Already Broken, by Joyce Kornblatt

Patti Smith, Jesse with Flower, 2003

Patti Smith, Jesse with Flower, 2003

Although it felt like flight, I knew the fall was wrong: body upended, working to right itself even as it spiralled head-first, it seemed, down. I’d gone over the tiniest cliff, from darkened footpath to an unseen recessed lawn. On my back, I looked up at faces—my husband Christopher, my step-daughter Miriam, a nurse who’d been a guest at the memorial service we’d all just left, others whose features came and went like stars.

Stars: a skyful above me, glory I appreciated even as I writhed. The pain, the cold night air, the way my body shook in every cell, how I seemed to be dissolving inside my skin (You’re in shock, the nurse repeated. I want you to breathe from your belly until the ambulance comes), and that diamond-swept sky.

I think I might be dying, I whispered, and the nurse said again, It’s shock, darling, you’re going into shock. Breathe.

Dissolving into a heaven of stars.

You’ve got a broken leg. It’s very painful. Breathe.

In the ambulance, a daze of morphine and motion. Someone holding my hand.  Where was the sky? I could not move.

In the ambulance, time and space buckled as my leg had. Folded back on themselves.

During the ten-minute race to Prince of Wales Hospital, through the leafy eastern suburbs of Sydney, Australia, where I’d come to live two years before—a surprising late-in-life marriage to an Australian man raising his daughter here– the ambulance morphed again and again, American sirens from my first fifty years clear to me as a magpie’s call. My mother’s and father’s heart attacks; her feared stroke, a later fall and fracture; his gasping allergic reaction; a daughter’s car crash, a husband’s suicide:  all but my daughter dead for years, but their rescues—successful and failed—happening right along with mine. Felled grandparents and aunts and uncles, a neighborhood boy in flames, girlhood friends gone to cancer in their youth.

All their stricken bodies sharing the space of this speeding van.

And no separation: their bodies broken in mine, mine in theirs.

Dissolving into a heaven of stars.

Life brings suffering, the Buddha taught, and he didn’t say mine or yours.

We’re here, the attendant holding my hand announced. The ambulance doors swung open for us all.

***

In the emergency room cubicle, I lay in a bed of drug-muted pain. A girl with a spinal injury had just been helicoptered in, and her treatment would take precedence over mine. I imagined her strapped to a board, her face pale, the trajectory of her life severed in an instant.  I sent her wishes for well-being, a Buddhist prayer of loving-kindness—May you be well, may you be peaceful, may you be free from fear and the causes of fear–even as I panicked about the delay in my own care.

 Breathe!

Strangely, it confused me that a broken bone could hurt so much. Why wouldn’t ruptured tissue set off neural alarms? Injury without pain is an illness itself: the body is meant to signal its hurt. I’d carried a false notion of bones as insensate. As if the skeleton were an inanimate armature upon which the living sculpture of the body had been created and from which it would depart. An image of clay on metal.

Not so.

Bone is elaborately alive.

From Grey’s Anatomy:  “Where there is no hyaline cartilage, the periosteum covers the surface of the bone. Ligaments and tendons are attached to the periosteum….Nerves are distributed freely to the periosteum, and accompany the arteries into the interior of the bone.”

The interior of the bone.  A landscape foreign to me as Australia’s Red Centre, that mysterious desert that makes up the bulk of this country to which I had migrated in 2003.

Worlds within worlds.

How is the girl with the spinal injury who was helicoptered in that cold August night? I think of her still, years later, nearly every day.

Was I wheeled to x-ray on the emergency room bed, or trussed like a turkey and shifted to a stretcher? The latter would happen a number of times during the next ten days, but may not have happened during that initial stay in Emergency.

I can’t be sure and I want to be sure. I have a wish for exactitude here. A craving for fact. I want my memory to reconstruct those first hours in the hospital as surely as the surgeon would reconstruct my leg. I want my mind to have the precision of his hands. Impossibly, I want to be a surgeon of shattered time.

