What to do?

More mountain climbers die on the way down than on the way up, partly because they become so fixated on reaching the top that they ignore things like time, fatigue, and deteriorating weather. The more energy a person devotes to something, the harder it becomes to change directions. I see this in myself. I live as if I were a train on a track.

I seldom leave home or have a visitor, and the phone rings only for Peggy. Unable to do much else, I listen to the rain and edit my journals, all the while promising myself that I will seek publication someday—I’m too depressed to make the effort now. I’ve edited 2,000 pages over the years and have only 200 to go. Maybe when that’s done. Maybe when my knee is better, and the weather is nicer, and I am less depressed, I can face buying a Writers’ Market, or learning about web publishing. Much of my writing is marketable, the question being how much trouble I am willing to go to, and how many alterations I am willing to endure.

If I don’t publish, my writing will probably die with me, yet how odious is the publication process and how scant the reward. For years, I have been unable to either go forward or to give up the idea of going forward; so I keep finding reasons to procrastinate.

I need to say something positive because recording only the negative limits my thinking to the negative. I enjoy re-reading my work. My humor is dry and original, my phrasing clever. I possess depth, intelligence, and poignancy; and am uncommonly honest even when I appear less likeable for being so…but I am boring myself. Actually, I am just waiting for summer to arrive and my knee to improve, so Peggy and the dogs and I can go to the mountains.

Jack Ketch and his famous knot

I attended a presentation on public hangings in Oregon last night. I was specifically interested in the knots that hangmen used, because it is my understanding that the so-called Jack Ketch knot (named after a 17th century London executioner) of movie fame was less popular than simpler slipknots. The matronly speaker said that this was not the case in Oregon, adding that she had seen a Jack Ketch knot in a museum.

I hadn’t imagined that the same knot would be used repeatedly, although this would explain why hangmen’s ropes sometimes broke. Ropes can only survive a limited number of drops, which is why mountain climbers throw away ropes that still look good. Age also weakens a rope, four years being the maximum for climbing ropes even if they are unused.

I was also interested in the disposal of the bodies of the executed because my lodge has the skeleton of a man who was supposedly hung (literally a skeleton in the closet). The speaker said that the two men who were legally hung in Lane County were buried, although she couldn’t speak for those who were lynched.

Even many legal hangings were botched, with the prisoner either strangling or being decapitated. The real life Jack Ketch was notorious for such ineptness. Ironically, he never hung anyone, and didn’t even create the knot that is named for him. Instead, he used an axe, which he welded so badly that he once took eight blows to sever a man’s head. His victim spent much of this time complaining bitterly, because he had tipped Jack to expedite the proceedings. When Jack Ketch died, his name was popularly applied to subsequent executioners, which is why—when hanging became the method of choice for executions—the knot of choice bore his name.

Knotted ropes break under less strain than unknotted ropes. The common square knot, for example, weakens a rope by 50%, because it is tied with 90° turns. Knots with numerous and winding turns are stronger, which means that the hangman’s knot is a strong knit indeed.

I suspect that my knot repertoire numbers about a hundred, although I rarely have need of them. Tape, hooks, screws, nails, straps, buckles, buttons, snaps, zippers, Velcro, bungee cords, and tensioners, have made knots nearly obsolete. So, why study knots? People who love knots are brothers to those who love steam engines in that both are drawn to inventions that have been superseded in practicality while remaining unequalled in beauty. Much of life is that way. Few of us would want to cook over an open fire, yet stoves and microwaves are ugly by comparison.

Letter to a volunteer

My letter to the volunteer receptionist at Sacred Heart:

I am sorry that I do not remember your name. I tried to get it from Sacred Heart, but they have a policy against giving out even first names.

I came to Short Stay for knee surgery on February 6, at 11:30, and you checked me in. I noted that you were a volunteer, and that you were polite, efficient, immaculately dressed and groomed, and that you had what I took to be Parkinson’s. I was struck by how much work it must have taken you to get ready and come to the hospital, and I said, “May God bless you for the work you do.”

