Granted.

You take a lot of things for granted.

You take for granted your physical health.  That’s cliché, but it’s also true.

For years, I ate crap and taxed my body with irregular meals.  One day, I woke up and found I was suddenly fructose and lactose intolerant.  I also found I was reactive hypoglycemic.  Just like that.  I’m sure that, in actuality, I was deteriorating into those conditions, my body regulating normalcy until it could no more, like a button whose twine frays but allows the button to still function until it finally snaps clean off.

You take for granted your mental health, that you’ll always have the resiliency to go on.  I think people who’ve never suffered genuine anxiety – like a bout of hyperventilation, or a panic attack – don’t know how fragile their minds are, instead thinking they can always strive forward, on and on relentlessly, obliviously.

You even take for granted that you won’t go crazy, that at some point in the middle of the night, when you’re tossing and turning trying to find sleep, and listening to the sounds of the house settling that have become so commonplace they’re white noise, that voices just won’t start chatting to you.

And you even take for granted the unspoken rules of society, that strangers won’t waltz into your house when you leave the doors unlocked; that the guy behind you will give you space at the ATM; and that drivers will give you right of way at an intersection when the little WALK signal has come up and the ticking for the hearing impaired has begun to pulse frenetically, like it’s urging you across the road.

You take a lot for granted and then, one day, something just goes.  As easy as clicking your fingers.  Your sanity.  Your resiliency.  Your security.  Or even all of them.

Then your world becomes fractured, and you see everything through cracks, always hoping those cracks won’t get wider and wider, that the prism of your mind, your body, your life – the prism of you – won’t just shatter and collapse, and leave you with nothing but chaos, or nothingness, or whatever it is which lays under years of aging, conditioning, and whoever you are.

You take a lot of things for granted.

Post-Surgery.

I’ve had surgery a few times in my life. The thought of it doesn’t worry me. It’s the post-surgery I’m apprehensive about – knowing I’ll wake up with pain.

The anaesthesiologist told me what they’d be giving me afterwards, including the painkiller Ketamine. She told me not to be worried if I had hallucinations, or vivid dreams, which were possible side-effects. A popular side-effect, she said, was patients waking up and thinking their room was covered in grass.  Why would I be worried seeing that?

They wheeled me into surgery, and again I was out of it quickly. The next I awoke was in Recovery, just when they were wheeling me out. There was a pain in my leg, but it was nothing bad – more like I’d stubbed the shin walking into a low coffee table. The nurses brought me back to my Ward, and rolled me back into my bed space, where I slept sporadically.

Over the next several hours, the nurses performed their routine checks of blood pressure, temperature, and oxygen level. Morphine, apparently, can affect your respiratory system, and one of the nurses told me she almost had heart failure when she counted that I breathed only once in a whole minute. Consequently, they relieved me of my morphine clicker for a couple of hours, although I barely remember using it.

I’d come out of surgery mid-afternoon, and slept fitfully through the rest of the day, until the nightshift nurse came on duty at 9.30pm. She periodically checked to see if I’d used my bladder, and warned me if I hadn’t used it within twelve hours of surgery (which would be 2.30am) she’d have to insert a catheter. The fear is that the bladder doesn’t awake after anaesthetic.

This was a thought which filled me with dread. I’d already had one inserted during the original surgery. There’s a convenience to it, but the sensation of it coming out is:

  1. painful
  2. grotesque (as you visualize it slithering out)
  3. then more painful and grotesque, as A  and B compound one another and create a vicious circle.

I didn’t need to go until midnight, but when I tried I couldn’t. I kept trying as the need grew over the next hour, and still couldn’t. The nurse checked on me regularly, monitoring my progress, and said that the catheter might be the way to go. I stressed I really didn’t want it.

She suggested changing position, and perhaps sitting up on the edge of the bed, with my newly-operated right leg perched on a chair. If I was vertical, gravity was meant to help. I didn’t know if the logic was sound, but was willing to try anything.

