“You walk better than most people I know.”
An insult conveniently wrapped in a compliment. A stinging backhand. The intent was clear: after several years, he finally brandished new ankle-foot orthotics, or AFOs, and given his previous struggles, the comment came from a place of love, of pride.
But it was, in fact, a slight. A slight against his intelligence, for he knew otherwise. That his walking was worse than the average person. That the culmination of aging and the progression of his symptoms would cripple him in various ways, both obvious and subtle. For the sake of being polite, he grit his teeth and smiled.
The doctor smiled. His wife smiled. Tears fell in celebration.
The comment seeped into his mind like a poison. You walk better…
He tested his AFOs. Tried to jump, to jog, to spread his legs as far apart as possible. Though his knee dug up old pains and discovered new ones, he was, in that moment, happier than he had been in a long while. On the drive home, he and his wife would discuss this newfound elation. Simmering beneath, however, was the silent acknowledgment that this was like slapping a bandage on a bullet wound. Despite this, he would relish in the moment, a drunken fervor that bordered on concupiscence – he wanted to taste the salt on her skin.
Cerebral Palsy had other plans.
She wanted it, too. “Wanna meet me in the bedroom?” Blue-eyed jewels gleaming, a small, crinkled smile. Heat and tension thickened the air. All the harder to breathe.
“I want to but…”
“Your knee?” There’s disappointment baked into her tone. “I get it. Sit down. Rest. I’ll cook dinner later.”
The heat chilled between them. The tension slackened. Another opportunity squandered and he could not help but carry the disappointment she shared. There’s always next time. Until there isn’t. On the couch he grimaced and massaged his left knee. It was cold. Fatigue pulled him down into a soporific trance. Then a final descent into sleep, where dreams eluded.
He awoke to find darkness. What little light slipped through the windows was not enough to guide him, so he pat to his left and to his right, scouring for space to move without tumbling into an accident. Once his brain warmed, his knee screamed.
Nerves set aflame and burning, always burning, and him groaning, clutching for some inner strength to not cry out. But it hurt. He tried to stretch but it only worsened. He bit his tongue, buried his face in a pillow, turned his body so that he lay flat on his belly. Recumbent like the dead but so very alive, too alive, the pain still surging from his knee down to his calf.
He wanted to call for her, but she had work in the morning. She needed her sleep. Please stop, he begged. Please. No more. It’s too much. I can’t take it. Cut it off, cut it off! One slow stretch, a last ditch effort, and finally the pain wandered into the background.
Breathing heavy from the ordeal, he moved toward the kitchen to find water. He knew he needed surgery, but there were no experts – those that specialized in his condition – in the state. It also cost money, and insurance wasn’t about to lend out thousands of dollars on a whim regardless of his plight. Left to his own devices, he wasn’t sure how long he could last before his troubles overshadowed all else, and when such torture would leave him in ruins.
The water was a gift to his parched throat. Cold liquid drained into his empty stomach and sloshed there. In better spirits he raided the cupboards for something to eat. Food had become a distraction beyond the usual sustenance: to quell boredom that stemmed from unemployment, not knowing what to do during the days he spent alone in the house while his wife worked, and in the silence of the night, when harmful thoughts encroached like fearsome beasts.
He found a package of ramen noodles and cooked them. Then he returned to the living room where he picked up yet another distraction in the form of television. So he would eat his noodles and let his mind sit idle as he binged a movie series he had already seen countless times before, and would probably do so again in the future, if this routine was kept.
Such was his life, and whether he knew it, or chose to ignore it, a depression crept in. It did not trespass, for it was given a key, and impressed upon his tone, his mannerisms, his mood, like ink-stained fingerprints. In the quiet night and the lacking day.
“You walk better…”
A minor improvement for a tenuous hold on independence. He strapped on his leg braces, furled his socks over the top straps, and waited, showered and dressed like he was meant for an event that would never come. Perhaps a walk. It was a risk to his knee, but the exercise would be another distraction to tally on his ever-growing list. Time to think. The dog could come, too. A precious Chihuahua that was slight even for her breed, short-haired and eyes that bulged to such a degree that one would think, as he had on many occasions, that they would burst out of their sockets.
He gathered her, leashed her proper, and ventured outdoors. It was a crisp atmosphere: the air held the last gasps of winter as spring marched through. Not quite ready to trade hands. He walked, the dog beside him with her hurried pattering. The shouts of children playing echoed like they were rebounding off of canyon walls. Birds sang. A weak wind breathed through the trees and their leaves scraped together like rough paper sheets. Nature exhaled for the first time in months.
This perambulation’s distinctive rhythm, of stepping in time, filled him with a sense of calm. Pain, however, would pin-prick his patella like nerves regaining feeling. Insects crawling beneath his skin. Then, an electric shock, a defibrillating reminder that all is not well, and at once he buckled. The dog stopped and cocked her head in a manner that suggested confusion, or worry.
