“Do not turn back when you are just at the goal.”
Maxim 580 of Publilius Syrus
As soon as they took the oxygen tubes out of my nostrils they started my breathing therapy. Four times a day, every six hours, whether I was awake or asleep, a nurse would put a mask over my mouth and nose and pump in some kind of mist that I was instructed to inhale as deeply as possible. Breathing with broken ribs is excruciating, which is why so many victims die of pneumonia: consciously or unconsciously they start breathing very shallowly, and that allows mucus and other fluids—blood, for example—to collect in the lungs and grow all kinds of nasty germs. Think toxic mold in your basement. The mist they pumped into the little mask was similar to the inhalant asthma patients use, and the idea was that breathing it in for ten minutes four times a day would help keep my lungs open and healthy.
They also gave me a little inhalant tool called an incentive spirometer, an ingeniously simple device to encourage me to use my lungs fully and deeply. By inhaling though it, the patient essentially replicates what the lungs do naturally during a good, healthy, hearty yawn. I was given instructions to use it ten times an hour and to monitor my progress with the little gauge on the side. And then we began physical therapy.
Physical therapy out in the wide world, for patients who have left the hospital and are attempting to resume their lives, means a gradual process of guiding the injured body back into normal patterns of strength and movement. Physical therapy in hospital means attempting to get the body to resume a pale, watery adumbration of the most basic and normal movements we all take for granted. (Both are very different from the rehabilitation that the radically injured have to undergo, the stroke victims, the paralyzed, all the poor devils who have to relearn the fundamentals that have been snatched from them.) In my case, as with most trauma patients, physical therapy meant overcoming the body’s natural tendency toward inertia and its equally natural fear of pain. In other words, getting my lazy ass out of bed and forcing myself to walk. One of my many doctors told me a physical therapist would come to help me stand upright for the first time and help me start to move. Having a fairly accurate idea of what it would entail, I asked if we could postpone the therapy until after the next presidential election, or until Halley ’s Comet returned, whichever came last. The damn fool doctor must have thought I was joking, because he laughed appreciatively as he walked out the door.
It turned out two physical therapists had been assigned to me, Collin and Michael. When I first heard their names I had a lovely fantasy of being helped to stand and walk by two Irish terrorists…
Sure, it’s a fine soft night, so I think I’ll go down to the pub and talk a little treason with me comrades.
…but it didn’t turn out that way. Collin was a local boy built along the lines of a NFL linebacker and as prototypically American as Iowa on the Fourth of July. Michael was Chinese.
Getting out of bed. What a simple thing, such a natural, easy thing to do, something you never have to think about or plan for any more than you have to think about and plan for the act of breathing. Which, since I had to think consciously about breathing, and still couldn’t do it very well, pretty much summed up part of my problem. Everything I did, every movement, no matter how small, how easy, had to be prepared for, considered, planned with the kind of forethought that normally might go into a Navy Seal operation. Just reaching for the button that controlled my morphine caused enough pain that I had to do it slowly and carefully. I gave myself a shot of morphine (actually, this was when I tried to double the dose and realized that the override restriction unfortunately worked) and, slowly, by degrees and with their help, was able to get my legs over the edge of the bed into a sitting position. Michael stood in front of me, holding my good hand, his legs braced, while Collin hovered nearby to catch the falling carcass if things went south. I was advised—frankly, honestly, openly—that it was going to hurt like hell, that it would continue to hurt like hell for weeks to come, and that the only way I could fight my way through to eventual improvement was to try and muscle through the pain. And then, in one of those moments of total unreality that always strike me as unbearably funny, Michael told me to breathe deeply as I used my legs to stand. I started to laugh so hard it made me scream. I told him he was a cretinous, sub-human lowlife for making me laugh, and reminded him that breathing deeply was precisely one of the many things I couldn’t do. And then we went for it.
It was as close to the original pain of the accident as I could go without breaking something else, something new, but I made it. Collin unplugged all the various electronic monitors that recorded heart rate, oxygen intake, blood pressure, other bodily functions—brain waves, and the degree of political correctness of those brain waves, for all I know—and pushed the little stand with all my various IVs while Michael kept one hand on the elbow of my good arm, and off we went. It wasn’t quite as exciting as winning the mile in front of a cheering crowd of schoolmates. It wasn’t as exciting as loping a good horse or dancing drunk beneath the stars with the girl you love and the wind in your hair and that glorious sense of immortality you can only have when young and healthy and happy, but just the simple act of being out of a bloodstained bed, out of a ten by twelve room, out of the helpless confinement of my own body was delicious. I used to run a sub-five minute mile; it took me longer than that, and almost that degree of effort, to make it out of my room and to cover the less than ten yards to the nurses’ station. We turned around there, and by the time we made it back and I cautiously lowered myself, bit by broken bit, into my bed, I was so exhausted I fell instantly asleep.