Late May 2006. The brisk clicking of my high heels on linoleum broadcasts my first visit to Bellevue as a full-time business professional, rather than full-time patient, and I have worn a super-smart pantsuit to mark the occasion. I’ve come for a checkup with Dr. Vargas, who has finished his term as chief resident of the hand-surgery team but is standing in for his successor this week.
He has been a regular presence in my mind since my last appointment with him in February. Because of the sensitivity he has shown through our interactions, I have imagined him appreciating my challenges and efforts to a degree that my loved ones cannot always achieve. As I make my way to the hospital’s outpatient clinic, I look forward to showing off my progress, and hope he will find it heartening, too.
The nurse shows me to an exam room that’s larger than others I’ve seen, furnished with a periwinkle-blue papered examination table on one side, built-in desk occupied by a large computer on the other, and two shelves above it supporting a smattering of medical texts. The paper sheet crackles and rips as I seat myself on the exam table, cross my legs, and pull my BlackBerry out of my pocket to scan emails.
I hear footfalls at the door not long after I’ve settled in, and look up to see Dr. Vargas standing in front of me, smiling broadly. Grinning back, I raise my right hand and flutter my fingers; he flips his palms up in response, as if to say, Look at you! I don’t know if this is his invitation to do so, but I hop off the table and we hug: a rich exchange of sentiment, free of language’s constraints. Then I hop back up onto the exam table and hold out my right forearm, scar side up.
“How’s the pain?” he asks, lightly taking my wrist in his hands, thumbs atop and fingers beneath it, tilting it left and right so he can see how the wound has healed.
“Good. I mean, minimal,” I respond, watching his hands on my wrist, wondering how it looks through his eyes. “I’m totally off the drugs now.”
“Great. What about sensation?” Now he’s holding my wrist in one hand, tapping with the index finger of the other along the path of the median nerve. He doesn’t have to tell me that he’s checking for the Tinel sign and wants me to tell him where I stop feeling the little sparks that indicate recent tissue reinnervation.
“There,” I say when he has just crossed the heel of my hand. The nerve has grown a little over three inches in about four months, a healthy pace. “And I can feel hot and cold now. But nothing else.”
“That’s still good progress. All the sensations don’t return at once.” He needs to perform a few more sensory tests for the record nonetheless, so he pulls a tweezer-like tool out of his pocket, and I close my eyes. Lightly supporting my open hand at the wrist, he pokes my palm in different spots with the tool, sometimes with one prong, sometimes with two, to see whether I can distinguish between the sensations. I can’t, which is not surprising. Two-point discrimination is a sophisticated sensory task, which regenerated peripheral nerves rarely perform.
My ability to feel light touch is also severely compromised. In OT, Beth tests this by touching, then stroking, my palm with paintbrush-like tools that have varying numbers of stiff bristles. But because surgeons don’t have these tools in the outpatient hand clinic, Dr. Vargas uses a capped pen. I sometimes feel a slight trail of pressure and vibration when he draws it across different parts of my palm, but almost nothing when he touches it lightly in various spots. I can, however, perceive the difference between sharp and dull pain, which Dr. Vargas proves to us both by alternately pressing the capped pen and one prong of the tweezer thing into my palm. Not something I’d tried at home.
The sensory tests completed, Dr. Vargas next asks me to perform a round of my current OT exercises. Despite having read Beth’s notes about my progress since our last appointment, when I couldn’t even open my hand, he’s nodding and “wow”ing as I run through my repertoire of hooks, fists, and fans.
“What about dexterity?” he asks.
“Lousy. Buttons, keys, fiddly things like that, are a nightmare. But I can type! And that’s what my hands spend most of their time doing, so . . .” I shrug.
“You can type? But you have to look at the keys because you can’t feel where your fingers should go, right?” he asks, looking up at me.
“No! I make tons of mistakes, but I’m fast. I can correct them as soon as I see them on-screen.”
“Amazing,” he says, now holding up two fingers in front of me, a near Boy Scout salute. I squeeze them hard to demonstrate my grip strength, eliciting a slight wince. All this exertion makes my hand hurt, and I cradle it in my left elbow to give it a rest.
A clinic checkup would normally end at this point, but Dr. Vargas continues. “Amazing,” he says again, eyes on my hand, then at me. “You’ve far exceeded our expectations. You’re a really good healer.”
“What did you expect?”
He pauses, then says, “We were all really worried about you . . . Dr. Matthews, Dr. Espinoza, the attending in charge of the department . . . everyone is very happy for you now.”
