The Guilt of Injury

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18/09/2024

Pretty sure I just broke my arm, I text my boyfriend minutes after slipping down a climbing wall. I glanced at my left arm, bent weirdly, part of it so severely displaced I could see it with my own eyes. When I looked up, multiple concerned looks from other climbers landed on mine. ‘I think I need an ambulance,’ I say.

I never thought I would end up in a hospital. At least, not because of climbing. Not when I’m alone, my mother in a different country, my friends at work. An hour ago, I petted a sweet dog who settled into my side while I watched his owner climb. Now, the owner has come up to me, asking if I’m okay because he heard that crack from the other side of the gym. The thought of that sound, the quick snap of my bones, makes me nauseous. The pain – a constant throbbing that numbs my shoulders and back – is so bad I can barely think. They are not sending an ambulance, I’m too awake, too conscious. I will need to call an Uber to drive me to the hospital. Once again, I think, how can I do this alone? I’m not at my regular gym, the one with a hospital across the street, the one where my friends work. These are strangers who watch my steady stream of tears, who call me strong and brave as if I’m a child.

The last and only other time I broke a bone was in sixth grade. I tell this story now in the Uber to the woman working at the gym, who has kindly agreed to accompany me. (Later, in the A&E waiting room, I will ask her to clean my nose before I remember to ask her name). I got spooked by a spider and ran away in an irrational moment of fear. I slipped, crashing into the classroom’s radiator. I was in pain, but not enough to paralyse me. Children are more resilient. I asked to go to the toilet, dried the tears I managed to hold back in front of my classmates, and after that lesson (thankfully the last one of the day), I took the bus home. A couple of hours later, my brother found me on the couch, crying. I still didn’t know what was wrong, only that my arm felt heavy, that I couldn’t lift it, my body hanging off the sofa, unable to get up. He called my mother.

This time, ten years later, I have to call her. And she can’t just get off work to take me to the hospital. She can’t be the one to improvise a sling. All she can do is be there on the phone,

neither of us quite understanding how British hospitals work, me barely understanding how German hospitals work.

Later, after I have been fitted with a cast, given to me under tears and laughing gas (the nurse joking, oh no, don’t cry, it’s not called crying gas, is it?), the doctor tells me I have a double fracture. He tells me I will need surgery.

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As a writer, I am dependent on my hands. I am right-handed, but used to being able to type fast with both hands. The emails I now write to my therapist and supervisor after the accident, the messages I write to my friends and my mother are all written with just my right thumb, an excruciatingly slow process full of typos that reminds me of my grandparents’ way of texting. How am I supposed to complete my final project for university – a series of articles due in January – like this? With my arm in a sling, the smallest movement still painful, a constant reminder that, yes, within the cast, my arm is still broken.

After the surgery, my arm is bandaged, my fingers still swollen, half of my arm still numb and bruised. Everything hurts, the painkillers only relieving enough to not be in agony. I am told to rest, take medication, and go to my GP for dressing changes within the next three days.

I don’t know how to rest. I can be lazy. I know how to procrastinate, not doing things when I should be doing them. But not doing things when I shouldn’t do them? I feel like I should get over my injury. Lots of people break limbs, lots of people undergo surgery, and lots of people get up again and do their work. People expect me to bounce back – I can dictate my words; I can use my right hand to type. But I can’t.

Gavin Francis (2022), a physician and writer, observes that a lot of ‘my patients often need to be granted permission to take the time to recover they need. […] medicine has become expensive, and the first casualty in cost-cutting is time.’ What if they cannot afford to take time off? Sinéad Gleeson, an Irish writer who grew up with arthritis and was later diagnosed with leukaemia, writes that ‘[i]llness gives us permission to drop everything – jobs, commitments, the tangle of repetition that is everyday life – but the price is high’ (2020, p. 114). An IPSE study from 2019 revealed that 62% of UK’s freelancers won’t take time off because ‘they were

worried about letting their clients down,’ 60% ‘were concerned about future periods without work,’ and 57% ‘did not want to lose money when they could be working instead.’ Even when they aren’t ill, but when their bodies need to recover, freelancers are less likely to stop. Eight weeks after Gleeson’s son’s birth, ‘[f]reelance work life resumes […] because of financial necessity’ (p. 128). ‘Taking time to recover,’ Francis says, ‘can seem quaint or impractical,’ which to me seems like an oversimplification. Not everyone has the privilege to recover, it’s not simply a ‘quaint or impractical’ inconvenience. For many in low-income jobs, those who have multiple jobs and those who don’t get sick pay, taking the time to recover can threaten their livelihoods.

