A4 and The Great Beyond

We drove on roads covered with silt from the recent floods. The river ran turgid and swift carrying entire trees on its current, great chunks of its banks gouged out forming small islands around which the water flowed. It was Wednesday morning, and we were on our way to the Emergency Department. We arrived shortly after ten am. A wheelchair conveyed me first to the waiting room, then the registration desk, and finally, at breakneck speed, down a long corridor to A4. Here, I was given a johnny and instructed to remove my clothes. Divested of all but my undies and socks, I struggled onto the gurney and was covered with a warm blanket. Robert pulled a book out of his pack, and I settled back to take in my surroundings.

Though referred to as a room, A4 was really a curtained alcove surrounded by three similar alcoves: A1, A2, and A3. I was cut off visually from the other patients but could hear most of what was taking place. During the course of my stay, A1 was inhabited by a guy who fell off a ladder and had to have his head stapled back together. He tolerated this procedure without a whimper, but his courage failed him at the threat of a tetanus shot. A2 first housed a woman from the nearby rehab facility who didn’t know where she was or how she got there and then by another woman whose meds ran out and caused some kind of reaction. In A3 a woman studied her phone, while her small child was looked after by a fellow who might have been his grandfather. He talked to the kid in dog-obedience language. Sit. Stay. The boy did neither.

I landed in A4 after a nasty fall in my very own living room.

The ED was a bustling place, the air of organized chaos reminding me of art project day in my elementary classroom. The whole place hummed with the sound of beeping machines, the rattle of cleaning trolleys, the ring of call buttons, and the muted voices of patients. Healthcare professionals in scrubs — nurses, technicians, interns, LNA’s, and the doctor — visited my curtained alcove and questioned me about my fall. As a postscript to each repetition of my story, Robert or I mentioned my need to leave the ED with a walker.

Finally, I was escorted down several corridors on my wheeled bed to the x-ray lab. The technician obligingly lifted my right leg for me so I could slide onto the waiting bed where my hip and pelvis posed for pictures. X-rays completed, the technician assured me the results would land in the doctor’s computer in a matter of minutes and I was wheeled back to A4. The x-rays may have arrived in the doctor’s computer, but the doctor was otherwise engaged for the next hour. Then, a serious woman whom I hadn’t seen before showed up.

Without preamble she said, “I’m here to take you to your CT scan.”

“Wait. What? I need a CT scan?”

Another gurney ride down several corridors, the leg and body lift onto another bed and my soft tissue was photographed. Another hour waiting for the doctor to arrive with a diagnosis: a minor nondisplaced fracture of the greater trochanter. Yes, there’s such a thing, a kind of bump located at the top of the femur. The fracture didn’t require surgery and should heal on its own, absent any more falls or foolish moves on my part.

The doctor declared me free to go, after which a nurse came with the discharge papers. While I worked on these, she searched the hospital for a walker returning several minutes later with a brand-new model courtesy of Medicare. After the nurse adjusted the height, I took the reins of my walker — soon to be christened my sidekick, Tonto — and she escorted me down another long corridor to where Robert was waiting with the car.

Settling into the passenger seat, I was filled with gratitude — that the Emergency Department staff had proved capable and kind, that I was on my way home with a diagnosis and a walker, that my hip wasn’t broken, I didn’t need surgery, and my injury would heal.

And I’m grateful, in retrospect, that I didn’t know how long that healing would take.

The Oft-told Tale of my Tumble:

The Monday evening of the flood, as the rain pelted down inundating nearby roads and causing rivers and streams to breach their banks, I tripped on the leg of the dog’s raised bed as I hurried from the kitchen to the living room. For a frightening moment I was airborne, screaming, before landing hard on my right side. The pain was immediate and intense. “This is it,” my mind said. “A broken hip. You’ll never be the same.”

The commotion brought Robert from the other room. He tried to calm me, but my heart was racing. I was shaking and sweating and nauseous. Calm, I was not.

“Let’s get you up,” he said, but I couldn't move my right leg. Wrapping my arm around his shoulder, he hauled me up and we managed the short distance to the couch. I lay shivering uncontrollably, the pain in my groin and upper leg so acute I thought I’d either be sick or pass out. Robert called 911.

The fire department is only a mile or so away from our home, but the road was flooded at the intersection. They’d need to take the ambulance on a series of back roads, but they’d get here as soon as they could. Twenty minutes later, Zander began to bark, and a shout at the front door further alerted us to the arrival of the EMT’s. Two big guys in rain gear and carrying medical equipment stomped up the stairs and introduced themselves as Thomas and Sandy.

As Thomas began to unpack his equipment, Robert described hearing me fall from the next room and finding me shaking and crying on the floor. I was still shivering, unable to control my chattering teeth and shallow breath. I asked Robert to bring me a blanket.

That’s shock,” Sandy said. While Thomas took my vital signs, Sandy reminded me that we’d met once when he’d come by to renew our permission for the VAST trail to cross our land and give us the complimentary bottle of maple syrup.

“You guys take such good care of the Rail Trail, too,” I said. “We walk there all year long. And we’re always grateful for the maple syrup.”

“That’s my syrup,” Thomas said. “I make it.”

“Do you? Well, I don’t think we got ours this year,” I teased.

