Rock the Healing

Fully Healed - Oct 18

2008-10-19T23:00:00.003-04:00

Last Tuesday, October 14, I had my x-ray. The previous x-ray, in April, showed bone growth but a significant gap. At that time, there was a real chance that I might need another major surgery - a bone graft. The x-ray before that, in December, showed no bone growth at all.

So, I prepared myself for an ambiguous, cautious answer from my orthopedic surgeon. Instead, he said this:

There's nothing more we can do for you orthopedically. The small gap that you see in the image is just an x-ray finding, the density shows that it's fully healed. You should have no limitations from the standpoint of the bone. I don't need to see you for a follow up appointment.

I wasn't prepared for such splendid finality. Fortunately, Melissa was. I played hooky from work for a few hours while we went out to brunch to celebrate. And this weekend ... I led some climbs and even took an unplanned lead fall. Whew! (here's a couple of pictures - Mark & Melissa in NH, Mark at the top of a climb, Teacup in a bag).

Hard to describe what this means - the ominous potential for another major surgery has been lifted. I am no longer convalescing; this chapter can close while we embark on the next. I no longer have to fear the tangle of insurance - trying to juggle two health plans just in case coverage is denied on my new employer plan. I am more than my accident.

Financially, we are so fortunate. To those that donated, your help allowed us to dip only partially into our savings this past year. And then, a friend covered even that gap plus all of my alternative care for the coming year! To many health practitioners, thanks for forgiving a portion of my debt. To Massachusetts, a humane safety net made all the difference. To various advocacy groups, thanks for coaching me on standing up to an unethical insurance agency. To Girls' LEAP, it has been tremendous to have work that was flexible and to which I could return at my own pace. And to the rock - thanks for leaving my head and heart intact!

We're even more fortunate in connections to people. When we went out to brunch, our waitress (who happened to be from Boulder, CO), asked what was the biggest lesson we had learned through the ordeal. Without hesitation, we both responded that it was the support of people - old friends, new friends and those that touched our lives. We couldn't have done it without you.

There is no Tri, only do or do not... (September 11)

2008-09-11T09:15:00.002-04:00

To mark the passing of a year of recovery, my friend Ken convinced me to do a triathlon. I was hesitant, since the run concerned me. However, I tried out a little "jogging" (if you can call it that) and found that I could manage a couple of miles. So - I signed up for a sprint triathlon: 1/4 mile swim, 12 mile bike, 3 mile run in Hyannis, MA.

Tropical Storm Hanna approaches...

My friend Steve's parents live down near the Cape, and he has run this particular triathlon for the last 10 years. He invited us down to stay over night for a 7 am race start. Ah, the best laid plans. We didn't get out of Boston until 8:30 pm. Gridlock traffic from construction and an overturned vehicle choked up I93 South, so we detoured on Dorchester Ave for a lovely tour of Boston's innards. We didn't arrive at Steve's parents in Falmouth until 10:30. After socializing with parents, we got to bed close to midnight. We knew that parking was bad for the race, and we had a 25 minute drive. This led to a 5 am wakeup. Even at 5, there was no update on the website.

Approaching the parking lot, we saw the stream of cars leaving. "Race canceled." Whitecaps on the water with waves lapping up on the shore. An overnight shower had soaked the road and left puddles. Makes sense that they canceled. So, we went out to breakfast and talked about how hardcore we were. ("I would swim in that water.") Thus, the first leg of the triathlon (omelets and hash browns) was completed.

Back in Boston, Melissa's parents were visiting. I had never taken the Sam Adams Brewery tour, and we decided to go. It was not all that enlightening (we just wanted to taste the beer). The beer jokes were definitely aimed at the college crowd. We had a small glass of three different brews, and the second leg of the triathlon was over.

We had planned to go out to dinner with Ken to celebrate the triathlon. I didn't feel like going, but Melissa convinced me that it would be fun anyway. I was speechless when I realized the surprise. Friends from out of state, from college and from Outward Bound showed up to celebrate my recovery. I even received a trophy! What a wonderful surprise and support from friends. Ah yes, the third leg of the triathlon, replete with dessert on the house.

All in all a lovely day, but then I had to earn the trophy. The next day, Ken and I did a 50+ mile bike, a mile swim and a 2 mile trail run (dark by this time - we ran with headlamps). Some other friends, Erin and Sarai, having a football party, sent us off and also cheered us at the end with a toilet paper finish line. A little more private, and a fantastic celebration of recovery. The truth is, running probably won't be in the cards in the future. With restricted ankle motion, too much impact is transmitted to my knee. Still, considering what might have been, this was a fine alternative and a fine milestone.

Colorado! - July 4

2008-07-04T08:55:00.003-04:00

Colorado is amazing. (This isn't a recent discovery). It was such a blessing to take a two week trip out West during the first half of June.

This trip was about people.

Of course, we managed to get some nice adventures in. We climbed with an Outward Bound friend in Vedauwoo. This is an area of granite outcrops near Laramie, WY that is famous for it's offwidths - heinous, awkwardly-sized cracks that require stuffing appendages in using all manner of configurations. While we didn't avoid the offwidths entirely, we mainly stuck to some classic hand and fist cracks.

We also did several hikes. In one case, I was able to manage a 9 mile round-trip hike into a snowy basin. It was a tremendous affirmation that beautiful high places in the mountains are not lost to me. Remarkably, the mountains seemed to invite us in - at 2 pm, snow that should have been mushy was mostly navigable without postholing.

However, the main event was seeing people. We spent time with Tom and Kathy Hornbein along with their daughter Melissa and her partner Blase. (Remember them? They were on the rescue team). One of the pictures here shows Tom, Blase, myself and Steve Komito (who has resoled my climbing shoes for 15 years, but whom I'd never met). We were treated to an amazing welcome at Tom and Kathy's house along with rapturous views of the Diamond on Long's Peak and the rest of the Rocky Mountain NP vista.

We also saw old friends - the Jarrards in Lander, WY. I met Steve 17 years ago when his oldest daughter was just out of diapers. Since then, he and his family have welcomed me and then Melissa. I often parked my VW bus in their driveway when I was invited over for Mary's homemade pizza. Now, their oldest daughter has finished her first year at Boston University.

It was a glorious welcome at the Rocky Mountain Orientation for Outward Bound in Leadville. So many instructor friends showed such affection and relief to see me alive and walking. The news of my accident had circulated through the Outward Bound community. It is a community that has known loss and that walks with the understanding of risk in mountain pursuits. It is nice to have a happy ending when a peer has a traumatic accident.

My mama drove up from Albuquerque to visit for a few days. It was very sweet for her to meet us out there - and of course, my mom is not afraid to poach a campsite and sleep on the ground. She has been so supportive through this whole ordeal, and it was good to see her for a few days in her bioregion.

A few other friends from Outward Bound and Princeton Blairstown Center (an outdoor ed center where we all worked) have made their way to the Denver-Boulder area. And of course, they all have children, so we asked lots of questions (since we're thinking...). A theme that seemed to come up: How do you get out for adventures while raising kids? It's wonderful to see how different families patch their lives together.

And now we are home. I owe some more posts, but I should note that Melissa and I have moved into a new apartment - the first time in 6 years that we have our own space. This past year, through the recovery, has felt challenging in a cramped apartment sharing our space with housemates.

Also, we received some very good news regarding medical bills. The Colorado hospital wrote off a substantial portion. This means that we're probably not going to end up with medical debt. We're still holding out for Massachusetts, especially since I'll be switching insurances and there might be more expense. However, the short answer is that all of YOUR HELP has made a great difference, and the bills that we do have are largely covered by the outpouring of financial support.

My life feels something like a bonus right now. It could have ended on August 8, 2007. Instead, I have wonderful friends, an amazing relationship with Melissa and much fulfillment. I'm so fortunate.

Spaciousness - May 20

2008-05-21T13:27:00.004-04:00

Time is passing quickly, as the curve of my recovery slows down a bit. There is still plenty of recovery available, it's just not as immediate now that I can walk around.

Spaciousness. Melissa and I are moving. It will be the first time that we have our own apartment for the 6 years that we've lived in Boston. (Our new address is 9 Spaulding St, #1 Jamaica Plain, MA 02130). My work is also moving - again to a much more spacious office. The extent to which we were piled on top of each other had passed a threshold of absurdity.

And the spaciousness of the outdoors. It has been good to get out. The hiking picture was from a 3 1/2 hour hike in the Blue Hills - a rocky tract of woods and rocky knobs about 8 miles outside of Boston. Yes, my leg hurt, but it wasn't so excruciating that I had to stop. That picture was about four weeks ago.

The climbing picture is from Rumney, NH. I was able to spend a day climbing with a friend. For those attuned to climbing grades, we climbed about 15 routes from 5.7 through 5.10. It wasn't a matter of not being able to do hard climbs so much as particular moves. There were just some motions that my foot and ankle didn't want to do, but on the whole it was immensely pleasurable to move over stone.

Melissa and I are heading to the Gunks this weekend - to climb with old friends. Then, it's off to Colorado for 2 weeks. This is a momentous journey. We'll stay with friends to whom we were introduced by a particular rock...friends who helped on the rescue. We also plan to do the climb on which my accident occurred. Actually, the accident didn't happen on the climb, but on the way down. We'll take a different descent route...

My leg continues to gain strength. I have been thinking this week about how miraculous the human body is. Sure, I have some limited range of motion, but this appendage that was dangling by a few sinews is now firmly attached and working! I deeply appreciate my biology and the healers who set up the conditions that would allow my tissues to mend. Showing the gruesome first night pictures to some co-workers, I'm renewed in my appreciation for being alive.

Get in touch with us! Let us know how you are! What spaciousness is opening up with the approaching summer?

Mark

Continuing saga - April 25

2008-04-26T19:32:00.007-04:00

Some explanations are long overdue.

I am hard at work - I'll be transitioning to full-time Director of Development at Girls' LEAP. Grant season has kept me quite busy (not to mention my side project consulting for Melissa's brother-in-law's business). So, I have not managed to blog much.

Melissa is networking up a storm - trying to find her way into a good Social Work job after she finishes her degree this year. A congenial work environment, good clinical experience and a reasonable salary - not too much to ask.

Teacup (the brown dog) is exploring medical conditions - two UTI's and an abscess behind her eye (makes her look really grotesque). Fortunately, we have very good (though pricey) local veterinary care. Teacup came to us for free, but we've been paying for her ever since. On the other hand, Glory (the yellow dog) cost us $20 as a pup and has been largely issue-free. (She does eat poop, though)

Now for the x-ray.

The pictures here are from October. I was trying to get the recent ones, but the doc didn't send them in a file I could open. So, I'll try to explain, and you'll have to imagine. In October, you can see all the hardware. The big screws came out in my surgery in Dec. However, you can also see the clean-looking fracture. It looked about the same in December (clean = no bone growing). That was the big concern in December.

What we understood was that if the bone wasn't growing, I was going to need additional surgery. However, what we didn't understand was that the bone could be growing (which it is), but NOT fusing. (Here is where your imagination comes in) Imagine the bone at the fracture growing outward like a big old Ponderosa Pine. On my x-ray on Apr 9, the bone showed A LOT of growth. Most of the growth was outward, and the fracture only showed fusing on one side (lateral). It is not clear whether it will fuse without surgery, and my next x-ray is not until OCTOBER! Interestingly, my fibula (which has a much better blood supply) is completely healed.

So, here's what could happen:
1) the bone could fuse together on its own (I like this option)
2) the bone could fail to fuse, and I could get a bone graft (shave a piece of bone off my hip, grind it into a paste, insert it into the gap in my tibia, compress the fracture with a plate to concentrate the bone growth...) - not my favorite option
3) the rod could weaken (even crack) from use. I would probably notice increased pain. At this point, I would either need surgery right away, or the bone might be taking enough weight (and would be stimulated to grow more since the stability provided by the rod would be diminished) that I would not need surgery (I kind of like how dramatic this sounds)
4) I could heal through some other mind-body method like acupuncture, Tantric meditations or Dianetics.

Well, I AM trying acupuncture (which sounds better than option 2). My acupuncturist is doing something that seems a lot like the bone stimulator used by physical therapists. She wraps chains (and tin foil) around my injury and uses a sparker to produce some current. I don't know - it feels like it's doing something. I'm also getting regular massage - actually "structural integration." A lot like rolfing (very deep tissue work to break up scar tissue). This feels much more effective than the PT that I was getting, yet insurance doesn't pay for it. Still, it's worth it to me to try to get more range of motion back.

And today ... Melissa and I hiked for 3.5 hours. It's true. My leg hurt the whole time, but it didn't get worse over the course of the hike. I used trekking poles (but so did many of the other hikers out there). So - there's hope. Oh yes, I also bouldered on the retaining wall up the street (being careful not to fall off in an uncontrolled way).

This is a long haul. I get down sometimes. I think I understand why people give up, and I don't judge that. It's just plain hard. However, I also get stubborn. There's not much else to do except to keep on keepin' on. Giving up would only mean that I'd have to climb back out of that hole in order to move on - which seems like far more effort than doggedly staying on track. And so, the saga continues.

Seven Months ... and Climbing! March 9

2008-03-09T20:59:00.004-04:00

Three weeks ago, Melissa and I went up to Vermont to visit some friends from Eckerd Youth Alternatives - where I worked with juvenile offenders a decade ago. The first picture is our 3 mile walk - a beautiful sunny day on the road where our friends live. Naw, I don't miss open spaces and mountains at all...

Then, this weekend was momentous. Yesterday (Mar 8) was the seven month anniversary of my accident. It was also the first time that I've been on a climbing wall since. I was a bit apprehensive and doubtful; for the last half year, climbing has taken a back seat to more basic issues (like walking and pain management).

However, the trip went very well. Although I know this number won't mean much to some, I was able to climb several 5.10's - mostly without hanging on the rope. I even made it up an easy 5.11 with a couple of hangs. My foot and ankle didn't really do all the things that they're supposed to, but I'm happy that I was able to use it well enough to climb reasonably well.

It also reminds me that I'm not the only one with limitations. You don't really have to have a high profile, gruesome accident to have physical limitations (I just tend towards the dramatic). Plenty of climbers have tendon issues, knees that don't bend a certain way or shoulders that give trouble. The same goes for other sports. Somehow, it's a little easier to put things in that context - nobody escapes without limitations for long. And part of the task (or even the joy?) of getting older appears to be figuring out how to do a good job taking care of those limitations.

