way through
this injury.
Mark continues to heal so very well, but I'll let him tell you about
that directly. He is up and about and wanted to be in on the writing
of an update to our circle of healers and supporters.
As for me, I'll share just briefly. These wonderings I find truly
fascinating. First, a few weeks back, I was struggling to keep check
on replaying images of the accident over and over again in my head
(even though I wasn't even there...). Then after a couple weeks, my
mind switched it up--from Mark being in the image to ME being the one
to have my leg crushed. Wow. Second, I have caught myself, when I am
getting dressed or getting out of the shower and toweling off, to be
especially careful around touching my lower right leg---and then I
realize that I actually don't have a wound there---Mark does. Another
wow. I've had a passing glance at thinking of this as a pathological
level of involvement, but then I've just become very intrigued by
these responses. I've marveled at the ability to empathize, and to
truly share difficulty, to be deeply present with someone elses
healing. It also seems to me to be symbolic of the fact that it is not
just Mark's life that suddenly changed last month but that mine has
too.
And what else? Last spring, Mark and I had been talking about doing a
re-committment ceremony this fall on our 7th wedding anniversary in
October--a time to renew our vows. I'm not sure if we'll get around to
a ceremony now, but the last few weeks have been a ceremony of a
different kind. Seven years ago, Mark wrote in to our vows "I vow to
tend this union in times of ease and hardship that it might grow in
abundance and strength...." This whole ordeal makes for an interesting
relationship to hardship. Not that I would ever choose to have my
partner's leg crushed, or my own, and yet as we look at the event from
the distance of more than a month of healing, there is growing
"abundance and strength". In thinking about the transformation that
comes out of hardship, I turn to a line from Hemingway that I've held
close to my heart long before this injury. In working with trauma,
these words have been solace:
"The world breaks everyone
and afterward
some are strong
at the broken places." ----Ernest Hemingway, A Farewell to Arms
We've Moved! North End Rehab - September 7
We've moved!
Mark is now at the North End Rehabiliation and Nursing Center and is
likely to be there for the next week or 2. For Boston-based friends
who have the time and energy to visit, it's an easy walk from the
Haymarket T stop. Address below. If you can visit, call Mark directly.
It would be great if anyone can stop by to see him as my
responsibilities begin to kick in as of Monday with new internship and
classes! Off and running.....! My MGH "vacation" is ov-ah! And Mark
may go into withdrawal without the massaging....
70 Fulton Street
Boston, MA 02109
617-726-9700
Peace Salaam Shalom
Mark is now at the North End Rehabiliation and Nursing Center and is
likely to be there for the next week or 2. For Boston-based friends
who have the time and energy to visit, it's an easy walk from the
Haymarket T stop. Address below. If you can visit, call Mark directly.
It would be great if anyone can stop by to see him as my
responsibilities begin to kick in as of Monday with new internship and
classes! Off and running.....! My MGH "vacation" is ov-ah! And Mark
may go into withdrawal without the massaging....
70 Fulton Street
Boston, MA 02109
617-726-9700
Peace Salaam Shalom
Still at MGH - September 7
Hello Everyone,
A work week has passed since we wrote to you. We've been hard at work
trying to get Mark out of the hospital!
All is well on the healing front. Yes, the flap is still "booming and
swishing" and Mark continues to get superlative comments from the
doctors such as the flap looking "beautiful". I haven't seen the flap
yet, but Mark has seen it when the doctors take the dressing down
every morning. I hear that it is beautiful from a MEDICAL perspective
but that Mark *might* not be winning any prizes in the "Men's Sexy
Legs" rag...but of course he will in MY book! Scars are simply a map
of your adventures from our perspective. Mark has a VERY cool map!
Mark is now on the "dangle protoccol". This is a medical term for his
flap phyical therapy! He gets to dangle his leg over the side of the
bed 3 times a day for 15 minutes (just a few days ago it was only 3
minutes but they've progressed him rapidly because the flap is
tolerating the increased bloodflow so well and because he is handling
the discomfort so well).
