April 2 1016
It came as no surprise. The doctor’s face revealed the clinical truth with rolled eyes and a wry smile, as he told me, that, basically, my back was a sizable train-wreck of a wreck. I’d known that for some decades, what with the myriad techniques of pain avoidance I’d adapted: dangling from railed corners, grabbing the back of a chair for leverage in twisting, standing while working, drinking. It had begun in 1976 with the first rear-ender in LA, when a young girl zipping along in Dad’s little Japanese car was busy looking at her cassette collection, likely going 25 mph when she hit me, stopped at a light on Laurel Canyon. Her front end crumpled, and my neck took the whip-lash, this in the days before back-headrests. I popped out of the car, advised her that her radiator was leaking and other damage, and suggested if it was nearby she might make it home. Exchanged info. The next day the whiplash hit, an ice-pick in the neck. There went disks C3, 4 and 5 and arrived a year of serious pain and a life-time of chronic lesser pain.
And then a year later, more or less healed, at least as much as was going to ever happen, from 2 weeks in traction at Scripps Clinic in La Jolla and the usual fistful of pills, a burly guy hit me a lot slower, somewhere in the flats of the Wilshire district, but with the heft of a big steel American cruise-mobile, ripping the seat of my old Volvo off its welded moorings, to mangle another set of disks. He jumped out and yelled, “short stop” while I’d been sitting there at the light at least 30 seconds. I wanted to floor him but didn’t, and knew resignedly from experience what would follow. Pain. The damage that time was mid-back along with the neck, whatever the letters and numbers I never bothered to find out.
I glanced at the X-ray, appreciating the somewhat ethereal beauty of it, and noted the snake-like line of my spine, left, then right. And the doctor’s look of resignation. The MRI image was more exact and solid, from multiple viewpoints, and detailed the squashed disks, the narrowed spaces, the herniated one, the pinched channel that sent pain piercing down my left leg – the good old sciatica which had haunted me, at varying levels, for some decades now. It was all of a piece, and the pieces were falling apart.
Prescribing a regimen of pills – one to dampen the pain, another to relax the muscles, another to coat the stomach lining to thwart the toxic effects of the others, and another “natural” one to supplement missing trace elements to help bolster the body’s own self-care – and then a sequence of physical therapy things to do for a month, he then said “try this and….” And if this didn’t provide adequate relief, which his face said it certainly was not going to do, then it might require an “intervention.” To say a knife in the back. All this occurred in Italy, where I could afford these procedures – procedures which I could not have done in my own country without rapidly bankrupting myself, and hence had not done. My long acquaintance with Italy though made the thought of a knife in the back take on other shades.
So I and my back had shared a long experience of coping. As it happens, unlike some others for whom the languid enticements of opioids and other painkillers are strong, I prefer to be mentally active and find most of these drugs simply reduce my brain to a marshmellow state. I have, or have developed, instead, a rather high tolerance for pain. It’s been, for quite some time, a constant companion, often at levels that I know would send many friends scurrying to a doctor or a dealer to find some kind of alchemic relief. I instead tend to grin and bear it, so as to allow the cells of my brain to continue their minuet. I like to think, to ponder, to do, and sitting doing nothing is nearly impossible for me. If I really need a palliative a few bottles of good strong beer will do the job without closing down my mind.
However of late – the past year or so – the various jolts of pain were getting on the debilitating side, requiring periods of laying down, a modest stream of Advil or sometimes paracetamol laced with a touch of codiene. This declension had prompted the visit to the doctor, the subsequent X-ray and MRI, and naturally, the glance at the impending near future, which pointed, in one way or another, to life’s final denouement. Death, and often, if not always – a good car wreck, heart-attack, murder or other “event” can serve to short-circuit the process – the painful steps of getting there, issued out in myriad possibilities. The fading sight, the hearing gone, the broken bones, failing liver or lungs, each giving out at their own pace until the mechanism of one’s body can no longer sustain that thing we call “life.” Depending on one’s past and nature, one’s “character” or desires, one can shunt this all out, stumbling dull-minded to the end, or one can be ever more attentive with the dwindling means offered, acute until the curtain of consciousness closes. And everything in between.
Whichever path one takes or is taken on, the finale is always the same: your mind ceases and with it your “you” takes an infinite walk. And nothing remains but the traces left, the faint echoes of friendships and love to expire when their holders do, the tawdry material items acquired in these four score and whatever years, be they a house left in the will, a small empire of business, a studio of paintings, or nothing. Or, if one had acquired some grace of “fame” of some kind, a mythic shadow might envelop your name, which might become a much encumbered, and surely falsified asterisk in the brief trajectory of human history. But, finally, all arrives in exactly the same place as our selves evaporate and the simple building blocks of water, a fistful of chemicals reduce to the universal atomic levels which hide beneath our hectic comedy of life.
Returned from a week’s trip to Bologna, where I scrambled easily up the long San Lucas stairway and back down, and felt great, we did our last 3 days of doctor’s assigned physical therapy. On the next to last day, about half an hour after wrapping up, a stab of pain shot down my lower back and left leg. Nasty enough to require a hasty horizontality to elude the pain. The next day, hampered, did the final therapy session, with Cosimo, the therapist, doing some things which he concluded indicated inflamed muscle, and not nerve stuff. A bit buoyed by this idea, we went back “home”, did some water colors (dismal) and momentarily felt better about things. Foolishly. Then came the whammy of pain down the lower back, the happy-making pills providing no relief, I got some beers to dampen the jagged edges, and went, again, horizontal. Gravity is cruel when vertical, weight pressing down on shrunken disks, squeezing the thin lines of nerve tissue.
