Thanks Giving Thanks

I've always told my girls that we're rich. We have money enough to eat what we want to eat and to help a few of those who don't. That's my definition of wealth. To have too much is, in the words of a Fairground Attraction song, too absurd.

This Thursday is Thanksgiving in the US. The day after Thanksgiving is called Black Friday. I love Thanksgiving. There is something great about a country whose main national holiday is about gathering together with friends and family to eat and talk and give thanks. Call me naive, but I think Thanksgiving brings out the best in people. Conversely, Black Friday provides example after example of the things which aren't so great about the US: a rampant consumerism, a blatant disregard for people other than oneself, a bloodthirsty hunger for a bargain. If you think I'm exaggerating, have a look at Black Friday Death Count, which monitors how many people are killed each year. Killed shopping.

I've recently been elected onto the board of a regional food shelf charity. We supply food to local people who've fallen on hard times, people who haven't got enough money in their pockets to buy the food they need, people who are described, in policy speak, as living in 'food insecure' households.  'Food insecure' means lacking reliable access to affordable, nutritious food. The cheapest way to eat in the US is to buy junk food - high calorie foods which have little nutritious content - so, ironically, symptoms of being 'food insecure' often include obesity. There are also strong correlations between being 'food insecure' and having chronic kidney disease, diabetes, behavioral problems, mental health issues, and hypertension. The problem is growing: 14.5% of the US population live in poverty, 49.1 million people live in 'food insecure' households across the US, and 1 in 5 Vermont children experience food hardship.

At the last food shelf meeting, John asked us for more money. His  name isn't really John, but he doesn't like to publicize the work he does so I would feel uncomfortable using his name on this blog. He's a Mason. I've always been wary about Masons - based purely on crass stereotypes of misogyny and funny handshakes. For the past six years, John has been on a mission to make sure that people can have a hot Christmas dinner. John is a man of high standards: the meals are delivered hot within an hour of being cooked, recipients choose what they would like to eat from a menu, the service is completely confidential, and this year John and his team estimate they will deliver 250 hot dinners to local families who would not otherwise have a Christmas dinner. They are informed about people in need through social services, confidential referrals from schools, and word of mouth.
 
'In a way that's just the start,' he said, leaning forward onto the table. 'We encourage our drivers to be sensitive. Last year, we delivered to a woman who asked for a small portion because she had nowhere to store leftovers. Within three days, we'd had a whip-round and delivered a fridge to her house. Another man told us he hadn't had a hot meal for several weeks because his stove had broken, so we arranged for a handyman to mend the stove and check the safety of the other gas appliances while he was there. There's lots more examples I could tell you, but the one which stays with me...' He paused, pushed his glasses down his nose and rubbed at his eyes. 'The one which always makes me want to keep doing this year after year was a little girl who ran out to the driver wearing flip-flops. There were a few inches of the snow on the ground. The driver made a joke about how brave she was running around nearly barefoot, and she just smiled and said she didn't have any proper shoes because they'd got too small for her. Within 24 hours, we were back at her door with $150 cash.'

John explained he was embarrassed to have to ask for a larger donation from us this year. When he started his charitable scheme in 2008, he could provide a full Christmas meal for $3.05. That included a starter, main and dessert with generous portion sizes (and, given that John was a generously sized man himself, I can only imagine what must be a 'generous portion' in his mind!). He works directly with suppliers to try and keep down costs. Everyone involved is a volunteer, drivers pay for their own gas, and the local school funds the kitchen expenses. Even so, this year he can't manage to provide the meal at less than $5.43 per head. Unemployment statistics might be going down as the US appears to recover from the recession and gas prices might be the lowest for 4 years, but the real cost of food is higher than it has ever been.

As part of their charitable activities, our local supermarket has a Helping Hands food box scheme. For a $10 donation, customers purchase a box filled with basic food stuffs - oatmeal, cereal, pasta, rice, peanut butters etc. - which is then donated to the local food shelf charity. On Sunday, the girls and I needed to collect that weekend's Helping Hands boxes and take them to the food shelf offices. People had donated three shopping carts' worth of boxes. It took a while to fit them all into the car. It's probably the closest I'll ever get to the Black Friday madness - filling my car with special deals and forcing my children to squash into the back seat among all the bargains. And it felt great.

Yoga greed

The yoga studio is stylish: stripped wood floors, exposed brick walls, ambient music playing in the background. Among the comfy sofas in the waiting area, a wide selection of expensive yoga clothing is displayed for sale. Burlington has a lot of yoga studios, but I can’t name this one in case they sue me. I know that wouldn't be very yogic behavior on their behalf, but underneath all the window dressing they’re not a very yogic place. 

The receptionist was sipping something beige and gloopy out of a see-through plastic cup. We’d met before. She wants to be a yoga teacher but hasn’t completed her training yet. If she hadn’t already told me how passionate she is about holistic health and how much she believes in maintaining the purity of the human body, I would have sworn she had a hangover.

Ideally, I wanted to see the finance manager, but the finance manager doesn't have a fixed schedule and hasn't been returning my calls. The studio prides itself on upholding a laid-back approach to the work place which, the receptionist had explained in one of our earlier conversations, counters the relentless, insidious corporate ethos of so many other businesses. It's possible this makes the staff happy, but it doesn't contribute towards excellent customer service. 

I smiled, said good morning, and explained I’d like to talk about the bills I'd been sent; and the receptionist winced slightly - which could have been hangover related, or might have been her reaction to me speaking about nasty materialistic money-type stuff.  

‘What exactly don't you understand?' she asked, flicking back a strand of her unbrushed brown hair and fiddling with the edge of one of her big silver earrings. 

'I don't understand why I owe you several hundred dollars when I paid for all my sessions up-front,'  

'I'm sorry if I gave you the impression that you'd paid,' she said.

'But I did pay,' I interrupted. ‘You swiped my credit card, I signed, and you took money from my account.'

'Actually, that doesn't mean you paid.' She scowled at me. 'We don’t know how much to charge for a session until we've contacted your insurance company.'

Medical insurance in the US is complicated:

1. The majority of people pay into some kind of medical insurance arranged by their employer. 
2. If you can’t pay for medical insurance, you’re screwed. (Iola’s school in Cambridge hosted a fund-raiser last year for a family whose 8-month old baby fell ill and died within 2 months. The family were about to have their home reclaimed and to declare themselves bankrupt because they couldn’t pay their dead child’s medical expenses. When I mention this to American friends, they can all think of similar scenarios with people they know). 
3. Some insurance providers operate 'co-pays', where the individual pays a flat rate up-front for each medical visit; other insurance providers have a 'deductible' which means the medical provider bills the insurance company who then bill the individual. The amount of the 'deductible' varies from insurance provider to insurance provider, from employer to employer, and from individual to individual. 
4. Once the 'deductible' amount has been met, a greater portion of medical costs are then covered by the insurance provider. (It has taken us several years to pay the deductible and other bills related to Maya breaking her leg nearly three years ago; it will likely take us several more years before we have paid all the costs associated with breaking my neck. Illness and injury in the US are comparable to taking on an additional mortgage.)
5. Different medical providers charge different amounts for the same services. So, for example, a mammogram might cost several hundred dollars with one hospital but several thousand dollars with another. 
6. And the same medical provider might charge different amounts for the same service depending upon the client's medical insurance provider. 

