Doctor Baxter and Nurse Bonnie

I was telling my neighbor, Ellie, and her fourteen-year-old son, Josh, about my upcoming surgery. Ellie said that Josh had to do a certain number of volunteer hours for a school assignment, and that he could help me out with anything I needed done. “Well…I won’t be able to wipe my butt for six weeks…” I said lyingly. Josh continued looking cool, unruffled, maybe a little bored (I see him practicing this look on his way to school each morning).

Unfortunately, Josh knows me too well to believe anything I say. That wasn’t always true. When his family moved here, Josh was nine. One day, he was in the street with his remote controlled car. “Hey, Snow, look at this,” he said as he rolled the car several times. “Dude, I enthused, “that is like SO TOTALLY COOL that I’m going to try it with my van.” Here I got into the van while Josh looked at me in horror (this was before he discovered the importance of looking cool no matter what). “He’s just kidding you, Josh,” Peggy said. Damn kid hasn’t trusted me since. Go figure.

Peggy will be out of town for two weeks out of the five following my surgery. I wouldn’t mind this so much were it not for the dogs. Friends, neighbors, and lodge brothers are always willing to help out, except when it comes to the dogs which, ironically, is what I need help with the most.

My fantasy is that the dogs will help me. Specifically, Bonnie Blue Heeler would act as my nurse since she would look really cute in a starched white uniform and a nurse’s hat. There are only two things against it. One is that post-surgical odors scare the bejesus out of her, making it impossible for me to get anywhere close. The other is that she won’t wear clothes. At a Christmas party one year, Peggy tied a red ribbon around Bonnie’s neck before Bonnie knew what was happening. Bonnie was so humiliated by the ensuing laughter that she ran from the room and wouldn’t let Peggy come near her for hours. Though this happened ten years ago, it thoroughly discouraged us from ever again dressing Bonnie—that and the fact that she has extremely strong jaws and uses violence as a first response to interpersonal conflict.

My other fantasy is that Baxter Black Schnauzer—being a boy and all—would serve as my physician. He would look cute in a white lab coat with one of those round mirror thingy’s on his forehead, and his Nietzsche-like moustache would accentuate his scholarly appearance. Since he will wear clothes, the dress-up part is doable. The downside is that he’s an all-around idiot (Peggy vehemently disagrees with this assessment) and doesn’t exude an iota of the customary doctorly arrogance.

Such considerations make it clear that the dogs will be a liability rather than an asset. All I can think to do is to lock them in the garage for two weeks, and take them a little food if my head should clear sufficiently between doses of Percocet and vodka. Then again, maybe Peggy could tear open a fifty-pound bag of dog food and dump it on the garage floor on her way to the airport. They would immediately eat it all, throw it all up, eat the vomit, throw that up, and so on until her return. With luck, I wouldn’t have to buy another bag of dog food for at least a year, by which time I should be well enough to carry it home.

Two weeks from today

I am grateful for the kind words that my last post elicited. Your advice was valuable in that it told me of your caring, and because it confirmed that the advice I had given to myself was the best advice available. Sad to say, advice is not necessarily easier to accept because it is good.

Even so, my last entry—and your responses—calmed me remarkably, and allowed me room to think of things other than my fears, things like other people, for example. Self-absorption is like a whirlpool in that the lower I descend, the faster and tighter the maelstrom, and it is good to be out of the middle of that maelstrom, at least for now.

The thing that scares me most about this surgery is that, like all surgeries, it is a violent act. In this case, it is so violent that it will take months to recover from the wound. I recoil in fear. I think that, surely, there is a better way, a way that is gentle and encourages healing rather than treating my shoulders as if they were enemies to be conquered and enslaved. It was with this hope that I cancelled the surgery last September, but I have found no other way. I wasted a little money on herbs, a bit more on massage, a lot more on acupuncture, and a whole lot more on physical therapy. The bitter truth is that some problems don’t respond to gentle methods.

