Eight Months Earlier
101 Grand Avenue, Capitola, California
It was 4 a.m. I hadn’t slept for three days. The only noise was the sound of the waves sliding into the rocks at the base of the cliff below my apartment, and the strange robotic purr of the CPM (continuous passive movement) machine to which my right leg was strapped.
At that moment I realized I didn’t have to kill myself. I would die from despair.
#
Three days before I had undergone a seven hour experimental operation on my right leg to rebuild my knee and femur out of cadaver parts. It wasn’t an elective surgery.
Eight years before, in 1992, I had broken my leg, but had somehow failed to notice. I had been a competitive and obsessive runner most of my life and raced in 10Ks until 2000, when my leg started collapsing underneath me. I didn’t think the collapses were a major issue until it happened while I was walking through a cafeteria with a tray full of food. It seemed wasteful to buy an overpriced plate of macaroni and cheese only to have it end up on the floor.
I thought the cause was overtraining, something I was prone to do. But the diagnosis was much worse and changed my life forever. My leg kept collapsing because the right knuckle of my femur had broken off in an accident in 1992 and, over the years, the jagged remains of the bone had smashed the inside of my knee to pieces, like a broken glass bottle hammering into a filet mignon. An initial surgery to fix the problem was botched and the surgeon informed me that my knee had to be removed and replaced with a titanium rod. I was too young for a mechanical knee, and there was no way for the doctor to replace the large amount of bone I had lost in my femur, or the lateral meniscus, which he had mistakenly removed in the surgery.
He told me that the rod would prevent me from bending my leg. And wouldn’t make a cool didgeridoo sound when I walked, as I had imagined when I first heard about it. Unwilling to give up running or walking in stilettos I left that doctor’s office and never saw him again.
Then I embarked on a series of visits to twenty three knee doctors in the Bay area to see if someone had a better idea for my leg. At the start of my quest I had assumed that, since most of the doctors were well known and treated professional athletes, it would be easy to find a surgeon to fix my leg.
At each visit I would explain my situation, and produced the surgery report, X-rays, and arthroscopic pictures. Then I would ask if there was a solution for my problem that didn’t involve a rod. Every doctor looked at me as if I was asking if it was medically possible to replace my knee with something more interesting, like a Pez candy dispenser. No one could help me.
Then I found out that there was a doctor - one of two in the US - doing experimental knee surgeries with cadaver parts. And his practice was in San Francisco. Although I wasn’t excited about the idea of having a zombie knee, and was worried about where the parts might come from, I went to see him. Dead body bits seemed like a better option than having something in my leg that might make me more susceptible to lightning strikes.
And that’s how I met Dr. Douglas Blatz. At my first appointment he said he couldn’t help me. But then I managed to convince him to try. I’m ashamed to admit I did that by crying like a two year old and then threatening to cut off my leg. At the time he didn’t know that I was lying about owning a bread knife.
I had assumed that Dr. Blatz had spare body parts stored somewhere that he could use to fix my leg, but that wasn’t the case. He had to order the parts. So I had to wait around for someone to die who matched my bone and tissue profile so my knee could be rebuilt.
Chris Kuhn, a physical therapist who had treated me since the first knee surgery, worked many long hours during the eight month wait for a donor to prepare me for my zombie knee surgery. He kept my spirits up during the grueling therapy sessions by inventing fun games, like one where he would throw a ball at my head while I stood on a wobble board. “Next time try to catch it with your hands instead of your face,” he would coach. He knew damn well I would never catch it.
Dr. Blatz warned me that the surgery would be extremely painful, that it would likely fail, that I would never run again and that I would have to wear a brace on my leg for the rest of my life. He stressed to me that I would not be able to run again and that I would be limited in what physical activities I could do for the rest of my life.
I didn’t listen. I thought that if I had managed to run on a broken leg for eight years I could do anything.
#
As the weeks past I became more stressed out that Dr. Blatz would never find donor parts. And even with therapy the constant sharp pain in my knee failed to improve even as the scars from my first surgery healed. Because I have an allergy to pain medication, the only thing I could do was ice my knee and take copious amounts of aspirin, one week consuming 200 of them. I vomited blood any time I ate spicy food or didn’t eat for a few hours.
The pain affected my job as well. I was moved out of my position as an engineer at work because it required me to be mobile. I was forced into a program management role that didn’t require any physical exertion beyond typing.
I couldn’t run, I saw my new job as a demotion, and I was scared about having an experimental surgery. My partner, whom I had been with for about a year, did not understand what was happening to me. The worst medical problem he experienced was having his wisdom teeth removed by the US Army. Our relationship started to fall apart.
I made things worse. Instead of trying to talk about my pain and anxiety, I pretended I was fine. I didn’t give my partner or anyone at work a chance to help because I didn’t want people to think I was weak or a whiner. I shut everyone out and decided to handle the pain alone.
The day the donor parts were found I felt relieved. Finally, I thought, I’ll get the zombie knee surgery over and then things would go back to normal.