I learned during my surgery that I have advanced arthritis, and I was advised to permanently limit my activity. I had not expected this, and took it hard because I am a hiker and a lover of hard physical labor. I became increasingly depressed after surgery because my failing knee and enforced idleness caused me to look at the fact that, at nearly fifty-seven, I can only expect my body to deteriorate over the coming decades. I wondered how people cope with this, and I wrote of my problems to an elderly penpal who is battling bone cancer. He too had been a laborer and an outdoorsman, and he had much to say over the course of several letters. I will include some of it. Perhaps, it will cheer you too someday.

“Just keep looking on the bright side no matter how dark the other side looks. Enjoy out of life all you can and the other part won’t go away but will be easier to accept.”

“At the age I am now at, I’m just thankful that I can get out of bed in the mornings and do a few of the things I would like to do and not worry about the things I can’t do. A man can get to the point of worrying so much about what he can’t do that he can’t even do the things he is capable of doing.”

“I know what it means to have to give up things you enjoy doing, but keep a good outlook and other things can replace the ones you can no longer do and enjoy. I used to love stream fishing. I mean wading up a stream and casting bait ahead into the deep holes. That I can no longer do, but that doesn’t keep me from fishing the lakes and rivers with a boat, nor does it keep me from playing my guitar or driving my car on sight seeing trips to places I’ve never seen or to places I want to see again. A person just has to adjust their priorities. Sometimes a person has to change their whole way of thinking.”

Yet, he admitted that, at times, his illness really gets him down.

“I’ll tell you Lowell if it hadn’t been for my wife, music, and dog last summer I would have cashed it in. I was so sick, in pain, and tired of life I just wanted it to end. I’m 74 years old now and am enjoying what time I may have left.”

“I don’t do much work any more as I get tired very quickly, and my joints and muscles just won’t take it any more. I’m lucky if I can go out and clean up the yard of dog droppings every few days.”


Something else that helped was my thoughts of you. It was not just my observation that you were battling Parkinson’s, but that you were battling it with grace and heroism. I was humbled by your strength and goodness, and, when I was low, I would picture you sitting there at your desk, and a tear would come to my eye.

I would like for you to remember me if ever there is anything I can do for you. I would be honored to be called upon.

That awkward stage

I took a stroll Friday, eleven days after surgery. I couldn’t walk without limping unless I kept both knees bent. This gave me a Groucho Marx gait—a slow Grouch Marx gait—that attracted the curiosity of the few people who saw me. Saturday, I walked twelve blocks, almost normally; put my crutches back in storage; and returned my borrowed wheelchair to the lodge. Sunday morning, I took a bike ride, and worked on my feet the rest of the day.

Sunday night, I biked twenty blocks to the hospital to meet Peggy when she got off work. My knee was by then swollen and unbendable, so I had to pedal with my right leg while holding my left leg out to the side. (I propelled myself by repeatedly pushing the right pedal down half a stroke and pulling it back up with my toes.) The dogs ran behind me, off leash as usual. As soon as I awakened today, I got the bike out of the garage to see if I could still ride it, and was pleased to find that I could.

I have been spending a great deal of time during my convalescence wondering what to do with the rest of my life, and deprecating myself for being unable to think of anything. The house and yard will always require work, but I have finished the big jobs, either permanently or for the foreseeable future.

I always thought I would devote myself to writing and studying if I had the time, but I’ve found during my brief indisposition that sitting for very long might not be hell, but it’s pretty near purgatory. I am also utterly pessimistic of getting published and equally loathsome of the process. Finally, I cannot very well allow myself to write and study while Peggy is earning our keep, so, for now, I am at a loss. Each part of life presents its challenges, and all of them have struck me as what my mother called that awkward stage.

