The Body Otherwise
On my second night in the hospital, I had a dream. In my dream, I was waiting for an old friend. Instead, I found myself joining someone else, a new acquaintance, on a walk along a perimeter fence down to a schoolyard. It occurred to me that I had no trouble keeping apace with this companion and that, in fact, I was walking without pain and without my familiar limp. A wave of elation swept over me, the kind of happiness that engulfs you when you meet an old friend you haven’t seen in a long time. When I awoke, I realized that the old friend I’d been waiting for in my dream was my own body — once good and strong — returned to me as a gift.
The next morning Dr. James Bruckner stood at the foot of my hospital bed. He was the brilliant orthopedic surgeon who 48 hours before had performed a direct lateral joint replacement of my left hip.
“Doctor,” I smiled. “I dreamed I was walking normally again.”
Through his dark-rimmed glasses, Dr. Bruckner peered at me with the gentle countenance of an owl. “I assure you,” he said, “that will soon be a reality.”
At that moment I tried to hide my tears. I had waited a long time for this moment. Too long. He had no idea. Or perhaps he did. “And by the way,” he remarked before heading for the door, “your hip was crap!”
Of course, it was. This was the hip that had long exceeded its use. The hip that for five years had given me days and nights of escalating, excruciating pain.
But now the wait was over.
Shortly before she died of leukemia at age 47, the poet Jane Kenyon wrote these lines in a poem titled “Otherwise”:
I got out of bed on two strong legs.
It might have been otherwise.
I…planned another day, just like this day.
But one day, I know, it will be otherwise.
If we live long enough, I suppose, that “otherwise” moment is bound to catch up with all of us. Mine caught up with me two decades ago, while I was playing basketball at a high school reunion. While scrambling for a loose ball, I collided with another player. Hard. The impact sent me sprawling forward.
The next morning I woke up to a dull, insipid ache inside of my left buttock.
Although I didn’t know it yet, my life had taken on a new trajectory.
***
***
“It’s bursitis,” the first doctor said, confident that this bothersome ‘joint inflammation’ would disappear within six months. A second doctor concurred. Six months went by. The ache in my side niggled and burrowed, becoming the resident guest inside my body that refused to leave. The pesky ache only got bolder, sharper. Now it hurt whenever I walked.
The third physician ordered X-rays and an MRI of my hips.
Holding them up to the light, he frowned at my X-rays. “You know what you have?” Dr. Reyes said. “You have arthritis.”
“This here is the problem,” he pointed his pencil at the L hip section on the image. “The cartilage between the ball and socket is eroding.”
“It’s an old person’s problem,” he said, glancing at me briefly. “Happens to about ten percent of people your age.” At the time I was 44 years old.
Dr. Reyes tapped the desk with the same pencil. “I’m afraid it won’t get better. The body can’t rebuild cartilage.”
Sitting in my chair, I watched his lips move without taking in the words. I remember telling myself in that moment, I ought to be taking notes. This is important. Pay attention. But I was more intrigued with his hands, which were manicured and immaculate. Up until then, I had been hurtling through life like a mindless meteor streaking through time and space, barely brushing past potential disasters — until it had all caught up with me. My marriage had just imploded, the 10-year printing business that my husband and I managed together had collapsed, we had two young boys living at home, and I had lost the art of listening to what the universe was telling me. What was it now trying to tell me?
Only a moment before, I was marveling at the X-rays Dr. Reyes had pinned on the light board. Behold the wonders of the human skeleton — a luminescent masterpiece of tissue and bone housing myriad complexities. Was that really me? But how many of us remember the moment when our body betrays us? How many can pinpoint the precise hour when our body turns against us and we realize that we have lost our citizenship to the land of the healthy?
Sitting in Dr. Reyes’s office, I couldn’t see the miracle of my body. I could only regard it as an obstacle to the one thing I had long taken for granted — a superpower so basic most people don’t even think about until they lose it. It was — as a writer friend of mine once put it so well — “the ease of careless movement.”
The doctor’s mouth and jaw kept moving. “No more running or jogging—”
“What about rock climbing?” I blurted. Soon as I asked, I knew it was a stupid question. Two weeks before my basketball injury I had joined a sports camp and went rock-climbing for the first time. I was the fastest to reach the top and thought I may have a talent for the sport. The ease of careless movement.