A nurse taps on the doorframe, and Dr. Vargas steps out of the room for a second. I can’t hear their words, but when he reenters, he takes a seat in one of the two rolling office chairs, and I know he’s bought us a little time for my inevitable questions. I pull a list out of my workbag, along with a copy of his operative report, which I’ve underlined as profusely as I did my college English Lit reading. I’ve also sketched the cross-section of a peripheral nerve in the margins of the report and annotated it with more questions.
Dr. Vargas doesn’t stay seated for long. After my first couple of questions, he’s leaning over my diagram to point out the landmarks associated with his explanations, then pulling an anatomy book off the shelf to find other instructive visuals, and animating his descriptions with gestures when all else fails. “Ah. That’s a good one. The reason you don’t know where your hand is when you wake up in the morning, until you open your eyes to look for it,” he explains, now holding his right arm high in the air, “is proprioception.” Now eyes closed and touching his right palm with his left index finger. “It’s another kind of sensory experience that your peripheral nerves mediate, telling you where your body is in space.”
Often, he doesn’t just answer the question I ask; he anticipates my one or two follow-up questions, and answers those. Scribbling notes as fast as he can speak, which is New York fast, I am in nerd heaven. Finally, I cross the last question off my list, and reluctantly start packing up my notes. We both know it’s high time to clear out.
“All right, then,” Dr. Vargas says, picking his clipboard up off the counter opposite the exam table, “we don’t need to see you again for six months, for your surgical sign-off appointment.” By “we,” Dr. Vargas means whoever is running the hand team at that point, which won’t be him.
“Ah, OK. Well, that’s good news, I guess.”
“But if the pain gets worse, or sensation isn’t coming back, you may want to see a specialist,” he says as he fills out the slip of paper I’ll need to give to the clinic clerk to make the sign-off appointment.
“Could that be you?”
“I’m about to start a fellowship in a different specialty, and you’ll need someone board-certified in Hand. So I can’t treat you anymore,” he says, looking up to hand me the slip. “But you can leave a message for me, or any of the guys, in the plastics department here if you need a referral.” Then, after a second, “Or just to tell us how you are doing. It’s nice to get good news.”
“I will definitely do that,” I respond. But assuming this is our last-ever meeting, I tell him again how much the care I’ve received at Bellevue, and particularly from him, has meant to me.
“Well, you’ve been phenomenal through all this,” he says, smiling. No rush, no awkwardness, unlike our first follow-up appointment. “You’re a real survivor.” I give him a last, quick hug, then we walk into the hallway, and he sees me off with a nod as I hurry to a 10:00 a.m. meeting.
En route to the office, my chest feels hot and tight, as it has every day since my return a couple of weeks prior. My body won’t let me forget my former boss’s words, even when I’m not thinking them: “It takes six months to learn a job, but you’ve got to prove yourself in three.” I remind myself to take slow, deep breaths, and listen to “Razor” by the Foo Fighters on repeat through the whole commute, every single day. With lyrics about “cutting away” and saying goodbye, fans suspect the song is about suicide, though the band has never confirmed it. In any case, it’s not the lyrics that soothe me. It’s the singer’s quiet but resolved voice, the tender melody and the dissonance of its refrain against the undulating acoustic guitar backdrop. Reflecting my inner weather, these elements loosen the molten knots in my body.
Arriving at work, the unconstrained warmth of colleagues, many of whom I consider friends, calms and buoys me. Like the moms who visit with their new babies during maternity leave, I can hardly walk down the hall without getting stopped by someone who wants to ask after my health. They express gratitude for my recovery and ask if it would be too painful to tell them “what really happened,” because some of the rumors are even wilder than reality. Moved by the fear and sadness I often see in their eyes as we talk, I rush to reassure them that everything is OK now. But when one friend says, with mischievous delight, “I heard your whole arm was dangling by a thread!” I regale him with the gory details he craves.
I find it fitting that the first job of my second life is about finding new opportunities. What do our target customers want or need that we don’t yet deliver? Do we have, or could we acquire, the assets and capabilities to deliver it? If so, would the financial return merit the investment? As I settle in, I enjoy pursuing the answers with my colleagues, especially when it entails exploring external partnerships.
A meeting toward that end with one company is unremarkable, except that I get a good vibe from their analytics guy. He’s the most junior of them—and probably years younger than I am—but he knows his stuff, and he lets fly a few quips during his presentation that make everyone laugh despite a dry subject. Our eyes meet at one point, and he smiles. I like his eyes and the look of his forearms in rolled-up shirtsleeves.