But sitting there, right leg on a chair, bottle between my legs, I still couldn’t go, although I felt closer than I had when I’d tried peeing I into the bottle. I was hoping the problem was pressure – pressure I put on myself, which I do. With everything.

I stood, hanging onto the metal handle which hung above the bed, my right leg balanced on the bed, the bottle held between my legs, and the near-normalcy of the position (of standing, that is) relaxed me until I was going. It was the ultimate relief. I went back to bed and called the nurse, who told me that meant my bladder was fine. I used that knowledge later, as I still had difficulty going, so maybe my bladder was still a bit sluggish from the anaesthetic.  But assurance is an amazing thing.

I lay there, awake now (I’d slept on and off for nine hours) and tried getting back to sleep, but every time I closed my eyes my mind filled with incredible images – colourful landscapes and spectacular panoramic views which I enjoyed with (for me) an atypical lassitude. Usually I’m a panicker.  Not now.  Now I was tranquil as all these images unfurled in my mind.  It happened whenever I closed my eyes: I could pick a starting point (I kept trying to visualise a healing light) but then it would turn into something surreal and breathtaking.

I’ve never taken anything illegal in my life, since there’s always been enough going on in my head without adding to the confusion, but what I was seeing – whilst enjoying an implacable serenity – made me understand why people do use drugs. That was the most calm I’d felt in years, and the imagery in my head was realer than anything I could create through words. So this was the Ketamine.

In the morning, the intravenous painkillers were removed. They were surprised I’d barely used any more morphine, although the pain in my leg was sharpening, and my foot felt as if it was swelling in the plaster half-cast they’d wrapped around my leg. I don’t like taking anything, and after the earlier respiratory issues, was determined not to use the morphine unless I absolutely needed it.

The doctors did their rounds in the morning and examined my foot, which had swollen back up, although they were very happy with the surgery. By Wednesday – just three days after surgery – they wanted to discharge me. I bought an extra day. I didn’t want to be discharged until they were sure everything was fine, but now, while I was healing, it was just a case of waiting.

But that’s what everything seems to come down to: waiting for something to happen.  Even if you try to make something happen, you still have to wait.

So wait I did.

Step Zero.

I had an idea I posed to one of the nurses when I was in hospital: coma surgery. A patient comes in, they’re induced into a coma, and filed into a drawer (like they use in morgues) until their surgery. This would be perfect for people like me, who had to wait ten days. After the surgery, they’re stuck back in the drawer until they’ve healed. Then they’re awakened, and sent on their way.

I’m sure somebody unadventurous will point out the drawbacks of coma surgery, but I think it has a lot going for it. You don’t have to worry about hospital beds, about wasting hospital resources, and patients can sleep right through their experiences.

Not that that my experience was at all bad. In fact, my experience made everything tolerable.

The Paramedics
The paramedics arrived promptly, and I explained what had happened to me, and all my dietary intolerances and reactive hypoglycemia – just in case that had any bearing on my treatment. I then told them I was lucid now, but if I saw what was going on with my break (which was hidden under my tracksuit, sock, and runner) they’d lose me quick.

They gave me some sort of plastic canister to suck on which was meant to help nullify the pain, then got me into the ambulance. One of the paramedics held my leg in place while the other cut away the laces of my runner and my sock. At that point, I’m sure I felt my leg spread the way an egg would if you dropped it on the floor. Or maybe I’m just imagining it. The paramedics splinted my leg, gave me some morphine, checked my blood sugar, and brought me to the Austin, all the while assuring me, and warning me whenever the ambulance would hit bumps in the roads

Emergency
You hear a lot of horror tales about waiting in emergency rooms, although I don’t think you can blame hospitals for that. It just comes down to the amount of staff versus the amount of patients. (Possibly, another win for coma surgery!)

However, I was wheeled straight into an EMERGENCY room. I explained yet again what happened. I can’t recall if they gave me more drugs, although I’m sure they must’ve.

