There are really three journeys—
the journey you expect to go on
the journey you actually go on
and the journey that makes the story. ¹

I can remember a few days after the operation, a package arriving. It was an A4 white envelope. It was bulky and had no postage stamp on it.

During the morning process of washing and toileting I eyed it up on my bedside locker. Gifts were important in hospital. Once the doctors' rounds and meal-ordering had finished I managed to reach it. It was heavy. I ripped it open. It contained another wrapping. I ripped that open. Oh—it was my hip. My old titanium hip, and its plastic cup. Out of the two items it was the cup that looked the worse for wear—or rather the worse for its recent extraction. They cement the cup into the pelvis and this separated one still held chips of cement. The hip itself was sleek and cool to touch.

I hadn't been expecting my hip. I'd forgotten that I'd asked for it. Now, here it was. Enough.

*

I had christened this year 'the year of the body'. Maybe it was a way of trying to be in control. In reality, a large number of years in my life had been 'the year of the body'. Childhood arthritis dictated that.

My first hip replacement was when I was 17, the next when I was 20. The left hip lasted 10 years, a good 10 years, but then routine x-rays showed the femur was 'egg shell thin'. Egg-shell thin. Could fracture at any time. The voice of the surgeon echoed around my head page 95at night. He took the left hip out and put a new, longer model in. He said both hips needed to be replaced. The left was worse, but the right was well on the way. Then he changed his mind.

I waited.

Every annual check-up I held my breath on the way into the hospital, and exhaled on my way out. Late in 2000 he said, it's time.

*

How to prepare for an operation:

*

When I got to the hospital on July 16, I felt I'd done all I could to prepare. I'd drunk the carrot juice, reduced the calories, done the exercises, turned down work, taken leave from committees, tidied my desk, changed my answerphone message and tried to get my computer to reply to emails in my absence.

You've got the 'A' team, my surgeon says as he walks into the room, indicating himself and his colleague. He has told me recovery from this operation should be a lot quicker than the last—possibly only two weeks in hospital. He gets out the black felt pen and draws an arrow on my thigh pointing hip-ward.

The anaesthetist appears. I hear you're difficult to put under, he says. I wouldn't know, I say, I'm usually out to it.

I've got myself to the hospital and I figure the rest is up to them.

After

The fog is clearing. I have forgotten so much of what it was like last time. When I close my eyes I see things in stark well-defined colours, like the movies. Is it the morphine? There's lots of movement. Vibrant swirling colours and numerous vases, vessels, page 96urns. Calabash. Shapes like bodies, like places to hold flowers.

Did I nearly die? Loud voices shooting up and down corridors jarring like nails through bone.

So much to be scared of…

*

The early days are like scattered jigsaw pieces.

I am relieved when I come round. Thank goodness it's over, I think.

The anaesthetist appears just inside the curtain.

How are you?

Okay. How'd it go?

It was dan… challenging. On a scale of one to ten, what's the pain like?

I don't like having to lasso pain into my mind long enough for it to settle on a ladder. Four, five, I say. Ten is the step before hell and I want to leave lots of room to move.

There is a phone call from my brother, from Hamilton. He and his wife are both trained nurses and they like to know the details. I haven't heard the report from the surgeon and the operation notes don't say everything. Somehow I know I've lost a lot of blood. How much? I ask the nurse. All my own and half again, I relay to Kevin. There is a pause at the end of the phone.

I later learn the surgeon did come round. That my mother was there. That he said to her the operation was horrible. Just horrible.

I leave the Intensive Care Unit and am taken back to the ward. A nurse has noticed it's my birthday and has placed a bunch of balloons up in the corner of my room. This is called day one. Thirty-nine years for me and day one for my hip. There are more phone calls and visitors slipping in and out of vacant places in my head. There is all of that. And sometime there must have been the surgeon telling me. Somewhere there must have been the details. That this hip replacement was difficult to take out. That in the process of extraction, my femur page 97fractured in three places. That now, as well as the long shaft of metal, there are loops of cabling and somebody else's bone grafted onto my thin portions.

Day two

I just want to get up. To sit up further in the bed. To race my legs up and down the corridor. There is no sleep at night. Just racing. And jangling nerves. And a nurse appearing and disappearing and visitors too. The surgeon says it's all pretty fragile. That there'll be four weeks bedrest. No sitting up any further than 45 degrees. That they'll just see how things go.

