Episode 8: Rehab week 1 – To Arms and Order

Like a cairn marks the way in the mountains, moving to the rehab centre marked the way on the path back to the mountains. It was the first time since the accident that I would feel something akin to positivity after a long and exhausting fight through the gauntlet of surgeries. Photo by JM Watson

A Change Has Come

I transferred to the Life Rehab centre across the road from the Vincent Pallotti hospital for my post surgery rehabilitation. They just wheeled me across in the same hospital bed. It was the first time I had felt the sun on my skin for almost 7 weeks. Rehab was like a hospital in that we were in hospital beds in wards of 6 beds each. There were nurses and the same fluorescent lights. It was also unlike hospital, there was a canteen and a gym and patients were moving around freely, no longer confined to their beds. What a change.

On my arrival I met the physio, Madiga. She explained roughly how the setup works. I would sleep in the ward but would be doing guided gym sessions with her and an occupational therapist. They would get me into a wheelchair of my own. I would also be able to go to the canteen to eat meals. When she first saw me she asked why I was still in bed, I knew then that rehab had a different approach than that of the hospital. Instead of rest and recover, this was a place of action. Immediately I embraced that.

I didn’t have any physio that day, but I was able to use a kommode for the first time (basically a wheelchair with a hole in it to shit through). I cannot tell you how relieving it was to be able the sit on a toilet and shit again. The bed pan days were over, it felt as if the arduous journey through the Mines of Moria had finally ended.

On day two they brought me a wheelchair and I was able to eat in the canteen. It was novel to sit at a table and eat again. Lying in a hospital bed for weeks, my entire life had stopped, using a table again was a stark reminder of how much I had relied on other people to sustain me. That was changing.

I had my first physio session which was a challenge. No longer confined to the 15 min bed sessions with the physios in the hospital. Now I had an hour with Madiga in the gym. It was so good to exercise again and I felt some life returning. It wasn’t clear how long I would be in rehab but I would be able to do ‘home visits’ to assist in the transition back to the outside world. First for a day and then for a weekend.

A Week in Rehab

Routine established itself quickly. I would wake at the customary 5 am for coffee and wait for the rehab doctor to do his rounds. I asked him if it was possible to change the blood thinner injection to a pill form, which he agreed could be done. Long bone fractures and big wounds create a high risk of blood clots. Since day one I had been given a daily injection of Clexane into the fat of my belly. It was a painful daily experience. Wednesday marked the first day since the accident that I had not had a needle of some kind either permanently attached or stuck into me for some reason. Although I had the TSF through my leg, it was still a relief and a huge milestone for me.

After breakfast in the canteen each day I would head to the gym. I did two sessions each day, one with the physio and one with Nelia the occupational therapist. Both Madiga and Nelia were amazing, without them guiding me through the first phase of rehabilitation I doubt I would have made any progress at all. Whilst the exercise tired me out and the pain that it caused at the end of the day was incredible, I felt better for it. Finally I had some agency of my own on this journey instead of being a passive bystander as doctors cut and stitched me back together.

Standing using a walking frame in the physio sessions. Photo by Unknown

The freedom of movement and the canteen allowed for more visits from friends and family. Again it struck me how many awesome people I had met in my life and the support was invaluable. On Thursday I met the trauma counselor and discussed my feelings with her. She was far easier to talk to that the psychologist who had come to see me in ICU. My attitude continued to improve each day bolstered by the activity and conversations with friends, family and rehab professionals. The week had been exhausting. I was learning how to navigate the world with one fucked leg. As such it had taken every bit of me to stay with the flow of events in the first week of rehab.

A Time to Reflect

The first weekend in rehab I would stay there, not yet able to take on the rigours of a ‘home visit’. I would do one physio session on the saturday but otherwise rested. Sleep was better thanks to the exhaustion of the exercise and my mood had improved considerably. I had pizza with my mother and sister on the sunday, a welcome break from the hospital food. It was quite a social weekend for me seeing friends and family but the empty hours between the visits were still torturous.

Some form of normality after the bleakness of the hospital. Photo by Unknown

The pain was still considerable and the weight of the loss weighed heavy on me. I cried many times that weekend as the reality dawned afresh. Each new ability I gained (transferring into a wheelchair, using a toilet, brushing my teeth at a basin, eating at a table to name a few) came with a bittersweet feeling. Although I was elated to be making progress I was acutely aware of the ability I had lost. Every gym session or excursion outside stung with the memory of my previous life. Like a cold and final reminder that I would never live my dream of becoming an 8A climber.

