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DEaVF1 Essay 6 Tuesday, April 20, 1982 10/23 (43%) candidate joints hospital surgical replacement
– Dreams, "Evolution", and Value Fulfillment: Volume One
– Introductory Essays by Robert F. Butts
– Essay 6 Tuesday, April 20, 1982

(8:47 A.M. Our original idea was to insert the session Jane gave this morning in one of the earlier essays. This would have been a very mechanical approach. More, it would have involved altering dates, and changing or eliminating some of the copy to make the rest of it fit—all things I dislike doing. After Jane came through with her dictation I told myself I’d know what to do with it, and awoke the next morning with the clear understanding that her session should be presented just as is, and when we received it. Jane said okay. The subjects discussed are deeply charged for us, and the physical and psychological aspects of some of them could be devastating if we allowed them to be. Presenting the session in a more isolated manner here, then, may give the reader a clearer idea of how we felt during Jane’s early days in the hospital [and later too, for that matter]. This course also lets the session serve as an automatic bridge to some of the material in the earlier essays.

So last night, less than two days after she’d held her last session, I asked Jane for some material about the central theme of her days in the hospital, both from her own viewpoint and that of the doctors who probed, examined, and discussed her and her problems. Some of them talked about her right in front of her as though she weren’t there—and, Jane said, with her hearing still much impaired at that time, she almost felt as though she wasn’t there.

[... 3 paragraphs ...]

Being a proper candidate meant that I would turn my life over to medical science in the hospital for at least a year: a year spent in therapy, surgical procedures, and more therapy, until I ended up having at least four separate operations. My knee joints and hip joints could thus be replaced.

My condition had certain drawbacks, however: The two sides of my body were uneven, so I could end up with four bright new metal and plastic joints and still not be able to walk properly. I might need a cane, or a walker. Medical science would be willing to try, however. Out of the goodness of its heart, all of its scientific procedures would be put at my disposal. True, the amount of money required for such surgical possibilities was staggering, but insurance of one kind or another could be found to carry the cost. (We didn’t have nearly enough money, but could qualify for adequate insurance by fulfilling the terms of an 11-month waiting period.) But regardless of cost, one orthopedist saw me staying right in the hospital—now that I was there—until the entire procedure was finished. Particularly if, again, I proved to be a proper candidate.

[... 1 paragraph ...]

(9:05.) The particular group of young doctors I saw, the specialists, were probably the fanciest-looking dandies that Elmira has known. They were superlative-looking young men, dressed in the latest of fashions, and even in the hospital it was apparent that they were properly clothed in the finest of social mores as well. They were in their collective way like magicians, producing wonders out of the clear air, stunning you with their charming smiles and manners, trying to win you over to some strange cause.

[... 2 paragraphs ...]

(After a long pause in midsentence Jane began to doze. Her head dipped down. Her body began to slowly lean against the right arm of her chair in what has become a characteristic pose, for both her thyroid activity, and therefore her energy, are still below par even though she’s been out of the hospital for 24 days now. By 9:17 she was asleep. Watching her tilt more and more, I wondered whether she truly had the psychic and physical reserves to heal herself—whether anybody would under the circumstances. Perhaps her challenges were too much for her. What were her limits, how much more could she take after some 17 years of ever-increasing struggle, whether or not those challenges had been chosen—some of them far in advance—for whatever reasons?

[... 4 paragraphs ...]

(9:25 A.M. “That’s all of the stuff on the Introduction, then….” And now Jane dictated the equivalent of three typewritten pages of “other hospital material” that she knew she’d eventually want to use somewhere.)

Actually, I came to realize, Jane was so terrified by the thought of those operations that mentally she shunted aside all such prospects. Only when she was home did she begin to fathom the possible depths of the physical reality she’d created for herself, with my help. To coin a phrase, she was “truly, deeply shocked.” The doctors wanted to literally cut the major joints out of her body! To replace them with metal and plastic joints inserted into the bone ends and cemented in place. Jane cried. Her voice shook. “But in spite of everything, over all those years I never felt sick until I went into the hospital,” she wailed. The glowing reports we heard and read about successful joint-replacement operations meant little to her. “Sure, for one joint, or two, maybe,” I said, then shut up, not wanting to add my own fears to her fears. But four of those operations? And why stop there? If they fixed her knees and hips, what about her shoulders? She couldn’t raise her arms level with them. “Oh, they’d operate on the shoulders, too,” a doctor told me in front of Jane, without inflection, as though we were discussing an inanimate mechanism that needed rebuilding. Six operations, then. But what about my wife’s elbows, and her fingers? Somebody at the hospital —I forget who—told us that joint replacements for the fingers and/or knuckles usually weren’t all that successful: The bones in the hands were pretty small and delicate. But it could well be argued that Jane needed to be able to write with a pen or pencil, to express her basic creativity in that particular elementary fashion, even more than she needed to walk. (It would be great if she could at least use a typewriter!) So there could be eight operations, or ten, or …?

[... 2 paragraphs ...]

As I wrote in the first essay, “the trouble with having something diagnosed as rheumatoid arthritis is that not only do you have it when you go into the hospital, but when you leave it.” Even if Jane had all of those operations—even if she ended up able to walk after a fashion—she’d still have arthritis. She was suffused with it. Our beliefs said so. So did her body, as everyone could see. “Your joints are destroyed,” Dr. Mandali told Jane, after getting the opinion of the young out-of-town rheumatologist she’d asked to examine my wife. “Do you want to spend the rest of your life inside, in a wheelchair? That’s a pretty limited existence you’re talking about there….” And Jane, trying to protect herself from the negative suggestions that had been administered to her like psychic hammerblows, ever since she’d entered the hospital, could only weakly demur on the subject of operations.

Let me quickly add that all of the doctors who examined her advanced their suggestions while trying to be helpful, and in the name of “truth” as they saw it—with individual variations, of course. To us, however, in all but one case their general unconscious biases were negative. The exception was the youngish doctor Jane had referred to at the very end of her last session. As it happened, he was the one who’d had her admitted to the hospital to begin with. He’d offered Jane encouragement as she is, and she had felt an immediate psychic rapport with him. But he was a neurologist, and we saw less and less of him as it was determined that his special skills wouldn’t be of continuing help in Jane’s situation. In the overwhelming medical view, then, as Jane said, the operations were the only way for her to go….

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