He fell. Gasped. He attempted to brace himself against the coming collision and his hands met pavement in a clash of soft and sharp. His right forearm took the brunt of his weight. He kept still except for the breath coming and going from his lungs, his chest heaved in agony, his back seized by knotted muscles. Restrained here by his own weakness, not wanting to move in case a flare up would occur.
The dog nuzzled her nose against his face, trying to lift it, then licking as if her tongue could inspire him to rise. No one passed by. Being in a small village by virtue of population, it would be a long while yet before someone noticed his fix.
He imagined himself appearing dead, or mortally injured, and if only some kind Samaritan would take pity, to lift him, or maybe even to finish the work that had been started by his drop. After minutes, or maybe hours, the afternoon’s light unchanged, he tried to urge his legs on. But it was as if he were slipping on ice; he could not quite get them beneath him into a position that would allow him to stand.
Every turn sapped his strength, and by will alone or tapping into another well of stamina he did not realize he had, he finally got his footing. The job of his lungs identified new pains: his ribs strained, his chest sore as if a knife had plunged there and twisted, stayed. A cursory inspection revealed scrapes and cuts along both arms, two fingers on his left hand excoriated and bleeding, though thankfully not too profusely. His knee could hardly bear his weight now. A combination of the fall and suspect structural integrity given the placement of his kneecap forced him to gimp as if the whole limb lost function.
He held the dog in his arms and they went home. The couch welcomed him, and, by way of over-the-counter drugs and legally grey imbibements, he would mitigate his newfound ailments. Using a carven wood vaporizer, he inhaled hemp flowers. Several draws later, he relaxed. He stuffed three ibuprofen into his gullet, practically choking, easing the contents inside with a guzzle or two of water.
He did not bother to disinfect or bandage his abrasions and instead peeled the dead skin from the two flayed fingers. The bleeding stopped and began to crust, the color darkening from crimson to the first shades of black. He wanted to read or write, but the hurt would not allow: it was all his mind could occupy. Imprinted onto his body like an infected tattoo.
His wife came home an hour or so later. She greeted him, then noticed the damage.
“Babe, are you alright?” She came to him, gently studying, then made to become a nurse, retrieving the first aid kit from the bathroom.
“I’m fine. I just fell,” he said.
Ointment and Band-Aids in hand, she knelt in front of him and applied one after the other: antibacterial on the fingers, the forearm, and the Band-Aids to seal them. All the while there was a look on her face, one he came to know as well as he knew himself. She frowned, but it was in the shape of exasperation, poorly concealed by a hard smile as he joked about what happened and assured her that it was nothing, really. Just a bad day. She kissed his hand and then his lips, but he felt her pull away, falling into the first throes of caretaker’s fatigue. The kiss on his hand burned, and on the mouth it was a gelid bite.
That night they talked, separated by blankets and the hard things that needed saying.
“Eren, you need to find help,” she started, looking at him and then not, down at her fidgeting hands.
He sighed as if the whole of his being had answered this question in a previous lifetime, and this was just another hellish reincarnation, a punishment.
“I know. I get it. There isn’t anyone that could take my cast. We’ve gone over this shit before.”
“Then make some calls… Get references. Do something.”
“This won’t magically cure everything. Yes, right now the knee is the worst part, but my other symptoms are just going to worsen, and there’s not much I can do to stop it.”
“You can still try… Improve your quality of life.”
“And what happens when we don’t get the right answers, huh? What happens when we’re told no over and fucking over? This is my life, Aria. It’s pain and no solutions. It’s inconsistent work. It’s me… me being a burden. It will be this surgery, and then something else will go wrong because it always fucking does.” His voice lowered and broke, vitiated by a tightening throat and a rising heat that warmed his cheeks. Sinuses clogged. The intensity of all these physical stimuli sparked a chain reaction that tensed his back, all his frustration trying to bury itself just beneath his right shoulder blade, a mound of tension that hurt as much as his fall.
He cried and apologized, but no apology could rewind the spool: all the thread that linked them together spent, every frayed strand cut in one single defining conversation. He thought she was at her end, and he would meet her there, to bid her goodbye.
In the following morning he called the university medical center, located roughly three hours from where he lived. The secretary answered and he asked if there was anyone he could speak to regarding potential surgery.
“Do you have an appointment?”
“No, ma’am.”
“Would you like to make one with an orthopedic surgeon?”
“Yes. Yes, ma’am.”
He scheduled the appointment for a Friday, three days from then. Every morning until then and on the day of, his knee did not relent in its onslaught. He was, for this trip, officially bound to his wheelchair, and, through a bit of coercion, was made to take his cane.
The three hour excursion was filled with the sounds of musicals and Aria’s matching the pitch and tone, even as she forgot the lyrics. Eren slept for much of the way, to catch up on a poor night’s sleep and, in part, to escape the pain. He dreamt of walking better, without a limp and painless, down a narrow dirt road lined with trees whose leaves spread stark in their golden green, where the sun’s light maneuvered its way between those interstices, to glint and to blind but in a manner he embraced. A full heart within, ballooning and floating, floating into that blue sea firmament, and beyond, capturing stars and whispering wishes.
