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9781400069545|excerpt Caldwell / NEW LIFE, NO INSTRUCTIONS 1. Cambridge 2011 My first tip-off that the world had shifted was that the dogs looked lower to the ground. I dismissed the perception as a visual misread: Because I was on crutches and couldn't bend down to touch them, of course they would seem farther away. Then a friend came to visit, a striking woman whom I'd always considered tall. She was standing across the living room and I was smiling, happy to have her there, and I thought, Tink is small! And I never realized it before. The fact is that Tink is about my size, but until that day I had looked up to her in more ways than one. I was just home from five days at New England Baptist Hospital, where the chief of joint reconstruction had built me a new hip and lengthened my right leg by five-eighths of an inch. The measurement sounds deceptively slight, but then pi, unexplained, doesn't mean much, either. What the extended hip bought me was about two inches of additional height, because I was no longer bending forward in pain. It gave my leg something immeasurable: an ability to reach the ground, and the chance and anatomical equipment to walk right for the first time in my life. Almost as dramatic, at least in the beginning, was the re- orientation of my physical self in space. My perspective had been jolted to the point that trees and cars and other markers of street life felt closer to me, within reach in a way they hadn't before. I could sense the effort involved in making these neural adjustments: In a simple movement like a step forward, particularly outside, there would be a lurch of visual confusion, then acceptance. It happened quickly and brilliantly, and my comprehending it changed everything: What had seemed to be mere dizziness was in fact the brain's ballet. These were transient phenomena, the brain being a nimble choreographer of time and space. Within a few weeks I would be accustomed to the additional height and leg length; our bodies, perfect feats of design, respond to what is in front of them, usually without even bothering to let us know. But the dance I found myself doing with the physical world in the first few days and weeks after surgery signaled something larger, more long-lasting, that I would have to learn and relearn in the following year: the notion that life has an agency, some will and forward motion, greater than one's own wish or intention. Dylan Thomas called it the force that through the green fuse drives the flower. The idea that the whole blessed shebang doesn't have to be a free fall after all. I caught polio when I was six months old, in 1951, during one of the last years of the U.S. epidemic, before the vaccines. The virus, which destroys neurons, can lead to full or partial permanent paralysis; it affected the muscles in my right leg, and I didn't walk until I was past the age of two. Still, the mark on my family's door was relatively faint: no March of Dimes crutches or iron lung, just a faltering leg that often went unnoticed. The fact of the disease--important but hardly central--had long been incorporated into my shorthand self-description: writer, grew up in Texas, slight limp from polio. Part of the story I'd told myself all my life was that polio had made me a fighter--that I was hell-bent on being strong because of it--and that much was still true. But in the past few years, within the joys and demands of raising a young dog, I had begun to experience pain and lameness I'd never known before. The mystery of this decline cast a shroud of defeat over what I feared lay ahead. It seemed that the aftereffects of the disease had reemerged, ghostly and conniving, like a stalker who'd never left town. And then: A standard X-ray, ordered probably fifteen years after it was called for, revealed that the scaffolding of my hip was a junkyard of bone. However compromised my leg had been by polio, muscles can't work without a structure to hold them up. That I had been walking around at all, I was told, was astounding--and a lot of my recent decline could be addressed by one of the most common surgeries in modern medicine. The rest--the retraining and possible strengthening of a rebuilt leg--would be up to me. What do you do when the story changes in midlife? When a tale you have told yourself turns out to be a little untrue, just enough to throw the world off-kilter? It's like leaving the train at the wrong stop: You are still you, but in a new place, there by accident or grace, and you will need your wits about you to proceed. The revelation that there was a medical solution before me--a high-tech fix to pain and infirmity that by now seemed endemic and existential--shifted the angle of my vision in some essential way. It opened up the future and tinted the past, in the way that the unexpected can always disarm the reach of yesterday. Despite the mind-over-matter stoicism of Western thought, the mind cannot grasp the concept of wellness until the body announces it. The idea that I would somehow and someday be able to walk better--to walk without pain or urgent concentration--was a foreign notion and required a leap of faith. I didn't really believe it until months after surgery, when I saw my right foot climb a stair without asking my brain for permission first. I was being offered a new chapter to an old story, and the beginning of something else altogether. *** This rearranging