Archive for July, 2008

Celebrations

We have a full house again except the sleeping places are reversed: Sita and Jim in the upstairs room and Tessa and Steve in the barn. Actually Jim was downstairs working (or playing) on the computer when I got up at 5 AM. His night had not yet started when my day began.

Sita and Jim drove in from Western Mass. to celebrate Axel’s birthday. Steve and Tessa made breakfast and prepared dinner which consisted of grilled meat in a spicy Thai salad. Everyone had brought wine and ice cream to accompany the meal. This also included a partially bought, partially picked fruit salad with whipped cream in the color of Axel’s choice (green). We ate and drank until our bellies were too full. As a birthday boy Axel sat happily on his throne, a chair decorated with flowers, and we reminisced a bit about last year but not too much. In addition to choosing the main cours, the wine and the color of the whipped cream, he also got to select the dinner music and he picked Abba first. We ended the meal with Jimmy Cliff and we all sang or drummed along. It was a noisy and joyful celebration of our complete family. After dinner we laughed together over YouTube movies; the one that got us laughing so hard that we had to hold our (bloated) bellies was an Indian movie set to English text (google: Benny Lava).

At work, yesterday, the final big day of presentations, over which the students had obsessed intensely ever since I started teaching, had arrived. They had all taken the feedback to heart and outdone each other in flow, logic and visual esthetics. We have all come a long way since we started this experiment three years ago. Everyone was glowing with pride and a deep sense of accomplishment. After all, these projects are not irrelevant student projects but real attempts to alleviate suffering in the three countries selected. Paul was on the line (from Nigeria) to attest to this and comment (positively) on the experience.

I left work early to take care of some final course related matters and then joined everyone at home where preparations for our Axel fete were in full swing. This included Axel mowing the lawn himself while puppy Chicha kept putting a ball in front of the lawn mower, hoping for a throw and a catch and then a repeat.

Choppy waters

Today is Axel’s birthday. I won’t be able to congratulate him until I get back later this afternoon. Unless of course I wake him up at this early hour. I could not take the day off today because it is the crowning event of the BU course: the student teams will present the efforts of their work with their virtual teams in Malawi, Cambodia and Nigeria to an audience of some very seasoned public health professionals at MSH. There is much nervousness among the students, but we think they are as prepared as they can be. After the dress rehearsal yesterday we sent each team off with a mixture of congratulations and suggestions for improvement.

Before I started writing this morning I read the entries that Joe and I made last year on this day. Even though all is not entirely right in our bodies, it does make me realize how much is right and what enormous progress we have made.

I got home late, after a haircut, and arrived when the sun had already dipped below the Putnam trees. Axel had the boats waiting for us by the water and we pushed off into choppy and frigid waters. We paddle-rowed in the direction of town to see the cliffs on Smith Point Road where another old house was removed and, no doubt, a new McMansion will be built. This means more construction, hammering and large trucks in the neighborhood for another couple of years. I am not sure what this is a sign of. The housing downturn does not seem quite as obvious here.

Axel moved quite fast next to me in his kayak, slicing through the waves like a pro. It was serious exercise for his left arm. Reading the description of his very feeble left arm a year ago leaves me feeling very grateful. Our boat outing was a good metaphor for the year we have just completed. Our two shells, Alden and kayak, withstood the choppy waters well but it took all our attention and concentration to stay upright and steer a straight course. We made a safe landing and had a quiet dinner with the puppy stretched out by our feet under the table.

Poetry

I am writing while it is still dark outside so I cannot see the Cardinal that is chirping excitingly outside the window. It is one of our resident Cardinal families that are flitting around our yard in their red (and brown) splendor.

Nuha wrote me an email over the weekend with the words ‘We Will Fly!’ in the subject line. That we will is now beyond doubt. It will start with an introductory flight over Essex County, sometime in the next month. If she likes it, Bill and I will take her along on one of our 3 hour trips across New England in the next few months. The plane jumping she wants to do will have to wait; this is the best I can offer.

Nuha’s email also contained a more authoritative translation of her Arabic poem that emerged in a traffic jam in heavy rain driving from Boston to Lincoln. Such is the force of poetry. Emerson once wrote, “If a man doesn’t write his poetry it escapes by other vents from him.” He did not know this at the time but it applies equally to women. I know this from experience, and, clearly, Nuha knows this too. I just discovered that she has posted it as a comment, on this blog. As soon as I get it I will add a picture of her in her black robes in the desert. Although the picture may give the impression that she is from another world, her poem shows that where she’s lives, far from wet-green-lush Boston, there are men and women with the same hopes, dreams and aspirations as we have. It reveals a characteristic of the human tribe that is often overlooked.