Two months ago I was gently slipped into unconsciousness, so much so I hardly noticed. While gone a surgeon extracted my L 4-5 disc, which had been squished beyond use by life’s vicissitudes. While doing this he noticed a little fragment of the disc nestled against the sciatica nerve root, likely in hindsight the cause of some decades of on and off serious pain. He dug that out, though in process scarring the nerve tissue – of which more later.
I awoke in a drugged stupor, oxygen tubes slipped in my nostrils, an IV drip in my left arm. Marcella tells me I babbled incoherently, asking what this crap in my nose was. Typical post-op behavior. Finally coming around I met my roomy, Rachib, whose leg had been mangled in an accident. He hailed from Bangladesh, one of Italy’s many immigrants. For four days we chatted in a limited manner, constricted by our mutually minimal Italian, while nurses came cyclically to change the drip bags, check blood pressure and such, and the dismal – even in Italy – food was brought in, all while my body recovered from the major intrusion it had undergone. Marcella thankfully came frequently, bringing bites of better food, and the comfort of companionship. The four days whisked by, and I was released with a bundle of drugs and “integrators” to take, off to convalesce. Within the week I was up and about, if a bit hobbled and slow. Fortunately my philosophy glands were working fine, and despite the daily requisite pains, I was of good, if typically for me, dark, humor. It’s my view that whatever ill befalls you – physical pain, psychic trauma, bad news or whatever – it’s better to take it with a smile, a nice lathering of humor. To do otherwise is only to make a bad deal worse.
Rebounding well, after 2 or 3 weeks, with Marcella administering a special leg stretch of a 20 minutes cycle, twice a day, I was doing pretty well – walking, up and about for the day, busy painting and writing. Out of the woods. Until one morning I awoke, and attempting to exit the bed to take a pee, was administered such a jolt of pain, that I recoiled, trying to find a way to avoid it. It emanated from my left buttocks and hip, as if a muscle had spasmed and contracted in the worst of ways. However, after managing to get up, after moving about a bit, in an hour the pain subsided and then completely disappeared. At least until the next morning, when it resumed, worse still. Marcella and I had to figure a way for me to pee in bed, as getting up was pure torture. This went on some days – 4 or 5 – and I duly popped pain killers, until each day the pain subsided and things were “normal” again. The feeling was that a muscle in my buttock was seizing up, pinching the sciatica nerve, and then letting go. So it seemed. A post-op scheduled visit to the doctor arrived, and I told of this new thing, and he casually did a few pushes and pulls on my leg, and announced the cause was not muscle things, but that the scarring on the nerve, in process of healing – a growing process – would grab onto my spine during the passive hours of the night, and on getting up I would tear it, delivering one of Maggie Thatcher’s short sharp shocks. He prescribed some further pain killers, and integrators, and more of Marcella’s leg stretches.
Though the pain continued – and here more than a month later still does – it slowly diminished, I imagine as the scar is healing step by step. What was interesting was that the pain was far more tolerable once I knew what it was. It had for a while the same intensity, but knowing it was tearing nerve tissue, and that it would subside for the day within an hour, made it much easier to push through it, get up from bed whatever the pain, and get on with life. Though I was puzzled why I hadn’t been told on leaving the hospital that this might happen. It certainly would have made that first instance much less worrisome.
At the end of July, our beach town filling with summer’s mayhem, we moved back to Matera. The morning nerve tear pain has slipped away, and formal physical therapy done, I’ve almost gotten to my pre-operation routine of pushups, squats, curls and basic yoga stuff, with an added 20 minutes of walking. Along the way a few little hiccups of the hypochondriac kind showed up. For a period I had what I read as signs of an imminent heart attack: pain down the left arm, a kind of seizing in the left chest. I recalled once in a while having these long before, and figured the high blood pressure of recent years was taking over, ready to do me in. Though something about the pains I was having led me to doubt it was really heart attack stuff, so of course I went on-line to check it all out. Came up with the conclusion I was probably having acid reflux symptoms. But still went to the doctor, since here I am on Italian socialized medicine and the cost is a wait in a room and then a free doctor visit. The doctor twisted my arm a few ways, heard my view, took a blood pressure reading, and more or less agreed with my self-analysis. He prescribed some stuff for acid gut reflux and asked I let him know in 10 days how things were going. The pains went away after some days, my blood pressure danced around slightly high “normal” and the heart attack scare went away. Got myself back up to 60 squats, some curl like exercises and 80 modified pushups as normal on the ground ones are too much a stress on my lower back. And got the yoga stuff back to my previous normal. The stay in Matera was mostly devoted to getting my body back into condition, building back the diminished muscle tissue, and with a good wi-fi in the apartment, way too much time on line. Now we’re back in the nearly vacated beach town, and I hope to wean myself from the toxins of Facebook, and the on-line non-life which comes too easily.
Of course, with the sciatica pain gone, I now note more clearly the something going on in my right sacroiliac/hip area, which had been there a long time. It’s a modest little pain, incurred with a certain twist of the torso, and I’d think nothing to be done about it but avoid that little twist or pop pain-killers. I live with it. And wait for the next shoe, among the many perhaps to come, to drop.