In two weeks, I've been from the Colorado snow to the Palm Desert. I've worn cowboy boots and biked with saddlebags. The clip of life does not slow down, and sometimes that's a good thing.
Anatomy of an Injury
Yesterday, after running six miles along San Jose's Guadalupe River trail, I slipped on a sliver of glass on the sidewalk and landed, knee-first, on a broken tequila bottle. I sat for a moment on the concrete, staring at the jagged gash on my right knee, stunned. I've had my fair share of tumbles and falls, but this was different. The cut was clean but deep. I couldn't look at it. My iPod blared and my insulin pump was still safe on my hip.
I propped myself on the corner of the busy street and the trail, and within a minute had attracted a passing car. The driver was a man with a kind face. He asked if I needed help, and for a split second I considered saying no--I felt wobbly but was more shell-shocked than anything, and our apartment was only two blocks away. Some small voice inside insisted that I could do it--I could get home alone.
I looked at the man's face. He looked like someone's father. I thought of my own father, about the times he had been injured, and how he had, over time, learned exactly how and when to ask for help. "Yes," I said, "if you don't mind, I only live a block away."
The man, whose name was Frank, sat me down in his passenger seat and gave me a t-shirt to wrap around my leg. He asked me a few questions, and told me that I'd be all right, and I gave him directions to our place, and he insisted on walking me all the way to our doorstep. The white tee he'd loaned me was soon red and brown. When I got to our door I sat down and cracked it open. Ryan was eating breakfast and watching the Olympics, and when I saw the look on his face reflecting it all back--the blood, the dirt, the sweat--I panicked.
Ryan kicked into high gear, wrapping me in towels and getting me water, helping me test my blood sugar, and packing a bag of gear to take to the ER. I sat on our rug, focusing on a mental checklist of everything I'd need--ID, health insurance card, extra test strips, water, ibuprofen, cell phone, glucose gel. I thought of that day 13 years ago, when the doctor told me to pack my pajamas, that I'd have to spend the weekend in the hospital, and how long that had felt. I told Ryan to get a whole pair of clean clothes, and made him promise that no matter what happened at the hospital, he wouldn't let the doctors touch my pump.
He helped me hobble to the car and we drove to the ER. I thought about the placement of my feet on the run. Had the tread disappeared on my shoes? Were there rocks hidden on the trail? How, exactly, had it all been orchestrated? For the duration of the run, I had been thinking of all the things I had left to do in the four months leading up to our wedding--all the things we could afford, all the things we couldn't. All the things we needed, all the things we didn't. I had been thinking of scholarships I had worked hard for and still didn't get, meditating on all the half-finished stories saved on my laptop, the doodles I'd sprinkled around my office. I had been thinking about my nine-to-five job, daydreaming, really, of all the projects I'd love to do, if someone would finally give me the permission.
And then, suddenly, I was on the ground.
It must have been a slow morning at the ER because I was seen immediately. The doctor assured me that there had been no damage to the tendons or ligaments. They x-rayed my hands, which had spread evenly over glass when I fell. The x-ray technician told me that Ryan was cute, and I agreed. They wheeled me into a small room, where I was attended by a nurse and the ER doctor at the same time. They numbed my hand and my knee, and for twenty minutes one of them was on each side. By the time we left, I had 11 staples grinning in a jagged line across my right knee.
We stopped to get lunch on the way home, and I was aware of the stares we were getting. My white racing shirt had been stained with blood and dirt. My fingernails smelled of iodine. I hadn't eaten since the night before. I changed into a spare shirt in the car, which is when I noticed another a long scrape starting above my right breast and reaching almost as far as my belly button. I looked like I had survived a fight with a dragon.
Once home, I stood naked in front of the bathroom mirror, trying to figure out how to take a shower. I was amazed at all of the parts that still work. My knee still bends. I can bear weight. My hands are free of glass. My blood sugar is fine. The bruises will fade. Eventually the staples will be gone, leaving behind a stronger skin. I heard Ryan bustling in the other room, setting up our spare bed in front of the television so we could watch the Olympics. How lucky I am, to live this life, to be outside on beautiful spring days, to spend time with people I love, to have a partner like him, to have gainful employment. How lucky that Frank stopped his car, that Ryan was ready right away, that there was no wait in the ER, that my overall health is good. This was the year I'd resolved to no longer observe my anniversaries as a diabetic--in four months there will be other more important anniversaries to observe--and yet it seemed that February had still left its lasting impact.
