P A T E L L A R S U B L U X A T I O N
P op. Pain. Fear. Shock. Panic. Something’s not right. Something in my knee is not where it should be. Pain. Fear. Shock. Shit. What happened? Where is my kneecap going? Can’t stand. Can’t walk. Please stop. Please return to your place. I’ll stop running if you stop sliding. I just want to be able to walk and to not worry about this and to not have Scott say, “something looks like it’s sticking out wrong.” Oh god, I’m going to bed.
A ppointment. Normally, a patella rests and easily glides in a groove, between two femoral condyles, located at the end of the femur. My patella does not and, as a result, has partially displaced. It did this on a Saturday night in the family room in August, two months before I was planning to run my first marathon, when I got up from a chair and twisted my knee the wrong way. This displacement is painful but temporary and is called a patellar subluxation. I do not know this right away when I twist my knee. I know this 3 weeks after that Saturday when my doctor tells me at my appointment.
T raining. 7 months earlier, I had decided to train for my first marathon and to use that training time for not just running, but also for learning how to pay attention to the things I encounter while running—trees and their leaves through the seasons or my breathing or how the wind sounds or how my foot feels as it strikes the ground—and then try to write about them in an online running log. Running and writing, running then writing, writing while running helped my writing to move and breathe. Now, stuck on the couch, unable even to walk, I feel trapped. No movement in my legs, no movement in my words.
E nding. My doctor tells me I can run the marathon, but it will hurt. A lot. My physical therapist tells me that we need to wait and see how my knee does over the next couple of weeks. No running until the swelling is gone. I listen to my therapist. I wait and wonder: is this the end of my marathon dream? It is. My therapist tells me this a month later.
L ines. After days of sitting on the couch, restless and missing my run, I wake up one morning and memorize a poem: Gerard Manly Hopkins’ “Spring and Fall.” The act of reading the lines out loud and over and over again is more than distracting. It’s exciting. Exhilirating. I decide to memorize more poems in the mornings. And I do, a dozen in all over the next month, sitting at my dining room table.
L imericks, Ghazals, Rondeaus, Ballads, Rhyming verses, Centos, Acrostic Poems. I need some distraction from feelings: panic, frustration, anxiety, restlessness, boredom, irritation, fear and sadness. So I experiment with different poetic forms. A limerick about feeling restless with a knee that got hurt shortly after dessert. A ghazal remembering the initial shock of injury that rhymes four days with sore days and not shocked, more dazed. A rondeau about bad knees and swimming with the refrain: the water is too cold. A ballad anticipating a doctor visit with a patient sitting in the waiting room, staring at her book, wond’ring what will happen when the doctor takes a look. A rhyming verse inspired by Shel Silverstein with little Sara Puotinen who could not lift her leg just then. A cento combining Mary Oliver and Emily Dickinson with nobodies who don’t have to be good and only have to love frogs and bogs and wild geese and somebody. And acrostic poems that spell out injury and restless and limits and talk very crossly to injured right knees.
A nagrams. When I encounter a medical term that scares me, I write out its letters at the top of a piece of paper—big and capitalized and all spread out—and study them. Then I play with them, experimenting with different combinations. These experiments distract and delight me.
R epetitions. Every morning I write prose and poetry about injury. I record my feelings, my fears, my efforts to move in any way that I can by walking or biking or swimming. I recite lines, trying to remember them forever. Sitting at the table, while the rest of my family is still sleeping, whispering them over and over and over again until they are mine. Later, I might recite them to my daughter who is usually willing to listen. I worry: Will I be able to run in the marathon in October? Will I need surgery? Will my knee ever recover? And I tell myself, more than once a day, it will all be okay, even when I don’t believe it.
S trange, deranged words. Words can intimidate, alienate, overwhelm. My brain used to shut down when confronted with medical jargon. I would try, but just couldn’t listen to the doctor discussing patellafemoral pain syndrome or oseophytes. I’m trying to overcome this by engaging with these scary words creatively. Rearranging letters to weaken their power over me. This is working. Patellafemoral pain syndrome might sound really bad, but O Moral Leap Felt! pain syndrome or A Feral Poem Toll pain syndrome don’t. And who can be scared of oseophytes (bone spurs), when they’re transformed into a hot eye post or hot pot eyes or yo, the poets?
U h oh. Days after the initial injury, I discover while sitting on the ground with my legs extended that I can easily lift my straightened left leg, but my right one refuses. It will not lift. This is weird. Sitting on the floor trying as hard as I can to make my right leg lift. Willing my brain to make it move. Nothing. Can’t lift my heel. Can’t even flex my quad muscle. This can’t be good.
Googled “knee injury can’t lift leg straight” and not being able to do this seems to be a bad sign. Maybe a quadricep tendon rupture. That requires surgery. And recovery can take more than 6 weeks.
First, I am mad:
I don’t
Need this right now.