How low I have fallen

The surgeon drained 30 cc’s of fluid from the back of my knee yesterday. Fluid accumulation is a painful and recurrent problem for me, and I asked him for a couple of syringes so Peggy could drain it at home. He gave me some the size of canning jars so she won’t have to stick me twice. He was pleased with my progress; removed the bloody tape from the three puncture holes; told me I could begin taking showers, and said I should return in two weeks for a final checkup and a prescription for physical therapy. Meanwhile, I am to avoid walking as much as possible, and keep the knee iced and elevated.

Walking hurts, and I am obliged to do it slowly with my leg straight. If I am at one end of the house and need at from the other, I dread the trip; and God forbid that I should have to look for anything, because the pain increases with every step. I stopped taking Darvocet after I read about the side effects. I last took it in preparation for Fred’s funeral when I downed the maximum dose. Happiness and tranquility rolled over me in warm waves, and I understood how people get addicted to the stuff. On the downside, I felt as if my IQ had been reduced by a third.

I use one crutch around the house, and a combination of crutches and wheelchairs when I leave home. For example, I will use crutches to get inside a store, and then borrow one of the store’s wheelchairs. So far, I have had my pick of electric or manual, and I go for the manuals, because they are fun, fast, and maneuverable. I also have a wheelchair at home that I use when I want to take a little walk. Playing around with wheelchairs has been the only enjoyable part of all this. I often get myself into trouble while traversing slopes or trying to maneuver through heavy doors, and will use my good leg to extricate myself. Last night, I ran a wheel off the pavement, and, if I hadn’t been able to use my leg to push myself out, I would have been forced to yell for help or lower myself from the chair.

I’m unaware of any great change in the way people treat me now that I’m disabled. I am curious about how I look to others—like a cripple, or like a normally robust man who has been temporarily sidelined. Some tell me that I look like I’m in pain—I am—and those who know me say I look un-natural in a wheelchair. Indeed. How low I have fallen now that I am reduced to using elevators. I will catch myself grieving for my lost mobility, but will just as quickly feel ashamed since my condition is neither severe nor long-term. Sometimes, I pretend I’m Ron Kovic in Born on the Fourth of July, not because I identify with Kovic but because pretending to be Franklin Roosevelt or Steven Hawkins is too much of a stretch.

I take a wheelchair ride to a funeral; comfortless dotage

Six days post-op. For several days, I could bear almost no weight on my leg, and since I was supposed to keep it elevated above my heart, I couldn’t even work while sitting. Now, I can walk short distances without crutches, but every step hurts sharply. Lying and sitting hurt too, though not as much. I am concerned about my slow progress, yet it is still a great boon to be able to ambulate without crutches, because I can at least carry things and do housework.

I attended a funeral yesterday. I could have driven, but didn’t want to. I also considered biking, but was daunted by the prospect of putting my left foot down gingerly and in a straight-line every time I stopped. Then came the realization that my range of motion was so scant that I couldn’t pump the pedals anyway. I finally went in a borrowed wheelchair (the funeral being but ten blocks from home). Peggy pushed me part way, and I wheeled myself part way. I left the wheelchair in an empty room upon arriving, because I didn’t want to make my situation appear worse than it is, and because I didn’t want to draw attention away from the service.

The deceased was an elderly lodge brother, Fred Haase, who united two seemingly opposite personality extremes. One was the courage and tenacity to fight vociferously and without regard for personal cost for what he considered right. The other was the ability to cry often and openly when touched by a kind gesture or a sweet memory. I had thought that many of the speakers would make mention of this, but none did, so I felt obliged to limp my way to the microphone and do it myself. His son spoke last and validated the accuracy of my perception. His first words were, “My Dad was a great Dad,” and I wished I could have said as much about mine. I also wondered what my son—if I had a son—would say at my funeral.

