My beautiful old Van Dusen lightweight was Caroline’s boat; she taught me to row in it and left it to me when she died. I talk to the boat, by which I suppose I talk to Caroline. “Hello, bunny,” I usually say, once I have entered the cool, shadowy bay and reached toward it on its lower rack. “Hello, bunny, here I am”—which is silly, really, given that I think of the boat more as a horse than a bunny. Maybe I’m speaking to some ephemeral presence I count on—Caroline, the memory of her, the manifestation of her in the boat—to let them all know I am keeping up my end of the bargain. To keep going. To row the boat she can no longer row. To care for it, though not as well as she would—it is scuffed and doesn’t get the polishing and fussing over that it did in her capable hands. After she died I swore I’d row until I couldn’t anymore, and I set new goals every few years: to row until I turned sixty, or for ten years past her death, or for another hundred miles in a season. Her image on the water coached me: How am I doing? I asked, even as the rows dropped from seven miles to six miles and then, by the time the pain set in, to three or four. The summer after I’d found out about my hip, I modified my rowing vows to fit the news: I would finish out the season, and try my hardest to get in the thirty rows I needed to maintain my private boat rack.
Thirty rows in a season is a gentle quota for a fit rower, and I had maintained it for years without much effort. But these days people on the dock asked if I needed help carrying the boat. Nowadays, when I docked, I used an arm and my strong leg to hurl myself onto the dock with more sprawl than grace.
By late summer I knew I had to either push forward or give up and take a medical leave, which meant putting the boat into storage for the season. I started doing shorter rows, and as the light waned toward autumn every trip seemed like a victory—bittersweet and particularly beautiful, because, despite my surgeon’s predictions, I was not convinced that I could do this after surgery. The river became the place where I could take my pre-op anxiety, which was showing up in devilish and displaced ways.
I felt scared and alone. For so long I had felt invincible: I used to swim the freshwater ponds on Cape Cod until October, following the perimeter if the place was deserted. If I got caught in a summer rain while I was rowing, I waited it out under a bridge or rowed through it; it was like being baptized from above. But these days I sent a cautionary alert to Nancy or Peter from the boathouse before I went out: “rowing—home in two hours.” Now I did circles—a mile upstream, then two down, then back to the dock—instead of what I used to do, which was to row in one direction with heedless joy until I got tired.
One afternoon I went out on the river in a bad state. I was tired and worried about the surgery, and I had spent an hour the evening before immersed in a toxic pastime: Googling old boyfriends and pondering the road not taken. Thanks to the new world of knowing too much about anyone you ever met, this was hardly a revelatory activity, but that night I stumbled upon new data about two different men I had loved.
The first was a recent wedding announcement, the other an acknowledgment to a spouse in a book published years earlier. Both instances suggested the kind of wife I had never been and probably never could have been: both painted tableaux, at least in my mind, of flawless dinner parties and social hobnobbing and renovated barns in Greenwich or the like. I was lying on the couch in the living room when I read these tidbits, wearing gym shorts with my hair in a pony-tail. Shiloh and Tula were lounging nearby; I was having leftover chicken for dinner and watching reruns of Nurse Jackie. Here was the life I had created, and whatever it was, it was not a flawless dinner party waiting to happen.
The next day, while I was rowing, I let my mind run free. This was an old and treacherous internal tape: I had forgotten to marry and have kids; I often preferred canine company to human; I would die sad and alone. Such was my recitation of despair, pulled out from time to time like an ill-shaped sweater you can’t bring yourself to give away. My friend Jean had managed to interrupt some of the narrative on the phone the night before. “Really?” she asked, unimpressed by my former lovers’ new mergers and acquisitions. “Really? Sorry. Can’t see you renovating a barn for somebody else to write in.”