It is all very incestuous and almost impossible to untangle, and nobody likes talking about it very much. In the yoga studio in Burlington, the receptionist stared at her computer screen, as though hoping I might go away. 

'If I hadn't shown you my insurance card, would I owe you money? ' I asked. 

‘No,’ she answered. ‘If I hadn’t contacted your insurance company, the amount you'd paid would have covered the service.’

‘So it’s like going to the general store, and buying a gallon of milk.’ I began. ‘I pay $4 for the gallon of milk, but mention that Fred has given me the money to pay for the milk, at which point you decide to charge me $6.’

There is a particular facial expression some people use when they think they're talking to the village idiot; it tends to combine a tight plastic-y smile, clenched teeth and narrowed eyes. The receptionist put on her 'talking to the village idiot' face and spoke very slowly, 'You paid the amount it would have cost if you didn't have medical insurance. But you do have medical insurance. So you now owe this much money,’ she pointed at the bills I had put on her desk.

When I tried to explain I didn't think it was fair, the receptionist lost interest in our conversation. It's possible that, before trying to become a yoga teacher, she aced an assertiveness training course.'I'm not sure what you want right now,' she said. 'Some people like to vent because they feel bad about something, and if that is what you would like to do right now I am willing to listen. Other people want to understand a problem and, if that's what you want, then I have explained it to you and I am willing to repeat my explanation.'

I tried to take a slightly different tack. 'For my first session, I booked a yoga therapy evaluation. I was told it would cost $140. I paid $140. The session took slightly less than the hour I was told it would take. You have now sent me a bill which states I also received 'Therapeutic Exercise' for $110 and 'Neuromuscular Re-education' for $40. I did not ask for those services and, until I received this bill, I did not know I had received them.'

'How would you know?' she asked. 'You are not a medical expert.'

I still like yoga. I used to be able chattarunga with the best for them and my corpse pose is an absolute killer, but most yoga poses are more difficult for me now that I’m metal-necked and nerve-damaged. I'm pleased the receptionist and the finance manager benefit from working in an anti-corporate environment, even if it is funded by their extortion of additional funds from unsuspecting insurance providers. And I hope the finance manager returns my telephone calls one of these days. I haven't paid the bill yet because I still don't understand what I am paying for, so I'm sure she'll soon track me down with a reminder. While I’m waiting, I’m going to download a few yoga lessons from Amazon and set up my yoga mat in the corner of my bedroom. It's not a particularly stylish room, it lacks some of the atmosphere of the studio in Burlington and I'm sure there are ethical issues associated with using a large corporation like Amazon, but at least I'll know exactly what I'm paying for. 

Faith

I've been reading a lot lately: Anne Lamott's Traveling Mercies; Barbara Glasson's I Am Somewhere Else; Bruce Chatwin's The Songlines, and a heap of memoirs besides - accounts of misspent childhoods and voyages towards self-discovery. There's been a lot of 'God' on my bedside table and piles more on my desk: there's a half written letter to one of my closest, oldest friends who is being admitted into the Church of England as a Reader later this month; there's a little pile of gifts for two other, more recent but also very close friends, who are about to return to Australia - one to head a parish and the other to continue his academic career writing about Christianity. I've also been watching a slew of Netflix documentaries on Christianity, my favorite of which is 'For the Bible tells me so...' which includes the following film sketch (helpfully annotated here by Gay Star News).

My understanding of the Bible is similar to my understanding of Coronation Street - I grew up dipping into occasional episodes, and I have some understanding of the main characters, some memories of the main story lines, and a fascination with the more outlandish twists in the plot. I used to watch Coronation Street at my grandmother's house, glancing at the screen while sucking mint imperials and leafing through horse magazines; I used to sit through endless episodes of Christianity at our local church, half-listening but preoccupied by the village doctor snoring at the back of the choir stalls. By the time I became more interested in what was going on in the Bible and why, the village vicar had decided I was somewhat - ahem - "troublesome" and tended to avoid answering my questions on the rare occasions when he hadn't successfully managed to avoid me.

I don't watch Coronation Street anymore - in fact, I probably wouldn't recognize half the cast these days. The Bible has the advantage because their cast hasn't changed for centuries (except for the addition of a new saint every now and again), but rather than being reassured by the familiarity, I am increasingly frustrated. Primarily, I am frustrated about the absence of female characters and the awful behavior of those few women who have been written into the Bible's pages - Eve accidentally brings about the downfall of the entire human race; the only career advice Naomi thinks to give her recently widowed daughter-in-law is to sleep with a wealthy distant cousin (which proves the old adage that it's not what you know, but who... in the Biblical sense); Mary gives birth without a midwife (Really? The town was packed to the gunnels with females but none managed to help? Virtually every other birth in history is attended by females but not this one??!); Delilah gave Samson a bad haircut; Martha complained a lot about the housework; and Mary - the other one - gave Jesus an expensive foot massage.

I was in my 30s before I heard about Veronica. She's in that episode when Jesus is struggling to carry the cross to Golgotha and everyone is wailing and sobbing and gnashing their teeth on his behalf. Veronica steps forward and wipes his face with a damp cloth. I like that. It's something I hope I might do in those circumstances - to step forward and try to make a bit of a difference, even when there is not much anyone can do. Because I was excited about finding an admirable female in the Bible, I chose to sit next to a Jesuit priest later that week on a train journey from London to Scotland. He told me people normally choose not to sit next to him because they're put off by his religious habit. I think he might have preferred to sit alone, but I wanted to talk about Veronica and it felt like too good an opportunity to miss.
'What do you know about Veronica?' I asked as we drew out of King's Cross.
'Nothing really,' he answered.
'Really? Nothing?'
He shrugged and explained she wasn't an important part of the story.
We talked a lot over the next 4 hours, but it appeared there was really very little to say about Veronica.
Ten years later, I asked the Professor of Liturgical Theology at Harvard the same question. He's about as far removed from a Jesuit priest as you might imagine two people to be: one wears a brown habit, the other wears jeans; one has dedicated his life to obeying the Bible, the other one to deconstructing its message. But the Prof's shrug was similar.
'She probably didn't even exist,' he said, 'I suspect she might be a metaphor.'
The only woman I've found in the Bible who makes me want to encourage my children to read Bible stories, and she's probably just been made up by someone wanting to make some kind of theological point? Great.

I don't believe the Bible is the word of God, as some of my friends do, and I can't accept that every word contained on its pages is a great unquestionable Truth. In fact, if God was going to do the whole thing again and wanted my advice, I'd recommend he or she demanded a greater degree of editorial control.

But I'm not willing to throw out the baby with the bathwater, either. I'm not willing to reject my sense of wonder and amazement, to neglect my faith that something beyond humanity makes the world a better place and offers help in times of need (even when we don't or can't or won't listen). I'm wary of people who interpret the Bible literally and use it to justify their prejudices, but I also know that some of the most amazing people I have ever met are guided by a profound sense of faith - to name a few, I'm thinking of Anne Shumway and her dedication to vulnerable women across Massachusetts, of Pastor Rick and his peace work in Jerusalem, of Rev. Sekou and his determination that the voices of the people in Ferguson, MI will be heard because that is the only way the conflict will be fairly resolved. There are many, many more. In fact, I'm sure that for every bigot who uses the Bible for their own means, there are far more people working within religious communities to make the world a better place. And I am glad of them.

I don't know where any of this leads me, or leaves me. But I've been reading and I've been thinking and God has been on my mind.

