Friday, January 29, 2016

Broken-Backed in Puerto Rico

Here’s what I’m afraid of:

1.     Children on bicycles.
2.     The Carnival cruise ship ladies turning the corner at the Pandora store
3.     The sidewalk
4.     Anyone who has a cell phone
5.     My cats

These are by no means the only things: the bathtub terrifies me, for example. But if I leave the list incomplete, it’s really to protect myself, since I cannot dwell on the things that scare me. Yes, I could, I suppose, barricade myself in the back bedroom (closer to the bathroom): my doctor would love me to do that. But however alluring a two month sentence of bedrest may sound, trust me, it's not. Yes, I vowed to read The Brothers Karamazov, and War and Peace, and Don Quixote (again, but this time in the original), but I don’t have the strength.

You may wonder—how much strength does it take to read a book? Well, even Great Expectations—which I read before I was a teenager—proved too much for me: I flinched when Uriah Heep was about to put the screws to Mr. Wickham.

What happened?

Some night in the middle of November, I awoke with a Charlie horse in one of my legs. This was hardly unusual, and I did what I always had done: spring out of bed, grab the footboard, and force myself to stand on tiptoes. It works, though the muscle usually remains sore. But on that night, I fell hard, harder than I have ever fallen, and onto a marble floor.

I remember the sound of it—since a falling body (that is, a human body) makes a quite distinctive thud. I know that I moved myself off the floor, and was able to clamber into bed. What do I know after that? Very little.

I had grown up seeing my mother with her periodic bad backs, and I vividly remember her going on hands and knees to the bathroom during one particularly bad spell. And so she had seen a variety of chiropractors. What had happened to me, I imagined, was the same.

It’s true that the pain was more severe than anything I have felt in my life—but is that surprising? I am lucky to have good health: never to have been hospitalized, never to have broken a bone. Dental pain—yes. Childbirth—duh, no. And never, thank God, migraine.

I remember only fragments: the rest I gleaned from my husband, Mr. Fernández: I got up to eat dinner, for example, but it was he—not I, as it normally is—who went to the grocery store. I know that I took a hot bath every day, and that in the process, I learned the first of many physical routines that I had never contemplated before.

I could describe it: which hand first grips the side of tub, followed by the next hand a bit closer to the front of the tub….but isn’t it tedious? Certainly to write, then to read, and especially to live.

Tedious, but necessary.

I am a restless sleeper: various lovers, bedmates, others have described me as most of the way toward full swirling dervish status. But to turn in bed was an agony. I would stay in one position—ignoring my desire to turn onto my other side, or onto my back—as long as possible. That, of course, was counter-productive: by the time I could longer stand it, I was thoroughly awake. And so, at some point before maximal discomfort, I would grab the headboard, flex my knees, lift my torso, and then plop down onto the other side. There was, of course, one moment of necessary torsion, and that was when a lightning bolt struck the base of my spine. So if I were not already half awake, I was certainly awake now.

The solution, was to focus on my breath, and to keep the mind clean—old Buddhist tricks, but never had I practiced them as I did then: I counted to ten—inhale and exhale, inhale and exhale—for hours, then days and finally for a week. I felt the cool air on inhalation rustling the hairs in my nose. The warmer air of exhalation soothed the top of the nasal cavity. Through it all was a pain that made even thinking about movement an agony.

Let me jump ahead of the story to tell you: my internist asked how I was treating the pain, which she said must be excruciating. Later, the doctor who admitted me to HIMA hospital asked me: “what are you taking for the pain—morphine?”

In fact, I was taking Acetaminophen and Ibuprofen, on the advice of my doctor. Did it work? Not really, but it was something to take—I then, thinking that I was in muscle spasm, sent Mr. Fernández off to beg the pharmacist at Puerto Rico Drug Store for Cataflam.

It’s a secret in everyone’s mouth—or on everyone’s lips—that the local drugstores will happily supply you with antibiotics and anti-inflammatory drugs pretty much on demand. True, you may have to invent a good reason or two—your doctor left for six months to treat the refugees in Greece; you are boarding a plane for Thailand in the morning. The pharmacist will smile, and give you drugs in little plastic bags, one size up from a nickel bag of dope. So Mr. Fernández went off and begged, returning with two bags, upon which something had been scrawled. Was that a problem?

I am normally a fanatic researcher of drugs on Google: am I willing to put just anything in my body?


Hell yes!

You could have given me rat poison, and I would have swallowed it by the bucketful, if I had thought it would have taken away the pain. In fact, even if I had known that it was rat poison, I might have taken it. And here I will say that if there had been a gun in the house? You wouldn’t be reading this.