“You can forget about rock climbing. That’s out,” said his mouth.
“And badminton?” I loved playing badminton, a sport I’d played since I was ten years old.
“Badminton requires lateral movement, doesn’t it? You need your hips for that. No, no more badminton,” he said, dismissively.
Outside the doctor’s office window, four stories below, the wet city of Manila uncoiled its tentacles like a giant octopus, contracting into one giant rush-hour gridlock.
“It will only get worse,” said the mouth. “You’ll be looking at hip replacement surgery in three to five years.”
Nothing he said was sinking in. Instead, my mind slid numbly into cold panic as I clung to my plans. I was now a single mother living in Manila, Philippines. And I had dreams of emigrating with my two teenage sons to the United States.
“What is it I can do, Doctor?”
He pondered the question a moment.
“Swimming is good,” he said. “And stationery biking.”
I swallowed the lump in my throat, beginning to feel rumblings of anger and denial in the pit of my stomach. “How about…plain…walking?”
“Walking?” he echoed absentmindedly. He ceased tapping the pencil. Together we watched it roll to a stop on his desk.
“Well,” he said, “you can try.”
The next day I set out to walk around a large, grassy polo field near our house. I’d done it countless times before. Mind over matter, I told myself. I was going to prove Dr. Reyes wrong! As I rounded the third corner of the field, having covered a three-quarter-mile distance, the dull ache in my left hip turned defiant as a knife. I hobbled home in twisting pain.
Back in the house, I lay in a supine position on the floor. Once the pain subsided, I willed my left leg to raise itself. “Up! Get up!” My brain commanded, “GET UP!” Obstinate as a log, my leg refused. After doing its job for the first four decades of my life, my left hip — this loyal hinge that allowed my leg to swing and walk — had called it quits.
A fawn, when wounded, alters its tracks. The landscape didn’t change. It was I who needed to change.
Like all people struck with a debilitating condition, I was suddenly thrust with a new GPS with which to navigate a new “otherwise” world. My once-obedient body had become unforgiving and tyrannical. It now demanded of me a reckoning and a recalibration. I had to see the world with new eyes. I began by discarding the old coordinates. Distances had to be calculated in terms of how much time and discomfort they would cost. A walk through the mall was cut in half; an errand was abandoned if parking posed a challenge.
The new GPS came with a manual. Topography was more important than geography. Geometry was my new navigation tool. How about vertical lines set off at 90-degree angles, the kind you see in staircases? To be avoided. Going up a flight of steps required weight-bearing strength; going down required traction — a double whammy on the hips.
The Easter break after I was diagnosed with a defective hip I traveled with my family to Tokyo. The Japanese subway had been our favorite mode of transportation. Now I watched my brother and sister look gently over their shoulder as I trailed behind them. They searched the subway caverns of Ginza for escalators and elevators on my behalf. These were rare. Watching the ebb tide of humanity sweeping in and out of trains, I realized that the big cities of the world are designed not for the old and disabled, but for young people in a hurry.
For the next two years, I went about my life on two legs, did my work and chores with them, and at night slept with a bolster pillow between my thighs to alleviate the throbbing pain that now never left me, even while I slept. To me, the two limbs symbolized the halves of my life. The good right leg was a memory of the active life I once had. Beyond the withered leg was a future I could not bear contemplating.
Even though I hated everything about swimming, I hired an instructor to teach me to do laps in an Olympic-sized pool. If I was moving my family to the US, I had to be strong. The instructor taught me how to do the breaststroke. He also taught me freestyle, but with an “adjustment.” He gave me a pull-buoy — a leg float — shaped like the number 8, to place between my thighs as I swam. The buoy spared my legs from having to kick and push. I powered on, with just my arms and upper body pulling the rest of me across the water. If my hip was rotting, I had to keep the rest of myself strong for the new life I was planning. I kept at it until I could swim 40 laps in a 50-meter pool.