Words, faces and electric shocks

Some things seem inevitable: the stiffness in my neck and shoulders; the constant low-level pain; the restrictions in my movements; the itchiness around the area where my scar is healing (my scar, by the way, still looks spectacular - a kind of hybrid between bad-ass zombie war wound and Zippy's fastened shut mouth in the 1970s' tv show, Rainbow.)

But there are other things besides.  

1. Words

Because of the shattered bones in my neck and the real fears of paralysis, the medical team gave little attention to the lacerations in my scalp at the time of my admission to hospital. By the time they'd operated and I'd recovered from the anesthesia, the holes had mostly scabbed over and the nurses were unsurprisingly reluctant to poke about at my head when it was only connected to my body by a few bits of metal and a screw or three.

I began to notice my word confusion during my time at the rehabilitation center. Very specifically, I noticed my relationship with words had shifted when I spent an entire morning trying to find the word 'anatomy'. But this was during the 'hey, be grateful!' part of my recovery: a period where anything I noticed or pointed out about my condition merely emphasized how fortunate I was to not be (a) dead, (b) severely brain-damaged, or (c) in a wheelchair. (I am still exceptionally grateful for those things in a way I cannot easily put into words, I just don't use the exclamation mark as frequently.) 

By the time my 6 week check-up came around (starring the beautifully made up physician's assistant and the blue-eyed surgeon), I knew something was wrong. My words were addled and my short-term memory was shot. The beautiful physician's assistant pouted at the computer screen and scrolled through some of the CT scans which had been taken on the night of the accident, but she seemed unenthused - as though they were part of a soap opera episode she had already seen. By this point we'd also moved into the 'Let's Wait and See' part of my recovery, so her response to my concerns was, inevitably, 'Let's Wait and See' - delivered with a smile, before she went to touch up her mascara.

I've been obediently doing a lot of 'waiting' and 'seeing' lately, but I've also been talking a lot of nonsense. 

The typical morning in our house involves me chivvying the girls to get ready for school:

'Come on, Iola. You need to get your school sandwich ready.'

'I'm on school dinners, mmmmy.'

'Not your school sandwich - your school bag. Obviously, your school bag. Have you taken it out of the kitty litter yet?'

'The kitty litter?'

'No, not the kitty litter - the boot room! Have you taken your school bag out of the boot room?'

The girls are now so used to their mother being linguistically inept that they either laugh or try and guess what I really mean. It's more difficult when my words get messed up in front of strangers. 

For example, yesterday afternoon I'd arranged a play-date with another mother and her two daughters. We don't know one another well, but I enjoy her company hugely and I was looking forward to her visit. A few hours before her visit, she sent an email explaining the complexity of her day but saying she would probably be on time. I replied, telling her it wasn't a problem. Or I thought I'd told her it was 'no problem', until I opened the email later that evening. I had actually written that I was sure there was 'no probability' of her being on time. Hmmm, charming. I don't know if she thought I was rude or existentialist, or a mixture of the both, but I'll apologize next time I see her... if I remember.   

2. Faces

My accident happened two weeks after moving to Vermont. My children attend two different schools which means I need to know the names of about 15 new teachers and school staff, as well as smiling vaguely at more than 50 parents as we stand around at the end of the school day waiting to collect our little darlings. We also have new neighbors, I see new faces on dog walks, and I smile somewhat hopefully at the same people who serve me in the local shops, the post office, the library etc. It would be challenging enough to remember everyone's name even if I still had a short-term memory.

I have clearly offended some people - asking several times which child is theirs, or forgetting to acknowledge someone whom I was talking with only a few days earlier. Other people find it hilarious: Dan - who might be called Dave but seems to answer to both - has offered to write out name cards for people to wear whenever they speak to me, and Iola's class teacher suggested I might make a set of flashcards with people's names and faces on them. My concern about this second is that it risks ending up becoming a completely inappropriate version of Happy Families!

3. Electric Shocks

I've never been a fan of shopping, but nowadays it hurts. The worst culprit is the local organic supermarket which is all craft-beers and organic cotton yoga tops and homeopathic medicines. This morning I suffered 18 electric shocks between the kale counter and the kombucha bar. At the customer services counter, a young woman with enormous deer-like eyes, long hair and long silver earrings smiled as I approached.
'Does anyone else suffer shocks when they shop here?' I asked. 

'Shocks?' She nodded, but it seemed an involuntary movement - the infinite action of a nodding dog toy sitting on the parcel shelf of a car rather than an indicator of human agreement. 'Like what kind of shocks?'

'Electric shocks,' I said. 

'Hmmm,' she put her head slightly to one side, but continued nodding. 'Electric shocks.'

'They hurt,' I said. 'And it happens every time I shock here.'

'You shock here?'

'No. Obviously I shop here because that's why I'm here with my shopping cart and my collection of reusable shopping bottles, but your store gives me shocks and I have this thing with words right now.'

There was a lot more I was about to say but a look, midway between alarm and fear, crossed her beautiful deer eyes and, for a brief moment, she stopped nodding. It seemed like a good point to shrug and leave.

On the positive side, I won't recognize the long earring-ed customer services person when I next go into the store, which will give her plenty of opportunities to avoid me. On the less positive side, it means I'm no closer to a solution of how to buy my organic carrots and ethnically scented candles without repeatedly electrocuting myself. I had wondered about trying to find a home delivery service, but the combination of my tendency to use the wrong words and my inability to remember what I want could make this a very expensive mistake. Instead, I'll put on rubber-soled shoes and do the old-person shuffle around the store in the hope that it might make it less shocking. I can console myself, at least, with the knowledge that I won't remember the humiliation in too many details by the time I've driven back home. 

The mountain

No longer broken but not yet quite whole, I accidentally climbed the mountain.

Sunday was a good day for a walk: the sun was shining, the sky was blue, and the mountain was at her most fetching. A little tall, perhaps, but not ridiculously so.

The higher you climb, the smaller the trees. Here's a photo of Nathan being a Wood-elf King (we live in Underhill, for heaven's sake, and need to reference Tolkien and hobbits at least once a day...)

After a while, the trees gave up completely. On a camera better than mine, you'd see New York State and the Adirondacks spread out on the horizon beyond Lake Champlain. But look at the sweat on Nathan's t-shirt. See? We'd earned that view and it looks like we're at the top, doesn't it? Mountains are like that. Deceptive beasts, leading you on, pulling another challenge out of the bag just when you think you've won them over.

I learned a lot on Sunday. First, you know those thin pale gray lines on maps? The gradient ones? This photo shows what happens when they're really, really, really close together. And, second, when the Appalachian Mountain Club describe a walk as 'extremely challenging', they're not kidding. (It was around this point on the walk that I made the decision to believe every single word of every single thing I read from this moment on). Third, I learned how much my broken neck has affected my entire upper body strength. Three months ago, I could lift any of the boxes our removal men hoisted around; now, I'm significantly weaker and the nerve damage to my hands and arms means I don't always know where my hands are gripping unless I can see them. I managed to scramble up after Nathan (and follow him up a few other similar climbs besides), but it was not pretty and it was not elegant.