News that gave me cause to have a small (happy) tearful breakdown at
CVS yesterday while I talked with Mark on the phone (I've been
reassured that ANYTIME is an OK time to cry these days), is that
Helena spoke VERY confidently about the health of the tissue on Mark's
heel yesterday. We have been very attentive to this issue, knowing
that if that heel tissue did not survive, Mark could be in serious
trouble with use and longterm function of his foot. Yes!!!! Still, we
know there are no guarantees, but this vote of confidence is very
welcome! "Heal the heel" is still an essential prayer for us.
And discharge from the hospital? We are in a holding pattern. Turns
out Mark will need a visiting nurse to change the dressing daily and
the MA Health insurance program that we are depending on will not pay
for a visiting nurse. Ironically, MA Health WILL pay for Mark to be in
a rehab center which will be much more costly. So, the discharge team
here at MGH is working on securing a bed for Mark in a rehab center.
It is not our first choice, but we are making the best of it. We think
it will only be another week or two before Mark is home.
We are well. Mark is moving around in bed more and more. The time
between installments of pain medication is just starting to lengthen.
And yesterday Mark got orders from the doctor to be able to get out of
bed to use a wheelchair and go outside! We got him off the 13th floor
Plastic Surgery unit and went down to planet earth and hung out on a
patio for an hour, the first real sunshine Mark had seen in a long
time!
Thank you all for wonderful in-person visits, sweet cards, generous
care packages! Thank you for continuing to think about us and to
inquire about progress! If you haven't tired of visualizations and
prayers for Mark, keep a vision of him as healthy and whole and with a
fully functional leg in your mind's eye.
Peace Salaam Shalom.
Melissa and Mark
A work week has passed since we wrote to you. We've been hard at work
trying to get Mark out of the hospital!
All is well on the healing front. Yes, the flap is still "booming and
swishing" and Mark continues to get superlative comments from the
doctors such as the flap looking "beautiful". I haven't seen the flap
yet, but Mark has seen it when the doctors take the dressing down
every morning. I hear that it is beautiful from a MEDICAL perspective
but that Mark *might* not be winning any prizes in the "Men's Sexy
Legs" rag...but of course he will in MY book! Scars are simply a map
of your adventures from our perspective. Mark has a VERY cool map!
Mark is now on the "dangle protoccol". This is a medical term for his
flap phyical therapy! He gets to dangle his leg over the side of the
bed 3 times a day for 15 minutes (just a few days ago it was only 3
minutes but they've progressed him rapidly because the flap is
tolerating the increased bloodflow so well and because he is handling
the discomfort so well).
News that gave me cause to have a small (happy) tearful breakdown at
CVS yesterday while I talked with Mark on the phone (I've been
reassured that ANYTIME is an OK time to cry these days), is that
Helena spoke VERY confidently about the health of the tissue on Mark's
heel yesterday. We have been very attentive to this issue, knowing
that if that heel tissue did not survive, Mark could be in serious
trouble with use and longterm function of his foot. Yes!!!! Still, we
know there are no guarantees, but this vote of confidence is very
welcome! "Heal the heel" is still an essential prayer for us.
And discharge from the hospital? We are in a holding pattern. Turns
out Mark will need a visiting nurse to change the dressing daily and
the MA Health insurance program that we are depending on will not pay
for a visiting nurse. Ironically, MA Health WILL pay for Mark to be in
a rehab center which will be much more costly. So, the discharge team
here at MGH is working on securing a bed for Mark in a rehab center.
It is not our first choice, but we are making the best of it. We think
it will only be another week or two before Mark is home.
We are well. Mark is moving around in bed more and more. The time
between installments of pain medication is just starting to lengthen.
And yesterday Mark got orders from the doctor to be able to get out of
bed to use a wheelchair and go outside! We got him off the 13th floor
Plastic Surgery unit and went down to planet earth and hung out on a
patio for an hour, the first real sunshine Mark had seen in a long
time!
Thank you all for wonderful in-person visits, sweet cards, generous
care packages! Thank you for continuing to think about us and to
inquire about progress! If you haven't tired of visualizations and
prayers for Mark, keep a vision of him as healthy and whole and with a
fully functional leg in your mind's eye.
Peace Salaam Shalom.
Melissa and Mark
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