Learning From Injuries

An injury is always a learning experience. Most straightforwardly, if you are an active type, you acquire the dreadful knowledge of the precipitous drop in mood that follows one. There is also the terrible castigation, the self-flagellation that is the inevitable accompaniment to such disasters: there is always, in retrospect, some decision that was fatal, some fork that should not have been taken, there is always some moment you wish you could have back to dispose of all over again, that fatal instant before you hurt yourself. And even if you aren’t an active type, you very quickly encounter the most basic, and of course, valuable, lesson of all:  privation makes more precious the ordinary, the mundane, the weekday. Experience pain, and pain-free existence appears miraculous, salubrious, the most pleasurable state of being of all; you look back upon your pain-free times as halcyon days, hopefully to be revisited in the near future. You realize how terrible the suffering of those must be who live in a state of chronic pain; as you sense your mental fabric unravel, you wonder how they keep theirs together.

You learn about the essential automaticity of the body; on the occasion of an injury, there is little for ‘us,’ for ‘me’ to do, but sit back, and let the body do what it does best i.e., figuring out, how, given the resources available to it, it can get back to locomotion and physical activity as soon as possible. I pulled my calf this past Sunday; a limp appeared out of nowhere, unbidden and unprompted, and attached itself to my gait; my body had calculated the precise amount of pressure my left leg could bear and had made the appropriate adjustments elsewhere in my biomechanical frame; mess with that boundary even fractionally, and a sharp, agonizing pain in my calf muscle applied an immediate correction; there was no messing with my own personal taskmaster, the one that knew best how to accommodate any undisciplined silliness on my part. The body has a pace all its own, a method to its madness; there is accumulated wisdom here, acquired slowly and painfully through an evolutionary history. We now have occasion again to pay witness to it in action.

Lastly, you acquire knowledge about a new kind of euphoria, one that appears as hints of recovery make an appearance. As a spasmed muscle first begins to release, as pain provides the first indicators of a slow recession, we sense deliverance; we grasp at straws; we are grateful. We know we are merely destined to return to a state which we had been willing to scorn previously as merely ‘normal,’ but that destination now appears as the most desired of all. Sobbing with relief, we reassure ourselves we will be appropriately grateful for our daily blessings from now on; we will not take for granted what has been revealed to be a rare and precious treasure. We do this even as we know that we will not; that we will all too quickly return to the blasé acceptance of our fortunes. Till the next misfortune.

Shrapnel is Still Deadly, No Matter Where It Strikes

Many years ago, while talking to my father and some of his air force mates, I stumbled into a conversation about munitions.  There was talk of rockets, shells, casings, high-explosive rounds, tracer bullets, napalm, and all of the rest. Realizing I was in the right company, I asked if someone could tell me what ‘shrapnel’ was. I had seen it mentioned in many books and had a dim idea of what it might have been: it went ‘flying’ and it seemed to hurt people. Now I had experts that would inform me. A pilot, a veteran of the 1971 war with Pakistan, someone who flown had many ground-attack missions, spoke up. He began with ‘Shrapnel is the worst thing you can imagine’ and then launched into a quick description of its anti-personnel raison d’être. He finished with a grim, ‘You don’t have to get hit directly by a shell to be killed by it.’

I was a child, still naive about war despite my steady consumption of military history books, boy’s battle comics and my childhood in a war veteran’s home. So it wasn’t so surprising that my reaction to how shrapnel worked, what made it effective was one of bemused surprise. So those beautiful explosions, the end-result of sleek canisters tumbling from low-flying, screaming jets describing aggressive trajectories through the sky, those lovely flames capped off by plumes of smoke with debris flying gracefully to all corners, were also sending out red-hot pieces of jagged metal, which, when they made contact with human flesh, lacerated, tore, and  shredded? I had no idea. Boom-boom, ow?

As the aftermath of the Boston bombings makes clear, shrapnel is still deadly:

Thirty-one victims remained hospitalized at the city’s trauma centers on Thursday, including some who lost legs or feet. Sixteen people had limbs blown off in the blasts or amputated afterward, ranging in age from 7 to 71….For some whose limbs were preserved…the wounds were so littered with debris that five or six operations have been needed to decontaminate them.

This nation has now been at war for some twelve years. In that period of time, we have grown used to, and blase about, impressive visuals of shock-and-awe bombing, cruise missile strikes, drone attacks, and of course, most pertinently to Americans, the improvised explosive device, planted on a roadside and set off remotely. What is common to all of these acts of warfare is that at the business end of all the prettiness–the flash, the bang, the diversely shaped smoke cloud–lies a great deal of ugliness. Intestines spilling out, crudely amputated limbs, gouged out eyes; the stuff of medieval torture tales. Because shrapnel is indiscriminate, it goes places and does things that even horror movie writers might hesitate to put into their scripts: slicing one side off a baby’s head, or driving shards deep into an old man’s brains.

Weapons work the same way everywhere; the laws of physics dictate that they do. Human bodies are impacted by them quite uniformly too; the laws of human physiology dictate that.

Flesh and flying hot metal; there’s only one winner, every single time.

