Monthly Archives: April 2017

On the Sunrise View

About six months ago, I took a hard fall on a wet road. I wasn’t doing anything heroic—just coming back from taking the trash out at the field house in the foothills of Rainier where my advisor and I were staying that weekend, with seven undergraduates taking her fall quarter community ecology class. In my memory, I managed to slip spectacularly on a shoelace that was tucked inside my boot. All particularities of my gracelessness aside, the upshot (downstruck?) was that I fell, decisively, on my right knee. Stars were seen; breath was lost; tears were shed. Some combination of embarrassment, bravado, and a feeling of responsibility—I was the TA for the class and didn’t want to be the cause of delay or inconvenience—prevented me from mentioning much about this to anyone else. I limped over forested slopes with our students for the rest of the morning, and later drove over a hundred miles back to Seattle with my un-rested, un-iced, un-compressed knee twanging like a banjo and crunched into a very un-elevated position.

I had some x-rays taken, after three months with little improvement in pain. Here they are:

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“On the sunrise view,” wrote my doctor, “there is a stepoff consistent with fracture, but this is not evident on the lateral. On the anteroposterior view there’s a subtle lucency superomedially…consistent with a longitudinal fracture of the patella.”

Aside: I love sunrise view. It’s an x-ray taken with a bent knee, so you can see between the patella, rising like the sun, and the horizon of the femur. It’s the bottom right image here.

Surprisingly enough, I didn’t write this post to describe my knee injury. I wrote it because what I did to my knee that day is going to be something I carry with me for the rest of my life. The bone damage has likely healed, but joint fractures are quite prone to post-traumatic arthritis, and it seems likely I also crushed my patellar cartilage. (Alas—adult cartilage doesn’t repair itself.) Six months of rest and physical therapy later, I’m back on my bike every day and in the mountains every weekend, and most of the steps I take are pain-free—but I still feel a knife in the kneecap whenever I squat deeply or take a steep step up or downhill. It’s also taking a long time to unlearn the sneaky habits I formed in the immediate aftermath of my fall, when I started favoring my right leg to avoid the pain of putting weight on it.

I know I’m burying the lede here—not entirely unintentionally—but as my knee goes, so goes my brain. It’s no particular secret to most people who know me well that I have lived most of my adult life with depression. Major recurrent depression, according to the lovely Berkeley psychiatrist I was lucky enough to see several years ago.

Aside: I used to hate psychiatrist, but after I knew that the Greek iatros, which means “healer”, may come from iaino, “to heat, warm, cheer”, it became easier to appreciate. I take a small pink tablet each night, and so light a little warming fire under my soul.

What I want to say about depression, because I think it bears talking about even though, or perhaps especially because, I am currently quite well, and very grateful for my life—is that for those of us who have it, it never fades into memory.

Depression can bring acute pain, and this takes different forms for different people at different times. Once, I stared at a tear-slurred face in the mirror in a hotel bathroom in Hong Kong, attempting a smile but succeeding only in a terrifying rictus. I remember grabbing my cheeks in both hands and moving my muscles roughly around, in search of the person to whom the face used to belong. I was utterly unrecognizable to myself. That injury was fresh.

But these days, things are good. They have been for many, many days past; and this month, in fact, they’re great. I passed my PhD candidacy exam 11 days ago, which means if nothing else that five people whom I respect immensely believe I’m probably going to be capable of finishing what I started. I won a few small awards this season that I can use to fund my field research. My lab is changing, and while I’ll miss my amazing lab mates who are graduating soon, I’m so proud to be part of this lineage—and amazed and excited that I get to play the role of “older grad” to those who are joining us. I’m doing what I love, in a city I love, I have a climb of Mount Baker on the calendar for early June, and I might get to see my whole family again in December. Of course, I know that every hill rolls inexorably down to a valley, but this is my life right now: steady, satisfying.

And yet, while most of the steps I take these days are pain-free, depression continues to show itself. I honestly don’t think about this very much, because I’m so used to it. But when I woke up in the middle of the night last week with the most cynical, jaundiced, privative thoughts running through my mind—at a time when I should have been feeling proud and relieved—I think I finally realized how deep this scar tissue runs.

Here is the prosaic truth: I’ve gotten very good at batting away its attack, but every single day, multiple times a day, something inflames my immortal mosquito of fatigue and self-loathing.

Occasionally, this strikes me as deserved—because I think I am, in fact, all the things it accuses me of being. More often, it strikes me as ridiculous. Ungrateful. Unproductive. But most of the time, it doesn’t strike me for very long as anything at all, because I forget about it in a moment…until the next time.

I don’t really know where this is going. I really just wanted to share it because I know that from the outside, I generally look like I have a good head on my shoulders, and I can take stairs on my bad leg. I have been incredibly lucky—or as Ross says, unlucky to have the brain chemistry I have, lucky that it responds to treatment. And I still have to listen to this crap from my own brain. So if you hear it, too, or more, you’re not alone. And if you don’t think you know someone who does, remember: Some things are only visible on the sunrise view.