We entered week four of the BU course with a reflection on last week’s classes and how they had affected the students. I was pleased to hear that many of the topics had seeped into their personal lives – making requests versus complaints, inquiry over advocacy, how we react to changes, etc. After that we watched, some of us for the second time, the HBO movie Yesterday and talked about its relevance for our professional careers. I called it the 1 foot view, in contrast to the 30.000 foot view about international health, money flows and donor coordination that we were served next by MSH’s President and another BU prof.

With the Ethiopia trip cancelled I am starting to focus on the next trip, early September, to the Ivory Coast where I will be working with a dear friend, Oumar, from Guinea. We will take a group of people that usually has only a 30.000 foot view on Aids, Malaria and TB and bring them down to the 1 foot view. I am looking forward to the trip, especially because of Oumar, who I have not seen in years. We have both survived accidents that most other people do not survive so I think we were fated to work together once more.

Axel and I had driven in together in the morning, too early for Axel’s liking but nice enough for me. He started yet another therapy, this time vestibular therapy at MGH to help him recover from the dizzy spells he sometimes has. He returned home by train and helped Tessa and Steve move into their ultra clean studio. All the cat hair and cat smells have been professionally removed by a Portuguese couple that spent most of the day on this job. I got to see the results of all this activity late in the afternoon, sitting in a chair in the beautiful later afternoon sun with a beer in hand, watching the young birds make their nest.

Tessa and I tried to go for a swim but, against all predictions, the water was too cold to swim across the cove. A quick dip was all I could handle. We had dinner by the cove just as the mosquitoes and biting flies came out, and then served ourselves a desert of fresh raspberries straight from the bush. That is when we discovered the havoc wrecked by a baby bunny that appears to have made its home under the straw that covers the potato plants. It has been systematically removing anything green from our garden. This requires some urgent action which seems to be only on my priority list (somehow the place is called ‘my garden’). I fear that when I get to it (we will be away this weekend) it may be too late.

A changing of the guard

Telephone #4 has a new banner line on its orange screen: Sita&Jim has been replaced by TessaSteve. This phone was our connection with capable care during the night when we were not able to provide that to ourselves or each other. There are some stories involving this phone that now makes us laugh but they weren’t funny at the time, when we were so utterly helpless.

And so yesterday felt like the changing of the guard; while Tessa and Steve were driving eastwards on the New York Thruway and then the Mass Pike, Sita and Jim moved out of the barn/studio and headed west on the same Pike. They may have crossed path without realizing it as I suspect each couple was preoccupied with what comes next.

We were sad when the U-Haul truck drove away at about 6 PM, in the rain that had been threatening most of the afternoon and finally fell when the doors were closed. Sita followed in her car with cats Mooshi and Cortez meowing pitifully, squished snugly and brotherly in their one-cat animal carrier. The studio where they lived for an entire year is empty except for much cat hair (enough to knit a hair shirt Sita believes) and a few larger pieces of furniture. Tessa and Steve get to move these early this morning before the cleaners come.

The entire Sunday was taken up by Sita and Jim’s clearing out. We started the day slowly and late with a brunch in Salem on our way to pick up the truck. We celebrated their accomplishment (from incapacitated parents to more or less normal ones who can live on their own) with Essex clam cakes and other brunch delicacies and, of course, a bloody Mary. We toasted to their care and commitment that made it possible for us to concentrate on our recovery. We got to experience something that most parents experience much later, usually towards the end of their lives. We had this dress rehearsal with our children that left nothing to be desired or perfected as it was entirely perfect.

The only good thing about Sita and Jim’s departure is that the studio/barn will be freed of cat smells and cat hair. We hope that by the end of the day it will not be smelling anymore of indoor cats and the content of their litter boxes. We assume that the professional (and costly) cleaning crew today does a good job. The cats will be replaced by puppy Chicha, who will do her business outside. We only need to train her to do this further away from the front door and give the dead patches of grass a chance to recover from her previous stay.