The trail was made in the 1910s by some free-thinking creative Vermonters. In the places where the gradient was too steep to scramble, they drilled tunnels. Perhaps they were as tired of climbing as I was by this point in the trail's design. Standing up there at silly-thousands of feet, I could hear their voices from over a hundred years before...
"Damn your eyes, Fitzgerald, there's another scramble here."
"Might I suggest a little dynamite, sir?"
Whatever. I like tunnels. I really like tunnels. Tunnels mean you don't have to scramble up near vertical rock faces or leap across 5ft ravines. Regardless of how many times Nathan banged his head (because even free-thinking Edwardian Vermonters didn't build tunnels for men who stand 6'7'' in their socks), I will not have a bad word said against them.

I'm not sure if I expected an easier walk because we started from our front door (there's always that strange psychological glitch which suggests something is only truly adventurous if you have had to make a journey to get there), or because my broken neck is stopping me from thinking straight. And I'm still not quite sure how I hadn't understood that our path was taking us to the top of the mountain. But we did it, and the fact I cried twice, bit through my lip on one of the ascents, and could barely move for a few days' afterwards is neither here nor there.

The true testament of the walk is in this photo. It's taken me nearly 2 years, but - look! - I finally wore out the dog.

And this is what I look like after climbing a mountain with a broken neck. You'd never know, would you.

The problem with history

It was Iola who started the conversation with the man at Shelburne Museum. We were in the museum's printing shop: a real-life museum exhibit with an authentic assortment of large cast iron presses, printing materials, and an elderly man with half-moon glasses, a large printer's apron, and a face filled with carefully tended facial hair. 

Iola looked around at the alphabet posters which decorated the walls of the shop: 'O could be for Owl too,' she suggested

The man studied her for a moment over the top of his glasses, sniffed slightly and replied, 'Here O is for Oven.'

He is, I soon discovered, a man who does not like the possibility that things might be different from how he thinks they are. 

Iola had started the conversation, but he looked over her head and began talking to me. Together we admired the black iron hand press which he had used to produce the alphabet posters. It was his favorite and had, for many years, been the only one in the world. The corners of the man's mouth drooped suddenly. 'Then somebody found another one in New Jersey.'

I offered my condolences.

'There have been historians...' his face contorted slightly as though the word 'historian' tasted bad, '... who have looked at this hand press and the one in New Jersey. They said that this one was built in Boston, then the shop burnt down and the press maker moved to Philadelphia where he built the press which is now in New Jersey.'

I nodded, half-listening. 

'But!' His shout made both Iola and I jump, 'If that's the case then how can the New Jersey press have been built in 1826 when the Boston shop didn't burn down until 1831?'

He raised his eyebrows towards me, as though expecting me to answer. I couldn't. 

'Exactly! So, the historians go away for a while. Then they come back and say that means the New Jersey press was built first in Philadelphia, and the press maker moved to Boston afterwards.' 

'OK.'

'No, not ok!' He placed his hand flat against the press. 'This is obviously the older of the two presses - look at the shape of the handle here? At the way this part is engraved?'

I looked but, to be honest, neither thing meant much to me. 'What do the historians say now?' 

'They don't.' The printing press man pushed his spectacles up his nose slightly and smiled. 'They've gone away again and won't talk to me anymore.' 

While Iola wandered around the shop, I continued chatting to the printing press man. I enthused about the developments in technology which had enabled Mormons to carry small mobile printing presses on their travels in the early 1800s; how each new gold-rush settlement would somehow manage to set up a press and establish a local newspaper, even when the town had only appeared seemingly overnight. I thought he was interested, I thought we were having a conversation, until he interrupted. 

'The real problem is the patent office burnt down in 1836.'

'Oh.'

'So there are no printed records.' He traced two fingers along the engraving at the top of the machine, as though caressing the hair of a favorite child, and then leaned forward conspiratorially. 'I've got a theory,' he said softly, his eyes gleaming behind his spectacles. 'I've traced back her owners to 1860 and I''m not going to give up. I don't think she was made by the man they think made her!'

'Oh.'

Iola reappeared and tugged at my hand. I wished him success with his hunt and said goodbye, but he didn't answer because he was already telling another museum visitor how the hand press used to be the only one in the world. 

We made up other alphabet posters as we walked around the museum grounds: W was for Walrus because of the size of the man's moustache, U was for Unique, in case the hand press really was the only one in the world, and O... Well, O is for Oh because sometimes there is nothing else one can say. 

The Start of the Fall

A series of days when the sky is paintbox blue and the breeze is soft among the trees. I'm regaining some of my energy and can stay awake long enough to see the sky packed tight with stars and the harvest moon making moon-shadows across the grass.

Our mornings begin early: Maya's bus collects her just over a mile from our house at 6.50am and Iola's school starts at 7.30am. We wake before the darkness silvers into dawn and hurry through our breakfast, while the kittens weave around our ankles and the hens cluck about their yard. The dog, with the wisdom he has gained from no longer being a puppy, hides beneath the covers in the warmest bed he can find until we are ready to leave the house.

My mother is staying for the next few weeks and I'm seeing our area through her eyes. She's been driving to the village and back, braving all the Vermont trucks which meander along on the 'wrong' side of the road and slaloming between the potholes which mark the point where the road repairs began earlier in the year and then abruptly stopped when the State funding was cut. In the UK, I am sure, the road would be considered unsafe and either closed completely or signposted extensively to warn drivers to slow down or take a detour. Here, there are no warnings: only a subtle change in the color of the tarmac. One minute all is well, the next moment the car's suspension bucks and jolts. The grin on my mum's face makes me suspect she's rather enjoying the excitement of the Vermont roads.

She's also enjoying the amazing array of foods. We ate our way around Montpelier Farmers' Market on Saturday: kimchi and burritos, clay oven baked pizza slices and pan-fried heart, pickled everything and maple syrup creemees and apple cider. The farm stall between our house and Maya's school is banked high with squash, sweetcorn and this season's apples and many local homes have produce stands at the ends of their driveways. I'm sure we should be canning and pickling and filling the cellar with things to get us through the winter, but we're too busy eating a lot and smiling.

We're also walking a lot. This morning, after the girls were at school, we headed up into Underhill State Park. The park is open until the middle of October, but there was no-one there this morning except Linda, the warden. She was pleased to see us: it had been a long evening with no campers and only her dog for company.

We climbed up through the park and headed South along the CCC road, feeling particularly grateful to Ruth who has loaned my mum a pair of walking boots. This lower slope of Mount Mansfield is heavily wooded: the birch and beech trees slowly giving way to coniferous forest as the elevation increases. A couple of miles from the trailhead, a firebreak has been cut through the forest and the view is, to use the local parlance, awesome! My mum and I sat for a while, looking out all the way to Burlington and Lake Champlain and to the Adirondack Mountains beyond.

We would have stayed longer but we needed to get home: we needed to plan what we were going to eat for lunch!

Life Lessons

My stiff upper lip English-ness, which tends to keep chin wobbles firmly in check, has taken a bit of a beating recently. I have cried through a variety of teen movies and go all misty-eyed at the slightest touch of movie manipulation: a shift in the soundtrack, a close-up of the heroine's face, an allusion to parent-daughter relationships. This past week alone, I have cried through LemonadeMouth (a saccharine Disney Movie), Mamma Mia (a raucous comedy) and one of Iola's episodes of My Little Pony when the other ponies were being mean to Fluttershy! There have been tears of rage - when my old-person-fingers couldn't peel the lid off a yoghurt pot, when I got trapped in my sports bra; and there have been tears of exasperation - when the physical therapist wouldn't listen to what I wanted to do, when I couldn't knead the potato bread I wanted to make. I've also cried quieter tears of loss over the letter from an old school friend about the still birth of her son, over the news from another friend about the loss of her pregnancy when her ongoing journey towards parenthood has already taken so many years.  