My recent surgery took me from being able-bodied and multi-talented in the morning to being an invalid in the afternoon, and I reflected that the latter state would draw more and more upon me with the passing years. When I combined this thought with my knowledge that there is no one who I can depend upon to care for me, I felt dismayed. I still feel dismayed. I cannot think but that the day might come when I will have to choose between suicide and a comfortless dotage. The decision might seem easy enough then, but now it strikes me as like being trapped in a burning high-rise and having to choose between flames and pavement.

I see the surgeon in three days, and, if all goes well, it will be for the last time. I have called his office four times since my operation (three time with the same concern) without once speaking to him or getting my questions answered. If I had listened to my pre-surgery reservations, I would have changed horses in midstream. It is bad enough to endure the aftermath of surgery, but the pain and disability combined are not so grievous as having a doctor who does not care.

Heroic old lady

The volunteer who checked me in at the hospital was a woman in her upper seventies. Two things struck me about her. One was that she was impeccably dressed and groomed. The other was that she had Parkinson’s so bad that it was only with the greatest difficulty that she succeeded in checking off my name. I thought about how much work it must have been for her to dress herself and come to the hospital to help other people, this against the hopelessness of her illness. “May God bless you for the work you do,” I said.

I seek out books by people who survived disabling injuries and became mentally stronger for the experience, but never have I seen one sitting before me on a day I was going to have surgery. I grew up thinking of young valorous men as heroic, not old ladies with Parkinson’s. Yet, the heroic acts of the young—soldiers in battle for instance—are often over in a moment, and might not have been done at all had there been time for reflection. That woman has to get out of bed everyday of her life knowing that she is facing a protracted and fatal disease that will make her every movement—her every breath—a little more difficult. As I lie around the house feeling sorry for myself, I think about her, and I think that, if God has a face, it must look like hers. In the quiet way in which she placed an X by my name, I saw all the courage and all the nobility to which I could ever hope to aspire.

The mountain lion of disability

I am of better cheer today, three days post-op. I had little pain until Peggy removed the ace bandage on Tuesday to change my bloody dressing. The bandage had done an admirable job of keeping the swelling down, and having it removed for even a few minutes caused significant pain. Until the dressing change, I had taken only one Darvocet—and it at Peggy’s urging rather than because I thought I needed it. The dressing removal changed all that, although I only drug myself when I am in such pain that I would feel silly not to.

I prefer some pain, otherwise, I would be apt to go back to work, specifically on the bathroom exhaust fan. I spent much of last week doing everything I could to get everything ready for this week, only to have the louver in the bathroom fan become stuck the night before surgery.

I slept with my bed tilted downhill last night so the knee could drain, and I found the position far superior to having my knee on pillows. I observe the disgustingly misshapen thing without recognition, and hope fervently that I never have to go through another surgery. If I do, perhaps, I will have learned to cope better.

I lay in bed yesterday looking at the walls and ceiling that I so recently painted; then out the window at the trees I so recently pruned; and I thought about how difficult it is now simply to make it to the bathroom. I reminded myself that all will be better in a few days, but the thought came to me that, if I live long enough, all my days will find me helpless. Then what? I will have no family to care for me (Peggy either being dead or in poor shape herself). I will have my savings, but how long will they last if I become as vulnerable to con men as many old people?

When I was younger, I could scarcely imagine my body disintegrating; my mind, not at all. Last night, I could not remember how to turn on the light over my bed. I stood on my crutches in the dark for thirty seconds before I recalled that it has a pull chain, the same pull chain that I installed years ago. I have many such lapses, and they tell me that the one thing I had trusted to last, the one thing that I had thought of AS ME, is as perishable as an arthritic knee.

Today, I am getting my strength back, and such thoughts don’t strike me as any new or great revelation, but it is one thing to contemplate my dissolution when I feel strong, and quite another when I need help putting my socks on. The difference is like that of going into the woods knowing that I might catch a glimpse of a mountain lion, versus going into the woods and seeing a mountain lion stalking me.

