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.

It feels like falling in love...

I am waiting for someone to tap me on the shoulder, tell me there has been a horrible mistake, and order me to go home. Someone else should be living in this house.

For a start, there are the mountains. Proper jaw-dropping, awe-inspiring mountains just sitting there on the horizon, waiting to interrupt my unpacking by taking my breath away whenever I lift my eyes. Someone else - the person who should be living in this house - would know the routes through these mountains already. They'd be the kind of person who has climbing ropes, detailed maps, a kaleidoscopic knowledge of first aid, and calf muscles which never get tired. I have an old school bag of Maya's, packed with a tiny foil bivouac for emergencies (thanks to Sam), a miniature first aid kit, a water bottle and a spare dog leash. Each time I walk up the lane to the State Park I feel like I should apologize to the Park Rangers: my entire appearance screams amateur, and my knowledge of US State Parks owes more to Yogi Bear than it does to the Green Mountain Club.

Then there is the forest. Quite a lot of forest. Our forest to caretake and maintain. Now I can recognize the hemlocks and the sugar maples, the bracken and the bramble bushes... but the person who should live here would know every plant without having to take a book out of the local library (and the person who should live here would be able to find the local library without having to use their SatNav!)

We also have more than two acres of meadow and, I suspect, the person who should live here wouldn't let the grass grow into a mess of bright yellow dandelions and wild orange daisies. I have mown the area around the house 3 times since we moved in, but that is primarily due to a Sleeping-Beauty-esque fear that we will otherwise wake one morning to find our house has been swallowed by wild forest and thorny bushes. Perhaps I should be more diligent, but my enthusiasm tends to wane after the first two hours behind my little petrol-fuelled hand-push mower and it always seems that the grass I cut at the start of the day is as long as the uncut grass by the time I put the mower back in the shed.

Inside, there are definitely signs that this is a house for grown-ups, and I'm not sure I've reached that point in my life yet. There is a laundry in the cellar, complete with shiny white machine and shelves and washing lines strung up next to an extensive collection of boilers and pumps and radon extractors. There are built in closets and solid wood floors and the kind of American fridge-freezer that someone of Nathan's height could live within. I have piled the pamphlets about the various workings of the pumps and the systems and the shiny white goods next to my chair, but they already have several half-drunk mugs of cold coffee sitting on top of them. The person who should live here would have enjoyed reading them, and could have made sense of more than the first page of each.

But I'm not sure that the person I feel should live here could ever love this house in the way I do. They'd be too busy being grown-up to stare with wonder at the fireflies doing their torch semaphore to one another in the darkness, or to whoop at the large child-sized Barred Owl who watches us from the bottom of the garden. They wouldn't abandon the weeding to follow the common garter snake as he slithers along trying to find the 'just right' rock on which to sun himself, or to call the girls out from their bedrooms to admire the bright orange lizards. They would probably have known exactly what concoction of nectar attracts humming-birds to the feeders, but would, therefore, have had none of the fun of trying to find out. And they wouldn't unpack their books onto the floor because they want to reread them before putting them on the shelves.

But, until the person who should be living here shows up, we'll continue wandering around with those big cheesy smiles you only tend to see on people at the start of a romance. Our preferred soundtrack for the past 10 days has been Oh Honey's Be Okay... bright, poppy and almost obnoxiously happy. And why ever not?