They removed the splint and fixed the dislocation in my ankle by lifting my leg by the foot until the foot socketed back into place. There was some pain, but it was more the discomfit associated with the knowledge of what was going on which was the problem. They then bandaged me (and maybe even plastered me – apologies on the details; not the best time to be recording every detail).

They also took my blood sugar again. As a reactive hypoglycemic, I’m meant to eat something every three hours, and I was now over that by half an hour, (not to mention the exercise of the walk usually depletes you also).

Then I shook for a bit, as shock set in.

Afterwards, I was wheeled into a bay, and taken for several x-rays. But it was a case of waiting until I was ready to be taken for surgery. I had to wait an appropriate amount of time since my last meal. (If you’re curious why, it’s because when you’re under anesthetic, any food in your stomach can regurgitate into your lungs).

Surgery
You get wheeled into surgery and are fully aware. But by the time they prep you, all you know is oblivion.

I did go in, though, thinking they’d fix my leg. That’s the plan when you come to hospital, isn’t it? I’m sure I might’ve talked to the surgeon about it while I was drug-induced and hazy, but can’t recall if I did.

I did think I’d wake up on the road to recovery.

Post-Surgery
The x-fix.When I awoke and the doctors came around to examine me, I found they’d fitted an ‘external fixture’ to my leg – or an ‘x-fix’, as they called it. It was explained that there was too much swelling to operate, so they had to use this as a temporary measure to hold the bones in place until the swelling had diminished so they could perform surgery, (and insert plates).

It was Friday. I was told they were aiming to perform the surgery on Sunday. Three days!

So began life in hospital. Nurses would come around and check me periodically, asking me to rate my pain out of ten, offer painkillers, take the pulse in my foot (which was very faint because of the swelling), and check my blood pressure, temperature, and oxygen levels.

I was very disoriented the first few days – possibly a combination of shock and an acclimation to all the painkillers. And I refused to look at the x-fix, keeping the sheet over it at all times, and telling the nurses when they came to examine me that I didn’t want to see it.

The most humbling thing was being confined to the same position in bed – on my back, with my foot propped up under a ton of pillows and usually packed in ice, (all in an effort to reduce swelling). This position became my world. I ate in it. I watched TV in it. I spoke on the phone in it. I washed in it. I moved my bowels in it.

Mentally, it’s wrong. For example, at home, you don’t eat lunch on the toilet. Well, I don’t. It really compounded the dislocation of my situation, how everything was gone, how incapacitated this break had made me, and how reliant I was on staff.

Sunday came, and the surgeon decreed the swelling was still too severe for surgery. He explained that if he operated with the swelling as bad as it was, it could cause further complications – that he might not be able to close, for instance. He also told me that the break had wishboned, and tented the nerve, which is why they’d called him in at 11.00pm on a Thursday night to operate, because if they’d waited until Friday morning the damage could’ve been irreparable.

He rescheduled surgery for Wednesday – providing the swelling had gone down – and I started to get more comfortable with my situation. Not that I enjoyed it. One day when I had the curtains drawn and just after I’d moved my bowels and washed – exhausted and drained from what it takes to perform these every day requirements in this position – I cried, thinking how unfair it was, and unable to see when things would improve. I wondered if the woman who’d hit me was at home drinking coffees and enjoying herself.

Come Wednesday, my foot was deemed still too swollen, and the surgeon told me they’d aim for Friday afternoon, that he was off but would come in to do the surgery. I knew there was nothing to be done about it, but it was frustrating to be in limbo. Once the surgery was performed, then healing could begin. That was Step 1. But that wasn’t where I was at. I was in a holding pattern. Step 0.

Thursday night, the surgeon came in with a group of other surgeons, and again my foot was still considered too swollen. Discussing it, they said 7–10 days was standard in cases like this, and ankles were especially troublesome. Also, to my embarrassment, I found out I’d been addressing the surgeon as ‘Simon’ when his name was ‘Shane’. His colleagues started stirring him, calling him ‘Simon’, whilst one of the other surgeons assured me, ‘You have to laugh.’

I wanted to, but it wasn’t easy.