Being on my feet all day required an ankle cold pack, followed by a hot bath. With my leg propped up, just as in the olden days, we had dinner that included home grown squash which appeared spontaneously in our garden. We watched part of the Simpson’s movie until I had enough; an entire movie was a little too much of a good thing. Tessa, a die-hard Simpson fan would probably disagree.

Before and in between the moving activities I prepared the morning session for the BU students today. This is their final week. Just like the last week of school before summer vacation they get to watch a movie; I watched it yesterday. The movie is also called Yesterday, a docudrama that paints the tragedy of HIV/AIDS as it hits a young woman in a small South African village. I am trying to figure out how to fit the movie into the larger curriculum and also how many boxes of Kleenex to bring. It is a very sad movie about a whole bunch of societal breakdowns. The only redeeming part is the friendship of a teacher with a big heart and the innocence of a young girl. I think I will ask the students how the movie fits in with their lives.

This morning Axel and I will be driving in to Boston together, where I will drop him off at Spaulding for more therapy. He has been released from the occupational therapy but not from speech (brain) therapy. Steve and Tessa, who arrived after I went to sleep, will supervise the cleaning crew and then begin to build their new, and temporary nest, so that they can sort out what the next phase of their life together has in store for them.

More rain

More rain this morning, as if…

I woke up early after a night full of dreams that included being banned from an air-conditioned room in a hot and crowded place because of some rules. I first left and later snuck back in, quietly. This is very unlike me. I am usually very compliant with authoritative orders, especially if they come from people wearing uniforms. I cannot remember if they were, but the feelings are still accessible: disappointment, frustration, self pity and jealousy.

In my dream I also encountered people who work in development and who have scary airplane stories. Since they could not talk about these openly I, or someone, designed an ingenuous way to do this that involved technology, colors and food. Now that I am wide awake I cannot reconstruct what seemed so clever in my dream. I still ‘see’ in my mind’s eye the one person with a small plate who had selected yellow. It contained a little dribble of (yellow) food, something resembling marmalade, which made it clear she was not going to talk about her airplane scare. The ‘red’ people received cameras, cables and rechargers. These were the people who were going to talk. I woke up just as they were preparing their bit(s).

The airplane scare was probably brought on by yesterday’s Globe front page picture of the plane from Australia with a huge hole in its fuselage that ended up landing safely in Manila. There is a part of me that believes the universe is orderly and that things come in threes; and that, therefore, I am owed one more scare, to complete the trio that so far includes the crash of 4337P and my frightening take-off from Kabul airport.

With my co-pilot Bill by my side I took off for Rutland yesterday. The fog at Owl’s Head has become a bit of a joke as the selected alternative course is the one we actually take. This has been going on for months. It was once again a new experience that Bill is so good at selecting for me: mountain flying. We took his plane which has no Garmin but he has one that can be mounted on the controls. In the past these were his controls, but now they were mine. It feels and looks a bit strange at first. It is evidence of my mounting confidence that I could handle this change. We flew to Rutland in a more or less straight line, I zigzagged a bit, and encountered little traffic. As we approached the mountains I had my first experience of thermals which was a little unsettling.

The trip took us over breathtaking landscapes. Flying conditions were not ideal, as they often are in the summer: hazy skies and large clouds ahead of us that were collecting beyond Rutland. We stayed out of their reach and when we returned back to Beverly we left them behind. The airfield was lovely, and mostly empty, except for one small jet taking off and later, when we were taking off, one landing.

I learned how to leave an airport that is at the base of a bowl between mountains by circling around it to gain altitude after take-off. We flew back practicing the use of VORs, one to direct our heading and the other for triangulation to check our position. I am doing more and more of the work, which includes communication and frequency changes, although Bill was largely in charge of the VORs. I feel increasingly confident dealing with traffic controllers along the way. Bill has taught me many things that are responsible for my increased confidence; the biggest one is the set up for landing to ensure I land where I am supposed to. He has provided me with additional forms and checklists and models how to be organized about the recording of information one one’s knee board such as writing down frequencies, radio etiquette and fuel tank use. I now too have a double knee board like him.

I was back on the ground at midday. Axel picked me up after he had been holding (coffee) court at Zuma’s in Ipswich, meeting then this friend, then that one. We drove by a yard sale with a rowing machine in the yard; a few hundred feet later, after having contemplated the importance of having such a thing in our life, we turned the car around and bought the machine that is now in our basement. Getting it in the car was a challenge since the back door doesn’t open anymore but we managed (where there is a will there is a way!).