Okay - enough philosophy. On another note, I also carried Teacup for 10 minutes this weekend. Some of you know our arthritic pointer, Teacup. She walks for about 20 minutes, then we put her in the backpack and carry her for the rest of the walk. She's 50 pounds, so not too heavy but more than a day pack. Teacup has summited quite a few 4,000' peaks in New Hampshire that way. Well, today I carried her for about 10 minutes at the end of a walk. It was just like old times, and she and I both appreciated it.

One month from today - April 9 - I get my x-ray. I've started weekly acupuncture and rolfing, in addition to weight lifting with my legs and other cardio options. It's all I can do, so I hope it is stimulating bone growth. I'll know in a month.

Thanks to everyone for your care, friendship and support.

Six Months! Feb 8

2008-02-05T19:03:00.001-05:00

Some people travel the world taking pictures with a stuffed animal or pink flamingo in each frame. For us, it seems to be Teacup - our quirky mascot. She embodies such a wonderful attitude. With a sudden onset of arthritis four years ago, she went from being a marathon dog to a hobbler. Yet, she stays happy and excited and motivated. So, Teacup surfaces in our pictures as a symbol of good spirits in the face of adversity - and besides, we love taking her with us.

Friday was the six month anniversary of my accident. It is also the "halfway" point, based on the medical opinion that it would be a full year recovery. I feel like I'm able to take the long view - able to see that this will turn out fabulously well in the long run. No matter what bumps in the road I encounter in the short term, this can be a long-term source of motivation and staying present. It doesn't go away, so I have to keep paying attention - keep listening to what I need to do to heal.

Taking stock at six months:

- I'm alive
- I have a leg
- Melissa and I care deeply about each other
- We're not bankrupt
- I'm happy

What else?

I hiked 2 1/2 miles last weekend! Up a rocky trail in the Great Blue Hills just south of Boston. I did pretty well and didn't have to use my poles until the very end. My strength is coming back, and I'm supposed to do squats and lunges. I started with 65 lbs squats (yeah, I'm pretty ripped...).

Melissa is taking her last classes for her Masters in Social Work. We're counting down the weeks. It has been a long road, and this fall felt particularly difficult - trying to juggle school, work and caring for me. Lately, Melissa has been working both days on the weekend. And then I end up working both days, too. However, it feels really good to have work that I care about.

I'm trying to dodge all of the colds and flu that are going around Boston. Our housemate came back coughing up her lungs after a few weeks away. My co-workers have been sick, and Melissa has just come down with a cold. I definitely don't need to get sick while I'm trying to heal my bones.

I am walking around without a cane, though I walk slowly and weave occasionally. This weekend, I walked for an hour in the Arboretum without a cane. The last 15 minutes were pretty painful, but I didn't feel wrecked the next day. I'm sure a lot of people didn't notice my injury. I'm realizing that most of the time, other people's hurts and pains (even physical ones) aren't very visible. Lots of people have to overcome some kind of adversity every day.

I'm gravitating towards very energetic music - it seems to help drive me forward and keep up my motivation to heal. Green Day, Flogging Molly, Ozomatli - lively stuff. Lately, I've been wearing my iPod in the subway - it makes me feel like I'm in this self-contained bubble of happy motivation, and I can keep going through the pain and fatigue.

Learning to Fly - Jan 26

2008-01-26T18:27:00.000-05:00

I flew to Omaha two weeks ago. Ah, the heartland in winter - just the place for some R&R. Okay, actually, I went to my cousin's wedding. This cousin is the sister of my cousin (Jason) who was with me during the accident. It felt important that I go for so many reasons - to support their marriage (a gay couple having a ceremony in Nebraska), to see Jason for the first time since my accident, to support their family after some hard times this fall and to see my mom and sister. When I returned home, my mom came along to spend a week with us and help out.

Well, I was afraid to take the trip! I have never been nervous about flying - the statistics about airline safety usually calm my fears. However, the weather was rough, and I had just read Deep Survival. The author (himself an aerobatics pilot) recounts his research on airline crashes. As a result he declined to go on a scheduled flight because the plane was a DC-10. That very flight crashed, killing all aboard. Yikes - not a confidence booster. I also questioned my aboard flight reading selection, K2: The Savage Mountain...

Well, I did fly. I actually sat in the airport for half an hour before checking in - debating whether or not to go. The flight out was one of those bumpy, scary flights where the captain talks to you in a calm voice. Then, I spent an extra day in Omaha because of the Boston snowstorm on the day that I was supposed to fly back. (Kind of like spending an extra day in Cancun, but not quite).

I feel quite sure that this is the aftermath of the trauma. I feel nervous about other cars on the highway, knowing that a flimsy seatbelt won't keep me safe from a crash at highway speeds. I shudder to think about climbing the North Chimney to get up to the Diamond on Long's Peak. Interestingly, I don't feel very concerned about Boston's iced up sidewalks. Perhaps it feels more manageable when it's a hazard right in front of me that affords me a little control.

This is the work, learning to fly again. The good part - the clues to my recovery - are in the details. I was able to carry my luggage and to walk through the Detroit terminal. I noticed that I handled stairs much more easily than even a week before. Then, last week, I ran up a flight of stairs. (It was more of a galumph, really). I walked a mile twice in the last 10 days, and I rode the subway at rush hour!

After the trip to Nebraska, it was great to have my mom here for a week. She cooked a few meals and helped out whenever possible. She also downloaded nearly all of our music onto her new Mac! We had some walks and talks. Altogether it was a pretty low-key visit - not an easy feat when we put her up in the living room on a wafer thin futon mattress.

This is my life for now. I'm not sure what I'll be able to do when this is all said and done. However, I have the support of Melissa, my family and wonderful friends. I have fulfilling work at a local non-profit. I'm able to swim, bike and lift weights regularly. I have Pink Floyd playing on iTunes - all the ingredients needed for learning to fly again.

Holiday Gifts - Jan 6

2008-01-06T15:19:00.000-05:00

The picture on this blog entry has nothing to do with the holidays - its just a reminder of happy times and feeling whole and alive.

One thing about being injured - a lot of friends come to visit! It has been great to see many friends over the holidays. Friends came to cook, brought wine and treats, made us truffles and shared stories of what is happening in their lives.

There's something else about the holidays. So many people have been AMAZINGLY generous in helping us with medical expenses. Our financial picture looked pretty dim a few months ago. Since that time, it has been both humbling and uplifting to need so much help - and to receive it. Although we are not in the clear yet, the donations have been adding up. What looked like unimaginable debt (my bills total around $400,000) is descending to a level where we know we'll be okay.

Melissa and I have had many an emotional moment. Personal friends have reached out to help; we've also received support from parents and friends of friends. Several friends, including Mark's sister, have put together fundraising efforts. Mark's mom reached out to her circle, and they have been tremendously supportive. Friends who work in the outdoor field or attend graduate school (and we know how much they make) have helped out. A couple of friends who have the means have offered to make a meaningful gift to help close the gap. Even some strangers who heard the story and empathized have supported us. The list goes on. Finally, we should thank the state of Massachusetts that takes a humane stance towards people facing large, uncovered medical needs.

Our financial picture is not settled. Some insurance questions linger (Mark's insurance may pay a small portion, despite the effective coverage date coming after the accident), and we have yet to negotiate with the Colorado hospital. Even scarier, it is possible that I will need more major surgeries (we'll see how my bone is doing at my next x-ray in April). However, Melissa and I both feel so supported and cared about. It has eased considerable anxiety on our parts.

Several friends requested that we use their support for "extras." This has been so helpful. These days, I am in pain most of the time. Sometimes it diminishes to just slight discomfort, but usually I have a deep ache from my hip to my ankle. Thanks to some really generous friends, I'm able to get regular massage - something that I couldn't afford otherwise. It also allowed us to join our neighborhood gym - something that I need in order to do some specialized physical therapy exercises.

And there is progress - I have been able to walk normally (although slowly) about a quarter of a mile recently. I can walk upstairs (on a good day) without a cane or holding the rail. Downstairs continues to elude me. I'm still missing a lot of range of motion in my ankle and toes, but I continue to stretch and work for it. My thigh is so weak (and skinny!) that my right leg shakes when I stand on it and bend my knee. Still, I can feel the strength coming back. I'm also able to swim - a life saver in the Boston winter.

And there is always the question of how to deal with the hard moments. I wish I could say that I'm always upbeat, always remembering to be grateful for keeping my life and leg, always focusing on the positive. Well, I'm mostly those things. I have some moments when I swear or cry or mope. I don't give in very often, because I'm finding that frustration and desperation actually don't help my leg to heal. Even with the pain and uncertainty about my future abilities, I know that the only thing to do is to keep going.

I also know that I'm not the only one. Something else about being injured - I hear lots of stories about other people's injuries and medical travails. Our species seems to have a wise impulse to share stories; it is a holiday gift not to be underestimated. It gives me perspective, helps quiet my selfish sense of unfairness and helps me empathize with many others before me who have dealt with pain and trauma.

Let's hope that 2008 brings healing - on so many levels.

Under Better Circumstances - Dec 19

2007-12-19T19:14:00.000-05:00

We had a wonderful visit with Blase last weekend! Blase and his climbing partner were the first ones who arrived on the scene of my accident after my cousin Jason called for help. Blase also wrote a moving message and account of the rescue (in this blog - "Blase's Message - Sep 2"). It was great to connect with Blase under better circumstances!

Melissa and I had a chance to hear about Blase's work studying Montana's glaciers, his play on rock and snow in the West and stories about important people in his life. Blase and I circumambulated the great Peter's Hill - a towering monolith standing at least 200 feet high and providing a commanding view of downtown Boston. We ate scrumptious thin crust pizza at the local eatery and gabbed into the late evening.

Besides getting to make Blase's acquaintance for the second time, it was instructive and healing to reflect on the accident and rescue and to create a composite picture of what took place. Hearing his perspective helped me to understand how others reacted to the accident. I felt moved to hear that a whole crew of Park Service firefighters had scrambled up - ready to help but possessed of no technical rescue know-how. I stood in others' shoes when Blase depicted the team of 17 rescuers, drenched in sweat and out of water, straining to carry me safely and quickly.

It didn't hurt to hear Blase's perspective on my leg, either. As he noted, it sure looks a lot better than the last time he saw it. Though the rescuers worked diligently, the prospects for my foot had seemed somewhat dim with an eight-hour carry. He was pleased to see that I kept the foot, let alone that I am able to get around smoothly with crutches. The skin on my heal has been out of the woods for a couple of months, and my range of motion and strength returns slowly but surely.

This last point brings me to the aftermath of getting unscrewed. Curiously, the screw removal has left me with an interesting bit of pain at the fracture site that occurs intermittently with weight bearing. With any luck, this pain means that the bones have a little more play which should stimulate bone growth. I also have more flexibility in my ankle - still very limited. This increase in flexibility means that I can try to work my muscles back to life. I am amazingly weak - my right thigh can hardly handle a single-leg squat of even 6 inches! However, through some weight lifting and the contortions concocted by my physical therapist, I hope that this will improve quickly. I am cleared to swim as well, since the stitches were removed today.

Here is the news on the bone front. The orthopedist didn't schedule another visit until April! He said that we wouldn't see much bone growth before that, but we ought to see signs four months out from taking the screws out. He also said that the more important sign is how I progress. If I am able to return to more normal activity and don't feel any pain with weight-bearing, twisting or higher impact movements, that would be a better sign of recovery than an inconclusive x-ray in April.

All this is to say that I am well within a "normal" timeframe and that full recovery is going to take a long time. I continue to be patient and to have a fantastic attitude (except when I don't). In order to stay on the bright side, my latest response to "how are you?" is that I'm doing great considering that my leg almost got hacked off last summer. For the moment, my mantra is "grateful for my life, grateful for this trial."

Unscrewed! Dec 8

2007-12-08T08:44:00.001-05:00

Yesterday, I had surgery to remove several screws in my leg. The three locking screws (the blue ones in the picture) were connecting my tibia to the rod. In theory, by removing them, it will "dynamize" the rod - meaning that there will be a little more play in the bone ends. Hopefully, this will stimulate bone growth. The other two screws were holding my tibia and fibula together. They actually had broken, so only the short heads of the screws came out. (We had been told that this might happen). Those screws had been put in place to stabilize my ankle. With them out, we are hoping that I will get more range of motion.

The orthopedist performed the surgery using general anesthesia. Back in August and early September, when I had a surgery nearly every other day, it seemed like no big deal to "go under." I was totally dependent on the medical teams, and it wasn't that hard to surrender my consciousness at times. This time felt harder. I am glad to be "unscrewed," but I wasn't keen on having general anesthesia. I found it unnerving to breathe deeply into the mask and inhale the artificial-smelling gas. Earlier, while sitting in the waiting room, I also thought about the range of caregivers that I had experienced during my stay in the hospital.

Some were excellent - in tune with what I needed. Others brought strange power struggles into the room. One nurse in Colorado helped out when Melissa was at her wit's end trying to negotiate with the company that rented wound vacuums. The nurse spent an hour on the phone convincing the company to deliver a portable version. Frank, the ICU nurse and Rob, the anesthesia PA came to visit me several times after I had left their unit in the CO hospital.

On the other hand, after my flap surgery, one nurse was terribly passive aggressive. My catheter was draining improperly, and I was swelling noticeably. However, she gave a variety of excuses that delayed its removal. The next nurse came on shift and removed it immediately. Another nurse delayed giving me the oral pain medication that I was taking (percocet) for almost an hour after I asked for it. When I complained that I was in significant pain, she entered with a loaded syringe saying, "I'm going to give you a shot of morphine." After I protested, she chided me that the oral medication wouldn't take effect for 20 minutes - exactly why I had requested it earlier!

One nurse finally encapsulated it for me. She said that more important than wound or pain management, her top priority was good patient advocacy. Hospitals are complex places, and patients need to be and to have good advocates. Yesterday, I asked to forego "Versed," a medication that commonly is used to diminish anxiety before surgery. However, a medical practitioner had told me that it is actually a diluted amnesia-inducer. The advice helped me self-advocate to skip that medication.

So now, with this surgery finished, I will spend the weekend in bed (not as glamorous as it sounds). Then, we begin to "mobilize" my ankle - starting at my PT appointment on Monday morning. I hope mightily that getting these screws out will accelerate my return to some sense of normal function and activity. I also hope that this surgery will do the trick - stimulating my bones to grow. There is nothing to do but be patient and diligent with optimism and physical therapy. As Melissa said, "I'm looking forward to this being your last surgery."

