Instructions for When It’s Too Late


Central Park Runner - photo by mckaysavage on Flickr

1.) You won’t go to the doctor for the radiating hip pain until you can no longer avoid it. Unavoidability will happen like this: you’ll be limp-running around the Reservoir in Central Park, you’ll be telling yourself you’re running, telling yourself what your college coach tells you, Just put one foot in front of the other (The athletic trainer said it was probably tendonitis, said to run easy until it stopped hurting), right leg, left leg, right leg, until a man, middle-aged and fit, wearing a neon yellow tech t-shirt, will come up alongside you, will tell you to stop running right now, which you will do because he said so, and then he’ll tell you that he works with Iraq Vets recovering from bad lower limb injuries and that they run better than you do. It’s ok if you don’t respond; it’s ok if you, obedient, answer 110th when next he asks you what park exit you live closest to; it’s ok, this time, if you end up going along with it when he insists that he’ll walk you to 110th Street. It’s ok if you cooperate when he takes his phone out from a plastic baggie stuffed in his shorts and asks you for your email address so that he can send you the name of a doctor he knows at Columbus Circle, and so he can check up to make sure you actually do go to a doctor because you sure seem “stubborn.” You’ll spell out your e-mail address. Even though you’ve been telling yourself since the first weekend of college that you are never again going to give out your email or phone number to men, boys to whom you do not want to give your email or phone number.

2.) Go to the doctor Central Park Man recommends. He’s right, you really should go. This doctor will have invented a nickname for himself. He will call himself the Rock Doc. In his examination room, there will be a life-size cardboard cut-out of a flexing wrestler, who, when you ask, the Rock Doc will tell you is “The Rock!” Get used to The Rock; you will spend a lot of time staring up at that face while you’re prone on the examination table, the Rock Doc kneading your hips and asking “Does that hurt?”

3.) Definitely get the MRI. But a warning: even though you’ve been running and walking these past few weeks, as soon as you’ve broken down and gone to the doctor, the pain will all at once overwhelm you and you’ll be crying and limping the whole one avenue and six blocks there, the whole avenue and six blocks back with the unread films tucked into an envelope tucked under your arm.

4.) The Rock Doc and the three young male PTs in their red PT polos and you will all be in the room. The Rock Doc will put the films up on the light-up x-ray reading board. You won’t be expecting this feeling, so prepare yourself: intense embarrassment. This will be the first time you see an MRI image of your body, and it will be of your pelvis, not just the bones but also the flesh as a white haze around your bones, and the part that you will zero in on is this dip—you won’t know what these parts of your body are called, the term for where these lips come together, maybe you learned the name for this dipped meeting place in sex ed but if you did, you’ve never used the word since and you’ve forgotten. Still, you will recognize the spot on the lit-up board as a part of you that you did not think the whole room would see. You have never thought of yourself as someone who is embarrassed by her body—you’re a college athlete!—but you will be, intensely so. You are a sophomore in college, 19 years old, and you’ve never had sex with anyone, you’ve never even been naked with anyone. Which you will know is probably abnormal. But, remind yourself, your mum didn’t have sex until she was 22. You are still at a life stage where you feel uncomplicatedly reassured by following in your mum’s footprints. The Rock Doc will point out the obvious crack: a long, thin black line that cuts a rivulet through the otherwise all-white hollowed plane of your hip, cuts all the way through. “A full fracture”: diagnosed.

5.) I don’t know if anything I tell you in advance will curb your reaction or if it’s inevitable that you’ll start bawling, that you’ll totally lose it, crying in a way that you have never cried in front of anyone in your conscious life, not even your mum, not even by yourself, not alone in your dorm when you are sure your roommates have cleared out of the suite. Why? You’ll block the question. Not the Rock Doc, none of the three polo-ed PTs, not the receptionist who hears the racket and comes in, not you, will know what to do. Stress fractures are bad, full fractures are worse and usually involve pins and screws. Stress fractures mean no weight bearing for six weeks and no running for three months, and full recovery is never guaranteed. If you’re a female and thin, fractures mean you’re diagnosed as stuck in the Female Athlete Triad: amenorrhea, disordered eating, osteoporosis, a three-pronged diagnosis you know many have never totally escaped, a diagnosis that plateaus and eventually crashes so many running careers.  But none of this information is enough to validate this kind of crying. Eventually, you will stop. When you do, you’ll be given crutches, a script for PT, the promise of a bill, a follow-up appointment and a plan.

6.) A dose of perspective: it’s not so bad. Fractures heal. It will be your first stress fracture, so you’ll be hysterical but not apathetic, which is worse, which is coming. Yes, it will feel like forever again before you can race, run, even cross-train, even swim, and you won’t be able to stand your life without running. But, you won’t be so scooped-out feeling and defeated as you will be when it’s your third, fourth stress fracture, when you know what life looks and feels like without running and with pain, when you know your bone age is 54-years-old. You won’t be as defeated as you will be when the doctors inject and medicate you until they’re out of ideas and then when they send you out into the world without a plan for recovery. With your first, you’ll be hysterical, disproportionately aggrieved; you will look at your body with disgust, your legs like they are spindly, weak things, everything else lumpy and useless. You’ll call yourself a slug. People will start letting you know how much you’re over-reacting, how much you’re self-pitying, how miserable you are to be around, how much worse it could be. Which you won’t really believe until your second stress fracture, when you’re not hysterical, when you’re expecting it, when you long for the shock, the stark injustice of your first.