My colleagues and I don’t meet with the company again. But they’re clearly pitching to other parts of our business, because I run into Analytics Guy at work several times over the next few weeks, and when he invites me to lunch, I assume it’s a networking thing. I realize it’s not when, after trading professional summaries, he tells me he’s seriously thinking of a career change, which you absolutely do not tell someone you hope can assist with your current gig. That little existential bread crumb leads to bigger and bigger ones, until we are engaged in full-on, fantastic brain sex.
I love brain sex, even more than sex sex, which I like quite a lot. The thrill of new knowledge, the tingle of a daring hypothesis, the playfulness of brainstorming or debate . . . it’s an orgy of mental marvelousness that I never take for granted. It doesn’t depend on affection or physical attraction; you can have it with anyone, whatever your genre of relationship. But combined with these, it’s the dating lottery jackpot. So I’m pleased when Analytics Guy texts me the next day to make a date for the weekend. We begin “seeing each other,” which in NYC dating lingo falls on the more committed end of the continuum between a fling and a relationship.
As summer ripens, the patterns of my accident and recovery become clearer, consolidating into a picture of astonishing good fortune. So many people rallied to my aid. So many people told me they loved me, out loud and often. My care team was as ambitious for my recovery as I was. I’d had the opportunity to dedicate myself entirely to recovery and am getting more able with my “new” hand every day. And the pain and suffering I’d endured have become a mere fact that I recollect, rather than an embodied experience I can’t shake off.
Soon I’m tripping on full-blown survivor’s euphoria. Everything is perfect as it is, yet all good things are possible. It’s OK if I never get another promotion! But when my boss presses me to define my ultimate career goal at the company, I blurt out “general manager,” though I’d never aspired to the job before. It’s OK if I never marry! But Analytics Guy and I are having a ball together, and I think, Surely this is how all lasting relationships begin. It’s OK if I end up with poor sensation in my replanted hand! But I’ve been lucky in recovery so far . . . I bet I’ll be lucky in axon regeneration, too. I virtually dance through my days like an urban reboot of Disney’s Snow White, perpetually surrounded by chirping birds because wherever I go, and whatever I do, there’s something worth singing about.
By early autumn, after forty-five Bellevue appointments and over three hundred hours of OT, the new instrument on the end of my right arm is my instrument. Beth gives me the briefest of hugs at our last appointment and shoos me away before I can finish my heartfelt thank-you speech. “Aaaaah, get outta here! All my patients are so sentimental. But you guys don’t belong here.”
In late autumn, my euphoria deflates with the rude sound of a punctured balloon when Analytics Guy and I call it quits, after an unpleasant handful of weeks of slowing calls and failing to talk about what we’ve independently concluded: We’re both trying to figure out what we want out of life next, and with too few common certainties between us, chemistry alone can’t hold us together. I’m irrationally angry at him—not for his rejection, since I can’t imagine a future with him, either, but for his unwitting injury to the sense of gratitude and possibility I’ve determinedly wrung from my traumatic experience. I’m afraid of losing it forever, and realize that if I want it to persist, I will have to work hard to sustain it.
My first thought is to volunteer at Bellevue, where I’ve found emotional nourishment throughout recovery and might help others do the same. After jumping through a bunch of administrative hoops, I am cleared to join the hospital’s long-standing patient-visiting program and assigned to the trauma surgical recovery ward where I had spent the night following my surgery.
Each Saturday morning, the week’s accumulated tension falls off my body like hunks of melting glacier as I make my way through the hospital’s identification checkpoints and corridors to the ward. Stopping by the nurse’s station, I jot down the names and room numbers of patients occupying the ward that week on a small notepad, then I visit each room. I am (rightfully) not allowed access to information about the reasons for their stays, but I know that all will have undergone some type of major reconstructive surgery, whether precipitated by a traumatic accident, or disease interventions like amputation of a limb due to diabetes or removal of a malignant tumor.
Through awkward trial and error, I’ve learned that nobody wants to admit they are so bored, lonely, or scared that they need companionship from a total stranger, and that the more confident I appear in my purpose, the more readily they will open up, if that’s what they want to do. So I walk into each room like I own it, look the patient in the eye, smile brightly, and say, “Hi! My name is Becca. I’m a volunteer here, and my whole job is just to talk with people!” Then I shut up and stare, still smiling, until the patient responds—an annoying but effective tactic my psychiatrist uses on me all the time. People who don’t want to talk glance briefly at me, then away, and murmur, “Uh, no. Thanks,” and I move on. Those who do want to talk return my gaze and start asking questions.