L'essentiel est invisible pour les x-rays - Nov 15

2007-11-15T22:21:00.000-05:00

On ne voit bien qu'avec le coeur. L'essentiel est invisible pour les yeux. (Only with the heart does one see clearly. The essential is invisible to the eyes) - Antoine de Saint-Exupery, Le Petit Prince

On Halloween, I had some long awaited x-rays. Then, last week, I had the chance to go over the x-rays with my physical therapist. She showed me those x-rays side by side with others from August 10, the day that the rod and screws were placed in my tibia. No difference. The same gaping fracture showed up in the middle of my tibia on each slide.

Needless to say, the rest of my week was pretty hard. I couldn't shake the discouragement. Twelve weeks and no sign of the bone healing. My vision of bearing weight on a slowly growing bone crumbled into an image of walking around on a flimsy piece of metal with bone fragments and screws rattling loose. It's the most disheartened that I've been through this ordeal.

Well, there is nothing to do but continue. Melissa gave me a pep talk. Let this be a motivator rather than a de-motivator; this makes it even more important to have the right attitude and do the things that promote healing. Our friend Margot, who is a healer (and a Physician's Assistant by training) said that x-rays are crap. They disempower by dictating success or failure. Instead, we need to be empowered to promote our own healing. Deborah, with whom I stayed after the hospital, said to just deny the outcome of the x-rays and keep on being optimistic.

I think I'm through the slump. Everyone is right; there is nothing to do but stay optimistic. I'm also trying to take care of all bases. I've increased my calcium supplement; I'm heating the fracture area to bring blood flow; I'm bearing weight and promoting circulation on the bike trainer - and swimming, for the first time last week! We'll also try some massage and acupuncture. I'm ready to keep going.

Black and white x-ray images convey such a sense of authority. They seem to be the last word on how my healing is going. Long after viewing them, my mind's eye still traces the fracture lines. Given the apparent objectivity of x-rays, I found it exceedingly difficult to have faith in my body's own timetable for healing. It has been helpful to be reminded that the most important things - hope, determination, love and support from friends - are invisible to the x-ray.

On receiving help - Nov 1

2007-11-07T18:10:00.001-05:00

There are times that I think, "what did I do to deserve this?" when faced with the startling kindness of friends.

We have received so many amazing meals in the last few weeks. Our friends Dawnellen and Kurt cooked a magical chickpea curry and frosted Halloween cupcakes right before our eyes. Hondo and Alycia prepared us a medley of salad, quiche and lasagna. Then, Alycia's sister Greta - whom I have never met - treated us to mushroom and pepper quesadillas and chocolate chip pumpkin bread (which actually evaporates at room temperature). Tracey, my colleague at Girls' LEAP, besides loaning me the first two seasons of "The Office," brought over stuffed peppers - with vegetarian "lamb." Margot loaned her crockpot with some starter veggies for convenient stewing. The list goes on for a long time.

I have been transported to appointments. Many friends have lent their healing touch - through massage and energy work. Even the calls and emails buoy my spirits. When first released, I was taken in by Deborah and Phil for two weeks; now, I spend Monday nights at their house to ease the commute to Girls' LEAP. (Okay, I can't fib - it's really for the sci-fi tv shows on Monday night...who am I?) The help has been so valuable; besides spending a lot more time doing mundane tasks and physical therapy homework, we need to know that the community is there for us.

Our friends Rob and Aviva have helped as much as anyone. It has been hard for me to grasp at times. I assume that we are imposing, being a burden by needing this help. Rob and Aviva came bringing arugula, squash and fruit crisp while I stayed with Deborah and Phil. Rob has taken me to a few medical appointments. Lately, Rob has been escorting me on the 3/4 mile walk from Girls' LEAP to his house on Tuesday afternoons. Aya, their 14 month old daughter, rides in the backpack, then coaches me on walking when we arrive at their apartment.

At several points along the way, Rob and Aviva have thanked me for inviting them into my healing journey. Thanked me! I'm starting to let it soak in, though it's not intuitive for me. Rob and Aviva have plenty to do in raising their daughter in a kind and intentional way. I hardly understand how they are thanking me for adding more responsibilities. Other friends have said that it is great that we have communicated what we needed.

A quote on a recognition wall at Simmons College reminds that the point is not to pay back kindness, but to pass it on.

I am overwhelmed with kindness. It makes me look at the times that I have been self-absorbed or ill-attuned to another's needs. Feeling this kindness from friends makes me want to be there when the next person needs help. It makes me want to pass it on.

The Joy of Movement - Oct 25

2007-10-24T20:35:00.000-04:00

My father taught me a lesson in creative movement that I will never forget. When I was about 12 years old, my father's knees troubled him, preventing running from being his primary vehicle for exercise. Undaunted, he created a kind of squatting duck-walk that was every bit as aerobic and worked the quads much more than the patellar tendon. I was mortified. I was entering middle school and my father was so uncool - in public!

In recent years, my knees have troubled me also. Unable to run (or do much else) in the dreary Boston winter, I worked out a cemetery routine. Forest Hills Cemetery, directly behind our street, became the forum for hurdles over bushes, invisible chair squats against the walls and dips using adjacent headstones.

Last weekend, I was feeling pretty down. On Friday, my leg throbbed quite a bit, and I spent most of the day in bed. I woke up Saturday dreading a repeat. Finally, it occurred to me that I could be creative with movement. I turned on some jam music - live Poi Dog Pondering - then tossed about on my bed for two hours. I kicked my feet over the bed, created a rowing maching out of an elastic band and did lying down squats on the wall. The joy of movement. Without being active, I felt like Samson having his hair cut off - lost and powerless.

After this spark, Melissa contributed another one. She brought the bike trainer out and hooked up my road bike. Okay, so I wasn't spinning very fast, and my ankle hurt a bit. But I was moving and alive.

The tendon that held on - Oct 24

2007-10-24T11:43:00.000-04:00

It is too easy to get pulled into the mechanical paradigm of bones, tight tendons and swollen tissue. There is another dimension to this healing that is less tangible.

Melissa has been working with me using a healing modality called Somatic Experiencing. It is a body-centered or nervous system-centered approach to dealing with trauma that will complement her training in Social Work (plus it will add more letters after her name). The basic theory is that the body has an incredibly strong drive towards healing, and that the nervous system - or the reptilian brain - knows what to do. In a session, she will direct me to notice what is happening in my body and have me repeat motions very slowly. In one session, I felt like I could sense my left arm trying to push the boulder away, my gaze starting to turn to the left. My reptilian brain, such as it is, had initiated a response to the slipping boulder. That response never had a chance to complete. By getting into the experience, then "renegotiating" the trauma and recognizing that I am safe in the present, it gives my nervous system a chance to leave the event behind. A quasi-spiritual exorcism of the trauma.

A couple of nights ago, I awoke with my leg throbbing. I had tried to wean myself off my evening dose of Oxycontin. I flopped and thrashed until Melissa woke up. A line of tightness began at the outside of the bony part of my heel. It extended upwards through the outer muscle in my calf to a painful point on the outer tendon behind my knee. From there, it continued up the outer edge of my hamstring to envelope my right sit bone in a deep ache. Melissa rubbed it for a long while, then laid down to sleep. I still flopped and thrashed. It was painful, but my angst was more than physical. I rubbed and stretched to no avail. Finally, Melissa asked me to lay flat on my back while she held my heels.

Some floodgate opened, and I started to relive the experience. Melissa holding my heels must have provided enough safety to go there. I can't quite explain what occurred. I didn't exactly remember the sights or motions of my accident. I didn't reexperience the sensations of injury. Instead, I had the *sense* of what had been happening beneath a conscious level during the moments of falling and impact. As soon as Melissa put her hands on my heels, I started wailing and hyperventilating. My hands first went to my left leg, as though taking inventory of remaining resources. Then I felt the pulling in my right leg. The line from my heel to sit bone felt like tight piano strings pulled to the limit of their tensile strength. Without the bone maintaining structure, my tendons held on as though Armageddon were approaching.

I cried and rocked and rubbed my leg. Eventually words came. I found myself telling those tendons, "you did a good job." Then, "what would happen if you let go now?" At the same time, I felt sensation at the point of my fracture. I could almost imagine my tibia waking up, telling the tendons that they could relax, returning to the work of maintaining structure. It was cathartic. After two hours, the sun came up, and my tendons stopped aching.

Was it real? My achilles was a notch softer in the days following, and I am walking with a bit more ease. I don't know whether my tibia actually woke up. Unfortunately, the Orthopedist's x-ray machine was not working this morning, so I don't know whether the fracture is fusing. Revisiting the accident a few nights ago was real enough to expand the dimensions of healing a little bit more. Enough to rock the healing, I suppose. And at the risk of undue personification, I am glad that my tendons had the courage to hold on.

Two steps forward, One step back - Oct 14

2007-10-14T15:33:00.001-04:00

Last Wednesday, I went to my second outpatient physical therapy appointment. I like my PT, whose name is Amy. She is exuberant and positive about my progress. She also spends time talking to me as a person, not just as an injured leg. Because the Orthopedist prescribed full weight bearing, she has worked with me on standing and walking.

One immediate priority was to find footwear. My Berkenstocks did a tolerable job of containing my foot. Unfortunately, the straps pressed into my pitting edema. (Pitting edema is the congealed swelling in my foot and ankle. It has turned waxy, and can be moved around under the skin. Herein lies my latest party trick; I can press my finger into my ankle leaving a deep depression much as one might do in soft wax). The sandals also made it hard to practice the normal movements of walking.

On the way up to Maine (to pick up the pooches at Melissa's parents house), we stopped in Freeport at the L.L. Bean mothership store. A very eager and sympathetic saleswoman helped me out. She empathized and told me about her three toe surgeries. She was a thin Southern woman with big, round eyeglass frames. After a myriad of unsuccessful attempts, we found a shoe that fit me and allowed me to practice walking. I am now the proud owner of some size 11, 4E New Balance sneakers. Essentially, I live in a double-wide.

The two steps forward part is this:
I found that I could bear more weight with the shoes. In Maine last weekend, I walked a quarter mile loop around Melissa's house, including a portion along a trail in a field. (A quarter mile isn't that long - think high school track). A few days ago, I walked in and out of MGH to go to my physical therapy appointment. I walked in and out of the mall to deliver my haywire MacBook to the Apple Store. I walked with Melissa and the dogs in Forest Hills Cemetery, an exquisite green space for walking and contemplation. The more I tried to put weight on my foot, the more I felt like I was handling it.

Then one step back:
That evening, my ankle throbbed and throbbed. Melissa tells me that I groaned a lot in my sleep. When I tried to walk on it the next day, I could hardly manage slight weight bearing. I have spent the last few days sitting in bed. Making the journey to the bathroom felt like the limit of my endurance.

The psychological journey was much longer than any of the walks that I took. When I was able to stand and walk on my foot, I felt so hopeful. My mind quickly skipped to the future and extrapolated a quick recovery. The world was bright and sunny.

Then, the pain in my ankle coincided with a few overcast, rainy days in Boston. The outlook of the world seemed grim. I was sure that I had done inexorable damage to my ankle. There was a discrepancy in professional opinion between the orthopedist in Colorado and the one in Massachusetts. The CO doc didn't want me weight bearing until 10 weeks (mid-October); he was concerned that my ankle had been compromised. Please tell me I'm not the only one who jumps to the worst conclusion. Has anyone else had a passing pain in their chest and assumed that a major artery was blocked? Has anyone experienced back pain and assumed slipped disc or worse? Not that those worst case fears overwhelm me; they're just the first messages to flash on the screen.

I am happy to say that my outlook has swung back to the middle. I spoke to both orthopedists (in CO and MA). It turns out that the discrepancy in opinion is not as large as I had interpreted. I have not done damage to my ankle; I simply pushed a little farther than I was ready for (which is what Mark's do best). Today, I have been able to put more weight on my foot again, and the gap between my current function and hiking a mountain is a little less vast.

Melissa's Birthday - Oct 12

2007-10-14T15:02:00.001-04:00

Melissa entered this world late in the day on October 12, 1972. That day is a cause for celebration. If you read this, please reach out to Melissa and let her know that she is fantastic.

Melissa is a shining star in this world, but one that doesn't call attention to herself. Melissa cares deeply about people, about justice and about love. She has the endurance of an elk, the nurturing spirit of a mama bird and the sure-footedness of a mountain goat. She has worked so hard to care for people in need - at-risk youth or survivors of domestic violence. She has cultivated a deep caring for our dogs - even for Teacup's incessant barking! She has pursued reconciliation with her parents across the ideological divide. And now, she has been caring for me.

At first, I was so shortsighted about celebrating her birthday. I thought that I could do little to celebrate, since I was limited in walking, driving and even getting on the Internet (after my laptop fuzzed out). I thought perhaps that a little surprise was in order.

Amazingly, by bringing other people into the fold, the surprise grew in wonderful dimensions. The surprise soon turned into a double-header, two nights in a row. Friends added their special touches - scrumptious stuffed squash, a growler full of stout, scented candles, flowers and best wishes. It turned out to be one of my best efforts at celebrating Melissa's birthday, yet I can claim very little of the credit. Bringing community into the picture gave birth to a wonderful celebration of Melissa.

So what I want to say is this.
I really wanted Melissa to feel loved, celebrated, supported, noticed. Some days, I can hardly believe the efforts that she has taken to care for me. Some mornings, she has spent her precious time dealing with all the logistics that it takes to get me out for a walk in the Arboretum. (I am not low maintenance. I need breakfast in bed before I can take my pain medication. My wheelchair needs to be lugged down two flights of stairs, and if the car is parked facing uphill, I need the door held open). She has spent time massaging, holding and paying attention to my injury and my soul.

Sometimes I ache to try and do enough for her. I feel so limited; all of the physical tasks fall to her. I can't walk the dogs or shop or run an errand. I can't even cook much beyond the simplest options. I am deeply affected by her caring and attention.

Lately, we have become fond of a new Patty Griffin song. Here is the chorus:

When you break down, I'll drive out and find you
If you forget my love, I'll try to remind you
And stay by you
When it don't come easy.

Well, it hasn't come easy for over two months, but Melissa stayed by me.

Homecoming! - Oct 3

2007-10-03T21:10:00.000-04:00

Hooray,

Have a look at the leg! Beauty, eh?

