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."