Assembly line hospital

Sacred Heart was like an assembly line in which patients were passed off as quickly as possible between admissions, short stay, pre-op, post-op, o.r., and back to short stay. I was seldom asked if I needed anything; and clerks, nurses, aides, stretcher pushers, doctors, and sundry technicians appeared above my face in surprising numbers only to disappear as abruptly as they came. Being flat on my back much of the time, I was frustrated by my inability to know what was going on or even who was in the room.

During surgery, two people who I couldn’t see stood in a corner disparaging conservative politicians before saying goodbye to still other unknowns. My surgeon was unrecognizable behind mask, cap, and glasses, and, since he didn’t speak to me, I didn’t know he was present until he began the procedure. The anesthesiologist stuck the deadener in my back, but never asked how I was, and I couldn’t even tell that he was in the room. The operating staff began discussing their next patient while I was still on the table. Such impersonal treatment angered Peggy who is accustomed to attending to one or two patients for an entire shift, and, if they are still there, attending to them again the next day. The best I could offer was that some of the staff had seemed more constrained by time than compassion.

I thought it a very great thing to be able to see—live and in color—the bones and ligaments within my body. No one had such an opportunity until a decade or so ago, and very few have taken it since. I also found it unsettling to look at structures that appeared so very fragile, and that served as vivid reminders of my degeneration and mortality. The glistening curves of my bone ends looked no different than those of a freshly slaughtered hog, and the bright surgical light bounced off the back of my knee cap like sunlight off the moon.

Despite the impersonality of the hospital, I remain very glad that I have access to modern medicine with all its drugs and gadgetry. The accounts I read of Himalayan expeditions often describe the extreme poverty of places where doctors are rare and their ministrations primitive. I’ve read of porters who had no economic choice but to work despite leg fractures. No matter how tightly bound, the bone ends stabbed into their flesh with every step, and, if not for their many dependents, their best hope would have been that infection took them quickly. These are the kinds of places where children still die from vitamin deficiencies. Yet, even in this country, we can but prolong the inevitable, which means that a Nepalese porter who dies from a broken leg might suffer less than an American who is kept alive as long as possible by every means possible.

I am still relatively new to age-related degeneration, and I have yet to understand how people bear it. When your joints, teeth, ears, eyes, and taste buds, are failing rapidly, and you know that a significant portion of your remaining years will be spent in doctor’s offices, hospitals, and nursing homes; how do you find a point to it all? I went to the hospital to have my knee fixed, but came home with the knowledge that its failure has only been postponed for a brief time unless I am willing to give up much that I love. I can try to measure the worth of my life in terms of how much I can still do rather than it terms of what I cannot, but for now I am overwhelmed by the latter.

I got through yesterday partly by quoting poetry to myself. One poem goes, in part:

My mind to me a kingdom is,
Such present joys therein I find
That it excels all other bliss
That earth affords or grows by kind…

I laugh not at another’s loss;
I grudge not at another’s gain;
No worldly waves my mind can toss;
My state at one doth still remain;
I fear no foe, I fawn no friend;
I loathe not life, nor dread my end

Some weigh their pleasure by their lust,
Their wisdom by their rage of will;
Their treasure is their only trust;
A cloak├ęd craft their store of skill:
But all the treasure that I find
Is to maintain a quiet mind.
Sir Edward Dyer

I really must find a way to remain at peace in the face of the inevitable.

Surgery day

I only slept a few hours last night before drinking a half-gallon of water and a mug of coffee before my NPO deadline. I am less nervous today. I am cheered that the sun is breaking through the low clouds; I am enjoying a few final sips of coffee; and I am happily anticipating stopping off at the library on my walk to the hospital. I’ve been reading one mountain climbing epic a week along with books on knots and orienteering. These are old interests that I return to at least once a year.

For all my love of knots and wilderness navigation, I do little of either. I often use a map and compass to identify one mountain from the summit of another mountain, but I seldom have to rely on them to find my way. I fantasy doing so, but would have to go without Peggy as she would object to the undergrowth and fallen logs. This means that I am not likely to go at all since the pleasure I find in going to the woods comes more from her companionship than from the woods itself.