Today, Mark came home. It was a momentous occasion. No, there were no arthritic dogs to woof gleefully and fan their tails like windmills. The pooches are on an extended visit with their grandparents. No, our neighbors weren't here to greet us. One upstairs neighbor expressed sympathy as she grimaced at Mark's exposed leg and hurried by. No, there were no onlookers. Instead, the occasion was momentous in our hearts. It has been hard on Melissa, who has lived with one foot at home and one foot at MGH, at the North End, then at our friend Deborah's house. Perhaps it hasn't been quite as hard on Mark, who has only one foot to stand on. Moreover, he's an inveterate couch surfer.

So we came home. Melissa made 9 trips from the car while Mark cheered from the porch. We celebrated with some crackers and brie cheese and red wine. The homecoming was not without humor. Melissa valiantly attempted to organize the armloads of books, clothes and medical supplies that we had collected en route. At one point, she wanted to recycle a small plastic bin. Mark hemmed and hawed, so Melissa asked, "Are you going to brush your teeth in bed, or are you a man who brushes his teeth at the sink?" The most humorous aspect of this exchange is that Melissa really hadn't intended to question my masculinity. However, this didn't stop me from howling foul play. Sure, emasculate the guy when he's already down!

Something about homecoming has lifted a bit of the fog of placeless existence. We started to think about plans and routine. We discussed which days we might use the athletic facilities at Simmons College where Melissa is pursuing an MSW. Mark praised the merits of iCalendar (it's a Mac thing). Melissa blurted out that she wanted to know when we were going to have a kid... (Whoa! I'm still working on walking).

YES, today has been MOMENTOUS. I visited the Orthopedic Surgeon today. He wants me to work towards full weight-bearing right away! So, while Melissa sat in a lounge at Simmons, fervently trying to catch up on reading, I walked down the sidewalk.

I should explain what I mean by walking. It means using crutches for support and moving slightly slower than your average banana slug. My internal dialogue goes something like this: Engage glutes, now ease weight onto foot - ow, ow, ow - now roll to ball of foot and stretch the toes back, oops, big toe won't bend backwards. Release and push (yeah, right) with toes. People either ask me if I'm okay or hurry past without making eye contact. One old lady asked me if I wanted instructions. I thought she was joking. She kindly demonstrated how to place my foot and move with the crutches. She suggested that I might do better with a walker. Still, I'm walking.

Homecoming. I'm saddened by a well-publicized accident in the Boston papers. A man was driving when a storm grate was flipped up by a semi and smashed through his windshield. Amazingly, he lived. However, since coming home, he has not been able to hold a normal conversation or make eye contact. He and his wife are immigrants from Poland. By profession, she is a teacher, and he an engineer. The American Dream, until... His wife mourned that it almost wasn't the same person coming home.

How fortunate our homecoming is. I am intact. Melissa and I have grown stronger and deeper through this ordeal. If the price of a deeper, more loving relationship between us is one gracilis, a lengthy recovery and a few scars, then I got a great bargain...

The Journey - Standing! - September 25

2007-09-25T20:14:00.001-04:00

Today was the first day that I was able to put any significant weight on my foot. How my heart leapt. I hadn't realized how much I missed that feeling of being in balance. Months of leaning unevenly to reach for things and babying one side. Not that I could put a full half of my weight on that foot. No matter, though, because I felt it. I felt the first traces of function, like the first rivulets of snowmelt in the mountains in springtime.

I have tried to feel grateful for progress over these weeks. In fact, I have felt grateful. Still, I had this longing to feel the beginnings of use in my foot. I went through some moments of disbelief, wondering how I would ever walk on this battered limb again. To feel progress in the use of my foot is a joyous occasion. I am grateful, and I think I can be patient now.

Musings - Personal Strength - September 25

2007-09-25T17:56:00.000-04:00

Some thoughts on what it means to be strong in crisis - Mark.

There is a dimension to injury that is mythical and life-affirming. It is the hero's journey and brings many gifts wrapped in strange packaging. In this light, the injury is a sudden sundering of business as usual, a sudden fall from grace. The journey back to the surface is arduous, and the traveler is forever changed in the process.

Of course, it doesn't always feel this way. Sometimes recovery is just miserable, or worse, boring. However, it seems worth embracing the injury and the journey at least to some degree; it is the only way that I can find to make sense of this ordeal. It is not as though I can press rewind and return to my life before the accident. Therefore, embracing the injury and paying attention is my only recourse. Therein lies the essence of strength; the only way past this injury is through it.

Blase Reardon was the first on scene at my accident. A couple of weeks later, he beautifully expressed his observations and thoughts. Blase commended me for my strength, focus and grace. His words have reverberated in my head since then. I think that embracing the injury at the time was the essence of my strength. Ironically, I had to surrender in order to be strong. Maybe it was wilderness medicine training; maybe it was seventeen years of climbing and thinking about accidents. Whatever the case, my response in the first few seconds after the boulder crushed my leg was to acknowledge completely that this accident had happened. I don't remember even a moment of denial or thinking, "how could this happen?" In that instant, I surrendered my life as it had been a few moments before. The thoughts that accompanied this surrender were the source of my strength in crisis. I remember thinking that my leg was broken, that my life was forever changed and that I needed to stay conscious in order to survive.

We have all heard stories of amazing strength of character. I have wondered how I would have handled the trials of Ernest Shackleton's crew in Antarctica or the close call that brought Joe Simpson a hair's width from death in the ordeal he describes in Touching the Void. We have heard of Nazi officers who refused to execute Jewish civilians. As a result, those officers were executed - murdered, really. Why did I watch the Rambo series or Chuck Norris movies as an adolescent? Undoubtedly, I wished and hoped that I had some of their qualities of strength. I feel sure that this yearning was for something more than physical strength. I hoped for strength of character and some degree of righteousness in pursuing a moral course of action.

Perhaps I am not alone in wondering whether I, too, possess the strength to respond to a crisis. Would I jump in front of a bus to save an endangered child? Would I take a stand against tyrants, though it might mean my downfall? And in this case, how would I respond if I were critically injured in a rock climbing accident? It is a hypothetical question most of the time. I have certainly hoped both that I would be strong and that I would never have to use that strength.

One of the gifts of this ordeal has been that it called forth strength in me. During my rescue, my survival required a very immediate and intense focus. Within a few moments, I pulled off my t-shirt and asked my cousin to wrap my leg. I began to take webbing off of my harness to use to stabilize my leg. I looked in our immediate vicinity for a sturdy stick that my act as a splint. However, I had seen my open fracture with my smooth dark muscle exposed and a jagged bone cocked at a stark angle. I saw my foot flopping to the side like a dying fish in the bottom of the boat. I was able to acknowledge that there was little that we could do medically until the Search and Rescue Team arrived with more materials.

Now, during my recovery calls forth a different kind of strength. It demands a steadiness and patience that alters my sense of time's passage. It requires me to put great effort into small tasks that were once automatic. I have to think carefully as I turn my wheelchair around in the kitchen, collecting the articles for a bowl of cereal from high cupboards, barricaded refridgerators and unforgiving pantries. Each day, I must follow my routine and perform physical therapy, even though I have done it for days in a row, even though I don't feel like it this morning. Embracing this condition, the slow convalescence, can be harder than the intense first moments of injury.

I have recognized this same strength in others. In Mass General Hospital, an octagenarian kept his spirits up while he underwent procedures for cancer. A diabetic in my rehab center talked about what he might do after his big toe and several others were amputated. A carpenter smiled when he described falling and breaking an ankle that had been smashed the year before. These people were finding strength that blossomed through their trials.

While this ordeal has brought forth gifts of strength and patience, I offer them as testimony rather than as prescription. My accident could have been different in a hundred small ways. The rock might have cut a different swath. Assistance might have been further afield. The elapsed time to surgery could have stretched over days. Moreover, I might have been another person with a different constitution or mindset. It is not for me to judge others' responses to crisis, only to articulate my own as a small data point in comprehending what is possible.

Within a week after my accident, a long-time NOLS instructor and administrator was killed while rock climbing. Despite wearing a helmet, Pete Absolon died instantly when he was struck by a rock trundled by an unthinking hiker. This accident was "the big one." No amount of "personal strength" would have saved Pete. Perhaps I have been most fortunate to have just enough travail to discover this strength.

The Journey - Some Days Are Hard - September 20

2007-09-23T21:50:00.000-04:00

I stood in the shower naked today, crying over my swollen foot. I felt very tender - "it's so mangled," I managed to whisper between tears.

I have been overwhelmed by the beauty in the eyes and hearts and letters of people who care that I heal. I have embraced the silver linings of finding personal strength, of feeling the deep love from Melissa, of finding grace in small interactions with people. But still, some days are hard.

Unwrapping my leg for my daily dressing change is always a vulnerable moment for me. The idea of recovery can feel uplifting; it can feel like a pleasurable challenge or heroic journey. These ideas help me to make meaning out of this ordeal. And yet, when we unwrap my leg, the magnitude of injury chafes against lofty conceptualizations. I can hardly imagine moving from this unsightly appendage to a leg on which I could hike or run. I look at my still swollen heel, as large as a softball. I have little feeling, and the mild discoloration has not faded. I touch the area of my skin graft. There is no fleshy padding, and It feels hard against my tibia. It is warm to the touch, yet I have no sensation. Like waking up when one's arm has fallen asleep, I regard my leg almost as some foreign creature. I have been given permission to start bearing weight - up to 25% - on my right leg. However, my heel won't even touch the ground, as my achilles has tightened up. The outer edge of my foot touches down first; it screams and throbs before the ball of my big toe contacts the ground.

The cry helped. It had started earlier, when I noticed that my other foot and ankle was swollen. I felt mad, taken off guard by this unexpected ailment in my left leg. In all my efforts to be tender, hopeful and loving towards my injured right leg, I have resisted urges to be angry at it. When my other foot started to swell, it bore the brunt of any resentment that might have been brewing. I wasn't cheered even when Melissa reminded me that my left leg lost a whole muscle and a giant patch of skin; a little swelling was entirely reasonable after that trauma.

Finally, getting into the shower, it started. I could feel the tears welling up. I grieved, I felt better, I resolved to continue - to continue believing in the power of humans, individually and collectively, to heal. And when that level of belief isn't possible, I resolved at least to suspend disbelief about being able to stand on top of a mountain again one day.

Strong at the Broken Places - Mark - September 14

2007-09-23T21:49:00.000-04:00

I hope that this update reaches all of you in good spirits. Please
know how much your support and contact have meant to me during this
ordeal.

The short version is that I am progressing well, and I should be out
of this rehab center next week. I am a lucky man to have a partner as
loving and committed as Melissa. I am deeply appreciative. The
recovery process will be long, and physical therapy is unbelievably
painful (dangling my leg). However, I'm happy to do it in order to
heal.

Today was amazing! I have been in a rehabilitation center for a week.
At my follow-up appointment with Plastic Surgery, they poked and
prodded and peeled off dried blood and dead skin. They told me that
the graft is stable and that I can bear weight (if ok'ed by
Orthopedics), touch it, stretch, shower, ... They also took out my
last wound drain, stopped my antibiotics and blood thinners and gave
me their blessing.

It is humbling to notice my process. Even though I want to have
normal function, I notice the fear. Subtle thoughts occur to me - Am
I really ready to start bearing weight? Will I stay healthy without
antibiotics? Perhaps I'll wait another week to shower, just in case.
Institutionalization at work - I have only been in the hospital for a
month and have a strong drive to recover. If fear and doubt creep
into my psyche, I can only imagine the experience of people who have
been in this setting longer:

Down the hall is a brain-injured patient. At odd times of the day or
night, he WAILS, calling for the nurse. In many cases, they are right
next to him. He cries, "Nurse, don't be a witch."

Another woman is usually cheerful and dedicated to her physical
therapy. However, she was dispirited yesterday. She had a spinal
fusion (fused vertabrae) in June. She is disappointed because she
still can't walk after three months.

A young man lost the use of his legs 10 years ago as a senior in high
school. He simply lost feeling and the ability to move them--no known cause.
He is here for sores and infection, but he has no place to go afterwards.
He grew up in poverty and doesn't really have skills that could allow
him to work, to contribute, to find worth. Melissa and I have both
talked with him about some possible steps.

In this context, I am incredibly fortunate. I am healing well. I
have resources and a beautiful network of people who have shown me
their support. And Melissa... Melissa is a godsend to me. I can
hardly believe what an incredible partner she is. When the going
wasn't easy, Melissa really stuck by my side. She has massaged me,
stayed late hours, helped me to visualize and brought me treats. How
can I ever thank her enough?

Yesterday, I walked about 75 yards on crutches. Physical therapy
consists of (1) light workouts to strengthen both upper and lower body
and (2) the hugely painful process of letting my leg dangle. When
blood flows into my leg (as in standing or even just dangling it off
the bed), it throbs and swells. I start to get light-headed and
sweaty. I like to think of myself as a pretty tough character, but
after 10 minutes of dangling, I'm crying for mercy.

PARTING IMAGE: Did I mention that I shaved my head? Fun! I've never
done it before - sure makes hair washing easy. Wow, do I have a
widow's peak!

We think our next update in a few days or a week will be a "last"
update as we switch over to writing in a blog on a website
(rockthehealing.com) that a college friend is creating for us. It
seems hard to think of signing off with all of you. Maybe we can plan
a global simultaneous "toast" to healing to appreciate this joyful
vigil.

Strong at the Broken Places - Melissa - September 14

2007-09-23T21:48:00.000-04:00

Greetings from the North End of Boston, a hip part of town with tiny
cobblestone streets just big enough for horse and buggy--streets more
than just a touch scary for a guy in a wheelchair! Our outing to a
park 2 blocks away was a memoralbe adventure--adrenaline surges over
every treacherous stone!

Had we lots of time and money, we'd be wining and dining at fancy and
boisterous Italian restaurants and bakeries here in the North End. As
it goes, instead of red wine and eggplant parmesan, we're hanging out
with a crowd of people with ailments and issues much more tragic than
a superbly healing gracilis flap. The level of suffering in a place
like this (not everyone heals so quickly, not everyone will leave this
rehab center and go home) is profound, further fueling the gratitude
that Mark and I have been filled with every step of the way through
this injury.

Mark continues to heal so very well, but I'll let him tell you about
that directly. He is up and about and wanted to be in on the writing
of an update to our circle of healers and supporters.

