It was a beautiful summer day in London, picture perfect. My daughters, Erin and Meghan, and I were on the last stop of a ten-day, seven-country European cruise to celebrate my 60th birthday. They were giddy with the prospect of exploring the city on foot. They had already mastered the intricacies of the Tube, studied their guidebooks, and were prepared to go. I wasn't. For the previous two weeks I had managed to cope with my very painful right knee — thanks to a pre-trip cortisone shot and lots of pain pills. I had even broken down and bought a wooden cane in Edinburgh. It was beautifully carved, but that didn't help me come to terms with having to use it. But use it I did, out of sheer necessity. My knee, a knotty, arthritic mass of barnacled bone and misaligned cartilage, was getting worse by the day. "You two go on ahead," I told them. "I've seen London before, and I think I'd like to take a day to just sit in the park and read." What I didn't say was that I was heartsick at not being able to go with them and share in the joys of their explorations. But I knew there was no way I could keep up with them.
I did sit for most of the day in a little park across the street from our hotel; "sit" being the operative word. And that's when it hit me. I can't go on like this. It was a moment of truth. The time had come for me to act. I needed to do something serious about my knee. For almost a decade, I had adapted my life to accommodate this crumbling joint. I'd looked into knee-replacement surgery before, only to retreat out of fear of the pain and expense it would entail. But this trip had made me realize how restricted my life had become, and how much more restricted it would be as time went on. And so, sitting on that park bench in London, I resolved that when I got back home to Virginia I would begin making arrangements to have total-knee-replacement surgery. I was still afraid, but I figured that no operation could be as bad as the way I was being forced to live.
From the age of four until I was around 15, there was hardly a time when my knees weren't in some state of being bruised, scabbed, or swollen. But it was my right knee that seemed to lead in every fall, bump, and scrape. It was my red (made more so by a seemingly perpetual smear of Mercurochrome) badge of courage and evidence of my extreme tomboyism. Over the years, I never let a sore or injured knee hold me back from doing what I wanted. "Walk it off" became my motto.
It wasn't until I was in my early 50s that I started feeling some genuine discomfort in my knee. At that time a replacement seemed drastic, unnecessary. The bones would heal, I believed. After all, I'd never had any malady that didn't eventually get better. Well, it didn't get better, despite the special physical therapy, prescription pain drugs, cortisone shots, and hyaline injections. When I look back on it now, I can see that my knee was in a process of slow and continuous deterioration. All the while, I would make regular visits to my orthopedist, a nice woman who wore sensible shoes and, after cluck-clucking over my x-rays, would exhort me to do the same.
Over time, my footwear did become more sensible (out of necessity). Then came the visit to Dr. Sensible Shoes when she announced that I had pushed my knee as far as it would go. She said it was time for her to perform replacement surgery. "Stop by the nurse's desk," she said as she walked out of the room. "She'll schedule the surgery and give you a brochure." I could have screamed. I didn't want a brochure. I wanted her to take some time to tell me what was going to happen and what I could expect. We were, after all, talking major surgery here. How could she be so blasé? Now I was not only scared, I was angry. I put on my sensible shoes and walked out of there resolved to continue to live with my infirmity—and find a different orthopedist. Preferably one who had a little more time to talk to me about my condition.