Structural Cracks

We are coming up to SEVEN years since Vernon’s accident took place so I thought I’d share some reflections I pulled together a few months ago.

One of the metaphors that keeps returning to my life is the idea of a structural crack: how the tiniest fissure can go unnoticed over long periods of time but eventually knocks the whole building down. We can blame any number of things, the bigger the better, the more obvious, the easier. But it’s often the little mistake, the repressed secret, the unrecognized trauma, that is the core culprit. It’s so small, patient, and silent, that no one even notices. It can take years, even generations, to do it work, like dripping water on stone. But the longer it goes unnoticed, the more expensive the damage.

When I went to the hospital ER the night my husband was hit by a truck, I was told he might not make it through the night. He hadn’t been breathing when the ambulance got to the scene, so their resuscitating him was the first miracle. I was told he’d broken his pelvis, some ribs, his femur, his jaw, and his left forearm. Also as he’d hit his head very hard, they would have to induce a coma to keep his brain from swelling. There was no telling yet if there would be lasting brain damage, but the surgeons would be working all night on his bones.

He did survive the night, and when I saw him next, he looked like a mummy, all bandaged and splinted in his bed. In the days that followed, there were more surgeries, but the most impressive one was on his forearm. It was overseen by a young orthopedic surgeon whom the staff raved about. Apparently he made lego structures at home to problem-solve the details of his patient’s fractions—a genius. We knew we were in good hands with all of them. I was told that comas were important to keep the body functioning at the quietest level possible. And indeed, his healing seemed to be quick, at least as far as his fractures were concerned. I imagined it would take a lot longer to heal if he was constantly having to move around in everyday life. It would certainly be more frustrating.

But of course, there were other problems. More tests, more surgeries. His kidneys broke down ten days in due to some reaction to something I can’t remember now. So there had to be 10 hours of dialysis a week. A tracheotomy was performed so he could eat through a tube. Physical therapists would come in, moving his arms and legs, so the muscles wouldn’t atrophy, but his ankles hardened in a pronated twist, his right arm postured tight to his chest. (These were not the bones that had broken.) By the time he was awake, a couple months later, it did appear there was some brain injury, his short term memory completely shot, but his bones had healed as if they’d never been cracked. It was the one part of his body damage that we could forget about, as messy and dramatic as it seemed the first night. A good thing too, as for the next two years, all the other problems would only grow, requiring constant care. It was a frustrating frontier for everyone, and ultimately a slow decline to his death.

But that is all just background. With so many other things to keep our eyes on, it was very strange that years later, I noticed one day that his left wrist had become swollen. Had he banged it up somehow in the night? Was it a reaction from the unused emergency dialysis stent in his elbow? The swelling got worse—soon it looked like an inflamed balloon, so we sent him in for more tests, and were shocked to find out the arm had somehow broken. He hadn’t fallen, that anyone knew. The only thing we could tie it to was the original fracture, two years before. Somehow it hadn’t fully healed, although the initial x-rays had shown it had. The crack must have been so thin, it had gone unnoticed. Vernon was not one to use his arms much, he couldn’t even feed himself, let alone eat. So how had this happened? We never found out, but another surgery was ordered to reset the break. He was supposed to wear a hard cast, but of course, he only understood that it was uncomfortable and he took it off. Another cast was ordered, he managed to squeeze out of that one too. We could only laugh now, imagining Houdini at work when we were looking away. With all Vernon’s other functional problems, the arm was comparatively such a small issue.

One day, not long after, he was sent to the hospital with Sepsis. He’d survived the infection once before, but I knew it was unlikely he would again. His body was so much weaker now. Somehow it had gathered at the dialysis port in his chest, so they would be unable to dialyze. Fortunately, there was that port in his left arm, embedded just in case this sort of thing happened. But his reset Popeye arm was still swollen, making the port impossible to access.. At this point, I was told they could try to add another port in his right arm but it would be very hard on his body and probably unlikely to last long. So there was no choice but to end the life support to his kidneys, and a few weeks later, he was gone.

So what was it that killed him? I could say it was the brain injury, as it kept him from ownership of his own physical healing. I could say it was the kidney failure…indeed, that was the written cause of death. I could say it was Sepsis, the infection that corrupted his life support channels. These things might have been the cause at any point, the elements of a perfect storm. But I also know that it was that internal, overlooked hairline fault, the tiny piece of bone that didn’t fully heal, that initial crack of the arm hitting pavement that was at the heart of this particular storm. Who knew you could die of a broken arm?

I think about this a lot in my own emotional healing work, as I try to piece broken parts of my life together, wondering why they just don’t seem to fit where they used to. I do believe that the heart of our trauma is often unconscious. But that doesn’t mean it isn’t doing its powerful erosive work under the surface. Stay mindful when the cracks begin to show. Don’t ignore that niggling memory, that intuitive itch, the symbolic swelling—this might be the very clue to the thing with the power to bring the entire structure down. The body keeps score.