I never climb any of the high mountains that I read about either, which strikes even me as odd since I don’t just read about climbs, I also read about climbing equipment and techniques. Am I not tempted then to give technical climbing a go? Not really. I get enough thrills from reading about other people’s thrills.

People who seek danger are of a different breed than I. It takes more to physiologically stimulate them, and I resent the fact that many of them glorify their need for danger as a hallmark of superiority. I must confess, however, that I am no better. I might admire the guts and determination that it takes to climb an 8,000-meter peak, but I also feel superior to those who need to do it. I don’t use the word need lightly, because people who are obsessed with danger are very much like people who are obsessed with liquor.

True, Peggy has climbed, but driving three hours to Mt. Hood and coming home the next day is worlds apart from traveling halfway around the globe and spending months on K2. These are people who evolution failed, and they in turn fail everyone who tries to be intimate with them, most tragically their children.

Time to shower and walk to the hospital. Check-in is at 11:00; surgery at 1:00.

Later

I had a spinal anesthetic without additional sedation so I could remain alert. My arms were positioned straight out from my body, Jesus style; and my legs tingled, although I couldn’t tell what was being done to them. I looked up at one point and was surprised to see my left leg being held two feet off the table while it was scrubbed with Betadine.

I was cold no matter how many blankets they piled upon me, and the surgeon joked that I would be charged for the extras. His description of what I was seeing on the color TV was very different from what I expected. Since cartilage is a membrane, I assumed that torn cartilage would appear as sheet-like fragments. Instead, it looked thin and feathery as it undulated slowly in the five quarts of fluid that were pumped through my knee. There was also a lot of it. The surgeon attacked it with a conical-headed device with revolving blades that chewed it up and suctioned it away.

I was pleased and entertained by the process until he said that I have stage three to four arthritis (four being the worst). I wasn’t prepared for this, and became nauseated when he suggested that I avoid long hikes and working on my knees. He pointed out jagged bone spurs that protruded ridge-like above the cartilage as well as spots where the cartilage was completely missing. The latter areas looked like the inner bark of a tree that had been ineptly blazed with an axe.

I was taken from surgery to post-op where I had to stay until I could wiggle my toes. I was the only alert patient there, so I lay listening to the others puke, groan, and talk incoherently. I tried so hard to move my toes that I trembled from the effort, but the anesthetic was tenacious. My fingers had long since become so cold that they could no longer be used to determine my oxygen saturation levels, and I placed them against my thighs to warm them.

My legs felt like lifeless lumps of hot fat that disconnected from my body. I touched something that felt like a rolled-up washcloth, and I speculated that it might be leftover from surgery. I soon realized that it was my penis. I glanced about to see if anyone had caught me playing with myself. As I moved my hands upward, I realized that everything below my navel was asleep.

Rat poisons and taciturn surgeons

While I was admiring the neighbors’ new motorcycle today, Baxter ate a box of rat poison that he found in their garage. I caught him in the act, and poured hydrogen peroxide down his throat until he vomited. When Peggy came home from her weekend in the mountains a short time later, she told me of a dream she had the night before in which she mounted a grill on Baxter’s head so he couldn’t eat anything harmful.

I dread surgery tomorrow. It is not major surgery, and I have never dreaded surgery before, but I dread it now. I don’t believe that my dread is a premonition. It’s just that I am not a person who can sit still, and I will be sitting a lot this week—the first week in months for which pretty weather is predicted.

Then too, I don’t like my surgeon. I have seen him off and on for a decade about one thing or another, but he has never operated on me, and I have never needed so much—or gotten so little—open communication from him. When I went for my pre-op, he quickly grew impatient with my questions, so when he left the room to take a phone call, Peggy got the answers by reading my chart. I can but hope he is a better surgeon than he is a communicator.