The Oft-Missed Pleasures of Running

Late into the night of my 28th birthday, I was doing a passable impression of a dancing fool. It was almost four in the morning, I had consumed enough alcohol to administer local anesthetic to a small platoon of foot soldiers, and I was blithely unaware of impending danger. But there it was, in the shape of a hurtling body that belonged to a friend of mine, and which mysteriously, after traversing the length and breadth of the living room in whose corner I was safely dancing, placed itself in a load-bearing position on my right ankle.  When bodies had been moved, I found a rather large protuberance where my ankle used to be. Ice, an emergency room visit, crutches, in that order. And the end of my running career.

Before my right ankle suffered that disastrous third-degree sprain, I used to run. Respectably long distances in Central Park, with an eye on completing the New York Marathon someday. My longest run was eleven miles (2 laps of the reservoir, one loop of the park, and then another lap of the reservoir); my usual run was a morning six-miler, the classic loop of Central Park. I ran in summer afternoons and winter mornings alike; I ran in the rain and I ran in the snow. (My late winter evening runs through Central Park in the winters, when I could see the lights come on in the buildings that line Central Park West and the Museum Mile were as enchanting as anything else I have experienced in this great city.) I ran with professors and graduate students; I ran with roommates. Running made my financial insolvency easier to bear; it provided easy entertainment on days and evenings that sought diversion. (One summer, with my impecunious condition  making it ever harder to indulge in even the occasional beer or large meal, my running transformed me into a whippet-like creature, with sunken cheeks that enabled a resemblance to a prisoner of war at a not-particularly salubrious holding facility.)  I was never a particularly graceful runner but on a good day, I always felt like I glided through Central Park’s beauty, experiencing it in a way that was distinct from my interactions enabled by riding on a bike or by walking.  Running was yet another way to discover New York City, a physically and mentally transformative one.

But a busted ankle that made my right side unstable, and which necessitated the wearing of orthotics (to this day), coupled with sloppy execution of a rehabilitation program, meant that this running was first curtailed and then slowly choked off. I injured myself a year later, when I returned to running a few months later, and then again several years later when I tried again. I became nervous and tentative, and grew hesitant about lacing up a pair of running shoes. My running is now restricted to the occasional lap of Prospect Park, to attempts to run fast 5Ks.

Those occasional laps still manage, effortlessly, to transport me, even if only for much shorter periods, to those days when muscle-powered locomotion at eight miles an hour was mysteriously capable of inducing states of physical and meditative bliss.

A Bloody Shin, Homeostasis and Automaticity

On Saturday morning, while working out in my gym and attempting to complete a series of twenty jumps on to a 24-inch box, I momentarily took my eyes off the target, stumbled, and hit my shin on the jagged edge of the box. I almost fell to the left, recovered, and completed my workout. A few minutes later, after catching my breath and downing a bottle of water, I looked down to see that a 2-inch long, bleeding gash had magically appeared; the force of the blow had pulled a small skin fold away from the open wound; it lay on the right, forming a hairy, matted, bloody, sweaty mess on my leg.  It smarted a bit, and given the potential for the intermingling of various bacterial life-forms, dirt, and the body fluids of those who had previously used the box,  it was probably best to administer a little first-aid, so after washing the wound, I walked over to our handy medical kit, swabbed the area with alcohol, applied an antiseptic cream, laid on a cotton gauze patch, taped it over, and went home.

Two days on, as I gleefully look forward to the prospect of an interesting scar (always good for a story or two), and wait for a scab to form so that the healing process can accelerate, and I can dispense with the nuisance of bandaging, I’m struck again by how injuries and the homeostatic process of healing that follows their disruption of the steady-state equilibrium of the inner and outer layers of skin, provide salutary reminders about the exquisite biochemistry of the body, about consciousness, physical sensations, and attention, and the curious mixture of automaticity and autonomy that seemingly constitutes our bodies and our selves.

I barely felt the blow that caused that wound; at that moment, a host of other sensations–my legs burned from the effort required to explosively jump up on the box–crowded out that momentary trauma caused by the impact on the splintered, sharp edge, and forced my conscious attention elsewhere. The bleeding came to a halt soon enough as platelets and fibrin-containing clots set to work to repair damaged blood vessels; and voila, the always-magical process of wound healing began.

And as that series of complex maneuvers kick off, the admixture that we are is brought front and center: I do not issue conscious directives for this healing to begin, it has ‘a mind of its own.’ I can intervene (my first aid attempts for instance), disrupt and aggravate (by exposing the wound to more trauma) or facilitate (by changing bandage dressings), but the commencement of this exercise was not under my control. Equilibria disturbed; normal service is sought to be resumed. Stand back and marvel; one is given a glimpse of the humming factory that runs 24/7 just beneath, and even on top of, our skins.

Sometimes you can pay attention to the way you sweat on a hot day; and sometimes you need a smack upside the head–or a scrape on the shin, to remind you of the finely pitched control maintained by this fantastically intricate bag of skin, bones, and blood, striving constantly to maintain its integrity against all that presses in on it from the ‘outside.’