My courage has been battered too. As many of you know, Nathan experiences night terrors which send him careening out of bed in the middle of the night. In the past, I've cajoled him, reassured him, shouted at him, pleaded with him to get back into bed and go back to sleep. Now the sound of him moving around our room in the dark leaves me coated in cold sweat. I have fastened a child gate to our bedroom door and have three torches on my bedside table, because once I've got the lights on I can coax Nathan back to bed and he'll sleep through the rest of the night with no memory of what's happened. But I find it hard to get back to sleep these days.

Laughter comes easier too though: I couldn't tell you what started Maya and I giggling as I put the pasta on to boil this afternoon, but we were still snorting and wiping tears from our cheeks as I dished out the cooked food. Laughter shifts our reality by altering the way things respond to us. These days I laugh when the dog starts growling and huffing at strangers, and he soon gives up on his pretend aggression and asks to play ball instead. 

This evening the hens escaped as I was putting them to bed. Ordinarily, I would have been irritated. Locking up the hen house is a straightforward chore when the hens are inside, and an exercise in futility when they're not. It wasn't what I'd planned and they had no interest in going into the hen house when there were bugs to eat and cut grass to scrat around in. After a few failed attempts to round them up, I took out my deck chair and sat down to enjoy the view. It was a beautiful evening: the mountain piled high with storm clouds to the East, the setting sun making the air heavy as honey, the hens striking picturesque poses among the weeds. Maya joined me. For a while we sat in silence, then we laughed. Sometimes there is nothing else you can do. 

More on Dr. M.

It might be worth beginning with a few background facts:

• Seventy-five percent of Vermont is forested, making it the fourth most forested state in the US. (If you can imagine that Vermont is one tenth the size of the entire UK - Scotland included - you might get the sense that that is a lot of trees!)
• Vermont has the smallest carbon footprint of any state within the US.
• Vermont is the only state in the US which does not use coal to generate electricity. 
• Winter in Vermont tends to last around six months (mid-October through to April). 

The reason for mentioning these facts is to provide the context for my recent post-surgery conversation with Dr. M.

In Vermont, nearly every house has a large wood-pile neatly stacked in its yard because nearly every house is, at least partially, dependent upon burning wood for heat. Stacking wood is so ubiquitous at this time of the year that every conversation - in the farmer's market, in the general store - will include one person grinning broadly and commenting on how wood keeps you warm three times over: once when you chop down the tree, once when you stack the wood, and once when you burn it.

It took Dr. M. and me a little while to move our conversation around to wood. We were too busy defining the list of things I am not allowed to do since breaking my neck.

I began with my favorites:
'Can I start horse-riding again?'
'Not yet.'
When I sighed, he called up my x-rays on his computer screen and offered me a quick lesson in statistics.
'In a normal person, there might be a 15% chance of this part of the neck breaking in the instance of a fall.' He circled the section of the x-rays where shiny parallel lines depict some of the metal work I'll carry around with me for the rest of my life. 'Now with this kind of fusion, you'd need to factor in a 10% greater chance that the first three cervical vertebrae would fracture.'
He didn't need to say more. I'm not an expert on ratios, but I know that fracturing one of the first three cervical vertebrae is the kind of injury which landed Christopher Reeves, and many others, in a wheelchair. They were the lucky ones: breaking the top few vertebrae in your neck normally stops you being able to breathe as well.
'So not yet,' I echoed and Dr. M. smiled, apparently pleased at the readiness of my understanding.

'What about my bike?"
I love my bike. It's been my fast-moving, narrow-wheeled companion through four major relocations; carrying me up Cumbrian mountainsides, past Northumbrian coastlines, through Cambridge traffic, and, for a few short weeks, along Vermont roads.
'What kind of bike do you have?'
I leant forward in my chair, wrapped my hands around imaginary handlebars and, for a moment, felt the wind rushing through my hair.
'Don't sell it yet,' Dr. M. said, 'But you might want to think about replacing it in the spring.'
'Replace it with what?' Being told to replace my bike felt a little like hearing someone say I should replace my dog with a different breed.
Dr. M. sat up tall, old-lady-like, and lifted his hands to chest level.
'A sit-up-and-beg?' I scowled and, apparently less pleased by the direction of our conversation, he arranged his face into a more authoritative expression and quickly lowered his hands to his lap. 'Don't try and ride your bike this year. We'll know more in the spring.'

God loves a trier, although Dr. M. might not agree. My questions about yoga met with a shake of the head, the doctor made it very clear I shouldn't sign up for Iola's taekwon-do classes, there will be no cross country running for me this year, and rock-climbing is off the agenda. Furthermore, I should encourage the girls to help me with vacuuming, I shouldn't lift heavy pots off the stove, and it would be a good idea to have someone else carry the wet laundry up out of the basement.

The silence between us was not completely comfortable.

'Can I stack wood?' I asked, having exhausted every other physical activity I could imagine.
'Yes.'
I'm not often at a loss for words, but he was meant to have said no, wasn't he? Six cords of wood had been delivered to us that week (a cord, properly stacked, occupies a volume of 128 cubic feet. We hadn't measured the volume of our 6 cords of wood, because we had not yet made any attempt to stack it).
'I'm not going to advise any patient to fail to prepare their family for the winter,' explained Dr. M.
'And I won't cause myself any damage?'
'You won't damage the work I've done on you.' Dr. M.'s blue eyes sparkled for a moment. 'And your body will tell you to stop stacking wood far sooner than I can.'

Of all the things of which I am afraid (and you might now want to add stairs and light switches to that list), hard work is not one. The next day I tackled those 6 cords of wood with all the anger and resentment I felt at being forbidden from riding a horse or a bike, at being unable to throw a round-house kick, or sit among a group of elderly women muttering namaste. I lifted and threw every ounce of fury at those pieces of wood, and I learnt that I love wood-stacking! It's like playing jenga with weights and, while it is not as satisfying as riding my bike, it burnt off some of the adrenaline which has been stagnating in me for nearly two months. In truth, I might even have smiled and sang while I worked.

Dr. M. was right, of course  - it's his job to be right. I have barely been able to get out of bed for the past few days and the constant pain I live with has taken on a whole new set of dimensions. But you should see my woodpile: even a Vermonter would deserve to feel proud!

Follow-ups, or a taste for hospital drama.

I'd only met my surgeon - let's call him Dr. M. - once: he was in his operating scrubs with a white mask covering his mouth and his hands suspended in sterile awkwardness. We were only moments prior to a lengthy surgery on my neck and he acknowledged me with a rapid nod before beginning a roll-call of the people and equipment present in the operating theater. His eyes were very blue.

Following the operation, there was an endless stream of hospital staff. This is perhaps more typical of American hospitals than health care in the UK. There are, for example, regular visits by the surgeon's slightly more junior colleagues and the hospital doctors and the ward doctor; there are smartly dressed physician's assistants whose perceptions of their own seniority seem, sometimes, to be held primarily by themselves; there is a highly striated rank-and-file of nursing staff from ward managers and expert practitioners through to nursing assistants and trainees; there is a case manager who wears a smart suit and high heels and sounds like an accountant; and even the cleaning and auxiliary staff have a careful hierarchy within which each person has their own clearly defined place within the food chain organization. Even as an Englishwoman knowing few people in Vermont, I had little chance to become lonely, although my insurance company is now paying dearly for the company I kept: currently the expenses associated with my operation exceed $100,000.