#
Three days after the surgery, my knee resembled a rotting cantaloupe. It felt as if someone was jack hammering into the side of my leg. My femur coursed with an electrical sensation that ran through the bone into my thigh. Every time the CPM forced my knee to bend 20 degrees it sounded like someone slowly stepping on a box of Wheat Chex.
Since I had the surgery over the Thanksgiving holiday, the few friends I had made during my short time as a resident in Capitola were all with their families and friends, eating turkey. My partner’s company had just received a new round of financing from investors and he had to leave for an emergency business trip the day after I got home from the hospital. Having had no idea how bad the surgery was going to be, and not wanting to force them to fly during the worst travel week of the year, I had told my family on the East Coast that I would be fine after the surgery.
 The break in my femur |
 The bone plug |
 The cadaver meniscus |
But now I was trapped in my apartment, I was out of ice for the ice machine, and the only pain medication I could take that I wasn’t allergic to, Tylenol, had no effect. I had been given localized morphine after my surgery and though it had worn off after 24 hours, I was still vomiting from an allergic reaction to it and had broken out in a rash that went from my scalp down to my abdomen.
I had wanted to take some Benedryl for the rash but it was in the upstairs bathroom, and I couldn’t negotiate the narrow stair case to get to it with my crutches. I was in a soft cast that went from my ankle to my hip, with two huge metal gears sticking out on either side of my knee to keep it from bending. Walking any distance beyond the bathroom down the hall was too painful as I had to hold my leg slightly up and in front of me to keep it from touching the ground.
Exhausted, it never occurred to me to call someone for help.
The pain affected the rest of my body. My heart felt like it was trying to bounce off of my lungs and out of my body. My right hip cramped. My toes, covered in a substance leaking out of my knee that looked like baby shampoo, had swollen to cartoon proportions. It seemed that someone had set off a fire alarm in my brain and then evacuated without turning it off.
 |
| The day after my surgery |
#
In military strategy it is advisable to attack your adversary in the early hours of the morning because that’s when people are the most vulnerable. This strategy is borne out by scientific studies that show as the night gets darker, before the sun rises, people are slower to respond to the world around them, and their decision making abilities deteriorate.
At 4:15 a.m., three days after my surgery, I decided I was going to kill myself. The thought of enduring even 10 more minutes of the pain was unbearable. I had spent the past two days trying to figure out what to do, analyzing the situation from every angle as if it were an engineering problem. The issues seemed insurmountable. I couldn’t take drugs, Tylenol wasn’t helping, I was out of ice, and I couldn’t leave my apartment. I thought no one could help me.
There seemed to be only one solution. The only way to stop the pain was to stop everything.
I propped myself up on my elbows and looked around the room. How was I going to do it? I glanced over at the ocean, 40 feet below the cliff where my apartment building sat. At the bottom of the cliff were many large rocks.
In the short time I had lived in that apartment at least one tourist had died on the cliff, walking too close to the edge of it. The grass appeared solid but, underneath, was unstable. I’ll jump off the cliff, I decided, and began the slow process of un-strapping my leg from the CPM.
I got myself to the side of the bed, reached for my crutches, and then realized I couldn’t get to the cliff. My apartment was on the second story of the apartment building, and I couldn’t negotiate the steps down to the cliff with the soft cast. There was a service elevator, which I had taken up after my surgery, but it required a key that was kept in the manager’s office. On the first floor.
Cursing, I looked around the room again. In the dark I could see a balloon arrangement sent by my office. It had been decimated by Prickley, my feral cat. During my first day home after surgery she hid somewhere upstairs, terrified of me, the CPM, and the balloons. But by the early morning hours of the second day, she was emboldened enough to sneak down stairs. Sensing the balloons, which were drooping from helium loss, were sleeping, she crept up on the kitchen counter and then dived into the middle of the arrangement, popping the balloons.
The thin ribbons tied to the balloons would not be strong enough to strangle myself with, I determined. I had 20 Tylenol, but given the amount of them I was taking a day, I knew that would do nothing.
I thought about the kitchen. I didn’t have any sharp knives or small electrical appliances to electrocute myself with because I didn’t cook. I considered electrocuting myself with the CPM, but it was too big to carry and too big to fit into the kitchen sink, the only receptacle I could get to that could be filled with water. I didn’t have poison, razors, or even a lighter.
I had nothing.
I started to cry. Through my tears I could see the waves picking up in the ocean. It was now 4:30. In another hour the surfers would be showing up at the punch bowl, a local surfing area below my balcony. I was filled with hatred for them. They would be walking leisurely down the beach with their boards, floating out in the water, and then having breakfast on the boardwalk at Zelda’s before carrying on with their lives. They would be driving cars, working, going to the gym, eating pizza at Pizza My Heart, hanging out in the evening with their partners, talking and laughing. I would be lying alone in bed, doing nothing, unable to leave the confines of my apartment because of my leg.
