|Men Sleeping in the Rain, Green Park, London, 1902|
"It was a welter of rags and filth, of all manner of loathsome skin diseases, open sores, bruises, grossness, indecency, leering monstrosities, and bestial faces. A chill raw wind was blowing, and these creatures huddled there in their rags, sleeping for the most part, or trying to sleep....It was this sleeping that puzzled me. Why were nine out of ten of them trying to sleep? But it was not till afterward that I learned. It is a law of the powers that be that the homeless shall not sleep by night." (Jack London, from The People of the Abyss)
I've had one other joint replacement--my left shoulder--and am astounded by how different the required preparation has become. I got ready for that 2011 operation by going to a surgeon who looked at my x-rays and gave me a date for the procedure. A week prior to that date, I underwent blood tests, a brief visit with an anesthesiologist, and maybe an EKG. Here's what I have to do this time around:
In June, I had my first visit with a surgeon who looked at my x-rays and proposed a total knee replacement. A few weeks later, I spent an hour with my assigned "care coordinator." Ten days after that, Peggy and I attended a required two-hour joint replacement class. This Monday, I spent a combined ninety minutes with a medical assistant, a phlebotomist, an EKG technician, and an anesthesiologist. Today, I have a preparatory visit with the surgeon. So there you have it--many things to do, many people to see, many assigned exercises that I'm in too much pain to do, and a large binder of reading materials. I feel more unnerved than informed by all of this because it makes the surgery seem like a big deal, which it is, of course, but I could do with a few less reminders.
Before I had my first shoulder surgery, I made the mistake of watching the procedure on the Internet, and what I learned was that I have NO desire to ever again watch a surgery for which imagination alone will suffice. You might wonder why I am SO scared, and I've asked myself that same question. Aside from the risk of stroke, infection, weeks of pain and disability, and the failure of the new joint to bring relief, the thing that bothers me most is that I feel like a genetic weakling because so many parts of my body hurt so much, and because only one of the bone-related surgeries I've had (carpel tunnel) brought me significant relief. After this knee replacement, I'll be having elbow surgery, and then there's the likelihood of more shoulder surgeries. Even if I am so fortunate that these things help, I'll still live with significant back pain, and I'll still live in fear that my narcotics will be taken away. Ergo, I have no hope that I will ever be without pain and disability, and the fact that I'm about to do something that, for a couple of months, will add to that pain, makes me tremble.
On the bright side, I recognize that there is cause for hope based upon the skill of my surgeon and the advanced state of knee replacements. I tell myself that this surgery is just one more thing of many things that I have endured, or will endure, and that my life is a bowl of cherries compared to the lives of millions of creatures.
I'm a lover of Jack London, who made a career of writing about--and photographing--human misery, and who himself endured great pain toward the end of his forty-year life. I read him now partly because I need perspective, and I get it from reminding myself of the many millions of people who were--and are--far worse off than I due to the fact that they had no money, no safety, no shelter, no healthcare, little food, no loved ones, and no cause for hope. Compared to the misery of the humans and other creatures with whom London came in contact during his travels around the world, my problems are minor:
"From the slimy, spittle-drenched sidewalk, they were picking up bits of orange peel, apple skins, and grape stems, and they were eating them... They picked up stray crumbs of bread the size of peas, apple cores so black and dirty one would not take them to be apple cores, and these things the two men took into their mouths and chewed them, and this between six and seven o'clock in the evening of August 20, the year of our Lord 1902, in the heart of the greatest, wealthiest, and most powerful empire of the world." (op. cit.)