The basement is not a great place for (winter) rowing because it is wet and moldy. But Axel has great plans for the place. The big cellar clean up will happen when certain other things have happened that have to do with Sita and Jim moving out and repairs to downspouts and gutters. We have talked about this for a long time and there is still no money for it. Nevertheless, Axel is sure the cellar will be his graphic design studio before the start of the winter. A graphic design studio that includes a rowing machine and a TV I reminded him.

We cleaned out books from the half empty studio in preparation for the cleaners who will make the place spic and span for its next occupants (Tessa and Steve). The titles of the books tell a story about Axel’s past professional aspirations. I also found some of my missing books. We removed the cat hair and put them in three piles: keep, throw out and save for the Zugsmith Society (that is a story for later). It was a hot and sweaty job and we rewarded ourselves with a swim in the warm waters of Lobster Cove. After that we headed out back to Ipswich for a southern seafood gumbo stew and a wonderful evening in the company of our hosts, Carol and Ken and our friends Edith and Hugh.

Boomerang

I woke up in the middle of the night, yet so sound asleep that, on my way to the bathroom I walked straight into the door. It was not a serious encounter but a reminder that sometimes the body does stuff the mind has no idea about, or the other way around.

The BU students have completed their third week of the intensive summer course (8 credits) and are getting increasingly preoccupied with the presentations in front of MSH staff and invited guests, next Wednesday. So yesterday they practiced short presentations, on topics of their choice, on each other. We learned about what to do in Boston over the weekend, do’s and don’ts about pick-up lines, about Christmas and about names. They learned about being clear on what you want your presentation to accomplish, about teamwork and that there is no alternative to practice, practice, practice.

I learned that my trip to Ethiopia, on August 5, has been postponed until later notice. With that I gained another 2 weeks of summer, something I am grateful for. Coming home to Lobster Cove at the end of a full week was even more wonderful than it would have been otherwise. The sun was out, the sky blue and the tide high. Armed with two gin tonics we walked down to the beach and toasted to each other and miracles. We did not mention the ankle. And then we climbed into our kayak and Alden shell and shoved off, leaving the empty g/t cups on the beach. The water was choppy and the rowing challenging but being out there with the sun setting was spectacular and stretching arms and legs felt wonderful.

Back inside Axel cooked dinner while I was plotting my course for today’s flight to either Owl’s Head, we are trying again, or Rutland in Vermont. We ate dinner while watching the movie ‘A 2001 Space Odyssey’ and marveled how many of the things in that movie, science fiction when it was made in the 60s, are now normal, such as individual screens in planes, PCs and Skype with a webcam. We both fell asleep watching and did not see the end which we could not remember from the last time we saw it, so we must have fallen asleep then as well. We’ve had several evening and nights alone this week and could do whatever we wanted – such freedom!

I still haven’t seen Sita even though she came back on Monday. She left on Tuesday again to her new home in Western Mass and is now in Nantucket with Jim and her in-laws for a short vacation. Maybe I get to see her this weekend, since she still has much stuff here and the move-out has not been completed. This is a source of friction with Tessa and Steve who are driving down on Sunday, moving out of Canada, and ready to move in, which we know they cannot do yet. The professional cleaners that Sita and Jim hired first have to remove a year’s worth of cat hair from the barn before they settle in with their dog. Boomerang kids! As for dog Chicha, the chipmunks and squirrels have no idea what’s coming, fall will be challenging for them.

Still

The sound of birds rather than sheets of rain coming down woke me up this morning, before the alarm did so. I took it as a good omen. There was too much rain yesterday and it rained all day. Prolonged rain like this always affects traffic. My commute, both ways, was long and painful. The stop and go action on the accelerator is hard on my ankle. It feels like it heats up, from the inside only, not to the touch, and the pain travels up my leg and settles in my right hip. I limped from the garage to the classroom, a five minute walk, wondering where this new development came from; a new pattern of pain, psychological or not, that feels very real. Once in the classroom I got distracted by the task of teaching.