I was, however determined. Tool had released a new album, Fear Inoculum. Once again I would turn to their music to help me on the journey. Pneuma reminded me to keep my eyes full of wonder and Descending would help to keep me on the path to order. I had trained myself both physically and mentally to lean into challenges and I resolved to do just that. I would remain true to my faith in Being and Like Marie, it was time for me to demand “…give me my, give me my wings”. Thank God for Tool.

It was raw and challenging but the journey into the unknown had begun and like the warrior in Invincible I would struggle to remain consequential.

Episode 6: A New Hope – The Taylor Spatial Frame

This X-Ray was taken about two weeks after the surgery to install the Taylor Space Frame. It was a stark reminder of how my life had changed. Photo by JM Watson

The Last Days at Christian Barnard Hospital

The bottom is an ugly place, but that is not to say that it is not useful to reach it. When I awoke on Friday morning, frustrated, in extreme discomfort and emotionally depleted, I knew that I had indeed reached the bottom. I also knew that there was utility in that and I felt just slightly better for it. Although the day was no less grinding, I did meet with Dr Laubser who would install the Taylor Spatial Frame (TSF) around my leg. Finally it felt as if I was moving again, impossibly raising my head to breathe after drowning in chaos and despair.

He informed me that I would be able to bend my knee and weight bear post surgery. I would also not need to stay in hospital whilst the bones healed. Something which was not certain in my mind and a huge relief. I would be transferred to a rehab facility after about a week of observation and healing in the hospital. There they would help me to regain enough functionality to be released from hospital with the TSF. Exactly how long that would take or in what condition I would be was unclear. But at last there was hope and a foreseeable end to the hospital stay.

The next few days passed like decades. The same routine of early mornings, physio and doctors visits punctuated long hours of attempting to entertain myself by reading, watching YouTube and generally being an emotional mess. I wasn’t sleeping much better. I was, however, able to get a few patchy hours each night which helped. They transferred me to a private ward due to an infectious pathogen they had found in the tests they routinely did. The doctors said it wasn’t infecting my wounds but needed to isolate me from other patients.

The visits from my mother, sister, brother-in-law and friends sustained me, keeping my mind in check in the otherwise endless hours of neon lights and immobility.

The Taylor Spatial Frame Surgery

I transferred to Vincent Pallotti on Wednesday afternoon. Thursday Morning was an anxious time waiting for the surgery that afternoon. I knew I would be going back into a more painful state after the surgery. It meant more IV drugs and altered consciousness. The confused state precipitated by the drugs combined with the massive psychological trauma was not conducive to sanity. It took everything I had to hold on in those periods.

The Surgery was a long one and waking up in the recovery area was as confusing and unpleasant as I could possibly have imagined. I phased in and out several times before stabilising and I was in considerable pain. I could feel the same fractalization of reality between bouts of lucidity as I had when they gave me the Ketamine. Again I found the words of Dr Peterson useful: Shorten your timeframe. I tried to breathe and make it through each second. Not fully aware of where or at times even who I was.

My first view of the TSF, relieved to have the other ex-fix removed. Photo by JM Watson

My mother and sister were in the ward when I arrived, I was in considerable pain. The anesthetist had given me a PCA. It’s a large plastic syringe like pump that allowed me to self administer IV painkillers every seven minutes. This alleviated the pain somewhat but at the cost of lucidity. The pain would rise and I would push the plunger. Several seconds later I could feel my consciousness narrowing and be sucked back into the fractal world beyond. The struggle was real.

An X-Ray taken a few days later, the shattered bone and the screws holding it in place clearly visible. Photo by JM Watson

Hope, and Desperation Post Surgery

Surprisingly I slept quite well that night, but awoke feeling exhausted. Dr Laubser informed me that the surgery was a success in his eyes. A relief but it did nothing for the pain. The first physio session was unnerving to say the least. Bending the knee after almost 6 weeks of it being stationary was an uneasy feeling. It felt as though the whole knee was in a vice grip and it was more than i could bear to feel all the wires and pins inside me. I politely asked to end the session and subsequently broke down crying when the physio left. I felt stretched beyond what I could handle by the end of the day. Music helped to alleviate the burden of being until the sketchy sleep covered me.

The pain improved over the next few days but not by much. I was barely able to move around in the bed. Sunday was the next day with anything other than the routine of hospital life and visits from family and friends. The doctor cut away the protective bandage covering the TSF and I could see it for the first time. As always the sight seemed both shocking and intriguing at once. This thing before me, both biological and mechanical is what was left of the the leg that held a heel hook on Human Energy, a toe hook on Born into Struggle and hiked countless kilometers into mountains unknown. Now I could barely move it and not at all without pain.