No one can describe pain—but there certain things that it does. First, your world shrinks: before the fall, I had worried about things that seem insane, now. What was the Afghani army doing keeping sex slaves? Or was it the Iraqis? Whatever, I would have known about it, and worried about it, and perhaps even written about it. I would have known that in December—when everybody was busy and anyway had forgotten about it—the Vatican had at last released the autopsy results of the pederast prince of the church, Jozef Wesolowski. Ah, and how I would have snorted to read that no, there wasn’t a trace of any drugs or medicines or substances—not even a bit of alcohol from a glass of wine—in the ex-papal nuncio’s blood. Nope—he was clean as a whistle, that man who so conveniently had a “heart attack” the night before the first day of his trial, landed in intensive care,  and then had been able to be released from the hospital two days later. (Is there any other explanation than drug overdose that could explain that?)

Yes, I would have worried about this, because I didn’t have a body. Well, I did, of course, but having a body is really sort of a nuisance. One has to wash it and take it to get its hairs cut and feed it, of course, but really, having a body is not interesting to me. I do not make it run with balls to put through hoops or take across white lines in stadia or kick into cages. So what are we talking about? Horrendously poor design, since the only thing I have a body for is to support my brain, and let me play the cello. I contemplated this on those many nights when an antidepressant—Remeron—had driven me to crave Peanut M&M’s. For those of you with healthier diets, it’s the M&M with two little feet, and a bright smile.

Thus, there is NO reason why half of my body has to be legs. And if we eliminated 90% of my legs, everything else could be downsized, too. And consider toddlers—do they fall, those charmers just learning to walk?

Of course, and so close to the floor are they, they barely notice it. And so they get up, take two steps, fall again, etc. Walking and falling are twin processes for them, but for me, at six foot three? I was being dropped from the Empire State Building.

And so, now space—which had included the Vatican and Afghanistan—was whittled down to (for most part) the bed, the bathroom, and (reportedly) the dining room table. And as for time? Well, the dreaded Monday morning of anybody with a job had nothing for me. And so, days meant nothing, nor did day or night: I was just as likely to be awake at 3 in the morning as at 3 in the afternoon. And so I was floating in time and space, and the only thing that tied me to any sort of reality?


In the midst of it, imagining a time—such as now—when I would be without pain was impossible. Even in death, I would be in pain, and I spent that week in a suspension of agony.

Pain is different—I suspect—for different people, and in different cultures. What if the same injury had happened to me on the battlefield? Would I have experienced it in the way that I did? I think not: I would have run in retreat or—adrenaline pumped—continued to charge. And what I were Puerto Rican, and not gringo? Would I have reacted the same?

A nursing instructor had once told us: Norwegian-Americans are stoic. True, they may have their detached arm lying in the fields, and their amputated stump is shooting blood like a Monty Python sketch all over the ER, but “no, Doctor, I’m perfectly fine—you go off and take care of someone who needs it more than I….” So with these patients, you have to ask probing questions, and quite specific, as well. They will grudgingly admit—if you ask them—that they have an elephant sitting on their chest, they can’t breath, they are nervous. Otherwise—they’re fine.

With Puerto Ricans, the instructor explained, this tactic is disaster, because they have anything that you might suggest to them. And if they don’t have it? Ah, well then they will, and it will be the worst, the most extreme, the most horrific of its kind!

To test this, in my irresponsible youth, I had once asked Mr. Fernández if he was experiencing any itching under his fingernails.


This is unique in the medical literature, but did I tell him that? Of course not. And so I simply ask—when he is ill—what he is feeling, and I get most of a medical textbook of symptomology. I then discount by half, ands decide what to do.

And so I was in bed, but I was also a gringo, and also a nurse. Or rather, I had been a nurse, so that meant that I was completely capable of making clinical decisions, right? I mean, if I needed to go to the doctor, I would, right? Or maybe the ER? Or maybe call the ambulance?

I did none of these things, because I wasn’t a nurse. I was, instead, as trapped in my pain as the deer is in the headlights, and just as immobile. The nurse walks into the room and takes charge: I was in bed, and no one was in charge.

And what about Mr. Fernández? Well, guess who tends to make the health decisions in our house? Who says, “OK, we gotta get to the hospital!” And remember that good stoicism that the Norwegian-Americans exhibit. Yes, I told him I was in pain, but in his context, if I had been aching, I would have been screaming.

And was it something else? Pain is accompanied by fear, and fear breeds denial. Was I prepared to admit that I should have been taken, siren screaming, to the best hospital on the island? You know, the one where they take the worst car crash victims to?

Reader—are you still there? Because if you are, it’s a miracle. Yes, that you carried on to the (temporary) end, but more…

…that there would have been anyone to write this.