So I flailed along, rowing my way toward hip surgery. After a couple of miles my demented script had faded, or maybe widened, to the larger truth, one without projections or fantasies about people I hadn’t known for years. I was sixty and felt forty-five, I was dog-besotted and forgot to brush my hair, I liked AA meetings better than churches and forest walks more than restaurants. An unconventional life, but my life, and out of the blue that day, somewhere around mile three, I started singing. “On the Street Where You Live.” “Crazy.” “Red River Valley.” I rowed past kayakers and kids feeding the ducks from the shore, and I kept belting out songs with my passable second alto, a happy madwoman singing only slightly better than I rowed. When I got to the dock I was sweaty and hoarse, and I hauled myself out of the boat and lay there on the deck like a beached seal. And I, too often a self-accounting of imperfections and regrets, said aloud to myself, “You are so awesome.” And for that moment, I completely was.
16.
In the weeks before surgery, my life became the ship of organization I had always longed for. I paid the bills and put my gym membership on hold. Tula’s shots were updated, my teeth were cleaned. My freezer brimmed with decent one-zap meals. I rolled up the throw rugs (deadly for crutches), moved the houseplants inside, brushed the dog, and filled the pantry. I bought five thick novels and enough ibuprofen and lemon seltzer to stock a Red Cross tent. My friend Donna, an expert in public health, went with me to hip-replacement class at New England Baptist Hospital, where they handed out pens in the shape of a femur. I took four pages of notes with mine. We listened to surgical nurses and physical and occupational therapists; we learned how to get into and out of bed, climb stairs, carry dinner around one’s neck while on crutches. There was a camaraderie with the other forty-plus people in the room, who looked to range in age from their mid-forties to their eighties. One of the youngest patients was a man who said he was forty-five and had been working three jobs for the past two years, in order to take off the time he needed to recover.
I made a list called Friends of Gail, both for my peace of mind and for letting people know I was OK. Then I looked at the list: neighbors and dog people and rowers and writers and AA people and women from the gym. So yes, they happened to be cooks and carpenters and therapists—everyone you’d ever need to run an island—but they were also full-hearted: someone you’d holler out for during a tornado, or walk through fire to save. It was as if God had said, “List the amazing people you know,” and I did, and they turned out to be my friends, loyal and loving, and I was about to find out how much that was true.
Here were the realities and restrictions of the next few months: I lived alone in a two-story house with a fifty-five-pound young dog. I couldn’t drive for six weeks or bend at the waist more than ninety degrees, and was directed to use two crutches for every step (their italics). I couldn’t cross the vertical axis, or midline, of the body with my operated leg, or twist in any way that would rotate the hip. This restriction effectively keeps you in a straight line from rib cage to toes. To get into and out of bed, I had to use my strong leg as a crane to hoist the other one. I had a reach stick that could pick things up off the floor; a contraption with pulley straps that helped me put on compression stockings (a job that took thirty minutes the first time I tried, with Donna helping). I had a “dressing stick,” a euphemism for a cruel little device for grabbing socks and shoes that, once tamed and befriended, becomes to the patient like fire or the wheel. I could not sweep the floor, pick up the newspaper, bend over to pet the dog. By the time I came home from surgery, my house was outfitted with a shower chair (later recalled!), a raised toilet, a walker Peter had found in his basement, exercise instructions in every room, crutches, canes, and seven gel packs in the freezer.
I suppose all of us consider our loved ones extraordinary; that
is one of the elixirs of attachment. But over the months of pain and disrepair of that winter, I also felt something else that made the grimness tolerable: I felt blessed by the tribe I was part of. My fifties had been about loss: Caroline, my father and mother, then Clementine—all had died within a span of six years, almost to the day. Yet here I was, supposedly solo, and the real truth was that I had a force field of connection surrounding me.
When I had told Peter, months earlier, about what awaited me, I prefaced the news with a framework. Our brother-sister friendship is usually gruff and half-kidding, mostly about the dogs, so I send up a flare when deeper subjects are addressed. “I need to tell you something important,” I said that day, all good cheer so as not to worry him. I hurried through the outline: what the X-rays had found, total hip replacement, crutches, months of rehab. Then I took a breath.
Peter looked expectant. “Well, the dog is covered,” he said. “I’ve got that. But that’s it, right? You don’t have cancer or anything?”