Nuha surprised me with a poetic piece of prose, written in Arabic after a failed attempt to express her feelings in English. She explained that after our conversation the previous evening, her heart was all aflutter and she could not sleep; so she wrote – something else we have in common. I asked her to read the piece in Arabic. I love listening to this language. Having studied it for a while when we lived in Beirut, I was able to pick out a word here and there that I recognize. It was difficult for her to translate the piece into English and I am sure much was lost in translation but I got enough of it to cover my heart with a warm blanket. Another warm blanket came from Magid’s comments on my blog in an email. He is a fellow OBTS board member and hails originally from Egypt. I want him to meet with Nuha. This cannot happen of course without me as a chaperone which I will gladly do. The three of us will drink hot chocolate in Harvard Square sometime. Magid is a great fan of drinking hot chocolate and knows just where to go.

The bad weather of yesterday included a rare occurrence: something resembling a tornado not far north from where we used to live in West Newbury. It damaged hundreds of southern New Hampshire (vacation) homes and left many people injured and one dead. I feel for the people affected. For them it will be forever that fateful July of 2008, as July 2007 is for us. I think of the future plans that will need to be adjusted; my future plan adjustments are somewhere in there, between thousands of others – a consequence of stupidities, freak accidents, natural catastrophes and human errors, causing many untold stories of grief and despair, the nonstop sheets of rain so many tears of all those crying.

My own sense of despondency and despair this week has been put in perspective by that of Linda and her children. Linda lost her husband, Axel’s cousin Erik, a little over a year ago, still in his early fifties. We are hearing that she is now dying herself of breast cancer. Her children, about the same age as ours, have to deal with a near certain prospect of both parents gone that was only a fleeting possibility for ours.

These were some of thoughts I had while lying on my back, part way in the enormous Philips MRI machine that was taking pictures of my sick ankle. Headphones provided background music to my thoughts; they were also supposed to mask the loud noises coming from deep inside the machine, but the MRI is like a jackhammer at work inside Symphony Hall. Haydn’s Clock Symphony’s trio and minuet couldn’t quite outdo the clink-clonk, mandmandmandmand, and ratatatatat that were trying to trip up my heartbeat. I eventually hummed along with the sounds, right through the classical music, because it is true that if you can’t can’t beat ‘em, you join ‘em. It made the time go faster.

The experience of not being able/allowed to move for a long time brought me back to the destroyed cockpit and the pain and discomfort I experienced while the rescue crews were trying to cut us out. Feelings and reason were in near mortal combat to master that situation. Abandoning to feelings is easy but causes a deep panic that makes the waiting excruciating and difficult; letting reason take over requires a mastery and discipline that come from mediation practice, which I don’t possess, although, at the time, I was able to focus on my breathing as if I was in a yoga class. This time it took similar effort not to panic about the discomfort and cramps that started to set in, working their way up my leg into my hip while my foot was immobilized in a cradle inside the machine. I have discovered that physical pain can start as imagined (psychological) pain and that it takes tremendous effort to not go that route. When I could no longer stand it I asked Mike, the technician, how much longer, preparing for another endless 5 minutes, but he said we were done; I had been a good (still) patient and the pictures were clear. Relief.

Change

A restless night, compounded by intense rain and lightning storms, followed a long and wonderful day teaching. The topic was change, and lo-and-behold, several things changed. The students are pre-occupied with their team projects and communications with their team counterparts in Nigeria, Malawi and Cambodia. This shows that whatever you hold people accountable for (a compelling presentation to a professional audience next week), will drive energy (and anxiety). The changes that happened yesterday had to do with focus and beginning to see light at the end of the tunnel. The change is also about coming together, as a team here in Boston, and as a virtual team with their overseas clients. When Paul in Nigeria referred yesterday to ‘our vision’ as opposed to ‘the vision that you have for us’ the team of students were excited. As I watch these developments I am also excited because the students are actually contributing to the field project staff’s thinking and management.

The only person who seems a little less preoccupied with the team projects is Nuha. She is constantly thinking about the application of everything that is being taught to her life’s mission as it is unfolding; with much work to be done back in Riyadh. I imagine her brain busily putting bits of knowledge and data here and there, storage for later, accompanied by a thousand ‘but what if’ and ‘how would I’ kind of questions. Most of these questions are being asked quietly inside her head but a few are beginning to slip out. She brings something to this class that she may not even be aware of: the messy and complicated real world in a place so very different from ours here on the East Coast. Nuha is sharpening her thinking about strategies and tactics for change and I am so very pleased to be part of her journey this week. I am less sure about how I am helping the other students because their focus is on the course, and pleasing the professors; a label that fits me like an uncomfortable dress.