As for me, I'll share just briefly. These wonderings I find truly
fascinating. First, a few weeks back, I was struggling to keep check
on replaying images of the accident over and over again in my head
(even though I wasn't even there...). Then after a couple weeks, my
mind switched it up--from Mark being in the image to ME being the one
to have my leg crushed. Wow. Second, I have caught myself, when I am
getting dressed or getting out of the shower and toweling off, to be
especially careful around touching my lower right leg---and then I
realize that I actually don't have a wound there---Mark does. Another
wow. I've had a passing glance at thinking of this as a pathological
level of involvement, but then I've just become very intrigued by
these responses. I've marveled at the ability to empathize, and to
truly share difficulty, to be deeply present with someone elses
healing. It also seems to me to be symbolic of the fact that it is not
just Mark's life that suddenly changed last month but that mine has
too.

And what else? Last spring, Mark and I had been talking about doing a
re-committment ceremony this fall on our 7th wedding anniversary in
October--a time to renew our vows. I'm not sure if we'll get around to
a ceremony now, but the last few weeks have been a ceremony of a
different kind. Seven years ago, Mark wrote in to our vows "I vow to
tend this union in times of ease and hardship that it might grow in
abundance and strength...." This whole ordeal makes for an interesting
relationship to hardship. Not that I would ever choose to have my
partner's leg crushed, or my own, and yet as we look at the event from
the distance of more than a month of healing, there is growing
"abundance and strength". In thinking about the transformation that
comes out of hardship, I turn to a line from Hemingway that I've held
close to my heart long before this injury. In working with trauma,
these words have been solace:

"The world breaks everyone
and afterward
some are strong
at the broken places." ----Ernest Hemingway, A Farewell to Arms

We've Moved! North End Rehab - September 7

2007-09-23T21:47:00.000-04:00

We've moved!

Mark is now at the North End Rehabiliation and Nursing Center and is
likely to be there for the next week or 2. For Boston-based friends
who have the time and energy to visit, it's an easy walk from the
Haymarket T stop. Address below. If you can visit, call Mark directly.
It would be great if anyone can stop by to see him as my
responsibilities begin to kick in as of Monday with new internship and
classes! Off and running.....! My MGH "vacation" is ov-ah! And Mark
may go into withdrawal without the massaging....

70 Fulton Street
Boston, MA 02109
617-726-9700

Peace Salaam Shalom

Still at MGH - September 7

2007-09-23T21:46:00.000-04:00

Hello Everyone,

A work week has passed since we wrote to you. We've been hard at work
trying to get Mark out of the hospital!

All is well on the healing front. Yes, the flap is still "booming and
swishing" and Mark continues to get superlative comments from the
doctors such as the flap looking "beautiful". I haven't seen the flap
yet, but Mark has seen it when the doctors take the dressing down
every morning. I hear that it is beautiful from a MEDICAL perspective
but that Mark *might* not be winning any prizes in the "Men's Sexy
Legs" rag...but of course he will in MY book! Scars are simply a map
of your adventures from our perspective. Mark has a VERY cool map!

Mark is now on the "dangle protoccol". This is a medical term for his
flap phyical therapy! He gets to dangle his leg over the side of the
bed 3 times a day for 15 minutes (just a few days ago it was only 3
minutes but they've progressed him rapidly because the flap is
tolerating the increased bloodflow so well and because he is handling
the discomfort so well).

News that gave me cause to have a small (happy) tearful breakdown at
CVS yesterday while I talked with Mark on the phone (I've been
reassured that ANYTIME is an OK time to cry these days), is that
Helena spoke VERY confidently about the health of the tissue on Mark's
heel yesterday. We have been very attentive to this issue, knowing
that if that heel tissue did not survive, Mark could be in serious
trouble with use and longterm function of his foot. Yes!!!! Still, we
know there are no guarantees, but this vote of confidence is very
welcome! "Heal the heel" is still an essential prayer for us.

And discharge from the hospital? We are in a holding pattern. Turns
out Mark will need a visiting nurse to change the dressing daily and
the MA Health insurance program that we are depending on will not pay
for a visiting nurse. Ironically, MA Health WILL pay for Mark to be in
a rehab center which will be much more costly. So, the discharge team
here at MGH is working on securing a bed for Mark in a rehab center.
It is not our first choice, but we are making the best of it. We think
it will only be another week or two before Mark is home.

We are well. Mark is moving around in bed more and more. The time
between installments of pain medication is just starting to lengthen.
And yesterday Mark got orders from the doctor to be able to get out of
bed to use a wheelchair and go outside! We got him off the 13th floor
Plastic Surgery unit and went down to planet earth and hung out on a
patio for an hour, the first real sunshine Mark had seen in a long
time!

Thank you all for wonderful in-person visits, sweet cards, generous
care packages! Thank you for continuing to think about us and to
inquire about progress! If you haven't tired of visualizations and
prayers for Mark, keep a vision of him as healthy and whole and with a
fully functional leg in your mind's eye.

Peace Salaam Shalom.

Melissa and Mark

Blase's Message - September 2

2007-09-23T21:45:00.000-04:00

I am pasting in below Blase's message to us from a couple of days
ago...for clarification, Blase's partner is also named Melissa, and
she too was on the rescue. Many thanks to both of them for what they
offered during that time:

From Blase:

Melissa -

Thanks for including me in your updates on mark's condition and for
sharing your reflections on the situation. Since Melissa and I left
her parents in CO - a day after you arrived I think - I've been in the
field doing my thesis research or, for the last week, in class. I've
kept up with your updates as best I could, including getting verbal
updates from M when she met me in backcountry of Glacier NP after I'd
been out for 4 days. I am thinking of you both and visualizing as best
I can, though sometimes vascular flow or decreased platelets seem a
little abstract and remote out in the backcountry! Please, keep the
emails coming. I hope to visit you both sometime this fall while I'm
in Boston visiting my family.

I want to share a few impressions and details with you from the actual
rescue. I think they reveal alot about both Mark and the situation. My
friend Will and I were the 1st to reach Mark and Jason about 10-15
minutes after the accident. We were with him pretty much till he
reached the helicopter, except during the actual lower. I was right
behind the rescue group at that point, retrieving ropes, and heard the
whole alarm as the lower started and they pulled him back up and
discussed the tourniquet. So I witnessed Mark's response to the
accident pretty closely.

I'm a former EMT and have worked in the backcountry for most of the
past 25 years, as a ski patroller, river guide and researcher. Mark's
accident was by far the most serious I've encountered. It was
life-threatening and the actual injury was gruesome. At the same time,
Mark's response was by far one of the most remarkable displays of
courage and grace I've ever witnessed. He was calm, present and strong
throughout. I have tried to imagine what it would be like to look down
and see my leg like that, and I can only guess at how terrifying and
traumatic that would be. Waiting for a rescue in that situation would
have been trying, to say the least. Mark, however, never grew
desperate. He expressed a little urgency as we waited for the rescue
team to arrive - I was wondering what took them so long too - but he
never showed any desperation, never cried out or expressed any
frustration or fear, much less begged for anything, like I can imagine
myself or most people doing. It was impressive. We joked that Mark was
alert and oriented times 5 - though times 4 is the highest level of
consciousness in the actual scale - esp after he corrected Will on the
day of the week. That presence of mind and his medical training made
him a very easy patient. There wasn't much Will and I could do except
wait with him and Jason. Though we monitored his vitals, Mark was
maintaining regular breathing and staying calm and that was
tremendously important. It postponed shock long enough for medical
help to arrive. When shock symptoms did start just before they
arrived, the decision to reposition Mark was easy - it was his, and we
didn't have to explain the risks or prepare him for the pain. Mark
initially refused morphine - though they snuck it in on him. He
maintained that presence of mind and self-possession through the next
6 hours, letting the team help him, never asking how long til the
helicopter, never getting desperate or hurrying anything, never
complaining. It was courageous, graceful, and inspiring. I can only
hope some of it rubbed off in case I'm ever in a similar situation.

From my perspective, the rescue team, esp the nurse Mel Streeter, gave
Mark excellent medical care. After her initial assessment, she radioed
for more IV bags, a decision that now seems critical to Mark's
survival given that he went through 6 liters of fluids. I say survival
because I believe it was in question. He was bleeding continuously
throughout the rescue - there was blood dripping from both ends of the
litter for much of the time we carried him through the talus field,
and that was hours after he was stabilized and packaged. I am grateful
we were no further from help and that we were able to call for help
immediately after the rockfall. Will and I were not equipped to handle
an emergency that serious - we had no way to treat the shock that was
imminent even with Mark's level of consciousness. I'm also very glad
Mel didn't apply a tourniquet - his survival was in question and it
seemed quite possible that Mark wouldn't keep his foot and leg even
when we got him to the hospital. It wouldn't have been a wrong
decision. I think that Mark's courage and calm and his minimal use of
morphine made the difference in her decision. He was taking care of
himself and giving himself every chance he could and it inspired
everyone else to give him the same.

Despite the seriousness of the situation, it had plenty of lighter,
even comic moments. For one, Jason wasn't wearing a shirt, and we got
concerned about him getting sunburned. But all the packs with gear
were down below and no one had anything that would fit him. So Melissa
gave him a baby blue button-front shirt. Of course he couldn't get his
arms into it so he buttoned it around his neck like a mini cape. It
didn't even cover his shoulders. He looked like a comic book
superhero. It made everyone laugh. Picture it and you will laugh.
Jason was wonderful throughout. He cares deeply for Mark.

Lastly, I'm familar with MGH from 5 weeks of late night bedside vigils
for my mom and I've watched the sun come up over the Charles numerous
times. I can picture the place very easily - the rush on the 1st floor
during shift changes, the crowded elevators, the close, hushed waiting
rooms and the quiet wards with their surreal mix of monitors, intimacy
and anonymity. I emphathize with you - your task is not easy. I
appreciate your positive attitude and updates all the more. I'm
curious what unit Mark is in - an orthopedic ICU? MICU?

The upshot of all this is that based on what I've seen of Mark and
what I know of MGH, it's easy to be positive about his recovery. I can
imagine him handling each new turn with the same grace and courage
I've already seen. I appreciate the updates and your reflections and
you are both on my mind despite my silence to this point. Please keep
the updates coming.

Melissa sends her best.

blase

The Power of Witness - September 2

2007-09-23T21:43:00.000-04:00

Hello to each of you.

Good morning. We wish you well. We take in the healing you each have
offered us and send it back to in the many different forms that you
may need.

Mark is re-gaining some "fire in his belly" as we attempt to exorcise
the weakness and lethargy brought on by anesthesia, pain medication,
laying still for hours, conditioned air. He is moving a bit more,
laughing more, gaining ground, making plans....we may be discharged
(well, I guess Mark will be discharged, not me, though I DO know the
ropes here at MGH Plastics Unit very very well....) as soon as
Wednesday or Thursday! It is hard to imagine what lays beyond that
next bend in the river, but we are figuring it out. We think we are
going to stay with very generous friends in Cambridge because they
have a first floor that we can stay on whereas our apartment requires
two flights of stairs. Though Mark and I DO plan to embark on more
multi-pitch climbing down the road, those stairs are not going to be
possible for at least a couple weeks.

For those of you who were inspired by Mark's account of his rescue, I
want to share another account of those crucial eight hours. Blase
Reardon, a man who was climbing nearby and the first to reach Mark
when Jason, Mark's cousin, called out for help, wrote to us recently
to share his impressions of the resuce.

From a Narrative Therapy perspective, the power of witness is
essential. In some instances in Narrative, a circle of witnesses--in
addition to the therapist-- might actually be present as someone talks
through their story and then there is a wonderful process, elaborate
and simple at the same time, where witnesses reflect back to the
teller, layering the story, adding richness, adding detail, making
meaning. Another technique is to bring witnesses "into the room" by
asking the person, the "teller", to tell a piece of their story
through the voice of an important person in their life, or someone
central to an important event that the person might be re-telling. All
toward "meaning-making" and "preferred future" for the teller. It's
quite beautiful. Mark and I have shared a belief in the power of
witness. And for those of you who were at our wedding you might
remember that it was a significant piece of the ceremony--12 people
were our "witnesses" for various aspects of our relationship. We have
the flags that those 12 people made hanging above our bed. So, Blase
was a witness to Mark's composure duing the rescue and has taken the
time to share that with us. We are grateful for his words.....his
account helps Mark and I to make meaning out of this and to move
toward a preferred future.

Pictures of the Rescue - September 1

2007-09-23T21:42:00.000-04:00

I mentioned rescue pictures last night if anyone wants to see the
accident scene. I wanted to clarify that they are NOT graphic at all.
They are just interesting because you can see how rough the terrain
was and you can see what a skillful team it took to get Mark down.

There are several pictures from the accident posted at the following
website (thanks, Adam!)....

http://rosi-kessel.org/mark

Mark and I have had the deepest sweetest good fortune to be in
correspondence with some of the people who were at the accident scene
almost immediately--folks not even on the official search and rescue
(SAR) team--who came to the scene and helped stabilize Mark and sat
with him, patiently, for close to 2 hours until the SAR team could get
to him, and who then assisted over the next 6 hours to get Mark down
safely. These photos from a rescuer, as well as kind and generous
dialogue over email and phone with this rescuer and others, have
helped us to continue to make meaning out of this craziness.

And, Mark is more energized today than yesterday. Little by little.
The flap is still booming and swishing which is exactly what we love
to hear when the docs come in to check.

Onward

Enduring Spirits - August 31

2007-09-23T21:41:00.000-04:00

Healing continues.

A very quick update to let you all know that the flap is doing well.
Though we get no guarantees in this little deal we've made with the
Gracilis, if a flap is going to fail, it usually does so within the
first few days, so we are gracefully and gritfully moving out of the
danger zone. The doctors come in to check the pulses in the flap every
hour with a "doppler" and we get to hear it---the arterial blood
sounds BOOMING and the veinous flow sounds swishy....all good
news....vascular surgery will surely be my profession in my next life!
These people get my highest admiration. Plastic surgery is a hellava
lot more than I ever knew.

These post-surgery days have been rough ones. Mark was in the OR for
more than 11 hours. When he was wheeled back into his room at 11 pm on
Tuesday night, I put on Natalie Merchant's "Wonder" and tried to tell
him that the surgery had gone really well. I'm not sure he knew who I
was, let alone any news about a "beautiful" flap. Then the nurse
snapped at me to turn off the music while they flurried around him
setting up a formidable fortress of medical "things" to keep him hot
and flapping. More like Hell than Hawaii I've already told one friend.