Although I have the financial privilege to take time to recover, my brain still makes me feel guilty for feeling exhausted. I’m only lying around. How can I be this tired after not doing anything? How can it be so hard just to watch a show on Netflix to entertain myself? I have all this free time now — should I not use it to write, to finish forgotten articles? We live in a world in which recovery is seen as more of a privilege than a right. We are taught to feel guilty for needing time — not because we are needed elsewhere, but because we are expected to push through.

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11/10/2024 (three weeks post-op)

It’s my first time back at the climbing gym. It’s not the gym where I fell, so I don’t relive the accident, but I can’t help feeling anxious. I’m nowhere near jumping on the wall again – my first physiotherapy appointment is in three days, my arm not used to quick movements yet – but the thought of standing on a slope-y hold that is very easy to slip from fills me with fear. At the same time, my body itches to figure out routes. Climbs that require strong fingers and balance are calling to me. I read the route without knowing whether I can do it, or whether my beta is the intended beta. It’s a desperate need to put myself in a small box, to burst up and grab the next hold. To be explosive and precise.

It’s a fantasy.

Watching my friend climb is frustrating. Climbing means being part of a community, of trying things together, but today I can only guide her from below.

We’re looking at a climb full of crimps, one that makes use of an arête – it is a climb that I would usually love to do, one that fits my style perfectly. I tell her to use the sidewall, holding onto it while leaning away from it for stability. Her hands need to be further up, but she keeps them on the starting holds, stubbornly crimping a hold we both agree is a foothold. I want to get on the wall myself, to show her what I think will work, my words and my stumbling attempt at an explanation remaining unconvincing. I need my body to twist intuitively; I want to engage my arm muscles, to stand up on a tiny hold with a tight core. I know I can do this. I know my way will work, and I want to prove it to my friend — and to myself. But I can’t.

My arm hurts from merely standing around, the weight of it hanging almost dead by my side and cramping up my shoulder. I can barely carry a plate of food or a glass of water. I definitely cannot support my own body.

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When I tell my doctors, therapists, and teachers that I feel like I should be back to normal now, a month after surgery, they shake their heads, reminding me that ‘you went through trauma! You broke two bones!’ Reading Francis’ reminder that ‘the pain, stiffness and weakness that follows a broken bone may go on for months […] to rush back too early into work, or to push yourself into too much activity, is to risk a relapse’ feels comforting and distressing at the same time. Parts of my arm still feel numb, the cut nerves only slowly recovering, and although I have reached a point of seldom pain, it aches constantly. I feel lucky that my job requires simple finger and wrist movements, but it seems as if I’m betraying my body by doing too much too quickly.

I have not been brought up to ignore my pain. My mother is a medical professional, her company is a mobile nursing service. She knows when it’s serious and when it’s just a cold. Unfortunately, being raised with an it’s just a cold, go to school and we’ll see if it gets worse mindset means that now I have an I’ll be fine, it’s not that bad mindset. The story of my twelve-year-old self going home with a broken bone is not as cute as I want it to be. Although it elicits sympathetic awws, I walked around with a broken collarbone for more than two hours without doing anything about it. You might fault my teachers for not worrying more, for not immediately calling my mother, but even now recalling that I broke a bone because of a spider

fills me with shame. I can’t imagine how it would’ve felt to say, ‘I’m injured because of a spider, can you please call my mum?’ in front of my classmates.

I get through things. I am hardwired to believe that everything will turn out fine, that a little sneeze (or indeed a lot of pain) should not stop me from working. Even when I am told repeatedly – by doctors, therapists, and teachers – that I should stop working.

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I am obsessed with my arm. I constantly look at it and the two scars that miraculously do not hinder upon my tattoos. I constantly touch it. Touching it to see whether the numbness that I have carried with me has vanished (it has not). Touching it to feel the grotesque dent next to one of the scars, to feel how much harder the scarred skin is.

When my bandages were taken off, the stitches still holding my skin together, I saw blisters (my skin reacts badly to adhesive plasters). I couldn’t stand the sight. Like the initial glance at my broken arm, I avoided looking at it. It felt wrong. Sickening. In a 1995 interview, surgeon and writer Richard Selzer talks about ‘a certain natural physical revulsion for other people’s wounds and diseases’ (Kushner, p. 496). I feel that same revulsion for my own wound, for the blisters surrounding my incision scars.

I know that for my arm to look like this now, my surgeons had to open it first. They had to slice it open, my bones visible to them, inserting metal plates that will hold the bones stable while they grow back together. Selzer says that surgeons are ‘in a sense anesthetized’ too, to ‘be at some emotional remove from the white heat of the event, the laying open of the body of a fellow human being’ (Kushner, p. 497). The doctors, these strangers, now know my body in a way I do not. For them, my surgery was a straightforward routine; for me, it was a physical reminder of a traumatising fall, a painful slip of gravity.

