Gotham Diary:
Not A Machine
15 September 2014
I don’t know why I’m feeling so much better today. It’s not just the Advil that I took to deal with my stiff and somewhat swollen knee — the result of disuse, walking back and forth to the bathroom, no more, and otherwise sitting, or stretched out in bed. I felt well enough to take the Advil, for one thing. Perhaps I have gotten used to the antibiotic, although I don’t know if that’s possible. It’s certainly stronger than anything I’ve ever taken before, and I’m taking a lot of it. My appetite has dropped to zero, creating the rather desperate problem of trying to eat enough to take the pills without forty minutes of heartburn. I thought that today would be the last day, but I counted out the pills, and I’ve got to go through tomorrow. The last dose will be one pill, not two.
The infection — cellulitis — has long since ceased to be manifest, and I pray that the antibiotic will have done its job. There is no reason to think that it hasn’t. But a recurrence will require a return to the hospital. Miserable as I often felt these past few days, I was very grateful to be suffering at home.
Cellulitis is a new one for me. I knew the word, but only that it mustn’t be thought to have anything to do with cellulite, whatever that really is. (The spell-checker doesn’t recognize it, either.) Cellulitis is a sneaky malady. Instead of festering at the wound, the staph and other opportunistic bacteria that hang out on the healthiest person’s skin spread throughout a subcutaneous level, where they grow at leisure. Kathleen and I thought that things were going fine: the cut (which I’ll explain some other time; suffice it to say that I bang my shins all the time, only to have the injury called to my attention by someone who notices the dripping blood), while deeper than ordinary, seemed to have healed nicely. Then, last Friday night, I noticed a certain stiffness around the ankle. By morning, the situation was clearly pathological. The outside of my right calf was swollen, red, and very hot. I let Kathleen sleep, while I toyed with denial. When she got up, and took a look at it, she confirmed what I dreaded: we should have to go the Emergency Room at New York Hospital.
Let’s not talk about my three nights (one of them in the ER) as an inpatient. The medical care was super, but the hospital’s rules were stifling. It was very noisy, especially in the ER of course, but later because of me, decked out with a heart monitor that flipped out so often that I was visited six or seven times by nurses and others who wanted to change the leads. Happily, the attending physician had left instructions to disable or remove the monitor, so I did get some sleep.
If the noise was unexpected — I can remember when hospitals were very quiet, before the Vietnam War made everything medical so exciting — Kathleen was allowed to come and go at any time, a real improvement over the old days. Being alone in the ER, for the hour that Kathleen had to leave me, was profoundly demoralizing. I managed better in the wards. By the time I left, on Tuesday afternoon, my leg looked fine. I felt pretty good, too. What I didn’t know was that the antibiotic hadn’t completed its work.
Beginning on Thursday, I couldn’t manage much beyond a liquid diet, and I felt terrible. I knew that I wasn’t really sick, and yet the breakdown of my digestion couldn’t have been more lowering. There was more to it than the toxic effect that stomach upsets have for me — I’m glad that they’re rare — but I shall draw a veil over the details.
***
Needless to say, I’ve done a lot of reading in the past week, and a lot of thinking as well. Clarity came unbidden. One train of thought was set by my circumstances. At some point during the first days of my homecoming, I was struck — cerebrally dinged — by the sense that the metaphor of the body as a machine is not only mistaken but dangerous. It is a very appealing idea, especially for Americans who have no only lived with machines somewhat more than anyone else, but who also have the habit of self-help when fixing is required. I believe that the body-as-machine figure underlies all diet fads — and the fact that diets are usually unsuccessful, or otherwise ineffective, emphasizes one of my points, which is that we are all, however grossly similar, peculiarly distinct, and unlike almost everyone we know, when it comes to the intricacies of organic processes.
Examples of the body’s complexity, orders of magnitude beyond that of the most sophisticated machine, could be piled up to the heavens, but it takes only one observation to reduce the metaphor to dust: all the machines that have ever existed in the world were created by human beings, who, however, had nothing whatever to do with the design of the human body. “Design” is not the most apt word; I myself do not believe that the body was designed at all, by any agent. It evolved, by trial and error, by involuntary adaptations that either worked out or didn’t. The amazing advances that medical science has made in the treatment of disease, so compressed into less than a century of decades, oughtn’t to blind us to the incompleteness of accumulated wisdom. I should say that our triumphs have usually involved mechanical or pharmacological solutions (artificial hearts, antibiotics); only caution incites me to qualify that statement. As always in human affairs, the desire to know more is occasionally maddening enough to convince us that we do know more than we do. We give a deaf ear to scientific reservations; we have terrible weakness for good news and a positive outlook.
Meanwhile, the subway station! As you can see from the photograph above, which I took this afternoon, during a very short walk with a hospital cane that settled my mind about the stiffness in my knees, the work has begun to reach street level. The rectangular structure below the red patch has the look of the top of a ventilation shaft. Concrete poured around the entryway structure, on the other side of the driveway, has almost reached street level. Very heartening sights! And work on the railings of the balconies that overlook Second Avenue, the last phase of the project, is underway — not quite halfway done, but getting there. When the project is complete, the scaffolding will come down (as it already has, in front of the building — a variance, I expect, required for the subway project), and life in these parts will be less suggestive of a checkpoint.
***
There may be setbacks in my recovery; tomorrow may not be comfortable enough to allow for writing. (Remind me to mention Nick Jenkins’s being stalled as a writer by the mere existence of the post-Munich Hitler.) But I hope to be here tomorrow. Here, I mean, on a screen in front of you.