Saturday, the doctors did the rounds and deemed the ankle still too swollen, which deflated me. I’d been here ten days, and now had to wait another three. However, the surgeon came in an hour later and judged the swelling good enough to go.

Time to heal. Maybe.

The End of the World as We Know It

Here is what life became in the aftermath:

  • an external brace was fitted to my leg to hold the bones in place until the swelling had diminished enough for surgery. The brace was an odd metal contraption which sat on top of the leg with what looked like drill-bits going through my leg and into the bones. I wore this for ten days.
  • seated in a bed for ten days, with my foot up (to help reduce swelling), unable to move. When I was given crutches, it was just to go to the bathroom. Otherwise, stuck in the same position – not just bed, but the same position.
  • an injection in the stomach every morning which was to thin blood and stop blood clots. I had to learn to do this myself and continue doing it when I got home.
  • two slow-release painkillers at 8.00am, and two at 8.00pm.
  • another painkiller and two Panamax four times through the day.
  • for a week, medication meant to help dull the problems from nerve damage.
  • two laxatives twice a day, which was to help mitigate the constipating effect of the painkillers. All the other medication was taken for a month which for somebody like me – who only takes medication as a last resort – was dispiriting.
  • pain.
  • nerve misfirings – severe pins and needles; feelings of claws digging into my soul; burning sensations; excruciatingly sharp jabbing sensations which would cause me to jump; feelings like somebody was twisting off my toes with a set of pliers. At their worst, they made doing anything else impossible. I just had to bear through them. However, they could last for hours at a time, and medication did nothing to negate them. (They’re still going on.)
  • the knowledge of intense rehab just to get my ankle moving again.
  • more rehab learning to walk properly on my right leg again, (and I was told it’d be six months to get back to normal).

I didn’t know this, of course, as I sat on the nature strip, clutching my ankle. If I did, I might’ve stepped back out into traffic, being the fatalist I am.

What I did know, however, was that my world has collapsed in on me. A broken leg meant ambulance, hospital, surgery, no more evening walks, no more swimming, no more going to football, no nothing, a long recovery time (I’d broken my arm in 1986, and had suffered nerve damage to my hand; that had taken a year to recover); and, as REM sings, the end of the world as I knew it. Yeah, I’ve already admitted I’m fatalistic.

A woman approached on the nature strip. She was fifty or sixty, short, squat, and the sort of migrant typical to my area – sad-faced, beaten by a life of immigration and working hard at some crap job to save up lots and provide for family. I thought she must’ve come from one of the houses to see if I was okay. Instead, though, she apologized for hitting me.

I was stunned. Obviously, anybody can be behind the wheel of a car which hits somebody, but given the destructiveness of the act there was an assumption that the offender would be somebody destructive, some young hoon, stereotypic in appearance. You don’t think of somebody’s mother, potentially somebody’s grandmother, as the culprit.

I can’t remember what was said exactly, and any attempt would really just be my imagination filling in the gaps. She was very apologetic, though, as though if she could apologise long enough and hard enough she could undo the situation. Just as I didn’t want to be a victim, she didn’t want to be a perpetrator, and everything that meant.

I told her to call an ambulance, telling her she’d broken my leg. She apologized again. I briefly lost my cool. Generally, I’m very good in an emergency. Everyday life? Forget it. I’m hopeless. But give me an emergency and I’m actually calm and purposeful. A counselor once suggested to me an emergency narrowed my focus, and eliminated all the intrusive chatter which distracted me in every moment of everyday life – concerns, anxieties, random thoughts, all that sort of stuff.

I yelled at her, asking how she didn’t see the light, which was still green. Again she apologized. Back to calm: I told her to call an ambulance again. She told me she couldn’t, because her English wasn’t good enough.

She may as well have just come over and kicked me in the crotch while I sat there.