Photography Credit: Fotokon | Dreamstime "Chest X-Ray"

Photography Credit: Fotokon | Dreamstime “Chest X-Ray”

When I was a child, I loved x-rays. At the dentist, when the films I bit down on turned into photographs of a tooth’s hidden decay, the dentist and I were allies in an effort to track down cavities and fix them before they did real damage. Who imagined that the radiation itself might be destructive? Only in a bomb, we thought. Only as an instrument of malice.  Only in the hands of our enemies, the Russians.

Like the Nancy Drew books I devoured, I was a girl detective and x-ray my sleuthing equipment. In the shoe store, I’d stand in the magic box and see the skeletal architecture of the foot revealed: bones and tendons and muscles clearly visible, as if the skin were a sock that could be removed.  I believed in the red-eyed cyclops camera aimed at my jaw, as surely as others believe in their gods. I believed that the nuclear lens embedded in the foot-sized box in the corner of the shoe-store was perfectly safe.

Two women received me from the orderly who had pushed me into their domain. The older woman was short and solid, with a Russian accent and a face carved out of hard experience. Ivana, the name said on her badge.  Please don’t bend my leg, I said, and Ivana said to her assistant, She must be crazy. How can you x-ray a leg without bending it? . During the procedure, Ivana frowned, kept shaking her head, as if she were repeating to herself the unsavoury diagnosis: Crazy, crazy, crazy.  

The younger woman, a gangly Aussie girl, Kathleen, Irish in her bones and bright red hair, moved my leg into the positions described to her by Ivana, shifted the x-ray plate under the broken limb, rotated my body from back to side. With each adjustment, the pain spiked, broke through the narcotic meant to block it. I heard myself whimper. I sensed Kathleen was trying to be gentle even as she followed Ivana’s terse instructions  We are sensitive to the slightest calibrations of touch, especially when ill or injured. Someone works brusquely, another offers care: these differences would not be apparent to an observer, but to the one being touched, the whole field of one’s being contracts or relaxes, depending on the quality of contact.

Before each picture, Ivana instructed me: Don’t breathe! Don’t move! Her voice sounded military, absolute, as if I were a renegade about to mount an insurrection. Please don’t bend my leg. It was an unreasonable request, but not a crazy one.

I remembered how my mother had suffered in a nursing home from insensitivities and shamings that injured her spirit, when she might have lived her last year in dignity and peace.  Crazy, crazy, crazy, Ivana mouthed, and my mother came and joined me on the x-ray table, as we used to adjust ourselves in her single bed when I visited her in the years after my father died.  Having a snuggle, she liked to call those comforting interludes.

I’m not crazy, my mother said to me once, in tears, in the early stages of dementia. I’m just losing my mind.

Emma Mieville, Étaples, Ward of the Order of St John Hospital, 1917

Emma Mieville, Étaples, Ward of the Order of St John Hospital, 1917

In a public ward, I lay sedated with seven others on beds in a long corridor-like room. Though we have private health care, emergency cases begin in the public building. My pain was extreme, and the morphine equally strong. They vied with each other, and I rolled on a rough sea, waves of pain beaching me on quiet morphine sand, where, dazed, I rested until a tide pulled me back to the wracked surf. Once I dozed off and I remember dreaming we were on a cruise ship’s deck, the eight of us, bundled up against the cold sea air. The mattress rocked and rocked.

In the morning, still ship-bound, an orderly transferred me to the rolling stretcher so we can fix you up good, he’d said, and my husband was brushing the hair from my face. The corridor heaved, water took us down and brought us up again. I’ve lost the memory of arriving in the operating theater.  It lives in me from other surgeries, but I won’t import those details into this text: I’ll leave the lost arrival lost.

The nurse in recovery is announcing my name. A small paper cup with grape juice offered, as if in communion, to my parched lips. I taste it now, sweet as blood. This is the period known as coming to. Coming to consciousness, that’s what’s meant. Coming back to one’s usual sense of self. But mine had ruptured like the two shattered bones. What I am pointing to is not amnesia, dissociation, psychosis or even the altered state we call post-traumatic stress. More a movement of the spirit beyond its usual home, the body. A relinquishment of the temporal story. A gesture toward the unconstructed.

Transported to 263B, my leg swathed in a soft cast, each toe a blossoming bruise.  Christopher there, a touchstone, and then the surgeon coming to explain his work to us: the broken bones anchored with a shin-length titanium rod and screws at ankle and knee to affix the rod to the bones. Later I would see x-rays which looked more like a construction site than a human limb. On that day in the hospital, I listened to words that had no place to land. They seemed to float just above the bed, and I could feel my effort to grasp them, like dandelion pods we plucked as children and released with a wish.

