Not a bang but a whimper

Not a bang but a whimper

If you have been reading my blog, you know that I have been living through a sort of medical adventure these past seven months. Many tests – imaging of several types – and examination by nine doctors really became something of a medical thriller for me. Complication after complication came to light. At one point an exotic term was used to name my disease. The big question was whether some kind of surgery would be undertaken, to set the complications right and to relieve pain. This amounted to a kind of cartography – mapping out the terrain of my body, highlighting the bones, nerves, and muscles. As a neurologist said, we are peeling the onion all the way down, to see what’s there. That same doctor concluded, after that process was completed, that he had a good understanding of what was wrong with me, but really no idea as to what caused it all. Finally the doctors judged that in one way or another the problems are consequences of my birth condition – spina bifida.

I received two opinions, from two top-flight surgeons. Both came out at the same place, that the surgery would be too risky, that it might give rise to problems worse than I am presently experiencing. A third surgeon said to me that when a doctor, highly trained to practice the craft of surgery and accustomed to seeing the gratifying benefits that can be brought to the patient–when that doctor concludes that surgery should not take place, the decision must be taken very seriously.

All those doctors, all those weeks taken up with high tech, miraculous examination procedures, the exotic character of the disease–I felt that it was an exciting adventure, and that it was leading up to a big bang. But with the surgeons’ final decision, things took another turn, leading directly to what is called a “boot camp” for pain management and physical therapy. This will be time-consuming, challenging grunt work. The payoff is less pain and more mobility. It will be very satisfying in its own way, as I know from several years of experience in physical therapy programs. But, to use T. S. Eliot’s phrase, it will be more of a whimper than a bang.

However, there is much to be said for the whimper. In my case, the surgeons decided that not operating was a much safer course. My present condition, you might say, is the condition that is known, and even though the future results of physical therapy are not fully known, they are well winnowed procedures that we understand very well. The condition that might emerge after surgery is an unknown; it could be even more complicated, more difficult to deal with, and even less likely to have a successful outcome.

The difference between a bang and a whimper can be exaggerated. The bang may indeed describe a intervention that enables a new direction, while low-key whimper-like measures are required to make that new direction a concrete reality. In 2007, I underwent an amazing operation, that surely qualifies as a big bang event. I was the oldest person at the time ever to undergo surgery to untether the tethered cord that accompanied my spina bifida. This surgery , never performed until 15 years ago, is a regular procedure now for newborns and young children who suffer from the birth defect of spina bifida. Since a precise diagnosis of spina bifida was impossible until the late 1970s, when MRI scans became available, people in my age group mostly simply suffer with the consequences or consider what is basically a pediatric surgery. It was a seven hour operation, with my body in a “V” position, which put life-risking pressure on my lungs and eyes. Fortunately, I had access to one of the most brilliant pediatric neurosurgeons in the world, at the University of Chicago medical center.

What followed that big bang surgical intervention? Low-key whimper-like measures for the next four years. Hundreds of hours of physical therapy, exercises and fitness training. The results were wonderful. Not only did I reach the point where I could walk a mile without any assistance whatsoever, but I was in better physical condition than I have ever been in my life. I owe an enormous debt to one of the finest rehabilitation centers in existence, the Rehabilitation Institute of Chicago. The doctors, therapists, and trainers that worked with me for those years are still vivid in my mind for their competence, understanding, and a gentle persistence that drove me as hard as a Marine drill sergeant. Their guiding rule seemed to be: “If you are not today surpassing yesterday’s performance, you’re not progressing; you’re not doing well enough.”

I have been away from that environment for four years now, and even though I have reservations, I know that it is high time for me to get back to it.

Whether that stunning surgical intervention was really necessary, is still an unanswered question. My personal opinion is that while the therapy and fitness training might well have brought some good results even without the surgery, other spina bifida symptoms were ameliorated only because of that operation.

Months of examination and consultation by the finest doctors available have brought me this considered opinion: it may seem like a whimper, but it is the best course, and at age 81, it may bring at least moderate results. In my situation, “moderate” is good. I won’t be walking a mile, but walking in my apartment and using the wheelchair only when I go out, will be a big bang–let me tell you.

Those of you who read this are not in my situation, to be sure. But there may be a wider validity to this understanding of how big bang and whimper are related. If you have never yearned for a big bang, you are well acquainted with living a lower-keyed existence. Others of you may have considered a whimper to be too little; my advice to you is to remain open to the possibilities that may only exist at that level of living.

NOTE: This imagery of bang and whimper comes, of course, from T. S. Eliot’s poem “The Hollow Men.” For Eliot, the whimper is an image of emptiness, superficiality, the bitter frustration of life’s desires and ambitions. Eliot’s poem stands as one of the most vivid pictures of the empty life in all of literature. You may say that I am taking Eliot’s images out of context and severely re-interpreting, even mis-interpreting them. Indeed, I am doing just that. I admire Eliot’s poem more than words can say, but I do not think that the images of the big bang and whimper are bound inevitably to the poem, nor are their meanings limited to those of the poem. At the same time, there may aspects of aging and disability that Eliot’s poem captures for some people. There is a good deal of syrupy, cheerful talk of aging that seems to me to be simply denial. I am not writing out of Eliot’s despair, however, but rather out of a realism that abhors denial and tries to be open to possibilities. I am trying to be true to this blog’s title, “Liftthescreen.”

(C) Phil Hefner. 6/25/2014