They take another x-ray. They have to transfer me from the bed to the x-ray trolley. Hip transfer! the nurse hollers down the corridor. The physio has given me a hint: press the button on the morphine drip just before they move you.

While I'm away they change my mattress. Give me the one with the motor. A ripple bed. Four weeks on your back is not good for the skin.

Day three

They are in the middle of the wash. I am naked, lying on my side. There is a knock on the door. It's my surgeon and his entourage. He hesitates until the nurse says, come in, you've seen it all before. They come in, up round the bed. I pull the sheet up under my chin, but the back half of me is there. The huge leg with a drain coming out.

How are you? says the surgeon.

I'm feeling frantic. Frantic about how I'll get through the next four weeks.

He looks upset. But it's only day three. He looks at the charge nurse: Can we set her up so she can do some work in here? He sees the jack points behind the bed. Get a computer connection… can we?

I have no mind for working. But the charge nurse hasn't ruled it out. The doctor charts a sleeping pill, and a nightly injection to prevent blood clots.

Day five

My bed faces northeast, up the valley floor to the snow-capped Tararuas. A visitor, relieved to find me alive and compos, turns his gaze and mine to the hills. If only the hospital could pull anchor.

I am trying to read the second book in Philip Pullman's trilogy. It is too much, but the image of the witches stays with me. The gulls outside are doing their own wide arcs and I imagine witches, black scratches, flying in a parallel universe across the sky.

There are long times of nothing. There are long nights. The nurse that is kind: just ring your bell whenever you need me. The nurse that isn't: ignores the tears. The world outside my door is noisy and only occasionally makes its way into my room. Some friends are staying away because it's early days, others are coming. Too many or too few. I can only hold a positive thought in my head for a second. It's as if there is a turbulent river below me, which I must cross. There is a swing bridge, but all the slats in front of me are missing. It feels like courage and I are spinning in different orbits.

Day six

The trouble is I expected there to be a pattern. I thought because the last hip operation went well, this one would too. I expected that as my surgeon's predictions were usually conservative, they would be this time. There is no pattern.

How do people cope when they wake up from cancer operations?

Day seven

The nurse comes in. We've got to move you, sorry, someone else needs the single room.

But how will I, what about when I, in a room full of other people?

We have a perfume spray, she says, it'll be okay.

While I'm anxious about privacy, I'm also hungry for a different view—the corridor, the nurses' station—anything. I'm hungry to have sounds connected to people and objects.

They steer my bed into a cubicle with three other women. I'm lucky, I still have a window view. This time I am facing the Belmont hills and beyond them to Porirua, Plimmerton and home.

Day eight

The nurse prescribes some interest in my appearance and introductions to my roommates. My mother prescribes a bright smile, messages from siblings and friends, and hands to rearrange what is too far away.

I prescribe hiring a TV for a month, and small forays into conver-sations with the women across the way. Some friends prescribe a blank book for writing. How do you begin to put words on it?

Day nine

Begin with 'the thing' I tell myself.

It is morning on the ward
and doctors sweep in like the tide
incoming to the end of your bed
or your hand
or under the covers.

One woman will have a blood transfusion today.
Another will put her foot to the ground
weigh the cast, try out the green crutches.
The third will have her hair washed
the bed steered like a 747
to berth at the sink at the end of the room.

I am so sick of being touched.

Day ten

My gut is sore and I'm dying to roll up in a ball. I knew this would be the year of the body, but I didn't know it would take such a greedy chunk of my living. And what is living anyway? It is pooing and peeing and eating and washing and being in the best position to do all four.

Day 11

My stitches are due to come out. I lie on my side and the nurse swabs the site—a line running down my thigh to just above the knee. It's a good union, she says.

A good union.
A temporary separation
and now a good union.
Thank god it's not divorce.

How does skin heal?

Day 12

You cannot go back. This is the wisdom of the cubicle this morning. Margaret says, I used to be able to cut the lawns, trim the hedge. I used to go for long walks with my granddaughter but my arthritis got worse and now I can't.

11 visitors
lots of flowers
too much asking how are you how are you how are you

Day something

Margaret is mad at the nurses.
The nurses who danced all night
and talked over our un-dancing bodies this morning.