Here is the paradox: while the hospital culture was reducing me to symptom and specimen, I was growing more comfortable with the experience of a person-hood not confined by the physical. The presences of all my dead and injured beloveds accompanying me through the Sydney streets in a siren-announced surprise party as vivid as any séance must be, the ghosts arriving for dinner after a long time away.

 263A. On the other side of a white curtain, a woman moans. Another body in pain. Mine shoots up and down the leg as if electrodes have been implanted during the operation, set off to fire randomly. Hello, I say, as if I have phoned her on the telephone. Are you okay? I can sense her marshalling the strength to speak even a word. No, she says, a young woman’s voice, and you? No, I say back and we share something like a laugh. What makes a human bond?

She is the abdomen, her belly sliced open from hip to hip, the cyst its ovary excised. Benign, she murmurs like a mantra, again and again, as if saying it enough times might convince her of the truth. I was so sure I was going to die, she says. I can reach the curtain between us, and I begin to pull it back, but she asks that it remain drawn. I hear a plea in her voice for the privacy of the confessional, an intimacy she would otherwise refuse. She will speak to me for hours, for the next three days, a soft voice on the other side of the white cloth. When I need to make my way on crutches to the bathroom on her side of the room, I avert my eyes so that her anonymity remains intact. I never see this woman’s face or she mine. I will learn about the baby she had just months before with a man who left her in her fifth month of pregnancy. I will learn about the mother who wants her to move back with the baby to her childhood home, and how she, my companion, 263A, believes she should live like a grown-up, she says, though she sounds as young as a toddler who needs to be held. I will learn about a father she can’t forgive and a sister she has absolved. The heart requires a hearing, and finds it in unlikely times and places. I give her my phone number the day she leaves, but I know she will never call, and she doesn’t.

A day after she is discharged, a new patient takes her place. Abdomen, again. She arrives post-surgery, drugged and distressed. As her anaesthesia wears off, she assesses her situation. Rather than needing privacy, this woman sees our shared room as her own, with me perhaps the visiting cousin given the spare bed without consultation by the parents. She’s as polite as one can be when miserable, but it’s clear she’d expected a private room, a promise health insurance often fails to deliver in Sydney’s overcrowded hospitals.  Her lamentations are complaint rather than confession, the indignity of her emergency appendectomy exacerbated by my presence. It’s not personal, she says, which makes it, of course, personal.  Her husband, a bewildered quiet young man, sits on the chair beside her and tries to hold her hand, but she rejects his touch again and again, either too raw to receive it now, or customarily disinterested in his affection, who can know? She prefers the curtain between us opened, she instructs him, so she can see out the window on my side of the room. She’d come to Sydney with her husband for a week of theatre and ballet, I learn, and in the midst of their holiday: This! she says, pointing to her belly and the i.v. stand to which she’s tethered. She says, I absolutely hate hospitals. She says, Where is the fucking nurse? Her complaints are continuous, almost choral, and after an hour I can see she isn’t looking for any response from me, which is both a relief and a kind of diminishment. At some point her husband leaves—Alison, I have to get some sleep and I’ll see you first thing in the morning– though it has seemed he was vanishing little by little during the hours of his visit.

Van Gogh "Trees in the Garden of Saint-Paul Hospital," 1889

Van Gogh “Trees in the Garden of Saint-Paul Hospital,” 1889

Hospitals make more vivid the paradox we inhabit in all places and circumstances: we are alone, often frighteningly so, and we are also connected to each other as surely as the discrete cells of the body bind to each other to create physical form. A stranger is an intimate as soon as her gurney is wheeled into a shared room. In the hospital, I experience what my life outside has never quite embraced: all life is in constant conversation, however easeful or tense, the exchanges more prolific than any social network or internet can ever replicate. The silence and the babble: they contain each other. In this petri dish of human pain, once-abstract principles become embodied knowing.