Top view of the STF. Photo by JM Watson
The marks drawn on my knee helped the doctors align the TSF. Photo by JM Watson

The nurses also changed the bandages on the wounds still healing between the Meccano set and replaced the sponges around the pin sites (something I would later do each week on my own). Later that day the physio would help me move the leg over the edge of the bed and slowly lower the foot to the floor. The pain and discomfort was real. I was only able to sustain that for several seconds. I had touched the floor for the first time since the accident, a momentous milestone.

Dressing change. Photo by JM Watson

Dr Laubser also started the adjustment of the TSF, a process which would continue for 5 days. The support struts of the TSF which join the two rings together have a locking screw mechanism that allows them to be lengthened or shortened. A computer program determines the correct sequence of adjustments needed to correctly position the rings to align the bone shards. The movement is spread out over 5 days to lessen the pain and allow the body some time to adapt before the next adjustment. Whilst the adjustment wasn’t painful, it did precipitate more inflammation. I felt more pain at the end of the day after the adjustments.

The next few days passed much the same. The pain did begin to lessen and I moved away from the trippy drugs, thankfully. I did my first stand heavily assisted by the physio and with all my weight through my arms on a walking frame. I was only able to do one stand the first day. Progressively adding two more the next day and three the day after that. The journey back to the mountains seemed impossible. I was still in a dour mood for the week after the surgery, despite the progress and the hope it had brought.

My first touch of the floor for about 6 weeks. Photo by Lyal (Thank God for that guy)

The Last days at Vincent Pallotti Hospital

By the weekend I had recovered a bit more, I was in a lighter mood when My birthday came. I ate burgers with my mother and sister and although I was still distraught, I was eager for the transfer to the Rehab facility.

Love had been lost and purpose had been expunged from my life, all that was left now was suffering. Thankfully I had asked for a copy of Mans Search for Meaning by Viktor Frankl, which I had intended to read whilst in Rocklands. His words brought some dignity back to my mind and remembered in me some of the thoughts which I had cultivated over the few years prior.

” When faced with unavoidable suffering, suffer bravely” Viktor Frankl

Damn how I tried, through the tears and the pain. Looking back on that period I understand that I succeeded in rekindling hope. At the time, however, I could not see the forest for the trees. The forest had apparently seen me and was preparing the reveal itself. After spending a week and two days in hospital post surgery, I would transfer to rehab on Monday the 26th of August.

Concept 5: Why We Are (Still) Here

The summit of Kilimanjaro Photo by JM Watson

Concepts are challenging slippery devils to catch hold of. Just as you think you’ve got it pinned down, poof, it jumps out of your grasp and you’re left chasing it around the room as the phone rings and the kettle boils and some wave comes crashing in to upset your day. So how to we pin these things down? Well usually we use words and symbols. Concepts about economics are encapsulated in a body of literature and symbols and it’s customary for people to spend years deciphering these. So to are concepts of life and meaning enshrined in literature and symbolism. Myth, Religion and Culture are filled with examples of these words and symbols. Through the art of the centuries people have been grappling with these complex concepts and experimenting with different representations of their form. Trying to pin them down only to be frustrated by their elusiveness. The concept I’m trying to solidify out of it’s wave state in this post is as elusive as it is important. To try to coax it from its hiding place lets first look at some of the symbols and stories which I think gravitate around it.

The Battle of Helm’s Deep

In the Lord of the Ring’s written by JRR Tolkien, a battle is portrayed as happening at Helm’s Deep. It is a ‘no way out’ nook of the land which has been fortified with garrison walls and is described as the best and last defensible location of the kingdom of Rohan. Rohan is one of two kingdoms of humans on middle earth, the other is Gondor. Both are beset by cunning and massively overpowering foes seeking dominion over Middle earth. The battle that takes place is the first of the battles in ‘The War of the Ring’ and the odds are most definitely not in favor of the humans. Rohan’s foe, Saruman, has by cunning weakened their forces and resolve whilst preparing industriously and intelligently his own force to destroy them. The loss of this battle would ultimately lead to the destruction of one of the two powers left to stand against the coming darkness. Despite the seemingly impossible odds, the humans are able to fight and defend Helm’s deep and although become greatly diminished by the effort are able to prevent the sundering of the two kingdoms of light.