While I swam, there was nothing to do but be alone with my thoughts. But just sitting alone with my thoughts was the last thing I wanted to do. Because then I’d have to plan. I had begun to look for an orthopedic surgeon in Manila who could replace my hip. But the ones I consulted dissuaded me from doing so. They told me that artificial hips had a limited shelf life, that I was too young to have a transplant because in 15 or 20 years I’d need another one, and the second transplant would be far more difficult to pull off.
And then there were the risks. What if something went wrong? There were reports of faulty product recalls in the news; I read about patients whose transplants went badly, and who suffered even more afterward. On top of these misgivings, no one in my family had ever had a hip replacement. nobody in my circle came forward with a strong recommendation for the one orthopedic surgeon who could operate on me. There was talk about US-based Filipino surgeons who occasionally came to the Philippines to operate on a few lucky patients. I didn’t feel lucky.
But I had a plan.
When I visited Dr. Wang, my fourth hip specialist, I wasted no time.
“Before I get my hip replaced, I want to move to the US with my children.”
Kaya ko ba? Could I do that? My question hovered in the air, my expression hopeful and defiant.
“Judging from the way you walked into my office just now,” Dr. Wang answered gently. “I think you could.”
Was he just being kind? I didn’t “walk” into his office. I listed, like a floundering ship dragging itself to a new harbor.
One cool, clear night in 2006, I took my children, ages 11 and 14 at the time, to the top of a hill. The three of us sat on the grass under the stars as I unveiled my plan to emigrate to the States. “We don’t want to go,” they told me, even though they were US citizens from birth. It didn’t surprise me. Like the grass under them, they had grown tiny, strong roots in Philippine soil. They had the good life and didn’t want to leave their friends behind. But they also knew that as minors, they were powerless in the face of their mother’s fierce will. America was their destiny, I knew that much. In America they would grow new and deeper roots and stand tall. And somewhere in the United States was a surgeon who could cure me.
There, under a starry sky, both my sons sat cross-legged on the grass. I watched them. All my life I never could sit cross-legged. I always wondered why it was so hard for me and not for others. Within a year of moving to America, I would find out why.
***
***
In the summer of 2008, my sons and I moved to Edmonds, Washington, in the Pacific Northwest. Our first apartment was located on the third floor. The laundry facilities were in the basement. Parking was a long walk to the car. With each passing month that my hip deteriorated, each walking step became more painful and difficult. I tried to look on the bright side. At least there was an elevator in our apartment building. At least I had a laundry cart with wheels. At least I could apply for handicapped parking.
“Let me get a curbside consultation from my go-to ortho guy,” a nurse friend from out of state offered. The next day I emailed her my X-rays and MRI. A week later she called. “Reni, did you know you have hip dysplasia? You’ve had it since birth.”
I learned that hip dysplasia is a congenital condition that’s found in humans at a ratio of 1 in 1,000. The shallow pelvic cavity brought on by an abnormal formation and misalignment of the femur head to the hip socket proved to be a hospitable environment for osteoarthritis. With the layer of cartilage eroding, it was only a matter of time before “bone to scrape on bone.”
“Isn’t hip dysplasia associated with dogs?” I asked my nurse friend.
“Yes.”
“So, uhm, humans have it, too?”
“Apparently, yes.”
“But they put dogs to sleep, don’t they?’
“Yes,” she said.
A pause.
“Lucky you, you’re not a dog,” she observed.
We both laughed.
“I don’t want to see you with that,” my twelve-year-old son said the day I came home with a walking cane. Of course, he didn’t understand. How could he? He was an active kid who spent his afternoons playing basketball. But by then, all vestiges of vanity I ever had were replaced by something more pragmatic: a fear of falling. Also, my son was too young to understand that I’d gotten myself the cane as a talisman to ward off the unthinkable. Unless there was a drastic intervention of some kind, things would only get worse. I had peered down the corridor of time and there, waiting for me like a quiet appointment, was the wheelchair.
My walking cane was made of light, birch wood with a curved handle and a rubber base. He came up to just the right height for me. I named him Woebegone — Woeby, for short. For the next three years, friends and family came and went, but Woeby was my constant companion. As my hip deteriorated, I used him to walk everywhere, even at home.