Outside pigeons strut along the ledge
eating breakfast left by unhungry patients.

Last night the nurse massaged my leg.
Better than any pill.

Yesterday, all afternoon
the visitors stared at Peter's picture—
his tentative three-year-old steps
into circles and smiles—
arms that thread from the head, and legs
long and skinny
like string from a balloon.

Today they gave me a phone. I would rather have a leg.

All is quiet. No visitors. The room has been transformed. Malia is sitting on her bed deftly drying and plaiting her long black hair. Rubbing vanilla oil through it—and on her skin. Filling our room with tantalising smells. Malia who came to life after her shower—before that she was silent, face turned away from us and her husband. He played to us, she ignored him. But now, after being able to get out of bed and have a shower, she is different. You look reflective, someone says.

I'm thinking about my mother, she says. She has a brain tumour. She's paralysed down one side. I have to lift her. That's how I hurt my back.

Her husband returns with KFC, sits next to his silent wife and smiles at us until the curtains are closed.

Margaret hisses: that's why they all get diabetes—it's from KFC. Later, curtains opened, he offers us some of the KFC. We cannot resist, this is what our taste buds have been longing for. Later again, her husband gone, Malia says, I don't know why he brought KFC. I don't eat it.

Day 14

Morning on the ward

Hello, I'm Jeremy the pharmacist. I'm just going to take a look at your chart, if I may. He stands there, close-cropped hair, glasses, white coat, scribbling away in his hardback notebook, while out from the length of his chest on a tie, a fluorescent tweety bird sings. Someone comments on it. I try to brighten things up, he says. I've got a collection. My kids love trailing them through the house. At the end of the day I have to collect them all up again, ready for tomorrow's selection.

I hope you're feeling much better and have some nice people in your ward. We're going pretty well. Tonight we're going out to tea and it should be great. Hope you can sit up soon. Lots of love and prayers from Peta Maria.

Day 15—past the two week mark

In many ways our cubicle is like a terminal. It has times of high activity and times, usually in the evening, when it stills. It is in the quiet times that you notice its size and shape. It is a square room, with a bed in each corner. On one wall there are windows and the sky and closer along the ledge, birds. On the opposite wall is a wide doorway and through that a corridor. This is where the activity comes from. All day long there is traffic up and down—the rubbish man, the linen man, the tea lady and her trolley, the orderly with the x-ray trolley, the nurse with the toilet chair, the physio with sticks, the OT with helping hands, the blood lady, the pink ladies, the surgeons, the registrars, the house surgeons, the pregnant nurse. Up and down the corridor and in and out of our room. Arrivals and departures and those just passing through.

The other important feature of our room is the curtains. At intervals a nurse will walk in and pull the curtain behind her like a long tail. She does it without looking—a bit like a robot. It may start off with curtains round one bed. Then two beds. Never usually more than two. A flick of her tail and we're quarantined.

Day 17

I feel like I've been grafted onto the bed. My cheery roommate has gone. I have been in this cubicle the longest now. There are two new women. I am having a rest from introducing myself. I don't know how long they'll stay.

Day 19

Six kind things a nurse will do for you when you're stuck in bed:

Day 20

The visitors, the constant family and friends, the cards and letters, the roommates, even the roommates' visitors, have all become the way across the river.

I can now move myself from lying on my back to lying on my side, however I can't do the reverse. I tend to spend most of my days on my back and most of my nights on my side.

Day 21

The woman nextdoor has told the nurses and us to call her 'Vera'. She has moved from being beside me, to being opposite me. The other woman in the room, Elizabeth, has had a hip replacement and is hoping to go home soon. Vera is keen to chat and it's much easier now that we can see eye to eye. I have heard all about her children—an architect, a theatre sister at this hospital, and her youngest son with a job I can't remember. I have worked out I am about the same age as them. Louise, her daughter, visits often. Vera has broken her ankle, but the trip to hospital has seen everything else go wrong—her blood pressure, her sugar levels. Now the plaster cast feels too tight and they are thinking of putting a new, lighter model on.

Vera is introducing me to Louise. Louise wasn't at Vera's operation, even though she works in the orthopaedic theatre. I suddenly think to ask if she was at my operation.

Yes.

What was it like?

It was hard, she says.

