Notes From the Orthopedic Surgery Waiting Room

33 days since I broke my fibula.

14 days since the surgeon put a plate and 5-6 screws in my leg to fix the unstable break.

Yesterday I went for my surgery follow-up appointment. The PA and I talked about how putting screws in bones was pretty much like hanging a flat-screen TV -- you better put the screw all the way into the other side of the bone or you're not sinking it into the stud. I stared at my X-rays in horror and fascination.

They took out the stitches. The skin puffed around them like flesh pie crust, rather inhuman.

As I left with instructions to come back in three weeks and start moving my feet around three times a day, I both cursed another four weeks on crutches and thanked God once again this is injury and not illness. I view injury differently than illness, and I'm not alone in that.

I'm reading THE UPSIDE OF IRRATIONALITY, by Dan Ariely, who at 18 was burned over 70 percent of his body in a military accident. His experience gave him an interest in people's ability to tolerate pain and the events preceding their tolerance. He hypothesized, for instance, that those who had bad injuries could tolerate pain longer because they would equate it with healing.

He and another researcher set up a study in which they recruited folks to stick their arms in hot water for as long as they could stand it (they had to pull their arms out before they really hurt themselves). However, they forgot to exclude people with illnesses from recruiting and ended up with a few who had diseases. The ill people had a lower pain tolerance than the control group, while the injured group had a higher pain tolerance. He wrote:

"I suspect people with injuries like mine learn to associate pain with hope for a good outcome -- and this link between suffering and hope eliminates some of the fear inherent in painful experiences. On the other hand, the two chronically ill individuals who took part in our pain study could not make any connection between their pain and a hope for improvement ... in the absence of any positive association, pain must have felt more frightening and more intense for them."

Ariely acknowledges the accidental inclusion of ill people wasn't statistically significant, but his theory makes sense to me, particularly after this latest foray into pain. The day after surgery when my nerve block wore off, I could feel the plate and screws in my bone burning and throbbing like Anakin Skywalker after Obi Wan gets the high ground. It did indeed help to know the pain meant the plate existed, and the plate would ensure my bones healed correctly so I can run again without fear and without ankle arthritis. I just kept picturing that as I breathed through the burn and counted down the minutes until I could slam more Oxy.

In my outings on crutches, I've noticed people reacting to me in a way they haven't since I was pregnant. I have a theory now (and I'm sure I'm not the first) that people are the nicest to people with obvious short-term injuries or medical conditions, such as pregnancy, crutches or casts. Less so than they are to people with long-term injuries, like walkers or wheelchairs or canes. And illness, forget about it. Nobody wants to be in the same room with someone ill: Even if it's not catching, we're afraid we'll catch it. Some part of it.

Maybe the fear part.

It makes sense, I suppose. We don't like to think about our own mortality or how we would feel if it were us in the wheelchair instead. Crutches or a cast denote temporary conditions, ones we think we could probably live with, and that the otherwise healthy-looking person sporting them seems like us.

It's easy to root for someone on crutches.

Sitting in the waiting room of my orthopedic surgeon, I saw a lot of wheelchairs, walkers, canes and amputations as well as crutches and casts. The people with various conditions of injury also wore different expressions. The wheelchair-and-walker crowd for the most part seemed more serene, or at least resigned*. The cast-and-crutches gang was like me: really fucking pissed off to be there and not bouncing around like normal, sometimes crying as I did in the waiting room after my first visit when I learned I would need surgery and months of crutches.

I'm not sure what to do with any of these observations. I may very well become terminally ill at some point in my life. I mean, we're all terminal. My sister asked why I read these weird books, but I know why I do. I want to become resilient. I want to be the Zen guy in every movie about an airline crash on a desert island who is shockingly oblivious to the situation even as the hero runs around freaking out over his lost car keys. I want to be the calm one when they are both in the exact same situation, which the hero never seems to realize as he's trying to get the Zen guy to please freak the fuck out, already, thank you?

For someone with anxiety disorder to aspire to be the Zen guy in the airplane crash is some form of the Special Olympics, I'm sure, but hey, if they can do it, so can I.

I should note that long-term injury isn't a death sentence. In fact, it's something else Ariely talks about in his book: hedonic adaptation, which basically states humans have a base level of happiness they tend to return to no matter what happens to them, including wheelchairs.