I liked Woeby. He never judged or talked back to me. And he was always there when I needed him. Except that one afternoon when I found myself stranded in the bathroom just as my sons left the apartment to do an errand. I got up from the toilet, remembering I had left Woeby in the kitchen. The old familiar stabbing pain dug into my side. Helplessly, I stood by the bathroom door, figuring out my travel itinerary. Destination: kitchen. How do I get there from where I am? Always the question. Crawling on the carpeted floor was out of the question. The pain would have been catastrophic. To get to the kitchen without Woeby and with nothing but flat walls to maneuver, I first had to reach for the door jams that framed the two bedrooms off our hallway, using them to haul myself to the far end of the corridor in lip-biting pain. Door jams — painted in dove white and built by carpenters for no purpose other than to hold doors in — my hands clung to them now like life buoys as I dragged my unwilling body a few steps more. Had to reach the kitchen somehow.
Looking back, I realized that had a lopsided view of time. In the kitchen was Woeby, the next meal I was going to make for my sons, the next moment, where I thought life was waiting for me. Little did I know I had arrived at a great imbalance in my life. I didn’t live in the moment. I lived for the next moment. Life, it seemed, waited for me in all the nooks and crannies where I wasn’t, and where I longed to be.
A few months after we were settled in our new apartment, I met a woman at a party. She walked into the room using a stylish walking cane. And she had just had a hip transplant! The lady gave me her orthopedic surgeon’s phone number.
When I met with him a month later, the surgeon studied my X-rays. “You know,” he said. “I replace hips and knees all the time. But I only know three or four ways to do ‘em. But there’s this talented doctor I know, and he knows six or seven ways.”
And that is how I met James Bruckner.
***
***
Dr. Bruckner declared me an immediate candidate for total hip replacement. But with one hitch. My insurance plan stipulated that I had a “pre-existing condition.” As such, I had to wait nine months before I could be eligible for surgery.
Pre-existing, they called it. I had found the doctor who could save my leg. But I was asked to wait longer. For someone in my condition, nine months felt like a prison sentence. For the next nine months, I carried in me the weight of waiting.
“It got so bad I couldn’t cross the room carrying a teacup,” an 86-year-old woman I once met told me. I understood her completely. Weight was the enemy.
For four years now I’d been living with a “scale” strapped to my brain. My mind was constantly weighing and calibrating everything. I’d ask myself: Now, this next thing you want to do. Can your body take it on? Yes or no. The reality was, one leg was now carrying for two. And so anything that weighed me down, anything that wasn’t necessary, didn’t make it out the door with me. The math was unforgiving. The smallest of change wasn’t small enough.
But God was kind. He gave me two strapping sons, and they kept me. They carried the groceries. They lugged my books. They took out the trash.
There were times, though, when I looked at my boys and I could feel my hand on life’s throttle slipping. They were now in their late teens. Both would look at me, anxious to do something fun or go somewhere. What could I say to them, knowing that the body would deny what the heart wanted?
As many times as saying it broke me, I had to:
“Boys, it’s too far to go.”
In the end, like most families, we found a way to deal with it. I adjusted my ETA. They adjusted their expectations.
Being handicapped turned me into a wait-watcher. I learned to wait. And I learned to watch. One day a friend took me to Green Lake in Seattle. We surveyed the tall trees, kayaks gliding on golden water, ducks feeding happily by the shore. The sun was out. The sky was blue. The wide footpath wrapped around the lake like a beautiful white ribbon. It was a great gift of a day. The friend said, “I’ll walk. You watch.”
As I sat on that bench, I observed couples paddling on the lake. And I was suddenly overcome by the disenfranchising thought that this is what illness can do to a person. You get disinvited from the party of life. But not before long, I started noticing the strange configuration of fallen twigs on the grass. Then, I began to study the unruly patterns of silver bark on the torso of the birch tree beside me.
It was W. B. Yeats who wrote,
“The world is full of magic things, particularly waiting for our senses to grow sharper.”
I learned to wait in coffee shops while my family went shopping. I learned to wait even for something as benign as getting out of the car. I’d drive, park the car, get out, and stand next to my car door playing for time, killing the minutes. Cars would pull up next to mine, with people alighting out of their vehicles and with doors slamming behind them without so much as a curtsy or a care. You look up faster than you can say “WALK,” they’ve dashed across the parking lot and disappeared into where they wanted or needed to be. Me? I hadn’t budged an inch. Their thirty seconds were not my thirty seconds. I couldn’t move until fluids started circulating around the decrepit hip joint and a signal arrived in my brain saying, It’s okay. You can walk now. If I disobeyed and attempted to walk before I got the signal, there was pain. An excruciating can’t-run-out-of-a-burning-building pain.