Late into the night, a male patient across the hall begins screaming for pain relief. Then profanity and I’m getting out of here in a kind of growl met by another voice, raised, ordering him away from the door!  A nurse arrives in our doorway, ordering us to Stay put, the patient is a prisoner and that’s a police guard yelling at him.  I can hear the panic in her voice, mirrored by the way all my nerve endings seem to spark like wires that are shorting out. Alison gasps and gasps, a diver underwater losing oxygen. The melee settles. Alison is on the phone, announcing Get over here right away, we are going home. Before dawn, her husband has made his way, ashen-faced, to her bedside, and she is instructing him to pack her bag and help her get back into some clothes, and to the nurse who has sped to our room to see who has entered before morning visiting hours, Alison is announcing, I am fucking discharging myself, which is my right, and don’t even think of stopping me. Within thirty minutes, the nurse has removed the i.v. from Alison’s arm, and brought in a wheelchair for her elevator ride to the lobby. The prisoner who tried to escape hours before remains in his bed; the one in 236A has escaped. For the rest of my stay, I will be alone in the room, strangely missing the strangers with whom I had shared it.

This is what happens to ‘the leg’ during the nine days it lives in 236B. Its toes are checked several times a day by a nurse named Janet.  She pinches, she wiggle-tests mobility, she talks to the toes as if they were five prisoners she has assembled for a periodic roll-call. Sometimes, I’m convinced, she pinches harder than she must, to hurt me. She never meets my eyes, and she never calls me by my name. “Let’s check out these toes,’ and that is just what she means. I go silent. I surrender. I use the anaesthetic of denial—I don’t care, it doesn’t matter, I’m not hurt or frightened or enraged—to get through her visitations.

Monica comes daily, too. A physical therapist, her charge is to get you comfortable on crutches and able to do stairs before I will be allowed to go home. I never get comfortable with crutches, and refuse to do stairs—I’ve been told that if I have a fall during the three months I am forbidden to put any weight on the broken leg, I will wind up back in surgery and it will be a messy job, the fastidious surgeon warns. Why would I risk the acrobatics of climbing stairs on crutches? We’ll rent a hospital bed and set it up in the living room, and a wheel-chair so I can roll myself to the kitchen and back, learning how to make a cup of tea from a seated position.

I need to convince Monica to let me off the hook, to say I’ve passed the test which, in fact, I’ve flunked. I need her to look the other way, sign the chart while she crosses her fingers, and let me go home. I need her to be like the young Ohio State Patrol officer who passed me on my driving test decades earlier, even though I knocked over the cones each time I tried to parallel-park. Well, he said, shaking his head, I’m getting married tomorrow and I don’t think I want to flunk someone on their test the day before I take my vows in church.

When Monica lets me go home without mastering stairs on crutches, it is like getting my license all over again. It is not her wedding that intercedes on my behalf, but something similar: her divorce, just granted that morning.  Nothing ends perfectly, she says, tears in her eyes, meaning her marriage, and my failed crutches lessons, too.  You can go up and down the stairs on your bottom, if you need to.  We give each other a hug, cheering the other on, each of us injured and mending and resourceful and scared.

Discharged from the hospital, I move from one dream into another.  Across the threshold again, this time in a wheelchair, the attendant transferring me from the zone of the ill and injured to the realm of the convalescent. No putting weight on ‘the leg’ for three months, then visits to the house from a physical therapist who will teach me to walk again on both feet, as the atrophied flesh attempts to remember its muscled past. What’s changed forever is a leg without a memory of its fall, the metal rod through the shin held in place with pins whose heads I feel through the casing of skin at ankle and knee.  I know my body now as impermanence. The Buddha’s lesson learned in the temple of Western medicine. Wholeness includes brokenness—this cradling is our cure.  It is our very nature to be shattered again and again, each cell division a sundering, razed ground on which a new form arises and thrives, only to be felled itself. What we call flux or process implies all the deaths in which aliveness gathers again, to die. Standing, falling, fit, fractured: resurrection and dissolution in the palm of each other’s hand.

Christopher helps me settle into the front seat of the car. It’s an August morning, clear, winter in Sydney, my face still startled by the rush of cold air and that vast blue sky that is this city’s signature.  An uprush of white cockatoos appear like flying escorts, and we follow, broken and whole, into the dazzle, headed home.♦