She comes over, asks how I'm doing. Offers her laptop, it would be no trouble. She can bring it in early in the morning. She can come and collect it after she finishes for the day. I am still not convinced that email contact will bring me wonderful things, but she is kind and willing.

Day 25

Louise has brought in the laptop, but the internet connection doesn't work. She rings up one of the hospital IT people and they come and take a look. They say they can't fix it from here, but will try and sort something out from their office. My cousin has also offered a laptop.

Meanwhile Vera and I have a bubble blowing competition. On the wall behind our beds is a mottled blue and green panel. The nurses tell us it is meant to look like paua shell—that was the idea when they renovated the ward last year. I am unaware of the panel behind me, but can see Vera's. It forms a great back-drop to the bubbles rising above her head. She has told me my attempts were terrible and is now having her own go. I am telling her they don't even reach the top of the paua panel.

This becomes the story she tells visitors that night. That, and the fact that she is being transferred to the rehabilitation ward at Kenepuru Hospital, en route to home.

*

Three less than helpful things a nurse might do any old time:

Day 26

This is now called 'Tricia's room'.
Everyone here is stiff
everyone here is scared
except the ones that are dressed
and bustle like nurses
and even they are scared
of becoming patients.

Vera has left. Louise comes in and has another go with the laptop. There are too many emails and it won't download. I don't mind. We've tried and that's enough.

I don't use my phone much—it's always being moved out of the way for some procedure or other. But my sister has worked out a system that suits both of us. When she gets time she phones my home telephone and leaves messages—long messages about the latest page 105two-year-old or three-year-old happenings, or sometimes a personal concert from the five-year-old singing 'Twinkle twinkle little star'. I clear the messages in the quiet moments and it becomes one of the day's treats.

*

Thirty-two things you can give someone in hospital

red carnations
a cyclamen
a get well balloon
original art by anyone under 15
a yellow chrysanthemum
dried fruit, nuts & prunes
a pink carnation
ear plugs
a scoop of hot chips
stickers of happy faces
a bag of kiwi fruit
a plastic nun finger-puppet
a moaning back scratcher
original art by anyone over 15
tapes
a sleeping mask
a lotto ticket
scratchies
toy binoculars
pineapple lumps
a book of poems about Wellington's big weather
chocolate chippie biscuits
magazines
books
a crystal
more hot chips
face cream
bubble blowing liquid
eye gel
page 106 a lollipop
shortbread
another get well balloon.

Evening on the ward

The registrar is visiting. It is the end of her day and she looks tired. She sits on the chair by the bed. She is having friends for tea and is trying to work out what to cook. Trading recipes feels like an exotic activity. As I slide my leg in and out on the exercise board, I try and remember easy and tasty meals from my former life. You've got good movement in that, says the registrar. I didn't even know she was looking. Ahh. Something hopeful.

Day four-weeks-minus-one

Tomorrow they say I will 'sit out'
as if I am convalescing
in a southern State
and will be wheeled onto the verandah
of the family villa.

Four weeks

My surgeon isn't here. The surgeon who assisted him isn't here either, but I'm not letting anyone forget the deal. I'm x-rayed and another orthopaedic surgeon looks at the x-rays and says I can get up.

Now that it's happening I'm not rushing it. I ease my body slowly towards the edge of the bed, physio on one side, nurse on the other. Take a breath. Look out the window to the birds. Let the physio and nurse talk across me. Take another breath. They hold the leg and I move myself to the very edge of the bed. Stop again. Take a breath. One leg on the floor, their arms like crutches. A slow hop, a sideways turn, and lowering onto the seat beside the bed. A deep breath, a smile. I have made it. Now just take it slowly, says the physio. Here's the bell, says the nurse. I sit. Just sit.

My body is not used to creasing in the middle. My leg is still carrying fluid. I have lost the height of the bed, my feet are on the floor. Half an hour is enough. There will be another chance in the afternoon. Another chance in the evening. I don't need to rush it.

The bed feels fresher when I make my way back to it. A clean plate. Somewhere in there a friend from Foxton, and my mother are visiting. They leave to get a drink when I go back to bed.

Just before lunch the charge nurse arrives with the surgeon who assisted at the operation. He's just returned and looked at the x-rays. He says, I don't want you getting out of bed yet. I know you'll hate me for it, but I was at the operation. I saw what your leg is like. If it doesn't heal from bedrest you'll be put in a hip-spike; we'll have to totally immobilise it.