Yesterday I was reminded that when we refuse to slow down, our bodies slow things down for us. I love and respect my body, imperfect pancreas, stapled knee, scraped stomach and all. I'm just grateful to Frank, and Ryan, and the ER staff, and the world at large, for reminding me to focus on the goodness around us, to breathe it in and soak it up, because it has a way of multiplying, once you stop to notice it.
This is a public thank you to Frank. Thank you for stopping to help.
Rafael Campo and the Poetry of Medicine
Tuesday nights are sacred because Tuesday nights are writing nights. Every Tuesday I drive to San Francisco to attend Matthew Clark Davison's Writing Lab, a six-week generative writing workshop. Since completing graduate school I have felt anything but that--complete. The stories I started in Davis and San Francisco rattle around in my bones like a lost ache. In Matthew's class I've had a chance to step back and see the characters and conflicts with a greater kindness and compassion than I ever did in grad school. Last night's lesson had something to do with that.
Matthew shared an interview Cortney Davis did of poet and physician Rafael Campo. Campo believes that poetry is not only an expression of humanity, but an ongoing exercise in empathy. The interview, which is available on Poets.Org, explores how Campo turned toward medicine because he first thought it might "straighten" him out and "whiten" his identity. Over time, though, poetry became an important part of his practice. I was especially moved by Campo's belief that patients need to hear both a data-driven narrative and a poetry-driven one:
I think my patients are surprised sometimes to find a poem together with patient education pamphlets or scientific articles—and yet so often that’s what they want to discuss at the next visit. A poem says to a patient that I want to know more than just my own biomedical narrative of her illness—that I want to take care of her as a whole person, with attention to both the blood sugar results and also her struggles to maintain them in our target for treatment—that slice of birthday cake she couldn’t eat at her child’s party, the sting each time she must administer her insulin, are just as important. Such an approach, I think, not only has practical value—because the patient who trusts me will confide in me the detail of a symptom that helps me reach the correct diagnosis more expeditiously—but also is more rewarding on a personal level. So many docs these days feel alienated from their own work and from their patients. I think that’s largely due to all the obstacles to caring for patients, really caring for them, that poetry can help short-circuit: the burdens of such a rapidly expanding knowledge base, the constraints imposed by managed care on the time we can spend with our patients, the challenges of caring for increasingly diverse, multicultural patients. Poetry gets us past all the machines, literally to the heart of the matter; poetry expands the interaction with a patient to a space without time limitations; poetry bridges those cross cultural gaps by speaking in the most elemental and mutually understood form of language we have.
Last night I was struck by how perfectly Campo captured the exact feeling I have had, time and time again, while sitting in a doctor's office. I've written before about that gap that so often occurs between bedside manner and effective treatment. Test results and emerging technology can help us analyze data, but data is useless without full human understanding. As a type 1 diabetic, few things speak to me more than a physician's ability to see a blood sugar result and fully see the person behind it--the circumstances that caused a high number or the stress that caused a low one. As a writer, it is always my intention to approach my subjects with compassion, but that means seeing beyond deeply embedded cultural stereotype. That's the crux of it--that's where stories get interesting.
When Campo says that "poetry helps us get past all the machines," I think of all the times we find the easy story, versus the honest, more compelling one. Writing honest fiction to me means being patient with my characters, really doing my homework, reading, traveling, listening to other writers read, accepting shitty first (and second...and third...) drafts, and aspiring for empathy. When I sit down to write, it's hard not to take all of these expectations with me.
When I go to the Lab, though, the rules are different. Time is set aside to think and write. The burden of accomplishment, of having a fully realized, living story, is secondary to the greater intention to explore who we are, who our characters might be. That freedom reminds me of why I like to write in the first place.