Then I noticed something. Just a few feet off shore, a school of dolphins was swimming in the surf. There were at least 30 of them, maybe more, fins bobbing in and out of the water as they played in the rolling waves. At that moment the sun appeared, a faint yellow line on the edge of the ocean, gradually rising and making the dolphin fins glow.
That’s what I’ll do, I thought to myself.
I’ll swim.
#
February 2001 email sent to family and friends
As I have been getting a lot of inquiries concerning my progress in physical therapy, I thought I would provide an in-depth look at my experiences working with Chris Kuhn at the MORE clinic, located inside the Club One gym.
December 6
My first day of physical therapy. The session starts with a few wimpy exercises and then I'm wired up to a machine that shoots electrical currents through my knee. This is called "muscle stim", which is synonymous with "electrical torture that your HMO covers". Chris's assistant tells me that muscle stim is the part of therapy most people like.
I assume this remark is made to me to see how dumb and gullible blondes are.
December 15
While riding the stationary bike at Club One Fitness center I accidentally knock my crutches over. They bounce when they hit the floor and are way too far away for me to reach. Doppelganger of John Gotti comes to my aid. Oh great, he's going to think we are friends now.
December 18
I start work on a machine called "the shuttle". You lay on your back with your knees bent at a 90 degree angle and put your feet up on a board that is perpendicular to the floor. You then push off to extend you legs fully. The resistance of the machine is controlled by rubber bands. I am only doing 3 rubber bands. Everyone else is doing at least four. Chris announces loudly that I am only allowed to do three rubber bands.
Oh the humiliation.
Then a guy who hurt himself wind surfing (based on his physical appearance I was surprised to find out he had hurt himself exercising) decides to talk to me while I am trying to shuttle with my three wimpy rubber bands. He asks if I hurt my knee, which is still swollen to more than twice the size it should be. Um, yeah!
December 20
John Gotti and I are the only ones in the gym. Because of all the Christmas lights the floor is strewn with power cords. Maybe it's all a plot to kill me when I fall due to a crutching navigational error. Gotti comes over and gives me some tips on riding the bike because he knows I can't run away.
Chris is on vacation this week so I distract the substitute therapist in an attempt to read what Chris has been writing about me. His handwriting sucks so I can't read my file, although I notice he has drawn a very unflattering picture of my knee. It isn't THAT fat.
December 21
In an attempt to improve my knee-bending flexibility the substitute therapist tries to bend my knee past 90 degrees. He keeps talking as I pass out and then regain consciousness. He's from the deep south so he doesn't notice any lag in the conversation.
Also, he accidentally reveals the secret of muscle stim - the more hydrated you are the more conducive your body is to electricity. I decide to go on a water strike immediately.
3 January
My knee cap is finally visible again. I have moved up to 4 rubber bands and I am on my way to being crutch-less. I have found it is important to use my crutches in situations where a) Chris can see me and where b) there are dishes to be done or dinners to be cooked. The kitchen is a VERY unsafe place for crutches, except for the cabinet where the lemon cookies are.
12 January
I receive a note from Pacific Gas and Electric that if I don't lay off the muscle stim machines California is going to experience a power crisis caused by my knee absorbing all the electricity in the state. Also, I finally get to start using the balance board, which will rebuild the stabilizer muscles in my leg while at the same time make me look like a flailing idiot.
15 January
After listening to Chris' numerous complaints about my foot socks (which always fall off in therapy) I am forced to go shopping to buy socks that cover my ankles. My partner seems a bit suspicious and voices his opinion that I actually wanted to buy new socks. He doesn't understand that last time I made Chris mad he punished me by inventing a "therapeutic" exercise involving me walking backwards on the treadmill in the gym. I know I'm blond but did 5 people REALLY have to come up and tell me I was walking the wrong way?
22 January
Chris makes me stand on this white half circle foam thing (it looks like an upside down speed bump) to practice balancing. Then he hands me a ball and says I have to throw it at the wall and catch it while still balancing. He recommends throwing it close to my face to make it easier to catch. I sense a trick. I wait until he walks away to try it.
The first time I miss the ball and it almost lands on the face of a woman stretching three feet away from me. The second time it hits me in the face. I'm wondering if I should stop making fun of Chris for being a soccer player. His other, nicer, patients don't seem to be doing the same kinds of life-threatening exercises I am.
29 January
I have a minor set back in my knee flexibility when I decide to do my bending exercise for one hour instead of the recommended two seconds. Surprisingly, this makes my knee LESS flexible. Something to do with over-exertion apparently. To attempt a recovery I promise Chris I will take a whole week off of doing anything around the house. In addition I buy some new shoes just in case the ones that I currently own are contributing to the problem. I deny that I bought them because I am obsessed with shoes. It’s okay to own seven pairs of running shoes, even if you can’t run.
5 February
A weekend of drinking seems to have improved the condition of my knee tremendously. I have reached the twelve week mark of my therapy, which means Chris can really start, as he says, "cranking" on my knee. It's all downhill from here I guess!
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