There is nowhere in hospital to cry. My mother and June are allowed to stay over the lunch break. The curtains are pulled. They try and cheer me up. The charge nurse prescribes a pillow with the surgeon's face on it for punching. But I don't blame him. It's the frustration. The plan you've been working towards, that gets shifted.

My friend June is full of ideas. She says, the body listens to the mind. There is power in imagining. My mother listens to her. Can other people do the imagining for that person? This is the question of the mother. We can all do it, says June. We can all imagine the healing. To me she says, you need to come up with an image. Use your art. Use your swirling colours.

I do not want to. I have had enough.

The afternoon nurses' shift arrive. They do the rounds. I'm your nurse this afternoon. They don't ask how are you. They say, I heard. What a bummer. They say, you don't want to be in a hip-spike.

Day four weeks + one

This is the image cobbled together from everything. I cannot bring any bright colours to mind, the image is in gray. It is of an old old woman, a nun. She is frail and blind. She uses a frame to walk. She walks so slowly that you don't think she's moving, but she is. I think of her during the day, doing something I can't do. I think of her at night. Her slow steady movement. The crone walking the bone. Knitting me together

*

Hulloa Patricia

Hey we've just read your letter—thanks! Mum had updated us about the surgeon's recommendations so we're praying specifically for bone growth and strength.

By the way, we like to get letters, but don't let it be a pressure. I'm happy not to receive replies, especially as I know it can be awkward.

love from us all!

David

Hi there mate

Hope the nurses are looking after you okay. What do you think of my artistic efforts on the front of this card???

love from Wendy

Four weeks + two

There is a new woman in the ward, Diane. She's just come back from theatre. I expected her to want quiet, but by teatime she is sitting up and wanting something to eat.

She says there were two things she really wanted to get done before coming into hospital, the first was make a will, the second was to get her hair roots done. She only got time to do one. Glad I didn't waste my time on the will, she says.

Four weeks + four

Diane says being in hospital is a bit like being on a long flight—trying to find ways to sleep, unable to settle to a book, a magazine, another book, some airline food, a play on the Game Boy, back to the magazine.

Our conversation is interrupted by a commotion in the corridor and we learn the pregnant nurse has just gone into labour. We imagine her in the maternity suite a floor below. We hold our breath like friends, or mothers. That night we tell our visitors: the pregnant nurse had a baby girl.

Morning on the ward

The charge nurse has brought me in a gift. It is a farting gnome that was given to her husband for his 50th birthday. Apparently he is happy to lend it to me. The gnome looks like your normal garden page 109variety, but is made of plastic and has batteries and a recording inside. When someone walks past and breaks the sensor light the recording is triggered. The gnome has a repertoire of about five farting sequences, so someone walking back and forth is likely to get a different sound each time—short, loud, virtuoso.

By the time breakfast is finished and the doctors' rounds begin, the gnome has been placed in a strategic position on my bedside table. By the time the surgeon makes his way into my room, his entourage has doubled and nurses are hovering just outside the door.

How are you today? he says, standing just back from the end of the bed. Fine, I say, smiling.

I hear there's something a little different in here today, he says, moving closer to the bed. The gnome lets rip. He smiles and leaves. One of the other surgeons stays behind briefly to experiment. Very funny, he says.

There is a steady stream of visitors to the cubicle that day, but it's the woman in the bed directly opposite who enjoys the gnome the most. He set me off, she explains to the house surgeons as she and the gnome echo off each other.

Evening on the ward

The nurse says there's a call from my friend Wendy and hands me the ward phone.

Hi Wendy, hey could you ring back on my phone—the ward might need this—

No

Are you okay?

No.

Has something happened? It's Paul. He's dead. Oh Wendy. What happened? When? Was he in an accident? No. He killed himself.

After I get off the phone Diane says, are you alright? I don't know how I am. Paul is Wendy's eldest son. Diane tells me of her sister, who took her own life in her 20s.

Five weeks

I am up. This time it's for real. No x-ray, just the nod from my surgeon and I'm allowed showers and trips to the toilet. The word from the nurses is that they didn't know I was so short.

Paul's death notice is in the local paper.

Hudson, Paul Roderick—On August 21st 2001, tragically, aged 17 years.