“That’s on me,” Sandy said. “I dropped by, but you weren’t home.”

“Keep trying,” I said, and we laughed.

“Vitals are fine,” Thomas said, packing up his equipment. “Now, can I just check your hip?”

With a hand on either side, he squeezed my hip, then pushed down on my hip bones. Surprisingly, this did not hurt, though the pain in my leg, groin, and booty was acute.

“Stable,” he pronounced. “Probably have a slight fracture, though, so you’ll need an x-ray.”

Sandy took a breath. “We could take you to the hospital if you want, but the main roads are flooded, so we’d have to take back roads and it’d be a bumpy ride.”

“I don’t want to do that if I don’t have to. If you think it’s safe for me to wait until tomorrow, I’d just as soon wait,” I said.

“That hip’s OK,” Thomas said glancing at Sandy who nodded. “You’re better off staying home tonight. Take some ibuprofen and get some rest.”

I looked at Robert. “This is no night to be on the roads if we don’t have to,” he said. “We’ll get you to bed and figure out the rest tomorrow.”

By the next day, flood water had inundated Montpelier and Barre, washed away homes and businesses, caused hillsides to collapse, knocked out power lines, and brought the state to a standstill. I, too, was at a standstill. I couldn’t lift my right leg to pull on pants or bend over to tie shoes. I pushed a kitchen chair in front of me to get to the bathroom. Lowering myself onto the toilet was a literal pain in the ass.

I called the Health Center to inquire about getting an x-ray, but, like nearly everything else in our area, it was closed. I spent most of Tuesday reading in bed and wondering what my next steps would be.

The Recovery:

With the aid of my walker, I began to move slowly through the ordinary chores of life at home. I was able to make a salad standing at the counter or do dishes at the sink, but carrying dishes to the hutch or bringing items to the table while using a walker required a bit of problem solving. At first, I hung a sturdy tote bag off the walker in which I carried food items or a few dishes or the clothes I would wear that day. About a week in, though, my friend sent me a real walker pack with one main pocket, a place for a water bottle, and a smaller pocket for my phone. The pack strapped firmly onto the walker with Velcro and came in my favorite deep purple. Now, Tonto had a saddlebag, and we were ready to ride.

Or maybe not. When I Googled “treatment of a nondisplaced fracture of the greater trochanter” the news was both good and bad. I could expect the fracture to heal well with conservative treatment. The bad news was the treatment was bed rest, partial weight bearing for three to four weeks, and three to four months before I could expect a full recovery. At first, I was downcast by this forecast, but I decided standing was partial weight bearing. After all, I was only putting half my weight on the injured leg. And there was no way I was going to spend all day in bed. Bed was almost as uncomfortable as sitting.

Over the next week, I developed several accommodations that allowed me to perform ordinary and necessary actions with only minor pain. To get into bed, I learned to lift my leg manually by fitting my left leg under my right and swinging both onto the bed. If I sat far back on the toilet seat and leaned my upper body forward, I could mitigate the pain in my ass. And at my computer, I sat on a princess-and-the- pea sized pile of cushions in 20-minute increments after which Tonto and I would take a turn around the kitchen and living room to loosen up.

Towards the end of the first week, I logged onto the Jazzercise streaming service and clicked on an upper body mobility video. It was short, ten minutes, but moving my arms, breathing with the moves, and moving with the music felt liberating. I followed this with a ten-minute stretch. It was the first time since my injury that my body felt familiar to me; my legs held me up, my arms had good range of motion, and my core supported me. These short sessions of mobility, strength and stretching became my daily therapy, both physical and mental.

While I was working to touch my toes, climb stairs, and sleep on my back, homeowners were sorting through soggy belongings, getting estimates for repairs, and filling out FEMA forms. In Montpelier, shop owners were clearing out mud and debris with the help of volunteers, ripping out saturated sheet rock, and trying to salvage those items not completely ruined by flood waters. Recovery is slow. It takes patience and a willingness to keep at it, to wipe your brow and tackle the next mess of muddy goods or fill your walker pack with a few dishes at a time, shuffle across the room to the hutch, and do it again and again until the dishwasher is empty.

We do recover, though, if not completely. Last week, I climbed a section of Ricker Mountain with friends, and I’m dancing again with the instructors on the Jazzercise stream. In Monpelier, the shop owners are reopening; their spaces freshly painted, the inventory neatly displayed, credit card readers at the ready. But when the rain was bucketing down on a recent Saturday night, I imagine these shop owners experienced a vague sense of foreboding; an understanding that it’s just a matter of time until the floods return. Climate change is real; the shop owners can’t move the river.

It’s been easier to readjust my movements to accommodate my injury, than to readjust my self-image. Superhero-Septuagenarians don’t lean on their grocery carts for support or grip the rail and take the steps one at a time at the poetry reading or use walking sticks to struggle up small inclines in their yard. Old people do.

Nine hours of sleep, whole foods, and regular workouts may contribute to good health, but they can’t sandbag my body from its inevitable decline. I may not fully recover from this injury. And I will certainly experience diminished mobility and mental acuity, as time goes on. Mortality is real; this body comes with a guarantee of built in obsolescence. The challenge is accepting this fact with a modicum of grace and abundant gratitude for all the days it has, and will, serve as my spirit’s earthly home.