Sunday, March 28, 2010

How to know the body

i keep thinking about the photos my surgeon showed me. they were circular images printed eight-up on a glossy 8.5 x 11 page, two across and four down. showing me these pictures was his answer to my question "what exactly did you do to my shoulder?" i thought he wasn't paying attention to my query, but within a few seconds of shuffling he produced this sheet of photos, stapled to a series of other, narrative documents about the surgery. to him, these pictures were the answer.

the images would have been taken by an autoclavable arthroscopic camera inserted through a small hole in my shoulder at the beginning of the operation, when the team was deciding how to proceed. they have the beautiful precision of a high-resolution digital camera, if the slight blurriness of an extreme close-up. the bones were luminous and white (so, this arthroscopic camera must have a light source?) and there was, oddly, no blood -- in fact, no red at all. flesh, it seems, is putty colored. to me the most startling thing in these photos was amount of space in the shoulder: i had thought it must be densely packed, like an electrical socket with its confusing capped wires, but it appears instead to be hollow, like a mouth. the joint was photographed against a murky and distant-looking background of puce tissue.

the beauty of these photographs to me was almost entirely abstract, like a mona hatoum installation. i could not even begin to orient the images i was seeing with the body i inhabit. the surgeon pointed to one photo after the other and i pretended to understand, but i didn't -- at least, not in the way he did.

my experience of my shoulder has nothing to do with reason or causality. some days it feels good; other days it hurts a lot. some days i make great progress on my exercises; other days I can barely move. i cannot directly connect one day's activities to the next day's sensations. there is only an uncertain connection between painkillers and pain. while i can see a definite improvement over the last four weeks, it is virtually impossible to parse that improvement into shorter periods. healing is an uneven, illogical, and intuitive affair, and i often find myself yearning for the certainties of science.

the certainties of science, expressed with a certain geekiness and large, gentle hands are part of what i fall for in my physiotherapist. (i have written before about my crush on "oliver.") you could call it transference, this belief that if i endow him with preturnatural healing powers, and if i put myself under his spell -- the spell represented by physiotherapy's advanced knowledge of bodily kinetics, together with its mystical language ("med load," "tenodesis," "suture") -- i will be healed, wholly and completely. my role in this transferential relationship is to believe, to adore, and to adhere: to be the best patient possible.

(quick aside: this terminology, borrowed from psychotherapy, is imperfect. i don't recall ever feeling exactly this way about my parents, which is typically taken to be the ur relationship reenacted in psychotherapeutic situations. i have never heard anyone else talk about the relationship between physiotherapists and clients. nonetheless, transference remains the most compelling explanatory framework i have.)

on wednesday, it was hard to play my part. the shoulder hurt a lot. i lay on my narrow PT bed and tried to do my exercises, without much success. oliver stood at the head of my cubicle for a moment. "quiet today, huh?" he watched me struggle with the sixth repetition, and he probably saw me start to cry. then he did the most astonishing thing: he came and sat in the chair next to my bed. he described the surgery for me in the fullest terms i had heard yet. he told me how my body was healing. he said "you have every reason to be in pain."

in the days following our wednesday appointment, i became more and more amazed by his kindness and intuition. on friday i asked him how he came to respect the body so. i told him i understood the seduction of science, the lure of diagnostics, prognoses, crisp pictures, big words -- but that his treatment on wednesday suggested something different, a patience and a gentleness they don't teach in university. so how did he come to possess it?

he smiled and said, "through the science."


mari said...

Physios are the best people there are. In order to even get INTO the physio program, you have to have extremely high academics, plus you need to pass a personal interview in which you are judged whether you are nice enough to help people heal. Physios need to be able to figure out how to motivate many different kinds of people and educate them about their bodies. Physio students have every right to be as ruthlessly competitive as med students, but they just aren't They support each other to succeed as a group.

I know this because my big sister is a physio. I understand why you love them so much.

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