In spite of lots of pain accompanied by an inability to move, Mark
still manages to laugh and make fun of himself. Bad Ass Mo.....

We received pictures today from Fred, a blessed soul who was on the
rescue effort. Mark and I will be happy to share those with people who
find such things interesting....lots of ropes and rocks and people in
helmets. It brough it all home for me in a much more concrete way and
made me re-visit my immense admiration for the way Mark handled
himself in those first few hours.

Thank you for the continued support. We are so happy to hear from any
and all of you. Please do not hesitate to email back just because you
think we are inundated with messages....it has helped us, not hindered
us. We aren't really returning phone calls very much, but still love
to hear the voices of family and friends.

Peace Salaam Shalom.

Peace of Wild Things - August 28

2007-09-23T21:38:00.000-04:00

Sun is setting over the Charles. I see "alpenglow" on the collection
of high rises I can see from our 13th floor window---these modern
"peaks" of Boston. Mark's left leg has generously---and
successfully--donated the Gracilis muscle to his lower right leg!
Though I have no details, I've been informed the surgery went
beautifully! One of the residents who was in the OR with Mark today
just called and said they are just finishing up. They expect to wheel
Mark into the recovery room in the next 45 minutes or so where he'll
hang out for another hour or 2 before they will bring him back up here
to me.

We now embark on 7 to 10 days at MGH with "blood flow monitoring"
every hour in the flap to make sure it's doing what we want it to do.
The nurses are now preparing Mark's room for him to return to it in
the next hour or so--they've jacked up the temperature to the 80s and
have a special light above the bed much like one of those things that
keeps french fries hot in the bin at Burger King. Success of the flap
is associated with constantly warm termperatures in the post-operative
week. I'm heading down to Filene's to pick up a new bikini for this
very special week in our lives...:0

Attached is a picture from a weekend visit. Still smiling. And yes,
Mark is actually doing a pull-up in the picture.

Once again we have been blessed by your belief in us and in Mark's
ability to take on this challenge. Doubt not the power of a supportive
community!

I'll leave you with a poem by Wendell Berry, a favorite one of both
Mark and I. Mark gave me a copy of this collection of poems when I
first met him 14 years ago.

The Peace of Wild Things

When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children's lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.

Wendell Berry, Collected Poems 1957-1982
(Thanks to David and Kathleen for bringing this by this weekend.)

YES!

Ready for Surgery Tomorrow - August 27

2007-09-23T21:34:00.000-04:00

Hello Friendly Healers,

Mark is scheduled for surgery around 8 am tomorrow. Over the past few
days, his platelet count has trended downward! He is also on aspirin
therapy to make the platelets "slippery" so that there is minimal risk
of clotting during this vascular microsurgery. The plan is still to
use the Gracilis muscle from his left inner thigh and graft it into
the wound on his right lower leg. We are told that the main limitation
he'll experience after donating his Gracilis to this cause is that his
equestrian days will be over. We're OK with that!

We have been blessed with a lot of in-person love over the past couple
days. Thank you so much to those of you who've been able to stop
by---bringing Mark breakfast, lunch, organic cantelope, organic beef
jerky (!), dark chocolate, red wine (for me!), adorable toddlers to
amuse us, favorite CDs, lots n lots of DVDs, helping massage Mark's
leg, so much more. Thank you. And thanks to those sending their love
over the phone and through email. Just this morning Mark and I read an
account of a climbing accident in Climbing Magazine and the account
was profoundly negative, caustic, bitter. We were struck by the polar
opposite nature of this story we have unfolding in our lives...this
accident is not a story of bitterness or defeat. Dare I say
transformation? Dare I thank you all one more time for your part in
it?

If you will, throughout your day tomorrow, keep Mark with you....8 am
ish to 4 pm ish...

*Good blood flow....
*"Pristine" tissue, vessels, bone...
*Mark is safe...the danger is past......
*Doctors focused and skilled and pleased with the work......
*Mark is whole and healing......
*The next time you visit with Mark, this chapter behind him, him up on
his dancin' feet...

Peace Salaam Shalom.

Attached are a few pictures of Mark from the summer---one from
instructing OB for the summer (with student)---two from a personal
climbing day near Boulder.

You Are Safe Now - August 24

2007-09-23T21:33:00.000-04:00

Hello Friends and Family,

We have not tired of your support and kind messages! Thank you for
your endurance. I promise that the communications will slow down once
we are on the other side of these multiple surgeries. But for now, we
continue to lean on your energy and love.

You all know that Mark is scheduled once again to have the free flap
procedure on Tuesday. Helena now has Mark on aspirin therapy which
will de-activate the clotting ability of the platelets. They are also
checking his blood daily to monitor the count. The hope is that the
count has peaked and is now on it's way down. Doctors suspect it is
high simply in response to the trauma. It can also be related to the
many medications he is on. The bottom line for the free flap procedure
is that this is really a vascular microsurgery and good blood flow is
essential or the flap won't "take" and then we will have wasted a lot
of time and a perfectly good Gracilis :). If this happens, we'll need
to move on to Plan B and I'm not even exactly sure what that means. It
could mean taking his OTHER Gracilis for a second try or maybe just
sitting around in the hospital for weeks/months with the wound vacuum
on and letting it work it's miraculous wound healing yet at the same
time also praying that Mark doesn't develop a bone infection since the
bone is exposed to air. The bone being exposed is the main reason for
needing the flap. The Graciis won't actually function as a muscle when
it gets transplanted....it acts as tissue that covers the bone and
acts as a source of blood flow to that area so that it will heal, so
the the bone will fuse where the fracture is. Our wishes.....We would
like to get this flap procedure done as soon as possible so that the
bone gets covered and starts getting blood flow. We would like Mark's
platelet count to go down so that the procedure has as few risks as
possible.

From a Somatic Experiencing trauma-healing framework, trauma cannot
heal until the trauma stops. I know it sounds simple but it's at the
heart of re-negotiating trauma. See, it is common that a body holds
onto trauma in the nervous system that it was not able to adequately
negotiate in the moment (for many reasons---maybe because it happened
too fast as in an accident or because it was so emotionally confusing
as in an abusive relationship). In Mark's case, there was a tremendous
amount of information for his nervous system in a very compressed
moment----at that moment of impact, the system probably was likely not
able to digest everything that happened. The body can hold onto that
information AS IF the body were still trying to escape/get
safe/survive (this is where you begin to see symptoms of PTSD in
trauma survivors----hypervigilance is connected to a new body schema
that is still working as if the trauma is not over). One way that we
are working with that is to work with Mark's nervous system and to
reassure it that he is safe now. The danger is past. You are safe now.
I am blown away at the amount of settling that is visible in Mark's
body when we facilitate this process. If I hadn't already been sold on
this trauma resolution work, I am now.

If you are open to suggestions about how to keep Mark in your prayers,
here goes.

Continue to visualize....

*Good vascular flow is still paramount. Lots of tiny tiny vessels
getting connected from Mark's lower leg tissues into the transplanted
Gracilis and it all WORKING!
*Healing the traumatized heel tissue is still essential.
*Help us bring Mark's platelet count down. Visualize his body knowing
that he can stop that crazy platelet production. Visualize normal
healthy blood chemistry (Gee, every time I write this stuff I am
almost embarassed at how damn strange it is to ask you all to be
visualizing Mark's biology.....someday we'll laugh. Hell, let's laugh
NOW!)
*So, yeah, visualize laughter. Ha!
*Visualize Mark as KNOWING he is safe. The boulder has rolled past him
down the slope. He is not pinned. He has survived.....
*Safe. The rescue team has him well-packaged and all the lowering
equipment is sound and they know what they are doing as they lower
him.....
*Safe. He does NOT need a tourniquet. He can keep doing deep breathing
to keep his oxygen levels up now that they've backed off the
morphine....
*Safe. He is getting IVs and they will have him at the hospital soon....
*Safe. In the OR, the doctors are there to HELP him....
*Safe. A wide circle of friends are sending him their love and support...

Today Mark has two small trips within the hospital...one to the OR to
have the vacuum changed and the other for an ultrasound to rule out a
blood clot (platelet count could be related to this, though
doubtful...this is just a rule-out). The vac change causes a spike in
pain for the day. Mark is fortunate to have experience with meditation
as he negotiates his relationship with pain. Not much sense in feeling
bad for him. Rather, believe that he can relate to it with grace.

After today, no procedures for the next few days until Tuesday. Rest
time. Visualize rest! For Mark, for me, and maybe for yourself!

Thank you thank you thank you.

Peace Salaam Shalom.

Off to Sleep - August 23

2007-09-23T21:31:00.002-04:00

Hello Army of Powerful Prayerful Magical Visualizers,

Mark was very busy today healing himself and impressing the surgeons.
Today went fine. Even though it wasn't the "big" day and today was
"not a good day for a flap" (these were Helena's exact words to me
when she called me as I walked with Gia along the Esplanade on the
Charles this morning at 8 am---the phrase kept Gia and I somewhat
amused for the day), Mark was still in the OR and then a "mini" OR
("cath lab") from 6:30 am until 4 pm and then on a 6 hour "don't move"
order (had a catheter in his femoral artery and needed to let that
heal up). The "don't move" order is a pretty wild time for someone in
severe pain. And MAYBE an even wilder time for someone who LOVES the
person who is in severe pain.

So, all is well, the little bulging artery is now tied off and his
wound was cleaned again today and Helena called it "pristine"
(hmmmm...makes me think of a Rocky Mountain glade...) End of day
update: long exhausting day.

Tentative plan for the "free flap" procedure on Tuesday.

Still looking forward to visits over the next few days. Call or email
if you have time to stop by. I'll show ya around MGH and the West End
of Boston :)

You can write to him directly though I AM
reading him all of your fun, kind, loving messages.

If you've called and we haven't called you back, please know that we
looooooved hearing your voice---much comfort in that!!!

Melissa and Mark

Not Today - August 22

2007-09-23T21:31:00.001-04:00

Ah, stick with us folks! Just talked to Helena Taylor, our
second-in-command surgeon, and they are not doing the flap today.
Mark's platelet count is high---not a big deal she says---a very
normal response for what's going on with his body right now. But with
high platelets it is "not a good day for a flap" because of the need
for good blood flow in the tiny vessels they are going to be
connecting. However, he is still in surgery for a couple hours to take
care of some vascular issues that they found on the arteriogram the
other day. An artery that got crushed is now dumping straight into a
vein so they are going to tie that artery off---it is only one of
three arteries that feed the foot so Mark doesn't need it (many people
with lower leg injuries do find with only one of the three). So, keep
that good visualization going even though it's just vein work and not
the flap. Helena says he'll be out of the OR around approximately
noon.

So I will keep you posted and we continue to be grateful for how
present you have all been with us.

Peace Salaam Shalom.

Melissa and Mark

Free Flap Using the Gracilis - August 20

2007-09-23T21:30:00.001-04:00

Hello All,

Keeping you updated on this process. Thanks for sticking with us!

Mark has surgery scheduled for Wednesday morning at 8 am under the
care and direction of Dr. Winograd. Dr. Winograd says it will take
between 6-10 hours. He is going to take the Gracilis muscle from
Mark's left leg and put it into the wound in his right leg and then
sew lots and lots of tiny blood vessels together. Wow! Helena Taylor,
our classmate, will be in on the procedure too.

The other side of the surgery is when I personally am going to call on
your help if you live nearby! I'd love to get a line-up of visitors
who can help me to keep Mark comfortable. He is going to have VERY
restricted movement for 7-10 days. With the amount of pain he is in,
movement is one of his only modes of relief, along with the fairly
constant massage I've been able to offer. So, get yourself ready to
come and offer your smiles and your willing hands on his aching body!

Keep the visualizations coming!

Rich flowing vascularization.
Non-infection.
Union of the bone fracture.
Well-connected vessels.
A healthy heel.
Doctors pleased with the success of their work.
Mark contra dancing in a barn............

Peace Salaam Shalom.

Grit and Grace - August 19

2007-09-23T21:29:00.001-04:00

Hello Miracle Workers,

Another looong email to share some of the details of the past few days
in our journey.

If you just want the short version, last nights email sums it up. We
continue to get good news about Mark's healing process. We are so
grateful for your continued presence in this joyful vigil.

So, as you know from last nights email, we are in good shape. Mark is
healing extraordinarily well. Though we have a long road ahead of us,
we just keep getting good news every time a doctor looks at Mark's
injury.

We made it back to Boston on Friday afternoon. We are so grateful to
college friend Pete Rowinsky who is now a couple years out of medical
school. We talked to Pete while we were still in Colorado about the
medical world and how to navigate our way through procedures we knew
nothing about. His urging us to have this procedure done in a hospital
that is associated with a medical school now makes so much sense. We
are so glad to be here in Boston under the care of a team of very
progressive and current medical professionals. The doctors in
Colorado were excellent, yet it was such a different world—such a
smaller setting and only one plastic surgeon looking at the wound with
no other voices weighing in on other options. We are so glad we didn't
just opt to let him take Mark's latissimus dorsi!!!! (For those who
rock-climb, you'll understand! Yes, devastating to think about losing
the foot, but also devastating to think about losing such a large back
muscle!)

We were so apprehensive about the flight and yet it was smooth as we
could've hoped for. It was a direct flight—only 4 hours Denver to
Boston. Neighbor and fellow OB instructor and massage therapist (who
we hope will be part of the next phase of healing!) Sarai met us at
Logan and scooted us right to MGH where all of the nurses (and even
some of the fellow trauma patients) were eagerly awaiting the arrival
of the "rock-climber from Colorado". They'd been expecting us a day
earlier but we couldn't get a flight! Greeted with anticipation. So
much love everywhere.

Even with this eager greeting, we were still apprehensive about the
shift to a huge hospital. Would Mark get the attention he needs? Will
some young doctor fresh out of school be working on this complicated
injury? Would the nurses be so overwhelmed with caseload that they
wouldn't take care of his basic needs and thus slow the healing
process? We came in with our sleeves rolled up ready to be the medical
advocates that we needed to be in order to make sure we were being
served. And we needed it right away. On the very first night, within a
couple hours of hospital intake, a first year resident (first year out
of school) came in, undressed the wound, and then wrapped it back up
WITHOUT the "webroll" underdressing that Mark needs b/c of the
sensitivity of the precious little skin under there. She "couldn't
find any". At MGH? We called her back in and asked to please find some
webroll and re-wrap it because he was really uncomfortable and we were
both worried about the skin. Our friend Julie was with us and she was
ready to go on a hunt through the hospital to get us some damn
webroll. So the young doctor went and found some webroll and
re-wrapped the leg. We see ourselves helping the medical profession to
value the voice of the patient! My own work over the past few years
has included a lot of medical advocacy on behalf of battered women who
have been so silenced that they just haven't developed the skill or
confidence to speak their needs. I've been in training for this
moment!