I’m told my wounds are healing well, the scar slowly fading to a light pink, the irritated skin, where I peeled off my blisters in an act of manic satisfaction, blending into my usual skin colour. But I still see it as a broken thing, as something that doesn’t quite belong to my body. A machine whose signal failure means relearning processes and movements.

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30/10/2024 (five weeks post-op)

My body tenses as he stands up. His toes are on a hold as small as a £2 coin. For a split second, he’s not holding onto anything, his core a ball of taut muscles as his body springs into position, his hand closing in on another small hold. He is stable, his balance is perfect. When he reaches out his other hand to touch the final hold, signalling the end of his climb, I start to breathe again. I know what it’s like to be up there. I know what it’s like to come loose, to crash, to hurt. But he made it, a celebratory whoop coming out of his mouth as he jumps down. I smile and congratulate him, trying to calm my heart that believed he would end up broken and scar(r)ed like me.

My physiotherapist told me, best case scenario, three months until you’re back to basic climbing. A shock — and a relief. Before my accident, I had already been afraid of bigger movements; holds that were too far away would keep me from finishing a route because my brain would not allow me to do dynamic movements. Now, I am not only afraid for myself, but for everyone around me. What if they slip? What if they will need to go to the hospital and get surgery? And what if it will happen again to me once I’m back on the wall? My body’s trauma has infiltrated my brain, making it its home.

I have frequent nightmares about falling now. I climb up an easy route on an overhung wall. In my dream, the walls are higher than regular indoor boulder walls. I don’t rely on my left hand, utilising my feet instead, resting on my right arm. I finish on a bad purple hold (in my gym purple signifies easy climbs) surprised by the lack of grip area. I realise then that I somehow have to get back down. Jumping isn’t an option, it is far too high, so climbing down is the only way. But suddenly, I can’t put any weight on my left arm, my brain won’t allow my right hand to release, the fear of only hanging by my left arm, of my left arm giving out, of falling again—

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I feel this fear creeping into my non-climbing life, as well. Living in London, I am used to busy sidewalks, to people knocking against each other, and yet it is surprising when someone bumps into me, jostling my arm enough for pain to shoot from elbow to wrist. It’s the same pain that will randomly pop up now from time to time. Like an electric shock, it disables my forearm for a few seconds, taking me back to the initial oh shit, my arm is broken, and my brain turns off all movement signals. I’m afraid it will stay like this — unexpected, paralysing pain. Pain

which means my brain is focused not on my work, but on my arm. Always my arm. I have so much to write about, so many different things I want to write, but I can’t because the only thoughts I can grasp onto are what if I don’t get my sensations back or will I be able to fully turn my arm again?

Gavin Francis writes that ‘“Health” means “wholeness”, but there are many ways of remaking ourselves towards that state […] recovery is better thought of as something dynamic, just like life.’ It’s hard, almost contradictory, to imagine myself whole again. My bones have not fused back together, technically they are still broken. My latest x-ray shows a void between the bone fragments. It’s too early to say that the bone is not healing, but my doctor tells me about the possibility of another surgery, a bone graft this time, if the void doesn’t close up.

I thought I sensed disapproval that I hadn’t made more progress — I still struggle with pronation, the wrist movement where the palm is facing downwards. I feel like I have disappointed him, and, in turn, myself, by not doing enough. By not resting enough, but also by not exercising enough. I can recognise that I am projecting my own emotions onto him, as he goes on to repeat what I have heard from every doctor so far: that it is a severe break, it’s not a clean break, see, there are some cracks alongside the break, that every bone and every person is different, that no healing is identical and definitely not linear.

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I’ve never been drawn to books about illnesses. Whether fiction or non-fiction, reading about traumas, recoveries, and deaths was unappealing and too distressing. Now that my brain fails to focus on any words (I have not finished a book in two months), when I do read, I cling to authors fighting diseases, metaphorizing illnesses, making it into something poetic, something cathartic. I believe I am looking for understanding.

In ‘A Burst of Light: Living With Cancer,’ Audre Lorde writes that ‘[c]aring for myself is not self-indulgence, it is self-preservation, and that is an act of political welfare’ (1988, p. 131). This is her collection of journal entries following her breast and eventual liver cancer treatment. Her disease killed her, making me feel guilty for connecting with her attempt at rest. She lived with something incurable. I have an injury, one that will not kill me, one that will, most likely, not impact my life for more than a year. And yet, I resonate with parts of her suffering and fear.