She said she’d find somebody else, and flagged down another car which had just turned into the intersection, and was obstructed by her own car, which she’d just left in the middle of the street. Another woman emerged, about thirty or forty (I’m a terrible estimator, in case you haven’t noticed), who was terrific. She called the police and an ambulance. When she was done, I beckoned her over and asked her to take down the offender’s details, which she did. She was fabulous. It’s people like this and acts like this which really encourage you that the world’s not as hopeless as you might fear. Cliché, maybe. But sometimes it takes getting hit by a car to learn truths.

Now I just have to work out the rest.

May take a bigger car.

Them’s the Breaks.

Thursday night, 30th June, I was meant to go to the launch of Koraly Dimitriadis’s chap book, Love and Fuck Poems, with my work-partner and friend Blaise van Hecke.

In the ten days preceding that night, we were definite to go. Most days we’d check if we were still good to go, and we were. But come that Thursday, we were both drained from our respective jobs, and begrudgingly decided to give it a miss.

With that out of the way, I decided to have a walk that evening. I have an exercise regime which alternates swimming, punching bag, a really long walk, a shorter walk, and occasional cycling. On days I swam or punched the bag, I took my shorter walk in the evening. Since that hadn’t happened this Thursday, I was meant to take my really long walk – about six kilometres.

But I was finalising an edit, which took longer than expected as I to’ed and fro’ed with the author in email. So it was that when I left my house, I decided I had only the time (and energy) for my shorter walk, which was about three and a half kilometres.

Every time I leave my house for my walk, I turn left. Then I take this route around several blocks. It’s about forty-five minutes. There’s little deviation, other than for some of the initial side-streets I use, although they all knit back into the same main road, and from then on the course is always the same.

This time, I decided to be novel, and turned right, so would do the course in reverse. This is the first time I’d ever done my walk this way.

About half an hour into the walk, I reached a busy intersection. I was feeling good. I’ve had chronic back and neck problems for about eighteen months, which probably comes from sitting at a computer all day. Regular appointments with an acupuncturist, osteo, and physio had offered small improvement, but nothing marked or lasting. My GP thought I must have fibromyalgia, given my symptoms weren’t commensurate with the problems in my back, (a slightly deteriorated disc in my neck, and a slightly bulging disc in my back). Since nothing else had worked to that point, my response in the last fortnight was to up my exercise regime, and I’m sure my back was actually responding.

I pushed the button for WALK at the intersection. I didn’t have to wait long. The light changed. The little green man told me to walk, as did the ticking tempo which accompanies the changing of the signal.

It’s amazing the things you accept on faith in the world, where you rely on unspoken, unverified etiquette.

I walked.

There are a lot of clichés about dramatic moments in life – that they’re a jumble, that time slows down, that you black out, all that sort of stuff. But clichés usually derive from some form of truth. As was the case here.

Something unyielding hit me in the buttock and lower back. My foot and ankle were trapped under a tire. I realised then that I was in the process of a car running me down and, in that instant, the possibility terrified me about the scope of damage which could be done.

This was a car. It sounds stupid. But you see them every day and think nothing of their destructive potential, like the family dog who’s friendly and loving to all until it snaps unexpectedly and mauls somebody. We forget a car’s weight, a car’s size, that at any real velocity it’s an unstoppable weapon and you’re basically a house of cards.

I remember a crunch, although maybe my memory has imposed that retrospectively. But the one thing I was aware of as I spun from the car was that I suddenly had no awareness where my right leg ended. It was like my right foot had been severed. In a way it had. Now it flopped at the end of my leg, like a fish on a riverbank asphyxiating.

I hit the road and instinct took over. The car had turned from the intersection, coming from behind me, and run me over. Now I had to get off the road before another car finished the job. Clutching my ankle – I could feel the bone bulging from the sock – I crawled onto the nature strip and sat there. I knew my leg was broken. It was just a case now of how badly it was broken.

Dread filled me – the sort that fills you when you’re a kid, when you’ve done something wrong, you know you’re going to be in big trouble, and it can’t be undone.

Here was the alternative to not going to a book launch, to not taking my longer walk, to taking the course of my standard walk in reverse.

I was now in a circumstance which couldn’t be undone.