At the end of the class we picked up Axel at the MFA and drove to Wolffy’s place in Lincoln where students and faculty came together to simply hang out and eat good food. It was a slow bumper to bumper commute, not far in distance but endless in time. The good thing was that I got to spend this time with Nuha who I had given a ride. I learned much about her challenge of being a young Saudi woman who is temporarily let loose in this American society that is in many ways the antithesis of where she comes from. Somewhere in the picture are enlightened parents and supportive uncles. But in the background is an ancient tribal society that has the strictest norms about marriage and choosing a mate and where the word dating has no meaning. The tribal traditions even trump the religious ones, as Islam does actually encourage one to marry someone who is not from the tribes (qabiila). This is relevant for a 26-year old who comes from a large and old inland tribe that is very much set in its ways and requires her to marry one of her own. I was acutely aware how different the lives are of Sita and Tessa, who are in the same age cohort, and who have a freedom to do right (or wrong) as they please that they take entirely for granted.

Nuha and I have some things in common that bind us in spite of all the differences that separate us; one of these is that we are both psychologists and intensely interested in why people behave the way they do. We are both passionate about changing the way people relate to one another for the better. We want to understand what keeps some from embracing such changes, why they think they stand to lose more than to gain, so that we can be better at doing what we both believe we are called to do.

I got up early this morning to write and then prepare today’s class about communication. Last night when Axel and I came home from Lincoln we were too pooped to do anything other than tumble into bed, even though it was still early. Axel was exhausted from a four hour neuropsych assessment at Beth Israel that left him exhausted and feeling low. Tests do that to you because they check your upper limit; and no matter how high or low that limit is, the intent is to find out where you fail. The test results will be contrasted with a similar test he took 5 years ago and provide the brain injury doc with some, we hope, useful data to inform the treatment plan that is currently in place.

Denial

Funny that today I have to teach about change and here I am in one of the quadrants of this model myself, the one labeled ‘denial.’ The 2×2 model is based on Elizabeth Kübler-Ross’ stages of grieving. I am still hoping that this agony about unpleasant choices is not for real, and that I am just trying the various options on for size.

Just over a year ago I had never heard of the talus bone and now I am learning that a talus fracture, especially a dislocation and fracture is bad news. Until now, comparing my troubles with Joan’s and Axel’s I had concluded that I had been the luckiest of the three of us, escaping with only minor injuries. I am now trying to come to terms with the fact that this accident will be much more of a defining moment in my life than I imagined even a week ago.

Last night I put the words ‘talus bone’ and ‘dead’ in a Google search and found, between academic papers, several blogs from people who are in a similar position; all appear to be young and engaged in various athletic exercises before their mishap (falls from ladders, sport injuries) and have the same concerns I do about future ankle movements and continuing their active lives; none wanting to have their ankle fused; many citing months and months of non-weight bearing agony, crawling up and down stairs and being in pain. I am in pretty miserable company it seems. This sort of information is supposed to get me out of denial into the next stage, of anger (or resistance) but right now I don’t feel angry yet, just totally bewildered.

Yesterday was, nevertheless a great day of teaching during which I entirely forgot my ankle worries. It was only during the commute to and from when there was nothing else to do and I had to actively keep catastrophic thoughts about my predicament at bay.

Nuha is a student in my class. She is a young and spirited woman from a university in Saudi Arabia, bent on changing an archaic educational system into something more engaging to students that would help them become as passionate as she is about developing human potential. We have been talking this week about the various facets of aligning and mobilizing others to one’s cause. Yesterday we explored motivation. At lunch break Nuha approached me saying her head was full of questions about the applicability of what to do about poorly motivated employees that had been proposed by her American peers. She did not see how any of their solutions would apply to her situation back home. Right in style with her past classroom experience she did not want to use up valuable class time to voice her questions and thus approached me in private. It was a learning opportunity for all that was too good to miss and after lunch Nuha became the client and the students her consultants.

The course I am teaching in is a course about leadership. In the session around Nuha’s dilemma we saw how a young woman is trying to lead in a (old) male-dominated patriarchal society. It was inspiring and moving to see how her peers rallied around her, encouraged her to persevere in her difficult task, and offered their support in a variety of ways. Earlier in the morning we had talked about inspiration and what it does. One of those things is focusing: it focused my attention on something bigger than myself, my ankle and in particular my talus bone. I forgot all about it until I walked back to the garage and started my commute home.