When he reached the end of that road, he awoke. For a moment he thought he had come upon an alternate reality: the world had a shadowy tinge, like a layer of dark sheathed every line and every crevice imaginable. Afterimages of his dream still played behind his eyes but out of sequence, events shuffled, reshuffled, then put away, fading into his hippocampus, then gone.
Aria opened his door for him, ready with the wheelchair. “Are you okay?”
He rubbed his eyes, to dust off the crust and weariness. He almost took a dip trying to exit the car. “I’m alright. Just groggy.”
“You sure?”
“I’m good, love. Promise.”
Likely unconvinced, she rolled him toward the entrance. Thus the day would begin in earnest.
They checked in and then waited. An hour unfolded slowly, ushering people away and muffling the bustle of the hospital. Another hour, and silence conceived, within him, and her, to gestate with their worries and fears, giving birth to an anxiety that had them casually glancing at their phones to keep an eye on the time, for it was becoming the enemy. Then the silence was adopted by other strangers in wait, and his name called by a nurse: “Eren Germaine?” Aria rose, rolling him toward the nurse and she led them down a narrow corridor with rooms on either side. She then turned left, into a brightly lit room.
Eren clambered on the bed, lined with a thin white sheet, its crumpled protestations grating to the ears and adding to the problem of their nervousness. He sat up, his feet dangling. Aria spoke.
“What do you think they’ll say?”
Eren shrugged. The nurse strapped on a blood pressure cuff. It squeezed hard. She then got a temperature reading by inserting the end of a thermometer into his ear. He recoiled. After her examination, with a smile that conflicted with her tone, she said that the doctor would see him shortly. How shortly? he wondered, his patience thin and thinning still. It was not a few minutes when a knock came at the door, and without an invitation, the doctor strolled in.
He was a tall man, with a face worn by time and beaten by the sun, wrinkles etched deep into the corners of his eyes and around his mouth, which was recently shaved clean. He glanced down at a clipboard, reading the pages there, then extended a hand toward Eren.
“How do you do, Mr. Germaine? I’m Doctor Cann.”
“Nice to meet you, sir.”
The doctor’s white coat billowed slightly as he found his seat on a nearby stool, not quite fitting his larger frame.
“I see the x-rays on your knee. Your patella is definitely out of position, by a considerable margin. Are you in any pain at the moment?”
“A bit, yeah.” He glanced at Aria, who flashed him a quick smile.
“On a scale of one to ten?”
“Uhhh… 7? 8?”
He nodded as if that was the expected answer and he was just confirming a theory.
“Well, Eren, given your pain levels, and the severity of your overall condition, I would certainly recommend surgery.”
“Oh thank God,” he exclaimed, an automatic response to the news he longed to hear for so long. Aria was almost in tears.
“The soonest we can schedule you is probably a month from now. We’ll need to do a full physical examination just to be sure your body can handle the stress and that you’re in good health otherwise. Sound good?”
“Sounds great, doc. Thank you so much.”
Doctor Cann performed the examination. Eren’s oxygen levels were stable. His blood pressure was on the higher end of the scale but nothing too disconcerting, and, despite some considerable weight gain, he would be ready to undergo the procedure.
***
The surgery went as planned, though, like with his other leg, it was more extensive than intended. His knee cap was lowered, as discussed, but his toes had to be corrected (the big one curled under the others), and his hip stapled to prevent the foot from turning in as he walked. Complications arose, a skin graft from his thigh needed to cover the hole on his foot. He would be in rehabilitation for a couple months, and the pain, they said, would be quite severe until his strength returned.
His entire leg was cast. In addition to helping him heal and protecting his wounds, it also prevented the nails in his foot from moving. It would be a tough road, but it was one he had been on before, and could navigate again.
Then the third month came.
Eren was learning to walk. His knee pain was mostly an afterthought, but his hip had been bothersome to the point of excruciating. He didn’t want to move. Just lay in bed until the worst had passed. Alas, he gimped about the house, that hip lancing his nerves with a cold burn each time his weight came to bear. His lower back did not appreciate the effort as those muscles strained and pulled, and, on one occasion, tore.
Aria came home with a handful of mail. One letter was from the hospital. He opened it, using his finger as a makeshift blade. The gravity of what he read almost drove him to his knees, and would have if he were hale.
$40,000 owed and that included their insurance coverage. He weeped, openly, and the tears irritated his skin, a trail of red in their wake, and his nose drained snot. The physical toll wrought more pains, more stress, more everything he thought he left behind when the surgery resulted in a success.
Instead he felt the cruel gut-punch of failure. His wife held him, saying they would get through it, that it was a battle worth fighting, but he was tired of the war. He just wanted to rest.
“You walk better than most people I know.”
He did walk better, at the cost of making it all worse.
*****
Photography Credit: Jason Rice
Cody de Palma is 29-years old and currently pursuing his Bachelor’s in Creative Writing and English at Southern New Hampshire University online.