But Dr. M and I were not scheduled to meet again until this Tuesday, and I was looking forward to our meeting. I wanted to say thank-you, and I had a long list of questions written out on the back of a hospital menu.

But first I needed to introduce myself to the plump middle-aged woman behind the reception desk. She directed me towards a younger woman with a smaller desk, who confirmed, with careful and laborious care, that my address, date of birth, and credit card numbers had not changed since the accident. I followed the signs to radiology, where another receptionist greeted me. I suspect she is paid slightly less than her front-of-house colleagues: she needed to talk about bra straps and menstrual cycles rather than credit card numbers and insurance coverage.

The radiologist was male. After all the 'Good-afternoon-welcome-to-the-spinal-institute-how-are-you-and-have-a-nice-day' pleasantries of the previous staff, his silence came as a surprise. Behind the beard and lead apron, here was a man who saw himself as a tortured artist. We spent an uncomfortable half-hour together, trying to stretch and bend my neck into positions which were the most aesthetically pleasing for his work, and I think I was a disappointment to him: when I said good-bye, he grunted and did not return my smile.

In another part of the hospital, a male nurse showed me into the surgeon's office. He was a nice man of many words. A few years ago he had an operation on his neck. He's still in pain every day. Lots of pain. When he rides his motor-bike, it hurts. He showed me how much he could move his head to the left and right, up and down. He told us he shouldn't have been our surgeon's nurse that day, but the other nurse and her stand-in were both absent. He didn't like working so hard because it made his neck hurt. He had to hurry away to another patient before I finished offering him my condolences.

Being left alone in a doctor's office is typical of most doctor visits in the US. From what I remember of the UK, the doctor is in the room when the patient knocks on the door. In the US, the patient sits in the room - once, when we were waiting to see the pediatrician, for more than an hour - and it is the doctor who knocks on the door.

Except when it isn't.

After twenty minutes, the physician's assistant knocked. She was extremely beautiful and well-dressed, making House M.D. seem like reality television. We talked about who I was, which was useful because she had thought I was someone else, and I read out my list from the back of the old menu card. When she asked if she might examine me, I felt suddenly self-conscious about my plaid shirt and shabby jeans. I've never been someone who dresses up for doctor's visits, but I felt poorly presented for the role of 'patient with a broken neck'. Fortunately, the examination was swift: she looked at my scar, tapped my arms and commented upon my lack of reflexes, and left the room.

Dr. M's eyes were as blue as I had remembered. He was happy with the radiologist's artwork and the evidence of his own handiwork. He was gracious when I thanked him and his eyes, which were very blue, only strayed towards the physician's assistant's legs occasionally while I was talking. Overall, it was all very positive news. My neck is healing as well as I am allowed to expect, the nerve damage seems to be lessening over time, and my mobility is excellent considering all things.

My next visit is in 6 weeks' time. In the meantime, I am going to watch a few hospital tv shows so that I better know what to wear and how to deal with frustrated artists.

Wonderland

Iola and I have been reading an illustrated, abridged version of Alice in Wonderland. It misses out many of the weird hallucinatory sections I half-remember reading to Maya while she coasted on morphine during a long ambulance ride through the New Mexico desert, and it seems to linger instead upon details from Iola's own life: an older sister, a frustrated rabbit, a series of brightly colored mushrooms, a set of playing cards which are impossible to shuffle.

I'm probably not in the best position to give my children advice on staying safe, but I gave Iola a big talk on never eating mushrooms (she looked relieved, she doesn't even like mushrooms on pizza) or berries, or things she finds in the woods, or anything past it's sell-by date, or take-away chicken, or candy from strangers... Several minutes after her eyes started to glaze over I realized I'd fallen back into the rut I've occupied these past few weeks where everything seems to represent a risk. Iola's tactic is to quietly stop listening (you can tell she's not listening from the way her eyes become a slightly glassy shade of blue, and then close). Maya has developed a different strategy. A few evenings ago, I gave her a pep talk about walking down the lane to visit friends - 'Have fun, but keep to the left, and stop if cars come towards you... Don't walk on the verge because there might be poison ivy, and if you see a bear make lots of noise, and telephone me when you get there, and if you see any power cables down you absolutely must not touch them.. and you mustn't touch fallen branches in case they are attached to fallen power cables and ...'
'Mum', she interrupted, 'Do you know this song?' And she gave a fair rendition of Tom Petty's 'Learning to Fly': "I'm learning to fly, but I ain't got wings; coming down is the hardest thing." Damn right, Tom. Damn right.

So, after the warnings provided Iola with the excuse to never even try a cooked mushroom for the rest of her life, we went out for a walk in the woods to see how many types of mushroom we could find. For the record, I stopped counting at 16.

 

Hunting for mushrooms was good physical therapy because it made me have to try and look at my feet - not easy with several inches of metal sticking vertically through my neck. Iola wandered along in her own little Alice-in-Wonderland fantasy land and Maya found new routes through the trees. Scared of missing something, the dog tended to stand on each mushroom just after I'd photographed it; Nathan, I suspect, had a slight unspoken sense of disappointment that we didn't find chanterelles (the only kind of mushroom we felt able to safely recognize).

Afterwards, having found no March Hares, Dodos, Mad Hatters or Cheshire Cats, we collected up a large bag of trash left by day-trippers who had stopped on their way to or from the State Park and emptied their Dunkin' Donut coffee cups and beer bottles and yoghurt cartons onto the grass. If I saw them I would be all for chasing them with a rolling pin, but Iola prefers to be Queen. As she would say, 'Off with their heads!'

Time

"It will take time to heal," they say - all of them. The therapists, the doctors and the nursing staff; the hospital rector, concerned relatives and wise friends. "Just give it time." And those who know me, already know that I'm not good at this.

On my 40th birthday, I went for a run around Central Park in New York City. I was feeling fit, feeling good. Nathan and I found our pace and loped around the reservoir. We started overtaking people: I'm not normally competitive and I'm not going to make false claims about overtaking 'proper' runners, but I started focusing on the person ahead and trying to run past them. It felt satisfying - I may have just turned 40, but watch me run! Just after overtaking an elderly man with lean sinewy legs and shiny running shorts, something popped in my left calf. There was no question of running through the pain: I couldn't walk a step without wincing in agony. With Nathan's support, I began hobbling back towards the hotel. The elderly man overtook us once, ran another circuit of the reservoir, and overtook us again. He smiled at me the second time, and I thought of Aesop's fable about the tortoise and the hare.

Now I'm 41, and the possibility of even hobbling around the reservoir in Central Park is far beyond me. Car journeys exhaust me, short walks exhaust me, sitting in a chair on the veranda exhausts me. Worried that something might be wrong, I telephoned my physical therapist. There was a long pause after I explained my concerns about my fitness:  did I understand the extent of my surgery, she asked. Did I comprehend that it would take at least 12 weeks for the bone to have healed 80%? This was not a straightforward fracture, but a complex fusing of 4 vertebrae. No, she said, she would not give me more exercises to do. I needed to give myself time to heal.