Back home I found Axel ready for a cook out on the beach with just the two of us. Since we missed one set of ingredients we drove to the store and discovered that one of Manchester’s summer concerts in the park had just started. All of Manchester, young and old, was there on blankets enjoying a perfect summer night out. We changed our plans, bought stuff for sandwiches and listened to the music of the band Midlife Crisis playing oldies. Our friend Christine plays the flute and we recognized the large crowd of Spanish speakers we had met last week at her house; we did not join them because we finally had started to talk, really talk, about what this next phase in our recovery is all about. That is how I will be able to move towards the edges of denial and into the next quadrant where I get to be angry.

Irreversible

I dreamed about hardware, screws and such. This was not surprising given the last images I saw on the internet about ankle surgery before I went to sleep last night. I was doing research on the options that my orthopedic surgeon gave me if, indeed, his diagnosis of what is wrong with my ankle is correct.

I knew I was not out of the woods yet but I also had been living under the illusion that, eventually, everything would get better and we could resume our old lives where they had been interrupted. I so badly wanted to believe the doctors when they said, it will take a year, that I took it quite literally; expecting, with a child’s kind of hope that, sometime in July 2008 or this summer, everything would be OK again. I now know that that was just phase one; yesterday I joined Axel in phase two and, as he already knows, things look a little different there.

In the morning I spent an hour at the office of my orthopede, who is aptly named Dr. Wood. I had made an appointment some time ago when it was clear that all was not well with my ankle. I had gone in with some expectation that maybe an operation was needed to free a pinched nerve and put things right that were a little out of alignment; nothing a good doctor could not fix. I had also expected that I could then make an informed choice about what to do next, a weighing of pros and cons between two simple alternative (nothing or a routine operation).

What I had not expected was a diagnosis that contained the word necrosis. This, I knew from my classic education, came from the Greek word nekros which means death. Necrosis is the name given to unnatural death of cells and living tissue, according to Wikipedia. Bone cells inside my injured talus bone are dead because the blood supply was compromised. The symptoms and the X-ray were enough proof for the doctor to give the diagnosis of AVN (avascular necrosis of the talus) with a great degree of certainty. I will have an MRI on Thursday to confirm his diagnosis. Then we will meet again on August 4 and decide what next. This is when I will take Axel along. I would have wanted him by my side yesterday, had I known what was coming.

In the meantime I get to agonize over which of the four unappealing courses of action to choose: (1) do nothing and end up with an arthritic ankle and increasing discomfort in walking; (2) surgery that includes drilling holes in the bone to release some of the pressure and make room for small blood vessels to re-grow and fill the space; (3) fusing, which requires cutting of bone so the edges literally fuse together which would reduce the pain but limit my ankle movement (this option leaves me with the most questions such as, can I still fly? row? ski? walk on the beach?) and (4) total ankle replacement, a complicated and risky undertaking that may require repeat replacements after a certain number of years. Last night I started to read up on all these options; none had any appeal and some were plain scary.

After I left the doctor’s office I drove into Boston to my class in a (mental) fog with those four scenarios bumping into each other inside my head. I vacillated between despondency and denial. Two voices were talking to me at the same time, trying to out-shout each other; one saying, hey, you are still alive, it could have been worse, it’s not a death sentence while the other conjured up images of me hobbling for months, first with cast (back to wheelchairs and ramps), then the plastic boot, with the possibility of remaining a hobbler ever after.

At the end of the day, after my afternoon class I drove out of Boston into a dark and ominous fog, this time real, which contained a violent rainstorm that blocked everything from sight. The outside (natural) world matched my inside world: sheets of rain blocking my ability to see anything at all beyond the end of the next car and the sides of the road; no sign of anything better in sight. My stress levels were going up so fast that my ability to think straight was severely compromised.

I talked with Axel over the phone. He promised me that the storm had passed over Manchester quickly, dumping lots of rain, but then leaving everything sparkly clean under bright sunny skies. I took it as a metaphor and worked my way through the inner and outer downpour into Manchester where I was not only greeted by blue skies but also by a rainbow. If that was a promise to Noah, eons ago, it could be one to me, of something I cannot yet fathom and which requires some faith and trust that all will be well in the end. It’s just that I haven’t gotten to the end yet.

Amidst this bad news, some good things happened as well; the teaching at BU was fun, I had a wonderful lunch with my colleagues Cary and Wolffy who are co-conspirators in the BU course, and Sita returned safe and sound from London (UK) last night.


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