It was pure Peter, an endearing moment that would repeat itself over the coming months with other friends and other needs: Oh, OK, got that. But that day I remember feeling the treasure of the unspoken—of brusque dialogue between friends whom you simply trust and count on. What Peter was saying was that he would walk Tula every day, in blizzards or rain or when he was tired, for several months and sometimes twice a day. For however long it took.
I finished my thirty rows at the end of September. I washed down the Van Dusen, now twenty-five years old, and settled it in its bay and told it aloud that I’d be back. Surgery was scheduled for mid-November, but the first week of October I got a call from Dr. Mattingly’s office offering me a date three weeks earlier, and I grabbed it. The new date meant I got a jump on all that pre-op dread. That it was now going to happen on Halloween morning—one of my favorite holidays—seemed a good omen. Tula would go trick-or-treating with Shiloh and Peter and Pat while I was sleeping it off at New England Baptist. I spent five hours at the hospital for a preparatory visit: the digital bone scan, more X-rays, blood donation, meetings with social workers and occupational therapists and pharmacists who went over every detail. For two days I washed down my hip and leg with an antiseptic solution.
The night before surgery I had my final swim for at least six weeks and said good-bye to my throng of women at the gym. My friend Chris, an assistant swim coach, was a long-limbed, five-foot-eleven-inch physics teacher, so fast in the pool I called her “Neutrina.” She declared that on my return I would be Titania, named after the high-tech components of my new hip. Originally connected by where we had landed in the locker room, my gym friends and I were now joined by stronger stuff: I’d gotten to know two different women when they lost their beloved dogs; I’d seen food drop-offs on the benches for a woman whose husband had suffered a stroke. We may have been there for the pool or the treadmill or Pilates, but the heart got a workout, too.
Another crucial stop before surgery was the AA meeting I’d routinely attended for twenty-seven years—a place that, from my experience, was such a bin of compassion that no fear was too much to take there. I’d stumbled in during the summer of 1984 and said, for the first time aloud, “I’m an alcoholic,” then burst into tears; in the ensuing decades, I went there for a weekly dose of wisdom, courage, and high entertainment. AA broke down demographics of race and class and gender; a few blocks from Harvard, our meeting had regulars from the university, halfway houses, old Italian neighborhoods, South Boston, and the suburbs, and drop-ins from other countries. The elevator on the way up to the meeting had a sign engraved near its emergency button that read HELP IS ON THE WAY, and every time I saw it I smiled.
It would be weeks, probably months, before I was strong enough to get back here, so I was soaking up as much insight and hope as I could muster. But of all the advice and support I received, the one comment that stood out after surgery had come from a young guy who liked to remind people how tough he was. He’d had shoulder surgery a few years earlier, and the night I came to the meeting to say good-bye, he broke role long enough to slap me on the back as he was leaving. “Rehab sucks,” he said, “but you gotta do it.” And in every grueling exercise I did in the next few weeks, I could hear Richard goading me on.
My fears were amped up for a couple of reasons. The first was that I was going into this with muscles and mechanics compromised by polio, and no one—no surgeon or physical therapist or psychic—could forecast with certainty what or how much I would get back. I might wind up with a gladiator hip joint and a leg that still didn’t work too well. The damage done over the past twenty years—the amount of time I could trace my decline—was a noticeable decrease in strength, flexibility, and endurance. I now walked up stairs with one leg and a handrail. My left leg did most of the work of walking; my right had become so weak it was a pivot and cane, following the left leg’s lead. Musculature is what holds up the skeleton, and my internal scaffolding had all but collapsed.
It was a chicken-and-egg dilemma: Had the damage from polio been the causative agent in my hip’s failure, or had my hip’s breakdown been the reason for further muscle loss? This mattered greatly for one main reason: It would define how much strengthening and possibility I had before me. How well I could walk again. I wouldn’t know this for months, and I knew I wouldn’t know it, and that my leg—more than any doctor or prognosis—would be the one to tell me.