This morning, I took my usual stroll around our woods with Nathan and the dog. The cat decided to join us as well. Ed is a a large overweight cat, built more for comfort than speed. He likes food and belly rubs and sleeping. Refusing to hurry, Ed followed us; miaowing loudly if we moved too far ahead. We soon began to move at his pace, pausing now and again to look at the sun filtering through the trees, the light dancing on the river, the color of the different mushrooms growing on the forest floor. Slow and steady as the elderly man in the shiny running shorts, Ed seemed to be demanding that I take my time, that I slow down and notice the world around me. He's sitting on my bed now, watching me, and waiting for me to sit down beside him. I can't help thinking he's trying to teach me a lesson too!

Balance

F. Scott Fitzgerald said, 'The test of a first-rate intelligence is the ability to hold two opposing ideas in mind at the same time and still retain the ability to function.' I make no claims to a first-rate intelligence but, since the accident, my life has been a complex balance of two opposing world views.

On the one hand, I am grateful. I am grateful in ways I have never previously experienced gratitude. I am grateful to be able to move, to get up by myself, to walk around the house and gardens; I am grateful to be able to switch on my computer and check my emails without being dependent upon someone else; I am grateful to feel the warmth of my daughters' hugs and the weight of my kittens when they curl, purring, in my lap. If ever there was a time for thanksgiving, these past few weeks have been it.

Slightly more than two weeks ago, I spent many hours strapped to a board in a trauma unit in Burlington, Vermont, as news of my injuries gradually filtered back from doctors. There had been endless x-rays and CT scans and, initially, discussions covered all my various injuries - the lacerations across my head, my possibly fractured left elbow, the pain across my right hip and pelvis. But the second CT scan of my upper spine changed the debate. Iola and Maya love playing a card game called 'Top Trumps'. The sets of cards might be animals from the rainforest, or characters from movies - say, Star Wars or The Lord of the Rings - or superheroes (and I can't write this without acknowledging the irony that the first result in my Google image search for Top Trumps produced Superman. Christopher Reeves broke his first and second vertebrae, whereas I only smashed my 6th and 7th. I was lucky). Each top trumps card has a quantified score for a range of categories. In terms of my injury, the spinal fractures top-trumped all my other injuries.

Being strapped to a board: for 18 hours is surreal: I stared upwards at the same small square of ceiling and, occasionally, faces appeared in the tiny square of my vision. One of those faces, in the early hours of Friday morning, was a youthful looking orthopedic surgeon with very blue eyes.
'You've broken two vertebrae in your neck,' he stated.
I knew this - a nurse had already told me. Vertebrae - little bones - not like breaking a femur, I thought. Not like breaking something big. I had imagined I would need to wear a collar for a few weeks and everything would fuse back where it should be. I tried to nod, realized I couldn't, and mouthed the word 'yes'.
'So, we're going to operate today. We need to stabilize things. We're going to fuse the 4 vertebrae - C5 to T1 - together, insert steel pins and screw these into the bone.'
I think I said something very foolish, such as 'Are you sure?' or 'Is that a good idea?' or 'Will I still be able to do yoga?' In fairness, I had been lying on my back hoping the pain would soon stop and I would be allowed to go home, while the surgeon had been looking at x-rays and CT scans and wondering how his team could put me back together without paralyzing me.
'What are the risks of the operation?' I asked, trying to sound grown-up, trying to sound in control of what was happening, as though this was all familiar to me, as though this discussion was nothing more than a confidence trick where, if I said the right thing, the prognosis would miraculously change. I expected the surgeon to say something about infection or the risks of general anesthetic.
'If the spinal cord is damaged,' the blue-eyed surgeon said, 'you'll probably retain some sensation and movement in your upper shoulders.'
'My shoulders?' The words dripped slowly into my consciousness as though a tap was leaking somewhere. 'I'd be quadraplegic?' And the words twisted around my mind so that I was thinking about The Who and Quadrophenia and wondering if I'd used the right word, while the doctor told me that was a real risk.

That day was harder on Nathan than me. When he visited later that morning, he had to sign the forms on my behalf because my hands didn't work. He had to acknowledge my awareness of the risk I might become paralyzed; he had to talk through every possible detail while we drafted a living will together. I only had to stare at my tiny square of ceiling, while he had to take in the entire picture and then live out the long hours of the operation later that day while I was unconscious.

And, I am grateful. Grateful in ways I never imagined, grateful for things I have previously always taken for granted. And, on the other hand, I am also frustrated and cross and in pain. I am unable to unpack the boxes in our new home, unable to climb the mountain, unable to throw the ball for the dog or split wood or knead bread. It is quite possible I will never be able to ride my bike again because of the stress it would put upon my neck. It is likely that I won't know for another year whether the nerve damage pain in my hands will resolve itself, or whether I will just have to learn to live with the pain.

But, to return to Fitzgerald, I don't have a first-rate intelligence, I am no genius, and the two perspectives can't successfully coexist in my mind. Writing this, I realize how small a thing my frustrations are, because really I am just very, very grateful. And that thought top-trumps everything else.

Moving on

The progress I have made through my recent therapy sessions is remarkable to me and almost incomprehensible to my nursing team. It has been a tremendous and terrifying experience to be here in rehab, and now it's time to go home.

Rehab has also been my first taster of being a 'disabled' person. Compared to many of the patients here, my disabilities are minimal and, hopefully, temporary; but I have had glimpses into what it means to be seen as a disabled person rather than as a 'Zoe':
- riding in a wheelchair, I have watched people speak over my head as though I am not fully present in the room, or they have drifted away in the middle of our conversation and I haven't known because I can't turn my neck to look at them.
- I move with obvious awkwardness at the moment, and strangers have tried to second guess what I might need without asking - because they obviously know best because they're normal, right? It has seemed as though they are afraid to speak to me because they don't know what might happen next - how upsetting it would be for them if I was to have, say, a speech impediment or a mental disability!
- I have been laughed at in the cafe for spilling food down myself and found myself playing the clown as a way of minimizing my embarrassment.
- When I was unable to find a bag in my room, a volunteer told me I was probably hallucinating because of my pain meds (I'm not on any pain meds, but sadly didn't have enough nous to ask her about her own drug regimen).
- I have been stripped and dressed by male and female nurses enough times to no longer have any modesty: my body has become some kind of medical anomaly rather than something which belongs intimately and beautifully to myself alone.

I am glad I came to rehab. I've had the opportunity to work intensively with occupational and physical therapists for 3 hours a day, and I have had a room of my own where I have been sleeping for 15 hours a day. I've been well-fed and struck up some wonderful friendships, particularly with the hospital rector who pops by almost daily to chat with me about libraries, and his work in Palestine, and a trip to England he took back in the 1970s. Thanks to technology, I have been able to skype family and friends and read all the wonderful messages people have posted and emailed to me since the accident. I have worked my body until it is so tired I have cried, and then I've woken up the next morning ready to do the same again. (But let's keep a sense of perspective: I'm bench-pressing a walking stick rather than weights; walking up and down stairs rather than sprinting on a beach; trying to pick up a coin with my fingers rather than glorifying in some challenging new yoga pose.)