of a life started out, too, as a love story-- a human-canine one, filled with the usual pratfalls and dropped cues of romance. My four-legged Boswell was a young Samoyed named Tula, a beautiful, irascible sled dog with an intrepid heart and the strength of a tractor. Trying to keep up with her--trying to be a middle-aged athlete in a failing body--was what first revealed to me the sort of trouble I was in. As she hurled herself through life with me stumbling along behind, she became my divining rod, herding me toward places I could not have gone alone. She stood by when I fell and got up and tried again; accordingly, I tried to pay attention to the world as she saw it. Dogs have a present-tense alacrity that makes short shrift of yesterday's bad news. They are hard-wired to charge forth, to expect good outcomes, and that viewpoint can shape the future as much as it anticipates it. I don't believe I'd have staggered into this glen of insight and physical change without her. "Your body has been through a major trauma," a resident told me when I called the hospital at midnight, with a 100-degree fever and a racing heart. "It was a carefully controlled trauma, but it's still a trauma." It was my first night home, several days after surgery, and I'd been told to report any signs of fever or shortness of breath. The surgical fellow who answered my call sounded sleepy but interested. I said I'd been released from the hospital that afternoon and gave him all my vital stats--blood pressure, hematocrit, oxygen levels, history of transfusions. "You're lucid and articulate," he said. "I know that doesn't matter much to you right now, but it matters greatly to me." I realized that he meant I wasn't raging with fever or non compos mentis from infection. "Your symptoms are distressing to you but not dangerous," he said. "They're all completely within the realm of normal." "In other words," I said, "a bulldozer just ran over me, but the guy driving knew what he was doing?" "Exactly!" he said, and we both laughed, and both, or so I assumed, went back to sleep. Days of inpatient physical therapy had taught me how to maneuver the crutches I would be on for the next six weeks. My house was full of friends and food and as prepped as a military canteen. But when I first got inside the door, all I could see was the obstacle course that lay before me: all those stairs and chairs and corners and narrow paths. I had been reduced to the most elemental part of being human: living utterly in the physical world. Even through the blur of painkillers, I was not much more than a set of sensate responses to pain--pain being a self-contained universe, not so much awful as it was all-consuming. For what seems like forever but was probably a week or less, I lived only according to its dictates. *** "Do people ever regret having this surgery?" I was pleasant enough when I asked this question of my physical therapist, who came to my house the next morning. But I was dead serious. I felt mauled. Worse, I was afraid I had allowed myself to be mauled--that something horrid and ineradicable had transpired from which I would never recover. The physical therapist was chipper and gracious and she didn't hesitate to answer. "Oh yes!" she said, and I flinched. Then she said, "Most of them are where you are right now. At the end of the tunnel, they say it changed their life." "How long is the tunnel?" I asked. "About six months," she said. "And how long is the horrible part?" I said. This time she paused. "About four weeks." OK, I thought. I can do four weeks of horrible, to change a life. My history with polio and my parents' reaction to it--my mother's early fortitude, my father's rough-bluster loyalty--are what first tempted me to gather this narrative, to splice past into present and try to make sense of it all. Polio is a far greater medical odyssey than my experience can even hint at; its individual stories are in danger of being forgotten as a piece of the social tapestry, because its firsthand witnesses, at least in the developed West, are middle-aged or older. Most of all I told this story because I wanted to say something about hope and the absence of it, and how we keep going anyway. About second chances, and how they're sometimes buried amid the dross, even when you're poised for the downhill grade. The narrative can always turn out to be a different story from what you expected. Hope isn't my long suit, but if momentum is a physical version of hope, well, I've got that. I still have dreams of crawling as an infant, and my body heaves in an absolute sense of going forward, with a kind of determination that feels like rushing water; it is the way one throws off despair. As long as I can keep moving in the dream, I am all right. So I wanted to tell people that--to say that sometimes force is all you have, and that has to be enough. Because with just that force, according to Newton, eventually you get to someplace else. A calculus of hope and motion. There's a term in scientific language, vast and precise, that came into being after Einstein changed everything: slower than the speed of light. That's me--that's the ordinary world--and I'll take it. Excerpted from New Life, No Instructions: A Memoir by Gail Caldwell All rights reserved by the original copyright owners. Excerpts are provided for display purposes only and may not be reproduced, reprinted or distributed without the written permission of the publisher.