“You . . . just talk to people?” is a common opener.
“Yup, that’s it.”
“Why?” (Meaning, “You are crazy to come here on purpose.”)
“I used to be a patient here.”
“You were? What happened to you?”
I tell my story, then listen carefully to figure out where the patient wants to go from there. If I sense that they want to keep talking but not about themselves, I look for clues about their interests—maybe a book, a framed photo, or some kind of audio player on their bedside table—and ask questions about them. If all else fails, food is a great icebreaker. I ask, “What do you want to eat first when you get out of here?” and watch people’s tired eyes light up as they describe mouthwatering recipes from myriad cultures and implant their memories of meaningful meals in my mind.
My marital status is also of near-universal interest, unfortunately, and I am repeatedly stymied by the question “What’re you waiting for?” because not only is it one I have no desire to answer, but also, responses to deeply personal questions can expose differences—in values and beliefs—that might hinder connection or agitate rather than soothe. And I’m here to soothe, if I can.
I’m better at gracefully receiving the patients’ well-intended wishes (“Dear Lord, please reward your faithful servant Rebecca with a good man!”) and compliments (“You’re friendly. You’ve got a great story. If only you had a dog, you’d be the whole package!”).
Many patients respond to my story of injury with their own. I can usually bear it easily, inspired by the dignity and fortitude with which they bear their circumstances. And given my newfound passion for medical science, I am always intrigued. However, a small number patients them have endured such gruesome injuries or repairs that I have to freeze my face and body to keep from betraying an inner recoiling upon first sight of their unhealed wounds; and the stories accompanying them are inevitably tough.
More often, it’s patients’ existential distress that puts a catch in my throat. They wonder aloud: How many more operations can I stand, and will they do any good in the end? Will my young child ever overcome the trauma of witnessing my bloody accident? How much can I teach my teenager about life before this terminal disease kills me? Does God judge me for fearing death? They know I can’t answer those questions; they just need to voice them to someone who cares about what they are feeling and won’t be scared off by it. I know this because that’s what I needed during my recovery; it’s what many people need in hard times. In response, I do what others did for me: I listen closely, ask the occasional question so they know I’m listening, and try to find some non-cliché way to tell them I’m sorry for what they’re going through.
I take my leave when the patients stop filling the silences I leave open for them. After the visits that upset me, I lean up against the wall outside their doors to collect myself before moving on to the next room. The hospital staff never intrude on these moments; they know exactly what I’m doing. The patients stay on my mind after every shift, and for months as I fall asleep at night, I silently recite the accumulating names of everyone I’ve visited. Carol, who asked God to give me a “good man” . . . Pedro, with the 9/11 tattoo . . . Santos, with the BBQ sauce recipe . . . Elaine, who wants me to eat more fruit . . . Mickey, who’s nervous about his surgery next week . . . Nick, who goes back to prison soon.
When patients thank me for my visits, I tell them in all honesty that I benefit from them as much as they do. We’re obsessed with the same existential questions, like Who will I be when this is all over? And they share interesting perspectives I haven’t considered. They bring out the best in me, and it feels good to give it. Most of all, I feel that Death Club kinship with them, and calm in the certainty that I am living to the fullest when we are together. This is what life is about, I think as I walk back through the long corridors to the exit each week. Whatever else happens, we have given each other this.
On December 26, 2006, I celebrate my fortieth birthday with a small party, including Dad and Kate. It’s a lovely evening, but what I’m really excited about is the “handiversary” party I’ve decided to throw on the anniversary of the accident, which falls a few weeks later, on a January Saturday. On the night of the handiversary party, my apartment is filled to capacity with people who helped me through recovery. Guests of honor include Erica, Jen, and their husbands; my Brooklyn posse; and Mom and Charlie, who arrive laden with special-occasion Southern food that Mom has contrived to pack for travel from Nashville—her own thanks offering to my guests. I’d been pleased when Dr. Vargas, now deep into his new specialty training, accepted the invitation I mailed to the hospital for him and guests, and he arrives with a couple of surgery buddies in tow, all visibly enthusiastic in anticipation of a rare night out on the town.