After we asked the doctor and asked her to re-wrap Mark's leg, we felt
like we were ready for whatever challenges were ahead in terms of
speaking up for our needs. But it hasn't really been necessary. In
fact, we have had countless affirmations that we are in the right
place. Here's the most notable moment. When the chief resident in
plastic surgery (chief resident is a doctor who's been out of med
school for a number of years and has been practicing under a senior
"attending" physician with a lot of experience… in plastic surgery,
which is very specialized, doctors are residents for a long time until
they are able to move out on their own as independent doctors)
walked in for rounds the next morning, Mark and I and the doctor all
stared at one another for a short moment in disbelief. The chief
resident is Helena Taylor, a classmate of ours from Princeton and a
former Outdoor Action (OA) leader. OA was probably the most impactful
and important part of Princeton for both Mark and me (rivaled only by
the 2D coop). We take this as a sign that we are home, that we are in
good hands. We know from years back as OA leaders that Helena is an
outstanding person with extremely standards. Without any prompting
from us, she talked to us about the "flap"procedure and said that they
always want to take into consideration overall lifestyle and that they
would try very hard not to take the latissimus out of a serious
rock-climber! And without being condescending at all, she said that
some of the information we'd gotten from the plastic surgeon in
Colorado could be considered outdated and that we had more options
that we'd thought we might have. Helena called me as soon as Mark was
out of the OR yesterday to tell me the news that I've already told all
of you—that the tissue continues to heal amazingly well and that she
hopes we can take a much smaller muscle than the latissumus. She even
said that there is a REMOTE chance that if we left Mark in bed with
the "wound vacuum" on for another month, the hole might even close up
on its own and would ONLY need a skin graft. This is full-on
miraculous. This is the work of hundreds of people "holding Mark in
the light", praying for his healing, meditating on "heal the heel",
visualizing doctors being competent and pleased with their work. Mark
and I are speechless as we just look at each other, sometimes
laughing, sometimes crying. We know that Mark is very healthy and
deserves credit for taking very good care of his body. We know that my
presence by his side and the guidance and massage and love that I have
brought is a crucial piece in his healing and his outlook. But we just
cannot get over the feeling of being held in the loving arms of so
many friends and family.

This healing process has been a profound affirmation of my own recent
training in Somatic Experiencing, a body-oriented therapeutic
framework for trauma resolution. I've been in training for a few years
now, my interest anchored in working with abuse survivors. But trauma
is trauma and Mark and I have both been amazed at our ability to get
his heels to "talk to each other" by facilitating his nervous system
to re-negotiate the trauma.

Friend Extraordinaire Chris Fish marveled at how well Mark and I are
doing as a couple through this. He and I talked about how crises often
drive families apart. I have to thank my own Mom and Pop for their
example. My parents experienced their own life-changing trauma a few
years back, and they are stronger for it, not weaker. They have really
taken care with one another through grave difficulty. There are
lessons here and Mark and I are listening closely for them. This
crisis comes at a time when we are ready to honor each other's
strength and lean on it.

So, we still have questions ahead to navigate. We will continue to
call on the support and expertise and experience of those in our
community—you! The doctors say Mark will be dealing with this quite
intensively on a medical level for the next year. There is a chance
that he will need a bone graft anywhere from 3-9 months down the road
simply because the tibia is the hardest long bone to heal and the
place where Mark has broken it is one of the toughest spots b/c of the
lack of blood supply to the area. Rehab will be slow because Mark will
not be able to bear weight for a few months and bearing weight is one
of the key factors in healing the tibia. But amazingly, doctors are
saying that Mark could have close to normal functioning of this leg if
the heel heals and if this procedure goes well and the bone heals.
Wow. This is such a long way from what we were hearing ten days ago.

I got to see the wound for the first time today. Medical technology is
absolutely amazing! This "wound vacuum" that is on Mark's leg has
supposedly "revolutionized would care" over the past 10 years. It
sucks the "bad stuff" out of an open wound. The wound is packed with a
specialized sponge and vacuum connected to a tube that goes into this
toaster-sized machine that holds a canister that collects the gunk.
Nurses empty the container about every 24 hours or so. The sponge has
to be replaced every 2-3 days. In Mark's case, with the wound being so
large, this has to be done in the OR because removing and replacing
the sponge would be incredibly painful without full anaesthesia. This
vacuum makes wounds heal much more quickly than if they were left on
their own. It allows the wound to heal from the inside out, filling in
with "granulized" (?) tissue.

We thought Wednesday would be the procedure but now they are saying
maybe Tuesday. I will let you know, because we'd love to have you all
thinking about Mark during that time.

We think we are ready for visitors too. We want to see people and we
also want to make sure Mark is getting enough rest. So call or email
if you want to come by. Tuesday and Wednesday are probably out b/c he
gets really knocked out by the surgery but if anyone wants to come by
later this week, call first and let us know. He has an MRA (picture
taken of his vascular system) tomorrow so visitors MIGHT be an option
for tomorrow night. I've been here from 7 am til about 10 pm. I'm not
even sure what visiting hours are but nobody has questioned me. I
think it's pretty open.

My high school track coach/mentor/English teacher John Emerson has
kept with us through this ordeal. He reminded me that Mark and I don't
really need luck because strong people survive…. I've been thinking
about a track award John gave me in high school. For the "most
valuable performer" award as a distance runner, instead of giving me a
useless trophy, he awarded me with a pocket knife with the inscription
"grit and grace". I don't run nearly so hard these days, but I still
have the knife and I still have his friendship and his poetic voice.

Thanks to all of you for your firm belief in mine and Mark's grit and grace.

I will continue to let you know how upcoming procedures go.

You Who Are Reading This Have Worked Miracles - August 18

2007-09-23T21:27:00.000-04:00

Blessed be the tie that binds our hearts together.

This will be very short. Longer tomorrow after my eyes close for a while.

We are in Boston. We absolutely made the right decision. We are so
glad we are here. Many many mysterious affirmations of our choice.
I'll share some tomorrow.

Mark went into the OR midday to have the team of doctors look at his leg.

They are amazed at how well it is healing, how great a job the
Colorado doctors did on the bone set, and think that the large "flap"
(taking his whole latissimus dorsi) that was being considered will not
be necessary. They may instead be able to take a much smaller muscle
from his inner thigh or abdominals. His heel continues to be very
delicate and will need a lot of care and nourishment.

The very soonest any major surgery will be Wednesday which is good
because he really needs a break from the trauma of surgery.

We will start to let you know about visiting him. He'll be at MGH for
at least another 2-3 weeks.

If you want to send him a card or package, I would suggest sending it
to our home address and I'll bring it over to him.

69 Woodlawn St Apt 1
Jamaica Plain, MA 02130

More details tomorrow.

Thank you thank you thank you. Mark and I both know that this good
news is your work.

Flying Tomorrow - August 16

2007-09-23T21:26:00.000-04:00

Howdy Friends,

We're flying to Boston tomorrow, arriving around 4:30 pm. A good
friend is picking us up who swears her car will hold a lengthwise
Mark. :)

Thanks for hanging in here with us. The journey is really just
beginning. In talking with the doc this morning here, he let us know
we need to be prepared for the trauma team at MGH to (possibly) have a
completely different take on Mark's injury. We're ready.

M & M

Homeward Bound - August 15

2007-09-23T21:25:00.000-04:00

Hello Friends and Family,

We seem to live a lifetime every 3-4 hours here. Feels like I wrote to
all of you ages ago.

We are well. Forgive me if you are not found of foul language, but
over the past 2 days, Mark and I have taken to fondly calling him "one
bad-ass mother fucker". He is! For a guy who's been in an operating
room 4 times in the past 7 days, he is amazingly vibrant. This
experience living together here at Medical Center of the Rockies is
one of double vision. I am too close to be able to see outside of the
moment to moment decision-making and yet at moments I step away and
witness clearly what an outstanding human being Mark is.

We are quiet in our room, Kate Wolf singing to us through my laptop
here, crossing our fingers that tomorrow we will fly to Boston and
that a trauma surgical team will be assembled and waiting for us to
perform surgery on Friday or Saturday.

After long days and nights of sorting through information about the
procedure, with the help of amazing friends who've called and emailed,
we realize that we want to have this surgery done in the same place
where Mark will have his follow up after care. We want to head back to
Boston if at all possible. Even with the best possible outcome with
this surgery, he will have intensive medical follow up over the next
year. We want that care to be done by the same people who do the
surgery. This morning when the director of the trauma unit came for
rounds, we said we'd like to go to Boston rather than go into surgery
here tomorrow. The trauma team here supports our decision and have
been in high gear all day helping us make arrangements. They are just
amazing. They have made the calls to MGH to set up a team of
specialists to do the surgery. They have helped make travel plans.
They are making arrangements so that the travel will be medically
safe. While we are not SURE that this is all going to happen, we hope
to hear in the morning that indeed the head surgeon here was able to
get us in to an OR at MGH. It is scary to give over control of so many
arrangements and yet there is no way we could do this on our own. We
are grateful for this help. When Mark and I are rich and famous, we've
decided we'll give our big bucks to this hospital. Princeton has
plenty of donors.....

Visualizations?

A team of talented doctors awaiting us at MGH with determination to
execute their very best work on Mark's leg.

And everything else you've all been writing about.....so many
wonderful images are floating out there! So wonderful to hear how many
of you now have that river-yoga picture on your desktop!

I will attempt to share what we know about the upcoming surgery. The
plastic surgeon and the orthopedist here has been very direct with us
and have said that we are stretching the limits of what is possible.
Yet they also express confidence in this upcoming procedure. Mark's
injury is severe. He had an open fracture of both the tibia and fibula
(the two bones in the lower leg) as well as an ankle bone. He also
lost much of the skin on his lower leg and some of the muscle. He also
lost a major vein. So the surgery is called a "free flap" in which a
muscle from a different part of the body is wrapped around the wound.
A reason for needing a piece of tissue rather than just a simple skin
graft is that the leg (as is) will not get adequete blood supply to
the extremity. The grafted tissue serves as a new blood supply. The
surgery is truly a craft as the doctor sews together, under a
micorscope, tiny blood vessels from the transplanted muscle into the
wounded area. Then skin is grafted on top of it. The complications
that have spun Mark and I around and around and around include the
fact that (1) the wound is so large that the doctor says the muscle he
will use for the "flap" (Mark's latissumus dorsi--the muscle you use
when you pull yourself up on a pullup bar) is barely large enough to
cover the wound. This is scary for Mark--to think of loss of strength
and function in his back as well as this leg/foot issue.... (2) And
the tissue and skin on Mark's heel is not guarenteed to survive,
making the wound even larger and thus perhaps not "coverable"--and a
tissue/skin graft on the heel is a very difficult graft to do. And
this issue about the heel--we actually may not know whether or not the
heel is viable for weeks or even a month after the surgery. So Mark
and I have some peace with the possibility that even after all of this
surgery, Mark might still lose his foot. Yes, long days and nights
here acknowledging all of the possibilities. The doctor has told us
that for many patients (people who smoke, people with vascular
disease, obese people) they would simply amputate now. But Mark is one
bad-ass mother fucker :). He is strong and healthy and has been
incredibly resilient through each of the previous surgeries,
continuing to impress the surgeons with how well he is pulling himself
together. So we are acknowlegding the possible loss, setting it aside,
and moving forward in the belief that Mark is the one to make this
surgery work. Yes! Gonna keep on movin' foward.

Some good news!......Today when Mark went in to the OR to have the
wound cleaned for our possible travel day tomorrow, it was the first
time the docs had looked at his leg since Sunday. When I talked to the
doc post-surgery, he said the tissue looked even better than he
would've expected--healthy, healing, not infected. And he said there
is NO DEAD TISSUE ON THE HEEL. Yes! He cautioned that the heel is
still a question mark, but it is still viable. Yes!

Today I got to be in the pre-operating room with Mark before this
wound cleaning I just described. The prep nurses are required to write
on the limb that is going to be operated on so as to have zero
confusion in the OR about what they are doing in there (god, wouldn't
you hate to be the guy who had a knee re-construction on the wrong
leg??!). I don't know if this is what they always write, but I watched
the nurse write a big "YES" on Mark's right leg. This pleased me
immensely! Helped me wait the 2 hours before hearing that the leg
looks good! Yes!

If we cannot get to Boston, if they cannot set up the surgery there
within a few days, we're back to difficult decisions. So if you pray,
get to it, sisters and brothers!

Mark and I feel like we are at the center of a joyous vigil (is there
such a thing?) that is worldwide. Strange that life offers us joy in
situations like these! We have heard from people literally all around
the world who are reaching out to us and meditating on visions of Mark
healthy, healing, whole, and of Mark and I coming through this
stronger than ever.

If we travel tomorrow, it will be late afternoon. We are trying to get
a direct commercial flight Denver to Boston. Mark and I are preparing
ourselves for the challenge of flying with this kind of injury. The
doctors have ordered special equipment that we'll need for draining
the wound while in transit. And Mark will get a lot of medication to
make this all possible. We're ready!

With the blessings that you have sent us, we are ready. Mark and I are
connected deeply through this craziness. We are each other's healers,
trading off being strong, being scared. We are enjoying legitimate
dependency on each other. Wouldn't have wished for this one, but here
we are.

I'll leave you with two things. First a quote from a kind and amazing
friend Dawnellen and then I'm pasting in Mark's account of his
evacuation. Thought you might appreciate his words making their way
into this thread. Sounds like Mark was an active and crucial part of
his own successful evacuation. And it sounds like the team that got
him off the rock--both the civilians who so generously stepped in and
the park ranger Search and Rescue team--were true "rock stars".

Goodnight. Hope to see some of you in Boston tomorrow.....

From Dawnellen:

"Don't miss out on a blessing because it
isn't packaged the way you expect."

No Surgery Today - August 14

2007-09-23T21:23:00.000-04:00

Hello All,

Let me tell you once again that we feel supported and loved. It is
immense, the energy and images and love you are sending our way. We
feel it and we are riding on it when we waver.

