As you’re coming out of surgery, life looks pretty good.  The knife and saw part is over. The long put off decision has been irreversibly made. You surrendered to the suspect medical establishment and had the damaged hip replaced.

Plus for a day or so you’re in a strange new world of no pain — the lingering effects of the anesthesia and now the Percocet. No psychological pain either. You love everybody.  Dr. Foster shows up, and you thank him warmly for doing a good job. He says wait 30 days to tell him that. Some of the nurses and aides were your students at Blue Ridge CTC, and you’re chatty and playful with them, almost another you.

But that stage wears off, and soon you are identified as a combative patient because you keep trying to get out of bed. A plastic band is put around your wrist with “wanderer” written on it. An alarm goes off if your feet touch the floor.

Slogging through the opiates, blood thinners, stool softeners, at night you find that your room has rotated ninety degrees. Your bed is now up and down against the wall, and you’re standing on the footboard. What was once the wall has become the floor. The clock, the flat screen TV, the faded nature prints are now  lying on the floor, and what was once the ceiling is the wall facing you. You are aware of the this rotation as an illusion, but you can’t blink it away.

As luck would have it, you experimented with hallucinogenic drugs in your youth, so you’ve seen such distortions before. Once, way back when, your girlfriend sitting on the floor beside you became just her head, and stayed just her head for a good long while. A room rotating ninety degrees is child’s play.

After three days in the hospital, like clockwork, you’re loaded into a rehab center. Move ’em on, head ’em up. Keep them doggies movin’. Rawhide…. That peaceful, loving feeling is quickly dissolving. The first night in your new bed, you feel a fever coming on. You ring for the nurse. Yes.  A hundred and two degrees.  “That’s not good,” she says. Next night the same thing. “That’s not good,” she says again.

“Shouldn’t the doctor be advised?” you ask. She tells you that she’s in communication with the doctor’s nurse, and they’re keeping an eye on it.

“What are you looking for?” you ask.

“To see if it persists,” she says. You’re thinking: nurses talking to nurses is the closest you can get to a doctor right now. You remember reading in a recent piece by Ralph Nader that hundreds of people a day die from infections in such places. Several years ago you had a friend who died from an infection contacted in a hospital. You’re a number now, you’re thinking. You’re a number with certain numbers associated with that number. Patient number such and such (you) has had this number of fevers of this number of degrees for this number of nights. You’re in a formula.

Across the hall, a female patient cries out, through the night, “What’s going ooonnnn?… What’s going ooonnnn?”  Finally exasperated, you call back to her, “Nothing’s going on, damn it.”

Jesus.  A moment of peace and quiet. You wonder if anybody has ever answered her before.

“Can I help?” she asks.

“We’re on our own here,” you shout to her across the hall.  Poor woman.

You understand it better now. Largely, you’re in an old folks home, where people come to die. The rehab division is a small part of the operation.

. . .

The night fevers persist, edging a little higher. At what point will measures be taken, you ask the night nurse. You’ve done some private research on your laptop. Staff infections have become resistant to antibiotics. You have five of the ten listed symptoms. What’s going on? Your opiate soaked brain struggles for clarity.

One night, along about four in the morning, courage time, you have a heart to heart talk with yourself. “Is there an outside chance that this could be it?” the braver side of you asks yourself. The audacity of the question startles you like a thief in the night, like a surprise intruder into your deepest hiding place. And meanwhile the room has taken the same ninety degree rotation it had been taking in the hospital.

You try to run away from this conversation. But run away to where? To what destination? What end?… You are used to thinking about death in the abstract (yes, everyone dies, humans are mortal) but this feels quite different when suddenly applied concretely to you. What if you are dying? What if it’s your turn?  What if instead of living another ten years, twelve years, this is “it.” Right now. Or soon.

You slowly turn that possibility over in your mind. Given that “it” has to happen, would it matter all that much if “it” happened now, instead of, say, a decade from now? Not that a decade of a human life is anything to sneeze at, but would it matter all that much if you were 83 instead of 73 when you disappeared from the face of this earth.

You take inventory of all that is meaningful to you. Your children, your friends, would make the adjustment to your absence as easily now as ten years from now. As a writer, you are not going to write a poem or an essay better than those you wrote in the high energy of youth. Possible one or two decent ones, but nothing better. Your teaching is as good, right now, as it has ever been, but even if you are at the top of that hill, nothing stands still. On your downward trajectory, at some point you will retire. Your retirement years will not be the best years of your life. You can already see how more and more of every day must be devoted to just maintaining yourself. After this hip surgery, you’ve been told, it will be months before you can tie your own shoes again.

There could be possibly a new love relationship, on the way down the hill, but most likely you and whoever she might be could live without that happening, and nothing significant would be subtracted from the weight of her or your existence.

You consider Yeats’ poem, “Sailing to Byzantium.” “An aged man is but a paltry thing/ A tattered coat upon a stick, unless/ Soul clap its hands and sing, and louder sing/ For every tatter in its mortal dress/ …” If only you had a poem like that in you, a poem that you could live, and that lived in you — well, then yes, live on. “Rage, rage against the dying of the light.”

But that’s a big “if,” which begs an “if not.” If not, would now be equally as good as later? Perhaps better. Cleaner. A life lived into early old age, with very few infirmities.

“What’s going ooonnnn,” the lady persists across the hall, even as you are dropping off to sleep.

. . .

The following night, wouldn’t you know it, the fever doesn’t come back.



  1. Eugenia

    Excellent essay Jim. Glad you didn’t die.
    Makes me think. Life is so short and unpredictable.

    1. jamesralston@hotmail.com (Post author)

      It pleases me that you read my blog, Eugenia. I remember when you once came to a play (“Many Mansions,” and how after, when we were talking about it, I was thinking how deeply you saw into it. In particular, how Jerry (the character I was playing) was showing signs of senility that saw (and so feared and hated) in his father. I don’t think many people saw that.

      1. Eugenia

        Glad you like my comment. Stay strong. Life is a test and sometimes very harsh on us.

  2. Charles Sullivan

    I can confess it now, from this safe distance and after a sufficient lapse of time, that when I visited you in your room at Canterbury, for the first time since I have known you, I thought you looked small, old, frail and vulnerable, Jim. The unresolved questions about mortality were etched on your face: the musings of a turbid mind and restive spirit, some of it chemically induced. It could as easily have been me lying in that bed as you. How did we get to be old with such seeming suddenness? One day you can six miles; the next you cannot.

    For a while, I wasn’t sure which way it would go. But the last time we spoke on the phone, I knew that a resolution or a truce had been reached and that the journey would continue a while longer. You sounded like you again, the you I had always known, as if spirit and body were reunited, determined to go as far and as well as they can. As we age, these encounters will only become more frequent and the outcome less certain. “This could be it” moments are always there, circling like vultures in search of a corpse. The scent of carrion—yours and mine and everyone’s—is in the air.

    A week ago, my wife and I narrowly missed being killed on I-81 on the outskirts of Hagerstown, when a box truck with New York tags nearly ran us off the road and into oncoming traffic. It was a close call, our lives flashing before us. The unspoken presence is always with us. Breathing a momentary sigh of relief, I wiped the cold sweat from my brow and drove on to pick up some cat food.

    1. jamesralston@hotmail.com (Post author)

      Beautiful comment, Charley. Thank you. (I didn’t know I’d gone down that far, but the blog says that I did. And you confirm…. So on we go, to pick up the cat food, among other things.


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