Just leave me alone, you
Unnecessary derailment. You
Repugnant spectre.
You destroyer of dreams!
Then, I calm down and gain some perspective:
I might be overreacting. Stirring up
Needless worry.
Judging every twinge of pain or limp as if it signaled my
Undoing, which it doesn’t. Not
Really. I’ll run again or swim or something.
Years (or weeks?) from now this will make a good story.
Then, I imagine a different world where straight leg raise means something else:
Rise, starlight age!
Arise, great slight!
I light a grass tree.
I right a glass tree.
I get light as tears.
Sigh, art’s great lie!
B etter words. Sometimes a pop. Sometimes a slide. Occasionally a slip or a crunch. More panic than pain. None of these descriptions quite capture the feeling of what has been happening to me and my right knee the past few years. Do you know how many different injuries are described as being signaled by a pop or slip or a crunch? A lot. I need better words.
L uke. Almost half of the poems that I memorize are Mary Oliver poems: “Wild Geese,” “Swimming, One Day in August,” “Invitation,” “Can You Imagine” and “Luke.” The harsh and exciting call of her wild geese. Her praise for being alive on a fresh morning in a broken world. The invitation she extends to let the spirit deepen and go quiet or to tell her about despair. Her trees that are annoyed by birds and the slow, silent passing of time—their dark rings thickening—but are patient and happy anyway. And her dog Luke who is wild and free and content to love, without judgment, every blossom her nose touches. These lines make me feel calmer. More able to accept and adjust. Better.
U nimaginable. If you asked me to make a list of the top ten things that scare me or that I can’t imagine having to go through, a full body MRI would be on it. If that list had been written 15 years ago, the top item would have been my mom dying. But she died, in 2009, and I survived. So when my therapist tells me that if my knee doesn’t get better soon, I will need an MRI, one in which I am fully encased in a coffin-like tube, strapped to a table, unable to move, the curved walls closing in on me for up to an hour, I think that I will be able to survive that too. I reimagine the MRI, not as Magnetic Resonance Imaging, but as Musty Rusty Incubators or Mini Rhinos Inciting or Mutant Rats Infiltrating or Moody Radicals Impinging or Monster Roosters Incanting. This helps, especially the roosters, which I imagine will sing “The Girl from Ipanema” to me as I lay immobile on a table in the tube.
X marks the spot words. I’m always looking for the magic words. The ones that bring clarity. The ones that my doctor will immediately understand and then know what to do. I rarely find them. I’m always explaining things wrong. Too oddly. I get confused looks from doctors. Here is the problem: I like strange descriptions that are weird and wonderful and imaginative. And some part of me is stubbornly attached to this strangeness, making it hard to express myself clearly or simply or in ways that hit their mark. It would be nice to be understood, at least sometimes. But, then again, is it really necessary?
A cronyms. Sometimes I play with medical acronyms, converting their tedious explanations into whimsical wonderings. MRI is transformed from Magnetic Resonance Imaging to Musk Rat Infatuation. RICE, from Rest Ice Compress Elevate to Rapture is Coming Early or Red Indigo Copper Ecru or Rancid Icky Curdled Eggs or Random Isotopes Create Elements or Rhode Island Can’t Even.
T herapy. My physical therapist has given me several exercises to do to aid in recovery: isometric quads, functional knee extensions with tubing, passive knee extension stretches, squats and supine heel slides. My favorite exercise is the supine heel slide because I have liked the word “supine” ever since it was one of my vocabulary words in high school, along with restive, chimerical and harbinger, and because the movement, sliding my heel up towards my butt and then away from it while lying down, seems to help the most in loosening up my leg.
I ce. Here’s the best way I can think of to describe how it feels to walk around with a messed up kneecap that might suddenly, even when I’m wearing a brace, pop or pang or slide or shift: Sometimes in the winter, when the sidewalks are covered with new ice, or covered with old ice that is hidden by freshly fallen snow, or covered with ice that was melted snow that refroze overnight in jagged patches, I walk too carefully. My whole body is tense, waiting to fall. I ache in anticipation. My legs are tight. My movement forced, unnatural, very uncomfortable. I am fearful, apprehensive. Right now, in the first week of September, I am walking like it’s winter and there’s ice on the sidewalk.
O wning words. I sit at the dining room table and repeat lines over and over again until I own them. “Bedeviled,/human, your plight, in waking is to choose the words/that even now sleep on your tongue, and to know that tangled/among them and terribly new is the sentence that could change your life.” Choose the words/that even now sleep on your tongue. Choose the words/that even now sleep on your tongue. Choose the words that even now sleep…
N ew words. Some words make me worry too much, so I look for new words that make me wonder instead. I memorize poetry. Remix poetry. Write poetry. See poetry everywhere and in everything. I switch out oseophytes and patellar instability syndromes and bone realignment surgeries for goldengroves unleaving and musical battles with goldfinches and sentences that are waiting to wake up and change my life.