As I waited in numerous parking lots next to my car, time was now something I had plenty of. I now watched the people around me with brazen curiosity. They hurried into stores, churches, restaurants, arriving at their destinations with a breathless urgency that used to fuel my own life.
One day while standing in a parking lot and killing time next to my car, I happened to look up. To my surprise, I spied a magnificent black crow at a distance of about 50 yards. He was fidgeting on the high branch of a pine tree. I saw a flash of speed, a whir of black wing, and he was gone. The ease of careless movement.
Then it hit me. If I hadn’t evolved from a young woman in a hurry to a middle-aged woman with a bad hip, would I have seen the crow?
Slowing down had its own roadside attractions.
“When do you know it’s time for surgery?” Someone in the audience had popped the question during a joint replacement seminar I attended. The doctor drew two opposite vertical arrows on the whiteboard. “Your pain increases as your mobility decreases. You’ll know when you’re ready.”
By the time they wheeled me to the operating room for hip replacement surgery on August 9th, 2010, two days after my fiftieth birthday and after five years of debilitating pain, not a shred of fear was left inside me. I was ready for all of it — the surgeon’s knife, anesthesia, bed confinement, physical therapy, the unfamiliar road to recovery, even the risk that something would go wrong and I would never walk again.
At the end of the nine months, I was ready.
When I got home from the hospital, I was greeted by a bouquet of flowers and balloons from an aunt. My strapping sons, now aged 21 and 24, joyfully morphed into a pair of renegade nurses. Every day they’d deliver my meals to me on a TV tray, then dash out of my room like I had scabies.
“You forgot my orange juice!” I’d yell after them.
“Too late, Mom, you missed your chance! Room service has expired!” they’d yell back.
Due to the peripatetic nature of my sons, I morphed into a human Venus flytrap, snagging one of my boys each time he ventured into my room and inundating him with stuff I needed. My boys and I, we rubbed along.
***
***
When I was well enough to get out of bed and use a four-legged walker, I emerged from my bedroom only to find the hallway littered with empty boxes and junk. Instead of rolling out the red carpet for their mother, my sons had gleefully created an obstacle course. I laughed, and our laughter as a family only made my six-week recovery quicker.
A nurse came twice weekly to safeguard my blood from clotting. Hours were spent on physical therapy, as I graduated from using the four-footed walker to one-legged Woeby. I’d walk the halls of our apartment building, mentally unlearning my old walk, until the day I could cast Woeby aside and walk, alone and unassisted, with my new “bionic” leg.
“Are you loving your new hip yet?” asked the physician’s assistant during a post-surgery appointment. I never thought of a cold prosthetic made of titanium as something to love, but with each new pain-free step, I think I could. I am forever grateful for the miracles of modern medicine and for the Dr. Bruckners of this world who averted my journey to the wheelchair.
Meanwhile, the Earth is just as gorgeous as God made it, its hills and dales waiting for my footsteps. There remain a million things I want to do before I die, and I mean to do them. The world hasn’t changed, only my desire to hold it closer.
“Lord knows how many people are entering heaven with a new hip,” someone working in a nursing home once wryly observed. How the times have changed. Today, somewhere in this country is an 86-year-old woman who will slip and fall in her bathroom, break her hip, and get a new one the next day.
My journey to healing took five years. Looking back, I don’t feel bitter. How could I? If I hadn’t become intimately reacquainted with my body, if I hadn’t slowed down, if I hadn’t been given the gift of waiting, would I have spied the crow? The real gift lay not in what I was waiting for, but in the person I’d become while I was waiting. Waiting is not the same as stopping. The ease of careless movement may have been taken from me, but not the abiding grace of life and movement itself.
And Woeby? I still have him. I know I might need him again. He sits in a corner of my bedroom, patiently waiting for the next “otherwise” moment to arrive. When it comes, he and I’ll be ready.
