On His Third Day of Medical School...

....the student entered the examining room, trailing Dr. Roth, physiatrist and human being extraordinaire.  We were on the third floor of The Rehabilitation Institute of Chicago ready to assess my progress. I was here six months ago.  I thought I was doing better. Dr. Roth would know for sure.

RIC is bright and cheery, with wide hallways and low countertops and elevators just a little bit bigger than those at Macy's.  I feel blessed and lucky every time I step through the sliding glass doors, one block from Lake Michigan.  There but for a milimeter's difference in the trajectory of a bullet... or two... or three... go I. 

Dr. Roth confirmed it when we examined the x-rays of my pelvis - a milimeter or so lower and the head of my femur would have been shattered, too.  My hip would now be ceramic instead of bone pieced together with pins and glue.

My hip.... it's a term that has bothered me since getting shot.  I can find my pelvis and my hip bone and my pubic bone but where's my hip?  I know that the acetabulum is the cup like part into which the head of the femur fits.  I know that my acetabulae were shattered and that there is hardware connecting my pelvis to my pubis.  But where is my hip?

I had asked Dr. Roth to show me on my body exactly where the construction took place.  We started at my hip bone - all three of us could find that pretty easily.  As he traced the path of the reconstruction on the x-ray display, pausing to be certain that I was following along on my self, I began to realize why certain movements felt restricted.  They were, in fact, restricted by the repairs.  While predicting my continued improvement, he cautioned reminded reflected that even were I to achieve the best result possible, that result will necessarily be limited by the pins and screws and clasps that are now a part of my hip.... which sits at the bottom of my pelvis and is comprised of the cup and the bone and the lower edge of that pelvis. 

It feels more like an attitude than an actual destination, but I get the point. 

Do I need a hip replacement?  Is the arthritis so advanced that I'd be foolish to do anything else?  Not according to my favorite doctor of physical and rehabilitation medicine.  Nerves regenerate at the rate of one milimeter per month; my numbness will continue to retreat over time... lots and lots of time.  As the numbness disappears and I am more able to access the musculature which contributes to a smooth stride, my coordination and my gait will reappear.  My awkwardness is the result of many things, but structural integrity of the damaged areas is not one of them.  Over time... lots and lots of time... I will strengthen those muscles one uses to stabilize one's torso and the scrunchiness... the roughness... the uneveness will abate. 

That's the plan and I'm sticking to it.

I cannot attribute my continuing recovery to any one modality, Dr. Roth says.  When asked, I must reply that swimming and pool walking and physical therapy and pilates and yoga and weight lifting and floor exercise all have  contributed. 

I walked out of that room floating on air.  The doctor was most impressed with my progress.  He was as happy for me as I was for myself.  We kept interrupting one another because we were going to the same place at the same time.  "Can you move..." "Let me show you what I can...." "Six months ago that didn't happen!" 

So much of what's going on with me has to do with attitude.  I left RIC feeling that I have exceeded expectations, that I have further to go, that I am capable and competent and on the right path.  I am in control of the situation.  I have the power to create my own change. 

As he told the medical student, a young man of charming manners and a delightful mein, Dr. Roth and his fellow physiatrists treat the muscle and not the x-ray.

I'd say that they treat the person and not the pelvis.