"50 year old shoulder"

If I want to eat anything else, I have 15 minutes in which to do it. No solid food after midnight.

When I hurt my left shoulder about a decade ago, some now-forgotten person said to me, "Rotator cuff, probably. Rotator cuffs just wear out. You know what they call it in Chinese medicine? 'Fifty year-old shoulder.'"

Since I was only 45 or so at the time, I found this offensive. And it turned out not to be the rotator cuff anyway. Not then.

But now it is (only partially torn, however). Some other stuff going on in this 56-year-old shoulder, too.

Here's what the Dartmouth-Hitchcock Medical Center "What to Expect After Shoulder Surgery" sheet says: "Whether your shoulder surgery is done arthroscopically or through a regular incision, you should still consider your procedure a major surgery. You'll be living life with only one useful arm for awhile..." 

Here's what Gail, Dr. John-Erik Bell's orthopedic nurse, whose hobby is --- get this --- racing motorcycles --- says: "Look, it's a big deal. It is. Time, money, pain. Not being able to use your dominant arm is a biiiig hassle, I won't lie to you. But you need to think of it as an investment. Shoulder surgery is an investment. And it is so, so worth it."

She also says, "Stay ahead of the pain. Take the painkiller before you think you need it. We have good drugs. Use them."

I like her. I like Caroline, the scheduler, and Jessica, who was the first person in the department I spoke with. I like John-Erik Bell, too. Each of whom, though no doubt busy up the wazoo and no doubt sick of answering the same questions countless times, all gave me and David the impression that they had as much time and information as we might need in order to reach whatever the best decision for us might be. I don't think this was just "impression" either, for it's not possible to fake caring or thoughtful listening for longer than a few minutes before a glance at the watch, a set of the shoulders, a micro-grimace, gets across the too-busy-time's-a-wasting-can't-you-see-I've-got-a-job-to-do message. Those DHMC folks, at least all I've met so far, don't have jobs as much as they do callings: their attention and intention is aligned with being called to do do their particular work.  It's not only not just a job, it's not even just work; it's work with meaning: meaning for them and meaning for those they serve. Meaning is what makes work a calling.

A couple of times a day for the past week, I've been listening to the pre-op portion of a recording called "Stress Free Surgery: a self-relaxation program to help you prepare for and recover from surgery." Here's (in part --- it's 44 minutes long) is what it says:

"Breathe in ... re... breathe out... lax. That's right. In ... re... out... lax.
"You're at the top of a staircase of comfort. Each step down takes you twice as relaxed as the step above it. " (Don't get irritated at the grammar, Crescent.)
"Ten... Relax... Nine...relax.
"The doctors and the nurses will take such good care of you..."
"You'll feel the blood pressure cuff inflate, like a gentle hug..."
"Any sounds you may hear, unless said directly to you, recede into the background, and become a quiet... peaceful... lull, like waves on the ocean..."

For the first fifteen or twenty minutes of listening to this, I also listen to my mind, which chitters, ridicules, jeers, disparages, critiques the language use, wonders if the whole experience would be better if I had remembered to put the eye mask on and maybe I should get up and find it and put it on my eyes because it's really bright in here, and then I could relax. Things I haven't gotten done yet and really need to do before I am one-armed also run in and out, one after another putting in an appearance.

But eventually the part of me watching all this sighs, and says "Give it a rest, Dragon, chill."

And I really do. 

Here's what my mother's friend, the retired children's book editor Susan Hirschman, told her some years ago. "Oh, Charlotte, let's not waste time talking about our health. At our age, it's just one organ recital after another!" 

Here's what Gaelen, my down-the-hill neighbor, sweet pal, vernal wild-flower aficionado, and nurse says, "Do NOT take opioids without taking Colase and senna with them. " I demur, point out that I've soaked prunes and apricots, and David can make me fruit compote using them... I don't like discussions about intimate scatalogical matters. Gaelen repeats  "Do NOT take opiods without taking Colase and senna with them.Get David to pick them up when he has the painkiller prescriptions filled."

Undergoing voluntary pain and temporary disability --- it's anxious-making, no matter how good you are with anxiety, no matter how good the eventual pay-off from the investment.

Now it's 12:01 a.m. I've missed chance for eating the other half of that perfectly ripe d'Anjou pear I was eating at 11:28 p.m.

Here's what I say: how we tell our stories matters. I know this much is true, to quote the title of the Wally Lamb novel which is in turn based on a song originally recorded by Spandau Ballet and made popular by the 80's rock-pop group, whose music I never particularly liked, Tears for Fears. 

Here is what I say when I tell the story about this upcoming surgery to myself:

I'm glad I live in a time and place where people routinely live long enough to have 50-year-old shoulder, and that there is a medical intervention to fix it actually exists. As well as drugs to put you to sleep while it's being performed.

And that my doctor is a Johns-Hopkins graduate who did a residency at Columbia-Presbyterian just in shoulders, and shoulders are mostly what he does now.

And that the surgery is taking place at Dartmouth-Hitchcock, where they did such good work on David's spine two summers ago, and where, from the moment you walk in to that light, non-hospital-smelling atrium space and see the arch that says, "We, the employees of Dartmouth-Hitchcock, welcome you", and see the grand piano that a volunteer plays at noon each day, you know this is an astonishingly kind as well as well-practiced facility. (Left, DHMC's photograph of the info desk that centers the atrium --- a mandala out of which the life of the Center spreads)

And that David, the loving partner with whom I am privileged to walk through time during this phase of our respective lives,  will take care of me in the weeks to come. No doubt with a mixture of compassion, impatience, thoughtfulness, aggravation, and tenderness  --- much as I did when he had his spine surgery.

And that I made an extra lasagna, and extra black bean soup, and other stuff I fixed in the past few weeks, and froze it. Plus I taught David how to make a smoothie the way I like it, and that pasta dish with the garlic and chiles and loads of kale or swiss chard or broccoli and chick peas and lemon juice and Parmesan...

Here's something else I say to myself: it's elective surgery. You are choosing to do this. To that extent, it's within your control. You weren't in an accident. You got to pick.

Here's something else I say to myself: you fortunate girl you!

And sometimes, something else, something my old, one-time Eureka Springs compadre, Vernon Tucker, once said to me: "All this positive thinking is driving me to despair!"

I hear David coming up the stairs. Time to get offline --- for a month, six weeks? Time to get in the hot bath and let David scrub my shoulder with the presurgical Hibiclens. 

Time to say, goodbye for now, dear friends, readers, and colleagues.

Time to see what new insights this series of experiences turns out to have yielded. 

For here is what I also say to myself --- and if, again, I know this much is true, then it's the hugest and most comforting much there is, that of utility, usefulness --- I tell myself, nothing is wasted on the writer.