Jacob wrestles with God

This is a direct excerpt from the Bible that I found online, from Genesis 32:

22 That night Jacob got up and took his two wives, his two female servants and his eleven sons and crossed the ford of the Jabbok. 23 After he had sent them across the stream, he sent over all his possessions. 24 So Jacob was left alone, and a man wrestled with him till daybreak. 25 When the man saw that he could not overpower him, he touched the socket of Jacob’s hip so that his hip was wrenched as he wrestled with the man. 26 Then the man said, “Let me go, for it is daybreak.” But Jacob replied, “I will not let you go unless you bless me.” 27 The man asked him, “What is your name?” “Jacob,” he answered. 28 Then the man said, “Your name will no longer be Jacob, but Israel,[a] because you have struggled with God and with humans and have overcome.” 29 Jacob said, “Please tell me your name.” But he replied, “Why do you ask my name?” Then he blessed him there. 30 So Jacob called the place Peniel,[b] saying, “It is because I saw God face to face, and yet my life was spared.”

Joseph Cambell’s Hero with a Thousand Faces

Joseph Campbell was influenced by Jung and studied myths across the globe and from across time, from this he distilled out what he called the Hero’s Journey. A kind of blueprint pattern which seemed to span many myths and cultures. The video below describes it quite well. Although I have never read The Hero with a Thousand Faces, I have done some digging into this concept, I would add to the video’s description that the Hero’s Journey is not complete until the new found knowledge or skill gained from the struggle that the Hero endures is reintegrated into the community or society and as such, updates the otherwise stale culture.

Infected Rain: Stop Waiting

Whilst not everyone will appreciate a spot of death metal, they do tend to write about interesting topics. Here Infected Rain use the lyrics”we are…always waiting” and “…get up…get up from your knees….fight…fight for your dreams…”

The Battle of Britain

Even in the realm of recorded history (not that myths and story shouldn’t be thought of as history of some kind), we see examples of this idea. Here Churchill is referring to the coming Battle of Britain which was by all accounts a decisive event in the history of our world. What the world would have been like today if Britain had fallen in WWII is uncertain, although I don’t believe that it would have been quite as liberal as it is today.

Sourced from: https://winstonchurchill.org/resources/speeches/1940-the-finest-hour/their-finest-hour/

Do not go gentle into that good night (by Dylan Thomas)

Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.

Though wise men at their end know dark is right,
Because their words had forked no lightning they
Do not go gentle into that good night.

Good men, the last wave by, crying how bright
Their frail deeds might have danced in a green bay,
Rage, rage against the dying of the light.

Wild men who caught and sang the sun in flight,
And learn, too late, they grieved it on its way,
Do not go gentle into that good night.

Grave men, near death, who see with blinding sight
Blind eyes could blaze like meteors and be gay,
Rage, rage against the dying of the light.

And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.

Resilience, strength, fortitude, or some other synonym?

So what is this crazy Watson oke getting at here, can’t we just call it strength or something similar and move on? Alas it is not quite so simple. When I awoke in ICU I was very much in survival mode, it was really autopilot stuff. I didn’t have the time or energy to sit and think about how to do things, things were happening too fast and there was too much damage, both physically and psychologically. The physical damage had nearly killed me and could still possibly do so, through infection or some other unfortunate chain of events. The psychological damage was also extreme, one moment i was balls deep in living my dream of being a fulltime nomadic climber, living in nature with my dogs, crushing projects that were beyond my imagination and meeting extraordinary people to share the journey with; the next moment I awoke in an ICU without a leg and the very real possibility of losing the other, pain that was beyond my imagination, the full death of any planned future and of any dreams which I had worked so hard to move towards (and no dogs although they were alive and well). I was definitely not in Kansas anymore. Given this extraordinary set of circumstances, how was it that I was still alive and how was it that I was still what approximates sane? Sure I was beat up, taking shots, but I didn’t feel like I had given up, like Id been crushed by the weight of it all. Not that I like comparing myself to others but there are countless stories of people who go through flood events which are much less severe and turn into little puddles of jelly. A breakup or being fired or a stock that falls can send people into the blackest of holes. But I felt strong and resolute, It wasn’t a hopeful kind of strong for sure but I somehow knew that should I survive, this wasn’t going to be the end of me. Why was that?

During the second week of ICU I had a small break of sorts in the intensity of the operations, quite what made me able to think about these things on that specific day I don’t know. But the timing was fortuitous, the next two days would be one of the biggests tests of my life and to come through it in one piece would prove to be a challenge the likes of which I had not yet encountered. I thought of my experiences climbing and how I had been humbled over the years, of how each time I had been laid low by some event or failure. Through all that I had continued to grind, continued to fight, sometimes without hope. I thought of previous failure, in projects I managed and relationships, even academic failure and more personal failures I won’t elaborate on. Each time I rebounded, I learnt that overcoming such things is paramount in life. Although this time was the most extreme thing I had been through that character, that pattern, still resounded in me. Lying there looking at the rain falling on the city beneath me, crying and utterly destroyed, I understood one thing: You have an obligation, pick up your spear damn you and fight that dragon that assailed you, the outcome matters not, it’s the fight that counts.