Many of you have called. We aren't getting back to everyone simply
because there is so much to tend to here. Know that the calls means a
lot and I have felt very centered and grounded by hearing your
familiar voices in this unfamiliar land. So thank you.

Just wanted to give a short update. Looks like the vein graft and the
skin graft will happen all in one sitting rather than one today and
one Thursday. This is actually good news because Mark is exhausted
just from managing the pain. He needs the rest before he goes into the
OR again. So he is sleeping as I write and he needs this rest badly.

Again, we need you to believe that this tissue on his heel will stay
viable and then and IF he goes into surgery on Thursday (I'll explain
the if part below), we'll need your help. It will be a long surgery
(8-10 hours) and the surgeon has a big task of making Mark's back
muscle and skin integrate into his leg. Again, vascularization and
non-infection are the keys to success. And that heel! Keep the heel in
your thoughts. This is all pretty weird isn't it? I'll say....

OK, the big question we are dealing with today is that now we've been
presented with the question of whether or not we want to go back to
Boston for this procedure. The MDs here are excellent, yet MGH (MA Gen
Hosp) is an excellent trauma center too. We are sorting through a lot
questions with this one regarding MD expertise, the quality of care
given at a big med center like MGH, and even some financial
considerations (MA has a great Free Care system that I am trying to
research today---Mark has really crappy insurance that is going to
cover just the tiniest fraction of some truly gargantuan bills). So,
any ideas for visualization on this one? I guess just visualize wisdom
for us for today and tomorrow as we figure this one out. Either that
or a winning lottery ticket and a private jet to get Mark comfortably
back to Boston :)

We are in good hands. And we have been singing together here and there
when we have the energy. "Gonna keep on moving forward...." (Thanks,
Pat and Sandy!)

I'll leave you with a picture that Chris and Polly Kimbery sent us
this morning. We went to college with these two beautiful people. We
worked with them at Princeton Blairstown Center. We cooked hummus and
kale with them at the 2D Coop in college. And now they have 3
beautiful boys and the 5 of them sent us a lovely message for Mark's
heel. Check out the photo (hope I was able to attach correctly).

Peace salaam shalom,

A Picture of Mark - August 13

2007-09-23T21:11:00.000-04:00

OK, on the lighter side this time so I thought I'd send you all a fun
picture. And the picture has some meaning that I'll explain below.

We are still waiting to talk to the doctor about upcoming surgeries
and in the meanwhile, I wanted to send this photo to you as part of
the visualization party we all have going at this point. (We have
loved hearing about the different ways you all picture Mark. Thank you
thank you thank you.)

A crucial thing right now is that the skin that is still intact on
Mark's right heel stay viable so that the skin graft will work---too
much explaining, but you just need to know that Mark has a little skin
on his heel and we need it to stay alive. I've been doing a bunch of
my own trauma training work on his heels, getting the healthy one to
tell the injured one what to do.

So check out this photo. Mark and I just looked at his photos from his
OB courses this summer. I hadn't seen them yet. This one grabbed me
because of the use of the right heel! Check out this weirdo! They were
doing a small river crossing and Mark decided to show his students a
little yoga.

More later.

Address for CO Hospital - August 12

2007-09-23T21:10:00.000-04:00

Hello All,

We have more info that we will share later in the day after we try to
get some sleep. The short version of the story is that Mark is likely
to go in for 2 more surgeries this week--Tuesday for a vein graft with
a vascular specialist and then Thursday for a very big deal tissue
graft. I'd like to share more details when my mind is clearer--it's
been a surreal past 24 hours.

Know that Mark is ready for this. Know also that the surgery is not
guaranteed to preserve his foot. But if this surgery is going to work
for anyone, Mark is the one. We have a lot of confidence and much of
that comes from the profoundly amazing love and support we are getting
from all of you.Our confidence also comes from knowing what a
remarkable person Mark is and how well he has come through the past
few days already. Please keep the visualizations cooking---visualize
well-vascularized and non-infected skin and muscle all around the
calf and heel of Mark's right leg! The keys to success is blood
profusion and staving off infection.

Here's the address of the hospital:

Medical Center of the Rockies
Medical/Surgical/Post Trauma--North
2500 Rocky Mt Ave
Loveland, CO 80538-9004
Attn: Mark Wiranowski Room 4102

There is a chance that we'll move to a different hospital for the
Thursday surgery. If that is the case and you do send something here
for Mark, I can swing by here and pick up cards/letters/etc and/or we
may be back here for Mark's recovery.

I will write more later today or tomorrow.

We continue to be held by your love and support.

Mark's Next Steps - August 11

2007-09-23T21:09:00.001-04:00

Hello All,

I know I had written that I wouldn't write any more group emails,
however, now that I am here, I'd love to again call on your love and
support and your powerful imagery of a healthy and whole Mark.

Before I get started, I want you to know that if you do not want to
keep getting these group updates, it would be so absolutely fine for
you to just let me know that. Please do not hesitate. Much better for
everyone involved to just get yourself off this list and you can check
in with Mark individually or whatever you want!

It is tremendously relieving to be here with Mark.
The phrase "sight for sore eyes".....my eyes are pretty sore, that's for sure!

I am writing to all of you because your visions of Mark coming out of
the Friday surgery as healthy and with a strong bone and with laughter
and resiliency were tremendously helpful and powerful.......when I
have shared with Mark the things that each of you have written or told
me over the phone, he has lightened--I have literally felt his body
relax into relief with those images.........and....now we need that
community/sangha/family power and strength and vision once again.

Mark goes in for an exploratory surgery tomorrow with a plastic
surgeon. Now, plastic surgery does not, as I first thought, have
anything to do with a cosmetic fix. He will need some sort of muscle
and skin graft because of the amount of tissue that was
lost/destroyed. We got to talk with the surgeon this afternoon and it
left us both feeling quite sobered. Mark continues to have an
incredibly positive and determined attitude and yet this is the next
hurdle that feels quite scary and has a lot of unknowns in it. Because
of the amount of tissue lost, the surgery the doctor is talking about
doing (as soon as next Thursday---tomorrow is just to clean and assess
the tissue) will be long, complicated and delicate as he attempts to
make transplanted tissue (from Mark's belly or back) connect
successfully to Mark's leg and to get it to bring adequate blood
profusion to the lower extremity.

So remember those images of Mark I asked for you to concentrate
on......all of those plus....

*an image of healthy, well-connected tissue with lots of healthy blood-flow

Also, in terms of positive outcome, the images of:

*Mark telling you about this whole ordeal months or years from now and
talking about how well it went, how successful it was, how talented
the doctor was...
*The doctor working on Mark's leg and being confident, being pleased
with the procedure, walking out to the Operating Room with a smile of
satisfaction....

Thank you thank you thank you for being with us. We are held by your love.

Mark's Version

2007-09-17T22:19:00.001-04:00

I was climbing at Lumpy Ridge with my cousin.  The climb went fine,
but we had to work our way down a sketchy descent gully.  We rappelled
off the top, but the ropes got stuck.  I scrambled up to free the
ropes, then scrambled back down.  On the way, I leaned on a
refrigerator-sized block that came loose.  I surfed down on it, and it
crushed my lower right leg between it and the wall.  (The rock kept
going, so it didn't pin me).  I landed sitting up with an open tib-fib
fracture and my muscles and such all hanging out. The incident
happened around 11:45 am, and some other climbers reached us around
12:10 pm(?).  Search and rescue got there about two hours later.  At
first, SAR tried lowering me vertically (feet first) - since it was a
technical rescue.  However, I went orthostatic (shocky, lost
consciousness), so they rigged up a horizontal lower.  They also
lowered me head first for a lot of the ride.  They gave me six liters
of saline in IV form and a few mgs of morphine.  I think they got me
to the chopper site around 7 pm.

The rescue team was excellent.  At one point, the chief medical person
called in for permission to tie a tourniquet.  I sort of begged not to
- I said that I could stand the pain, and that if they would back off
the morphine, I could focus on breathing a
lot in order to avoid getting shocky.  It seemed to work (in
combination with their horizontal and head first lowers).

They flew me to a trauma center in Loveland, CO - a fantastic facility
that has only been open 6 months.  I am really pleased with the care
that I have received here.  The staff is competent and pleasant.  I
went in for surgery the night I got here (Wed).  They put a "fixator"
on - which is basically a steel suitcase handle on the outside of my
leg which is screwed into the bone.

On Fri morning, they took me in for a second surgery.  Basically, they
said that they might just go in to clean the wound out, but that if it
looked good, they would put the bone together.  Well - they put a rod
in my bone (Tibula?) and screwed a plate into my ankle bone.

Well - the bone story is pretty happy, but the tissue story is not.  I
lost a lot of tissue, so they are talking about grafting a large
amount of muscle and skin from my back onto my calf.  We haven't
received a lot of answers from the doc yet, but we'll be insisting on
a face-to-face meeting before any of these procedures go forward.  The
upshot is that it's not 100% that I'm keeping my foot.

One extra twist coming out of this incident is that I had medical
insurance coverage that was due to kick in on Aug 15.  The accident
happened on Aug 8 - one week before.  Despite the craziness with
American health care, I feel unreasonably optimistic about this issue
as well.  As Melissa and I have been easing into the idea of raising a
family, I have been drifting towards a full-time career.  In a strange
way, I think this will provide a strong impetus to flesh out my career
(sorry about the pun).  Heck, I may spend a few years in the private
sector to help clear this thing out.  Somehow, I don't feel scared or
stressed - This is what life sent me, and Melissa and I are going to
need to figure out what this means.

Good News, Bone is Set - August 10th

2007-09-17T22:06:00.000-04:00

Mark's surgery today went very well. He's in a good place both
physically and spiritually/mentally/emotionally. The doctor was able
to do more "fixing" than he'd expected....it was thought that this
surgery might just be more "cleaning up" and "stabilizing".

I/we still don't know exactly what the next step is, but things are
looking so much more positive than just 48 hours ago! Mark continues
to have good circulation and feeling in his foot and ankle. Phew! I am
absolutely sure that all of the positive images of Mark that each of
you have shared and offered are part of the reason for such postive
outcomes for Mark.

I fly out tomorrow very early and finally get to be with him. I think
I'll end this little email mini-series now that we are moving into a
less precarious place. If you want to be in touch with us, we will
probably have email access occasionally over the next few weeks while
we "vacation" :) together in Colorado, and we'll also have our phones
with us. Please don't be shy about calling us---contact with friends
has been life-saving the past few days! And I'm sure Mark would love
to hear directly from any and all of you so he can begin to boast
about this unfolding epic!

Visualize - August 10th

2007-09-17T22:04:00.000-04:00

Again, so many thanks for all of the healing and love coming to Mark
and I. Thank you for emails, texts, calls. It means so much.

Mark is holding steady.

I've been thinking a lot about how a sense of humor isn't simply a
wonderful personality trait--it is a crucial piece of a resilient
spirit. I know that Mark is mustering up occasional laughter as he
slips in and out of the morphine haze.

The tending nurses have been wonderful as I call them every couple
hours. I can't wait to meet them today or tomorrow! (still fumbling
with flight plans).

I just heard from dear friends Sarah and Jason who live about an hour
away from the Loveland Hospital. They visited Mark late last night and
they let me know that Mark is still very much present--proudly showing
them his original X-ray!

I want to share enough detail so that your love and healing can be
well-directed but not to overwhelm any of you. Mark is doing WELL. And
at the same time, the break is a very bad one. Mark and his cousin
were climing in Rocky Mt Natl Park and at the end of the day, climbing
pretty much over, Mark was making his way down a steep talus (large
boulders) slope and a very large boulder dislodged and crushed Mark's
leg against another rock. There was a long and technical evacuation.
Mark lost lots of blood. We are blessed that there were other people
in the area who were very accident-savvy and we are also blessed that
the evac team was top-notch. We are also blessed to live in a world
with cell phones! He was flown to Rocky Mt Med Center in Loveland and
was operated on almost immediately just to stabilize, not just his leg
but his whole system that had lost a lot of blood and fluid. The
doctor was impressed with how much was intact inside the leg
considering how icky (technical medical term) it looked on the
outside. They are watching very closely for circulation and feeling
and movement in his ankle and foot. We are very very hopeful that Mark
will keep his foot.

Mark goes into a second surgery this morning at 9 am eastern time.
While he is doing well overall, his leg and ankle need all of the
positive visualization you've got time for over the next few days!
Please.....

*picture Mark in whatever way you know and love him best
*picture Mark walking along a mountain trail
*picture Mark swimming across a lake, one of his favorite things
*picture Mark laughing
*picture Mark at karyoke singing "Like a Virgin" (you had to be at his
"bachelors" party!--I'm glad I wasn't!!!)
*picture the doctor being competent, efficient, kind as he works on Mark's leg
*picture Mark kicking a soccer ball
*picture a tibia in it's healthiest form--straight, strong, pulsing
with good circulation
*picture Mark telling you about "when I came through the surgery and
everything was in great shape...."

After the First Surgery - August 9th

2007-09-17T22:02:00.000-04:00

Thanks to all of you for your calls and emails. It means a lot to have
such loving support right now and I know your kindnesses are reaching
Mark.

Mark came out of surgery last night doing very well. I talked with the
docto post surgery and he was quite upbeat. As they were going IN to
surgery it was questionable whether or not Mark would lose his foot
and lower leg. This morning his is all in one piece and his
circulation in his foot is really good. Hooray! I've talked with him
and he sounds settled and determined and ready for the next steps.

Mark will be back in the operating room tomorrow morning. Keep him in
your heart.

My mom and sister are coming to stay with me for the next 24 hours and
then to take Glory and Teacup back to Maine with them so that I can
get out to CO. I'm flying out there soon and will be there for a few
weeks until he's well enough to fly back to Boston.

Thanks again for all of your kind words.

The First News - August 8th

2007-09-17T21:58:00.000-04:00

Hey friends and family,

Mark broke his leg (right tibia) tonight while climbing in Rocky Mt
Natl Park with his cousin. I am asking that if any of you believe in
prayer, send 'em on over to Mark at Loveland Colorado Hospital. He's
in emergency surgery right now. I've talked to the ER doc who was
kindly and optimistic and marveled at Mark's health and strength but
also said that the break is bad and that tonight will be only the
first of a few surgeries.

No need to email me back---I'm probably flying to CO tomorrow and
won't check email for the next week or so. But do send Mark (and me)
all of your optimism and vision and resiliency and healing.