I even understand her conviction that caring for oneself – by resisting the expectation to work while in pain, by prioritising oneself over the economic system – can be a political act.

Sinéad Gleeson talks about relating to Frida Kahlo in ‘A Wound Gives Off Its Own Light,’ an essay in her collection Constellations: Reflections from Life. Kahlo experienced a bus accident when she was eighteen, causing a broken body – literally, ‘a fractured pelvis and collarbone, broken ribs, a broken leg and a mangled foot. Her spinal column shattered in three places’– and more than thirty surgeries throughout her life (Gleeson, p. 176). Gleeson explains: ‘Our health issues differed vastly; hers were debilitating in a way that horrified me. I didn’t dare equate her suffering with mine, but our experience felt kindred’ (p. 177).

Here comes another writer who I feel connected to: Alice Hattrick who grew up with and still suffers from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). They write about (not) being visibly ill, expressing ‘shame when I made myself visible to others who refused to see me as anything other than a problem – as someone who did not fit in to [sic] the world of the healthy or the sick. As a child, I felt ashamed that I was not ill enough’ (2017). Once again, Hattrick suffers from something constant, whereas my broken arm will end. But the feeling of ‘not being ill enough’ struck a chord.

When I fell down the climbing wall, my injury was obvious — my arm was bent out of shape. Later, it was in a cast and then in a sling. Now I have scars, but if I wear long sleeves, it is impossible for others to know that my arm is not fully functioning yet, that my brain is still hanging back. I am still in pain. I am still exhausted from healing, an experience Hattrick associates ‘with the loss of myself, of my personhood, because, for a long time, illness, for me, meant failure. A failure to process information, to speak clearly, to concentrate long enough to read, and write.’

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21/11/2024 (two months post-op)

I realise that Lorde’s collection is informed by certainty. She affirms to have ‘liv[ed] my life every particular day no matter where I am, nor in what pursuit. It is the consciousness of this that gives a marvelous breadth to everything I do consciously’ (Lorde, p. 132). It is a state of mind that comes from accepting death as the end of a healing journey, the ultimate recovery.

That is not my experience; there is no certainty. Having an injury means healing can go awry. Healing can be slow or fast, agonising or endurable, straightforward or with hiccups along the way. Terminal illnesses are horrific, incredibly scary, and often torturous, but their end is clear.

I thought I was making progress. My arm felt stronger; sometimes I even forgot what had happened. Then, I noticed a lump. It hadn’t been there during my last check-up, nor during my physiotherapist appointment two days before. I dismissed it at first. It was a curious development; touching it, I thought I could feel my bone sticking out of its hinges. I described it as ‘bone, then dent, then bone’ to my boyfriend, who I asked if he could feel it as well, seeking confirmation that I wasn’t imagining it. I compared it to my unbroken arm, as I had done throughout my recovery — this is what I should be able to do, this is what it should look like. I didn’t call my GP immediately. I was back to my usual mindset, convinced that it would go away, that it would be fine. Yes, it’s hurting a bit, yeah, it feels a bit strange, but it doesn’t keep me from doing things, I’m already so much better!

Whatever this is, it could mean more surgery, longer recovery time, more pain. It could mean that something is still wrong, that I am not healing. I remember how I came out of my surgery: guilty, depressed, empty. I’m scared. I don’t know what will happen. It’s been over two months since I last climbed up a wall, since I last thought of bouldering as something incredible, as something that freed up my mind, something that made me ache in a way that didn’t feel excruciating. I don’t know how long it will take until I can feel like that again — if I will feel like that again.

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References

_{Francis, G. (2022) ‘We need to recover the lost art of convalescence’, The Telegraph, (14 May). Available at: https://www.telegraph.co.uk/health-fitness/body/need-rediscover-lost-art-convalescence/. (Accessed: 04/11/2024).}

_{Gleeson, S. (2020) Constellations: Reflections from Life. London: Picador.}

_{Hattrick, A. (2017) ‘Ill Feelings’, The White Review, 19. Available at: https://www.thewhitereview.org/feature/ill-feelings/. (Accessed: 05/12/2024).}

_{IPSE (2019) Taking Time Off As a Freelancer, Report. Available at: https://www.ipse.co.uk/downloads/taking-time-off-as-a-freelancer. (Accessed: 04/11/2024).}

_{Kushner, T. (1995) ‘Richard Selzer on Death, Resurrection, and Compassion’, Cambridge Quarterly of Healthcare Ethics, 4, pp. 494-498.}

_{Lorde, A. (1988) A Burst of Light: Essays. Ithaca, NY: Firebrand Books.}

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