So lets unpack these examples above and see if we can pin down this elusive concept. Its not as simple as one might think but definitely worth pinning down.

The first thing that strikes me as obvious with regards to this pattern is that is is completely devoid of hope. Hope, as the Roharim so eloquently said, has forsaken these lands. At Helm’s deep they had no hope of victory, it was a ‘Deus ex Machina’ that ultimately brought victory. When Jacob fought with God, what hope did he have of winning, the fact that God didn’t obliterate him instantly in the story is rather fascinating, but he could certainly not have hoped to win. So to in Churchill’s speech we read a tone of desperation but also of nobility, ‘their finest hour’ speaks to valliant action in the face of overwhelming odds. Even though there is no hope and cruel death is sure to be their fate, even when the Chaos of existence is surely too much to bear and will obliterate one, there remains a mode of being that is valliant, an obligation to transform that Chaos into Order in some way, however small. These stories above are examples of what happens when we do so, we are rewarded. Sure these are examples of the successful stories and no doubt there are countless stories of people who did such a thing and were still torn asunder by the Chaos, in my mind that doesn’t kill the theory though, to do nothing, to give up has never inspired myth or Legend. There is no fairy tale which reads: …and he cracked, sat down, peed himself and began to cry, the evil dragon of Chaos took pity on him and offered him some treasure to make up for the suffering. There is a randomness at work in life that does in the would be heros in a majority of these stories, and so they end. But the stories of success, so commonly presented to us and which seem to resonate with us emotionally are those where some kind of valiant action was undertaken despite the seeming impossibility of a better future. So abandon all hope ye who enter here, it will not avail you. But enter you must.

The next thing that I have come to understand about this resilience or strength is that it is voluntary. You must make a choice to fight, constantly. In Helm’s Deep the King of Rohan has a moment of weakness, with hope lost he gives up the fight, resigns himself to failure. Aragorn reawakens this fire within him by offering him a noble death by riding out against their foe head on, an act which will surely see them killed. In the book better than in the movies, Aragorn’s character was well portrayed as the redemptive man, a Christ like figure who had forsaken his obligations only to realise his faults and rejoin the fight. This was again a voluntary choice and his actions inspired those around him to do the same. When Jacob wrestled with God, it was God who said ‘let me go’, not Jacob trying to flee. Jacob, astoundingly, was fighting with God voluntarily and would not stop before God blessed him. If there is one thing you really want to avoid fighting with its a being who’s powers are described as omnipotent. But yet there’s Jacob, wrestling with him intentionally, the story is preposterous but yet we see it repeated over and over again in many guises. Even in modern art where Infected Rain is screaming at us, ‘Stop Waiting’, ‘Get up’, its a choice we must make despite the death of hope. So choose, will you go gentle into that good night or will you rage against the dying of the light.

But for what reason? Why should we fight, continue the suffering, endure the trial if there is no hope and in all probability no future reward? The answer to that is nothing short of the closest approximation to the meaning of life as I can get to. It is the very substance of our being that guides us into this resilience. Again i paraphrase Jordan Peterson’s words to describe this: There is a mode of being which transcends the suffering of life, and that mode of being is to stand up forthrightly, pay attention and speak you being forward. In other words you fight voluntarily using your best weapons of attention and spirit (or in Peterson’s words Logos, I suggest you dig into the meaning of that word on your own). Fight to turn Chaos into Order, the continuation of which allows you to bear the immense suffering that existence requires and not for hope or reward , simply to bear the suffering, personally. To stand up under the weight and say: I accept this burden and I will carry it until it crushes me completely because it matters that I do. It is understanding this that allows us to break free of the Nihilism of defeat and capitulation. To know that everything we do matters gives us the courage to act valiantly when the world goes dark and all hope dies. It is what the moral or the core that these stories above can be reduced to: If you continue, in every moment, regardless of what came before or what comes after, to fight, to turn Chaos into Order, you will balance the suffering of Being. Perhaps not in the future as the failed stories will attest but at least in that moment you will be able to bear the suffering levied upon you, no matter how great.

So its not Hope that makes us strong, or I would truly have cracked. Its not instinct which shapes how we act, its choice, a stark choice between the light and the dark. And its not Nihilism that builds our strength, its the knowledge that everything you do matters, now, and you had better make meaning of that. Pick up your spear, damn you, and fight that dragon that assails you, because it matters that you do. That’s what these Stories, Myths and Legends are telling us. This is what I drew from, this is why I am still here.