The activities have been good, but this is a surreal new world. Until yesterday I was not allowed out of my room unsupervised and - never having been good at asking for help - I spent long hours standing by my door listening to the sounds of the ward. There is one nurse who has not needed to visit me. She works with the badly disabled patients. She speaks in a loud, slow, patronizing voice which rings down the corridor, like a melody played over the top of all the television channels blasting from patients' rooms. I am sure she is very good at her job, and I don't doubt she provides a service I could not do well, but I cringe as I hear her speaking about bowel movements and the color of pee in the same tone that well-meaning grown-ups sometimes use with very small children. Perhaps her approach is necessary when a person's mind has been affected by their accident; perhaps she has wonderful successes with patients who would otherwise become constipated and dehydrated. But I can only think that, a few weeks ago, the person she's now speaking to used to be like you, like me, like everybody else. Then a few of us fell down stairs, or fell off motorbikes, or were felled by strokes or brain hemorrhages. We're all struggling with that: everyone here is in pain, caught up in a complex mix of thankfulness at being alive and mourning for the loss of how their lives used to be. Some of the people here will never walk again or live independent lives. And the lesson for me, having had the privilege of this insider's view, is that we're still like you, like me, like everybody else. It's just the rest of the world which sees us differently.  

They tried to make me go to rehab, but the man said 'no, no, no'

I've had the Amy Winehouse song circling my head for hours, not that the rehab route recommended for me entails the kind of rehab she imagined: this would be more raffia mat making and relearning how to chop carrots than intense conversations with tattooed Burroughs-wannabes. But there is a spanner in the works. On Wednesday, the spanner was gravity which pulled me, somersaulting and spiraling, down every bit of the wooden staircase, smashed my head into the walls on the way down and shattered two of my cervical vertebrae; today, the spanner is the insurance company. Despite evaluations and recommendations by two physical therapists, an occupational therapist, nursing staff, a physiatrist, and a team of doctors and neuro-surgeons, there is a man out there somewhere, sitting in an office with a database of macro-quantitative evidence who will decide whether my needs make me a cost effective proposal for the intensive rehab everyone else has recommended. He won't be a medical expert, he has never met me, he isn't even willing to talk with me and all our communications must be conducted through my case manager, but he's calling the shots, making the final decisions. He's the Man (I've heard about 'the Man' in the movies, and now here he is in my weird and filmic real life narrative - faceless, sinister, and unjustifiably powerful).

Because of the damage done to my nerves and spinal column during the fall, and because of the impact of fusing 4 vertebrae together with a mixture of metal, bone fragments and glue, I have fairly constant pain in my lower arms and hands, limited mobility, hyper-sensitivity to any kind of touch, and a prognosis which suggests I might, or might not, be pain free in the next 12 months. Intensive rehab provides the opportunity for me to work intensively on my hands and arms, to promote flexibility and strength, and to develop new ways for me to do the things I used to take for granted. Without intensive rehab, my recovery will be much slower and I might not reach the same potential for movement, strength and independence. But - let's face it - this isn't really about me. It's about the money and the returns on investment and the whole hickory-dickory-dock workings of the capitalist machine. In the UK, with the wonders of the NHS which the US can't even manage to comprehend, the decision would probably be made by a hospital manager with an MBA, in the US the decision will be made by an insurance clerk. And I don't understand - can't understand - won't understand - why the decision can't be made by the medical experts who know about these things rather than the experts in Prince project management, powerpoints, and cost charts.

But, at the moment, I am somewhere very special. Maybe wards like this exist in the UK, but I haven't experienced anything so good in either the US or the UK. A team of nurses and nursing assistants provide phenomenal care. Holly, who has worked on this ward for 23 years, tells me it has always been a good place to work: well managed, well staffed and well regarded. The level of patient care here exceeds anything I'd ever imagined. Some staff are young - Kevin, who exudes a calm constancy, who wants to become a transport medic working with critically ill patients, and who has happily developed his tea making abilities so that each morning I have the perfect cup of tea; Annie, whose first day working independently coincided with my first day on the ward and whose creative thinking provided me with a range of toys - bandages and crinkly plastic and warm bowls of water - which alleviated the pain in my hands; Allison, who stuck inspirational quotes around my room; and Chris, whose dry humor and absolute integrity have allowed me to maintain my dignity in some very undignified moments. Staff have drawn on their experience and expertise to make me nests of pillows so that I might sleep, been willing to understand my reluctance to take pain meds and found alternative ways to keep my pain levels manageable, and they've talked with me - soon realizing that talk is my favorite medicine. They've shared aspects of their life stories, told me about their lives in Vermont, about their dreams and ambitions. Because they are neither underpaid nor over-worked, they have the space to do this and I would argue to the nth degree that this is a valuable part of patient care. They've sat with me through the dark hours and they've shared my celebrations of the things I can do today which I couldn't do yesterday. They haven't offered false hope, worn platitudes or indulgent sympathy; they haven't been too busy or too tired; they've just given me time and space to work through it, to feel it, and to keep on going.

I wanted to tell you about the food as well - locally grown, freshly produced, cooked to order - but I can't type more and this has already taken many hours. So I'll end with a bit more Winehouse - "I got lots of time, but the money man thinks I'm fine... They wanna make me go to rehab, but He says 'no no no'. "

Butler Lodge trail

The thing to remember - the thing I tend to forget - is that I now live on the side of a mountain; a large panoramic wrap-around kind of a mountain, as opposed to the triangular point-y sort I used to draw as a child. The Abenaki Indians called Mount Mansfield "Moze-o-de-be-Wadso", which translates as "Mountain with the head of a Moose". Moose have big heads, and this moose likes to spend a lot of his time with his head in the clouds.

Last week, I joined a large group of women - 'the Mountain Mamas' - who walk together in summer, and ice-climb or x-country ski together in winter. The average age of the group is somewhere in the 60s, and I have found my role model for retirement! We pranced up the side of the mountain to the Taylor Lodge (one of the many bunk houses supported by the Green Mountain Club), and the women unpacked floral tablecloths and served up cakes and rhubarb syllabub. The conversations were wide-ranging - many of the women having arrived here in the 1960s and 1970s to live intentionally alternative lifestyles - and the overall experience was exhilarating, enjoyable, and slightly surreal. I loved every minute, felt humbled by their many kindnesses and hospitality, but realized I need to improve my fitness levels! The great thing about living on the side of a mountain, of course, is that one doesn't need to pay to attend a gym.

This morning, I took the dog for a walk on the mountain. While Thursday's walk was filled with talk, I walked today's trail in silence. I have always enjoyed walking by myself; alone, one becomes more aware of the noise of each bird, the shifts in smell as the deciduous forest gives way to conifers, the rhythm of one's breath, the sound of one's own heartbeat. My own heartbeat was loud enough to drown out the birds because the Butler Lodge path was a beast: when I hoped the path would level it became a set of wooden steps because the gradient had become too steep to support a trail; when my quads were burning and the sweat was falling like rain down my face, the blue markers directed me straight up a rock face.

It was worth it. Hard hikes are always worth it. At the top, just before the Butler Lodge appeared out of the cloud layer, the temperature dropped and the sweat running down my face cooled. At the gym, I'd often end my workouts in the steam room, hoping there would be no gaggle of women chatting inside. This was the inverse of a steam room: a feeling of being baptized in cloud, rewarded and refreshed by something I'd worked hard to achieve. The dog, of course, was fine and I suspect many of the Mountain Mamas would not have even broken into a sweat....

Inside the Lodge, an open paperback book had been left face-down on the table and someone's roll mat was laid out ready for their return. I was glad they weren't there. For ten minutes or so, it was just the dog and me, sharing my water and watching the clouds whiten the air. Then we headed back down through the woods, watching the air become brighter, the trees change color, and the pathway gradually level out as we left the Moose Mountain behind.