All Systems Go

Hi Everyone,

At some point during the last few months, I glanced at my list of Resolutions For 2011, and was alarmed by one of the entries. Which exact fit of late-night ambition prompted me to resolve to reach “six foot” by the end of 2011? I’ve been hovering at a solid 5 foot one and one quarter inches for at least a decade now. Gaining another ten and three quarters inches within a year seemed overly optimistic, even for me. I looked at my resolutions closer, though, and realized that what I had actually determined was to “fix” my “foot” this year. (And yes, already on my list for 2012 is “write more legibly.”)

In May of 2010, I hurt my right toe while hiking. At first, I figured it was a mild sprain or that my toe was just grumpy about all the hills I’d walked up. But when it didn’t improve over time, I figured I needed to introduce it to a doctor. Eventually, I found a fantastic podiatrist in Savannah, who I’ve been going to regularly for over a year. Her philosophy was to try everything possible before committing to surgery. I didn’t know I even had a podiatric philosophy, but it turns out, mine matched hers exactly!

We tried inserts in my shoes, shock wave therapy, and injecting joint fluid into my toe. Along the way, I met some great people and became familiar with lexical treasures like “sesamoid” and “osteonecrosis.” However, while some of the treatment helped heal a fracture in my foot, the pain did not go away. I was still able to walk and even run without problems, but I couldn’t stand on tiptoes or curl the toes on my right foot. These may seem like rather trivial activities, but consider a.) I have yet to reach six foot, and often need as much additional height as I can muster up, and b.) I express my excitement partly by curling my toes. Since I find 78% of life quite exciting, this action comes up quite often and I have had to find alternate solutions. I have taken to clenching my fists, but this makes me feel like a toddler having a temper tantrum and, I’m sure, confuses people. Let’s just say fixing my toe was a priority.

In the end, we decided surgery was the best option. So this last Wednesday, my doctor operated on the tendon and ligament in my foot. As far as I know, it went successfully, although there was a bit of confusion right before I went under, which made me laugh. The nurses came in and said, “So, we’re repairing the Achilles tendon, right?” I said, “No . . .” and then I gave a highly sophisticated explanation of the procedure as I understood it: “I think the doctor is going to sort of fold the ligament on itself to tighten it, and then she’d going to aerate the tendon or something. I’m pretty sure the Achilles tendon isn’t involved.” The nurses said that an Achilles repair was definitely written on my chart, but that they’d check with the doctor before the operation started. How kind.

It turns out it was simply a coding issue. Apparently, the code the office used to tell the hospital which procedure I was having could mean all the things I’d said, but it could also mean an Achilles repair. I had just enough time before I was knocked out to think, “Really? There’s literally an infinite number of numbers. They couldn’t just pick another one to differentiate between the two procedures?”

I woke up four hours later to a nurse saying, “You’re looking a little more awake now -- it’s taken you quite a while to wake up!” I would have said, “Oh honey, just be grateful it’s not the morning,” but I couldn’t figure out how to get my mouth to work. Since then, I’ve been at home, taking it easy. Yesterday was a bit rough, and my schedule resembled that of an infant: sleep, wake up, eat, sleep, wake up, sleep, wake up, eat, sleep. Today has been much better, though, and I’m a lot less loopy and narcoleptic since I switched from the prescription pain meds to Tylenol. I can now usually walk without propping myself up on the walls, banisters, and counters, and this evening, I was even able to take a little walk down the street with Becky to combat cabin fever. Things are looking up!

If I have learned anything about myself since being at SCAD (aside from the fact that I have osteonecrosis in one of my sesamoid bones), it is that I am a systems person. I have no problem doing small, annoying, bureaucratic tasks if I understand and believe in the whole system to which they contribute. So I don’t mind waiting in line at the post office or filling out forms for a job application. However, when the system itself is flawed, I lose patience pretty quickly. Taking care of my foot was my first real foray into the morass that is the U.S. healthcare system, and getting through the million seemingly nonsensical checkpoints was far more stressful and painful than any incision the doctor could have made. One morning, I spent three hours on the phone with about twenty different people just trying to get an appointment with a primary doctor who could sign a form to ensure I was healthy enough to have surgery. There were multiple eyerolls, venting sessions, tears, and plans to immigrate to Canada.

I tried to remember that most of the people I was speaking to were not frustrating in and of themselves (though some of them really were a bit dense. I think it should be a prerequisite for anyone who answers phones for a living to be able to actually listen to what callers are saying, or at least be polite while they’re busy not listening). Most of the time, I was frustrated with the larger healthcare system, which none of them had designed. It is the system that is too complicated, too intertwined with money, too unnavigable. It is the system that needs fixing, but which -- as the last few decades of U.S. politics attest -- is so difficult to change. (On the plus side, though, my dealings with the healthcare system have made SCAD seem like a well-oiled machine, and it’s nice to be leaving Savannah with a more positive view of my school.)

In the last few days, I have been contemplating various systems that do work well. I think the key is that the parts need to be aware of each other and aware of the whole. When one part needs help, the others need to be flexible to keep the whole working properly. In the system that is my living situation, Becky and Qian have been flexible in the last few days because one of the parts (me) hasn’t been able to perform my normal tasks. They have not only helped me get better by feeding me and helping take things up and down the stairs, but have also taken over some of the jobs I normally have (taking out the recycling, putting my dirty dishes in the dishwasher) to keep our household running smoothly.

Or consider the human body. It is one of the most gorgeously intricate systems in the universe. Even while my right foot is out of commission, the rest of my body is compensating to keep me functioning. My arms and left leg help hold me up while I’m walking, and my eyes keep closing to tell me that I need to rest to heal my foot. My left foot has born the brunt of my weight over the last few days. I might make it a medal.

So while I don’t know if there is a solution to the healthcare debacle in this country, I am grateful that there seems to be one for my foot. What about you? Which systems in your life work well? Which ones don’t? Do you tend to trust in whole systems or in their components?

Have a good week,
Sarah/Mouse