I talk to my visitors about it. We look at the line-up of cards along the windowsill. Many have been sent from Wendy in New Plymouth.

Five weeks + three

I am allowed to go swimming every day. The water is warm and my body seems to take to it as if I have never been away. I am allowed to touch my foot to the ground of the pool but not put weight on it.

My mother has ordered me a massage. My friend Marie arrives, closes the curtain, lights the incense, plays the soft music and eases circulation back into my muscles and skin. When she leaves I feel connected again and my body just wants to shake.

Paul is buried today.

Five weeks + five

My knee is not able to bend much. All the bedrest has stiffened it up and the surgeon is not sure why. Sometimes it happens, he says. Collateral damage.

I am back from the pool and two friends pop in. We chat. Now that I'm off the bed it's easier to say how I am. I'm scared. I don't know how I'll manage when I go home. I have lost so much muscle, and movement. They try and think of ways it might work. They offer husbands for help.

I tell them I always had it in the back of my mind that I might need to go to Queen Elizabeth Hospital in Rotorua to get moving again. But I don't know that I can face more hospital, and being so far away from home.

Another visitor, Liz, arrives. She brings Paul's funeral booklet. We put it on the windowsill with the cards.

Three kind things a nurse will do for you when you're allowed out of bed:

Six weeks

Each day is a bit better. I'm still frantic about the knee, but I can sit more easily and think of moving myself more—suddenly realising I might be able to put my dressing gown on by myself, or sit without the pillow on the footstool.

I have asked my surgeon if he will refer me to Queen Elizabeth Hospital. He thinks it's a good idea. What is Queen Elizabeth Hospital? the nurses ask. I say, it's like boot camp. Up at the crack of dawn and working all day. Five days a week. You live in and all you have to concentrate on are the exercises.

*

Peter, my nephew, has drawn me another picture. A big circle, two dots for eyes, a dot for the nose, small handles for the ears and a wide scribble of hair that hovers, like a halo.

Elizabeth, who was in our cubicle three weeks ago, has just arrived back after dislocating her new hip replacement.

Last night four admissions at 4am.

Six weeks + two

Today I stood at the basin to brush my teeth.

Seven weeks

The physio arrives beside my bed with crutches. They are called gutter crutches. There is a small gutter that you lean your forearms in.

I stand up. Prior to this I have been using a walking frame, pushing the frame and swinging the bad leg through. The physio moves the frame away and stands a crutch either side of me. I take them and lean. You put both crutches in front of you and then swing your leg through, she says. I try, but the lino looms and sways in front of me and I can't move. It's okay, she says. It's too soon. Practise with the page 112 frame over the weekend really consciously moving your leg through. We'll have another go on Monday.

Seven weeks + three

My bowel empathy has been all used up.

The surgeon has said I can leave once Queen Elizabeth Hospital is sorted. I am hoping to go straight from here to there. Nurses are lining up to be my escort. In my fantasy I catch a hospital helicopter.

Seven weeks + five

Elizabeth, wrapped in a hip-spike
plaster round her middle
and down one leg
is losing herself in a book
called Icebound.

This afternoon, scared of falling
and another dislocation
she talks to a social worker
about packing up her house
and the possibilities of rest homes.

Eight weeks

It is Monday. The sky stretches wide and blue behind the Belmont Hills.

The charge nurse comes in, sits on my bed.

I've heard from Queen Elizabeth Hospital but they can't take you for three months, she says.

What?! But I emailed them before I came in. They never talked about that kind of waiting list. How am I ever going to get going again if I'm waiting around that long?

She says, you're expecting too much of yourself. You've had major major surgery. Everything that could go wrong, did go wrong. You've done much better than anyone thought you would.

It's as if she's handed me the last piece in the jigsaw. All morning I fiddle around. I write thank-you cards. I imagine phoning up Queen Elizabeth Hospital and demanding some action. I imagine my desk, page 113my computer—everything at my finger-tips. I'm up and dressed, walking with crutches. What am I doing here? I ring the bell for the nurse. I need to go home, I say.

*

Postscript

Once home I contacted Queen Elizabeth Hospital. A couple of weeks later I flew up there for three weeks rehabilitation. In the following months my knee regained most of its movement and the new hip began to move more easily than the old.

NB: Some names have been changed to protect privacy.