A Crash Course in Vulnerability and Resilience
April 14, 2021
Image: Stephane Mingot, Unsplash
After a diagnosis of bone-on-bone osteoarthritis in early January, I decided not to delay the inevitable hip replacement surgery, but to take the first available date the surgeon offered, ten days later. Since Switzerland was in lockdown, it made sense to take advantage of the pandemic in the hope of being fully fit by summer. I naively thought that the hospital stay and the recuperation period would be restful, giving me lots of time to read and write. Although I have had surgery before, I “forgot” the harsh reality of being consumed by pain and nearly 100% dependent on others.
Having surgery—allowing someone to slice your body open to remove, repair or replace a part of you—is both an act of surrender and a miraculous opportunity to extend or improve your quality of life. An operation brings you in direct contact with the very fine boundary between living and dying and the connection between pain and healing. I knew that pain was inevitable, but also that, although I have a lot of grit, my pain threshold is very low. I hoped that my pain could be “managed”.
When the anesthesiologist struggled to insert the needle for the spinal block, causing me to moan with pain, the reality of “managed” became clear. I too had an active part to play. Differentiating what was in my control and what was not became essential to my well-being. I could either waste energy being angry at the doctor or choose actively to focus on breathing deeply to relax my muscles.
The surgery itself required absolute surrender, a challenge for someone who likes to have things under control. I knew that if I didn’t trust the surgeon to do a good job and let go of my unrealistic desire to control the situation, I would cause myself tremendous stress and anxiety and probably pain as well.
Only when I relinquished the illusion that I could control something that was clearly out of my control and accepted my powerlessness could I truly accept my humanity and embrace my vulnerability. This is the human condition in a microcosm. As living creatures, we are, by definition, vulnerable. We have needs and limitations. We can be hurt, physically and emotionally, by other people or events, and we are mortal. At the same time, we have tremendous power over our lives through what we think and do.
The hours in post-operative recovery, and even the first experience of standing up and taking a few steps with crutches, putting weight on my left leg, were virtually pain free, leading me to briefly think that this operation was a piece of cake. The pain descended in the evening and at night, reducing me to survival mode, focusing on breathing and being grateful that I was in a hospital bed where I could ring a bell and ask for additional pain medication. Over the next couple of days, the scope of my consciousness narrowed to the necessary biological functions and varying levels of pain, dependent upon others for most of my needs. It was humbling.
My recovery has been much more painful and slower than I expected, giving me abundant opportunities to reflect on and learn about how to deal with pain. I’ve learned that it’s essential to keep moving and looking forward, even when it hurts, because being stuck—physically and mentally—increases and perpetuates the pain. Life is one-directional and if I keep looking back, doubting, second-guessing, regretting, I can easily make myself miserable. In moments when I tormented myself with worries about an unsuccessful recovery, it was easy to fall into a passive, victim state. I could feel my motivation, energy, and hope decrease, creating a vortex which pulled me into despair and helplessness. If I regarded my pain as endless and insurmountable and saw myself as its victim, my suffering increased. If I berated myself for experiencing so much pain, compared myself to others who recovered quickly and easily, blamed myself for not being fitter, or denied the reality of the pain by telling myself that I shouldn’t be experiencing it, I felt worse. I realized that it was up to me to focus my mind and energy on what I could do, what was possible, rather than what wasn’t. When you take action, no matter how tiny a step (in my case, literally), you realize that you always have the ability to do something, and this increases your belief in your ability to overcome challenges. This is the essence of resilience. Even the tiniest success increases motivation, confidence and hope, creating a virtuous cycle.
Pain, whether physical or emotional, is part of the human condition and when we try to avoid it, we often cause ourselves more pain. Embracing what is, in the moment, even when it’s pain, is embracing life.