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DEaVF1 Essay 6 Tuesday, April 20, 1982 5/23 (22%) candidate joints hospital surgical replacement
– Dreams, "Evolution", and Value Fulfillment: Volume One
– Introductory Essays by Robert F. Butts
– Essay 6 Tuesday, April 20, 1982

[... 4 paragraphs ...]

Several of the brightest young rheumatologists and orthopedic surgeons had my future all mapped out for me, or so it appeared, as they discussed my case. When they spoke to Rob and me I tried to listen, but my hearing was still so poor that it was nearly impossible to make out one full sentence at a time. All the doctors seemed to agree that I had a kind of burned-out case of rheumatoid arthritis, with little active inflammation. But one doctor soberly told me that I’d never walk again, or even put my weight upon my feet again, unless I underwent a series of joint-replacement operations—if, he cautioned, I proved to be a “proper candidate.”

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.

[... 11 paragraphs ...]

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 …?

What might happen to the body, I wondered, even if its psychic tenant were willing to endure any or all of those “surgical procedures”? I answered my own question by remembering accounts I had on file, explaining how people of various ages had withstood numerous, incredible operations, sometimes over a period of years. But I was horrified to think that my dear wife might become involved in a similar reality, with or without my unwitting compliance. I knew that she was far from making any decisions about surgery, but I recoiled from pushing any such suggestions upon her, no matter how fine it would be to see her on her feet. Joint-replacement operations were irreversible procedures, and I also had on file material about how they sometimes failed.

Short of outright failure, however, some of the articles I’ve collected contain the information that a conventional artificial joint replacement—for a knee, say—usually lasts only from four to seven years before loosening. A most discouraging prospect! What does one do when the insert begins to wobble? None of the doctors we’d talked to had mentioned such a possibility. (One can always claim that being able to walk for even four years is a lot better than not walking at all!) Jane and I also read that through experiments with animals medical designers are working to perfect an artificial knee joint with porous surfaces, to promote better bonding of bone to metal; it could last 15 years or more. Someday, I told Jane, and regardless of whether or not we ever choose to take advantage of any of them, we’ll be questioning orthopedic surgeons very closely about what “surgical procedures” are available.

[... 2 paragraphs ...]

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