Moving through the party to greet guests and peddle cocktails, I watch the various realms of my life colliding and emitting sparks of pleasure: family meeting neighbors, business school meeting choir, college meeting hospital, finance meeting massage therapy . . . merry clusters dissolving and reforming in different combinations throughout the evening, putting names to faces and discovering the common qualities I value in them. There’s always one cluster sitting on the floor around my coffee table, writing in the guest book I’ve left out, and another standing in front of a large portrait of me painted by Julie, of the Brooklyn posse, who is a very talented artist. “I’m traumatized by your trauma,” she’d said a few weeks after my accident. “Can I paint you?” I’d consented, thinking that her creative act might be the only positive outcome of the accident.
The portrait depicts me in profile from the waist up, facing right toward an off-canvas light source. I’m holding my right arm up at the elbow with my left hand, with my newly stitched wound facing the viewer, and the light brightens my face against the darkness of my long hair, clothing, and the teal background. Julie captured the complexity of my feelings in the first weeks of recovery so well that I gasped the first time I saw the painting, nine months later. “She’s gotten the shape of your scar exactly right,” Dr. Vargas says at the party, tracing his finger in the air across my painted wrist.
After my last guests leave at 4:00 a.m., I stay up another half hour, reading comments left in the guest book and savoring vignettes from the night. Closing the book, I am closing out the year of the accident—and plunging into my second life in earnest.
As 2007 unfolds, I remain keen on my independent science studies and Bellevue volunteering. I also enroll in an evening writing class, where I continue to flesh out the narrative of my accident experience and explore the existential questions it forced me to confront. I love the process of writing, and trading stories and insights with my classmates.
The contrast between these activities and how I spend most of my days is sharp and increasingly problematic. I’d banked on my promotion to VP unlocking new levels of challenge and satisfaction, but it’s not panning out that way. The work itself isn’t as interesting as I’d expected, and it’s not delivering the results my colleagues and I had hoped for. And compared to the crucial work I see patients, nurses, and surgeons doing every week at Bellevue, our purely commercial mandate has lost its power to motivate me. I continue to work hard mainly as a matter of honor and commitment to my colleagues.
As the US plummets into recession between mid-2007 and early 2008, our experimental department gets disbanded, and we are parachuted into other jobs around the division. Then a large reorganization eliminates a number of jobs, including my own, leaving those of us displaced to compete with each other for fewer jobs.
My personal life is up in the air, too. By age thirty-five, the vast majority of my friends had married (twelve with me bridesmaiding them down the aisle), and most had started families. So while our mutual affection persists, our shared life, which was most of my personal life, evaporated in just a few years. It’s as though I’d been at a fantastic party, popped to the bathroom for a minute, and come back to an empty room. The surprise exodus makes me all the more grateful that Jen and I have worked hard, and successfully, to remain an active part of each other’s lives since she became a married parent, though we naturally see each other much less.
Thus, my mid-thirties had marked the beginning of an accumulating ache of bereavement as old and new friends continued to peel off our once-common path. The conventional salve would have been to get married myself, but I can’t force the stars to align in favor of the kind of forever partnership I would want. Or I could have jumped onto the parenting bandwagon. Kids and I generally like each other, probably because I appreciate curiosity and silliness, and I often feel a twinge of envy when I see parents and their teenagers enjoying one another’s company. But as my friends contemplated egg freezing, IVF, sperm donors, surrogates, and adoption, I realized that I only wanted to be a mother with a romantic partner. I’ve never wanted a child “no matter what,” and that’s the kind of conviction I’d need to contentedly forgo other meaningful paths in order to single-parent well.
The only way forward was to reinvent my personal life. So I worked to deepen casual acquaintances and to meet people through new activities—a choir, a running club, salsa dancing, art classes. Eventually I found a strong sense of community in the choir and my Brooklyn posse, though I knew that the shape and intensity of those friendships would change, too, and probably sooner rather than later. I’d finally grasped a fundamental law of adulting: life, for everyone, is starting over, all the time.
What does that mean for me now—single, just crossed over into middle age, and waiting for the axe to fall on my job? Turning this question over and over in my mind to no avail, I feel bone-weary and untethered. Gradually, however, it reframes itself into one I can answer: Do I want to spend my hard-won second life grasping at the fringes of my friends’ family lives, and relentlessly pursuing one of my own that may never materialize, or do I want to find out what it is like to live fully, exactly as I am, right now? That, that.
And then another question, thrilling to contemplate, tumbles after it: Given there’s no avoiding painful change, and I have no one depending upon me, what could I do with my life that would be impossible if I were on a more traditional path? The seeds of an answer arrive in early 2008, in an email from my company’s London office. Subject line: Interested?