The other reason for my anxiety was that whatever denial I had used to get through the past few years had been abandoned. After my crash course in Dr. Mattingly’s office that first day, I now needed to know precisely what the procedure entailed so that I could get into the psychic state to allow it. I was increasingly conscious of how protective I had always felt toward my right leg, which had worked so hard to keep up with its mate and suffered so many slings and arrows. I could be merciless about pushing onward: to swim farther, work harder, be a better person. Too often unforgiving, my inner voice was a tough coach even in a winning season. But my leg was always exempted from this severity, for reasons I am grateful for but do not understand. It was as though some split had happened long ago, creating some shelter, or conflict-free zone, in which the wounded part of me got a free pass.
Now I was about to let a group of miracle-working strangers put me under general anesthesia while they sawed off the top of my femur and built me a new chariot. I looked at the diagrams in online medical journals about the complexity of placement and range of motion; I read about the body’s natural defense to trauma. I was terrified, but I knew myself well enough to walk toward the terror, so that I could embrace what was about to happen to me instead of flee it.
The surgery was on a Monday. The previous evening, after I swam laps until I was too tired to think, I came home and devoured a last meal, fortifying myself with roast chicken and vanilla ice cream. I got a final call from the hospital telling me to be there at 7 A.M. Avery, who lived at the end of the block, was driving me. At dawn I put baskets of peanut-butter cups on the front porch for the trick-or-treaters and kissed Tula on the head; Nancy, who was next door, would come get her within the hour. Avery was on the first shift: Dr. Mattingly would call her when surgery was over to tell her how things went, and Jean would meet me when I was out of recovery, sometime in the afternoon.
I had had no food or water since midnight, and a couple of people had warned me about the potential backup in the O.R. “Oh, God,” one alleged well-wisher said. “If they have an emergency, you could be there all day, with nothing to eat or drink.” That became my focus and worst fear, dismissed when they took me into pre-op an hour early. I gave up my contact lenses and got the obligatory johnny, and they must have given me something else, too, because I remember only vague, pleasant snatches after my first moments in the room. Avery tells me I flirted with the chief of anesthesiology, a soft-spoken bear of a man about my age who took my hand as he explained his plan. When Dr. Mattingly appeared he clapped his hands and said, “Let’s do this!” He signed my leg
with a flourish, a standard procedure I found comforting as well as symbolic. I was to be his canvas for the next few hours. The nurse at my side was wearing a Halloween necklace of plastic skulls, which delighted me. I touched her arm and said, “I have one question: What music are you guys going to listen to?”
She grinned and said, “The Beatles!” and I gave her a thumbs-up, and the next thing I knew I was in a hospital bed and it was over, and I was looking at Jean’s shining blue eyes.
17.
Here is the official surgeon’s report from that day.
Date of Procedure: 10/31/2011
Preoperative Diagnosis: Osteoarthritis right hip with polio residuals
Postoperative Diagnosis: Osteoarthritis right hip with polio residuals
Name of Procedure: Right Total Hip Replacement
PROCEDURE: General anesthesia and endotracheal intubation, 2 grams of IV Kefzol, Foley catheter, lateral decubitus position, routine prep and drape. Posterolateral incision, posterior approach, dislocation posteriorly osteotomy made of the neck. The head and neck removed. Limited anterior superior capsulectomy was performed. Osteophytes were removed from the acetabulum, which was then reamed to 53 mm. A 54 mm. cup was placed in 40 degrees of abduction, 20 degrees of forward flexion and secured with two dome screws and a neutral liner. A 36 liner was chosen because of the patient’s history of polio with weakness to the right lower extremity. Attention was directed to the femur, which was then prepared and trial reduction performed. The real implants were then inserted with the stem in 25 degrees of anteversion, sleeve in 20 degrees of anteversion. The femoral head was applied, the hip reduced and found to be stable to extremes of range of motion with a combined forward flexion sign between 40 and 45 degrees. The +6 head was chosen in order to gain length since the patient was 3 cm. short by scanogram but had a flexion contracture of her ankle. We gained approximately 1.5–2 cm. in length. The wound was thoroughly irrigated and closed in layers with the posterior capsular and external rotator repair being performed.
New Life, No Instructions Page 8