I take my shoulder to the surgeon with the same mind that I take my dog to the vet. I know that the vet might hurt my dog in the short term in order to help it in the long run, but my dog cannot understand this. All my dog knows is that it was afraid and hurting, and that the man I have taken it to is hurting it more. Nothing I can say will make that okay. Like my dog, when my shoulder hurts, it screams, and I cannot reason with it. I want it to know that I am sorry; I want it to know that I am doing my best to help and that I would never hurt it without reason, but words cannot reach it. There is my rational mind, and there is my animal body, and they sometimes seem very far apart.

"Gloom, despair, and agony on me; deep dark depression, excessive misery"

I mowed today for the first time this year. I’ll mow once more before having shoulder surgery in late March; then I won’t be able to mow for months. This surgery takes a year for a full recovery, and I will never regain normal strength and flexibility. What’s more, both shoulders need the surgery, but only one can be done at a time. I’ve cancelled it once, and I’m tempted every waking hour to cancel it again. I can’t say I’m terrified, and I can’t say I’m devastated; but I can say I’m close.

Three years ago, I had knee surgery. Before that surgery, I could hike twelve miles up and down mountains, but my knee would swell a little, so I thought, what the hell, knee debridement is a simple and commonplace operation and, after I have it, I can hike without pain. Since the surgery, I haven’t been able to hike at all, and there are even days when I hurt too much to take the dogs for a walk.

Before having knee surgery, I liked surgical options. My thought was: “If something’s bothering you, don’t beat around the bush, get a surgeon to cut it out—what could be simpler?” I’ve since observed that one kind of surgery can be life threatening yet cause little pain and offer a full and speedy recovery, while another can have a low mortality rate but a significant risk of disability and chronic pain. This realization is similar to one I had as a boy when I would get so sick each winter with colds that I would wonder how, if a minor ailment could make me feel that bad, I would ever be able to hold up against something that might actually kill me. I was relieved to learn that people die everyday of things less annoying than a cold.

Now, I don’t know how I am going to hold up to months of being unable to use one-arm followed by the same thing all over again when I have surgery on the other. A local woman survived having both arms ripped off by a gasoline auger last October, and I tell myself that I should be thanking my lucky stars I’m not her; but reminding myself that I could be worse off never seems to make me feel that much better about how bad off I am. If it were that easy, few of us would ever be put out by much of anything, there being few things so terrible that they couldn’t be worse.

By day and by night, fear rolls over me like a fast train. If it were any greater, I would be hysterical. I say to myself that I am not six but sixty, and sixty is plenty old enough to have become a barbican of strength. I say to myself that I should be limpid, ataractic, eudaemonious, and there is no excuse that I am not. So I say, but berating myself for being afraid only makes me less able to summon my strength.

I feel damned if I do and damned if I don’t have surgery. I’m in pain when I am awake, and pain often awakens me at night. Sometimes, it’s terrible in its intensity, and can stay that way for weeks making it almost impossible to think of anything other than how much I hurt. There have been times when I could scarcely bear to walk because even the gentlest steps were too jarring, and sleep would only come when I was exhausted and would only last for a few minutes before the pain awakened me. Yet, I’m fairly functional most of the time, and the pain is tolerable if I don’t use my arms much.

If the surgery works, I’ll eventually be without pain. If the surgery fails, I’ll be partially disabled, and there’s a 10-25% chance (estimates vary) that the surgery will fail. But if I don’t have surgery, my tendons, which are 80% severed, will eventually break, and the ends will pull apart, making repair impossible.

I had three surgeries last year. Two of them involved biopsies. In the second biopsy, the surgeon went through the front of my throat to get to my vertebra. My fear when I had to get out of bed at 4:30 in the morning to go have my throat cut is beyond my ability to describe. As it turned out, I didn’t have cancer, and I was almost as good as new the next day. Even though my worry then was that I might die, that was preferable to my present fear that I might be permanently disabled and in pain.

Last week, I met an athletic looking man twenty years my junior who had the same surgery in November. He said he was in so much pain for the first two weeks that even Percocet didn’t kill it, and he still can’t raise his arm high enough to shake hands. He looked utterly beaten and demoralized, the living image of my worst fears. Sure, my own surgery could turn out worse than that—I could die—but he represented my worst-case scenario of that which seems easily believable. He even had the same surgeon, not that I’m jumping ship now, this being my fourth orthopedist and the only one I like and trust.