8.) You’ll become friends with the PTs. You will think you’re their favorite. They all look vaguely alike, affable and fit, upper bodies so smoothly gym-sculpted that you imagine them taking their muscles off at night and putting them on again in the morning. They will tease you for staying on the arm-bike for so long. You’ll be the only patient who is part of the office March Madness pool. They will crowd around you when you are hooked up to the e-stem machine to see what you’re reading. You’ll be reading about early Christian female martyrs who wrote their own or part of their own life stories. It’s for a paper, you’ll tell them, and you’ll tell Angela and Catherine refused food and ate instead the pus of the sick, scabs and lice of the sick, too, which tasted, they claimed, sweet as the Eucharist. They would stick twigs down their throats if offered food. Beatrice not only refused food but cut off body parts if she desired food. They’ll be briefly entertained.

9.) Here’s the part where you won’t need to do anything. You shouldn’t do anything. You never initiate. You will be balancing on the inflatable disc when one of the three polo-ed PTs whose name is Chris and who is not your PT (that’s Terrance) will come up behind you and say, “Let me guess: you’re a …. swimmer?” Don’t worry that you won’t get the joke about your skinniness and that you, having lost the balance on your disc, will turn and say, no, actually you’re a runner, to which he will say he was kidding, that it’s obvious. When you’re hooked up to the e-stem machine, Chris will start to tell you things that he’s doing with friends, and when you say something like, Sounds cool!, he will ask what you’re doing. Usually you will be busy with school. Also, the things he is doing (bars, concerts) won’t sound worth the travel on crutches. You have become attached to routine and solitude. Eventually, he will say why don’t the two of you meet for lunch one day when he has a half-day at the PT place, and you will agree.

10.) I know what you’re getting stressed over: your routine, right? You like control, you love it. You’re thinking, doctor appointments, PT schedule, practice and, now, dating someone? When will I do my work? Will I get enough sleep? What about practice times? Calm down. You will have PT three mornings a week, but you will come in five mornings to use the arm-bike for free. Between crutches and the arm-bike, your arms will be jacked. Still, the way your body puts on muscle when you aren’t running will distress you. After PT, you will go to your morning classes and then, at noon, after the first two weeks of prescribed inactivity, you will pool-run with your fellow injured teammates, all of your crutches and boots a metallic nest by the bleachers. Three days a week you will go downtown where you’ll be interning at a literary agency, and the other two days will be crammed with back-to-back classes. On weekends, the PT office will be closed, you’ll have no classes or work, and the gym will not open until 10 am. Brace yourself. You will spend those endless morning hours restless and hungry. You never eat before working out. You won’t feel like getting out of bed because you’ll have to crutch, but worse will be staying in bed because you’ll feel like all your limbs are seeping outside of their bounds into a mushy oneness with your mattress. Try to work. You probably won’t get much done, but it will be better than nothing. Sorry, but that’s the best I have for you. At 9:30, crutch to the gym. At the gym, you will spend an hour pool-running, an hour stationary-biking and thirty to forty-five minutes crutching from machine to machine, doing everything that does not involve putting weight on your lower limbs. Then you’ll crutch over to the library; most days you’ll take the elevator but some days you’ll crutch up the three marble flights of stairs to your top-floor study carrel, your favorite, tucked-away, where you’ll spend as long as you can studying before you get too hungry—you only ever pack apples and sometimes a Luna Bar for the library—and then you’ll give in, leave, get a salad from West End Market (spinach, cucumbers, grapes, sometimes feta, oil and vinegar for dressing, please), crutch back to your dorm, hope your suitemates won’t be home, hope you’ll be able to hoard up more time alone, and don’t worry, most of the time they won’t be home. Some of the time, though, they will be. But your roommate, Annie, will be quiet and mostly friendless, too, and she will stay on her side of the room folding paper cranes and filling mason jars with them. The jars will take over her side of the room, and when she’s home, the jars of cranes will feel too numerous and bright, will make you claustrophobic, but when you’re alone, you will grow attached to them.

11.) A caveat: even though your routine will not be derailed, Chris the PT will live in Queens, and it will take over an hour to get from your Upper West Side dorm to his apartment. But you’ll kind of like it. When you ride the Subway with Chris, you will take advantage of the long stretch of time to talk. You will surprise yourself with how much you will want to talk, and you’ll find yourself telling him about books you’re reading and your favorite, hidden study carrel and about pets you’ve had and what their names were and about your suitemates and their exciting lives and boyfriends and about how your suitemates get annoyed with you when you cook because they say your cooking smells bad but that you hardly ever cook anymore, only eat West Side salads, and you will tell him what you get in your salads, your meticulously-memorized ingredient list. When he’s not traveling with you and you’re alone on the E train, you will read, and you will feel for the first time like someone going back and forth to spend the night at her boyfriend’s (he’s not your boyfriend). You’ll think of that Stuart Dybek story where the narrator on the Subway imagines his younger self on the platform glimpsing his 22-year-old self speeding by in the car clinging to his girlfriend, standing up and not holding on, after a dinner of oysters and champagne. Sometimes you will wear t-shirts of his on the Subway ride home to complete your image of yourself. But, these instructions are getting out of order because it will be a while yet before you’ll go to his apartment. He’ll say, wouldn’t you rather stay in Manhattan anyway? Meet after work? Sometimes you will go back to your dorm, but your suitemates will always be there with the dance friends, ordering Dominoes, and asking you too many times if you want any, and you will feel hurt when he makes fun of the overpopulated cranes.

12.) Sometimes Chris will disappear for whole weekends, and you will think that this is how dating in New York works, everyone says so, and you’ll feel ready for some kind of experience to happen. You wouldn’t mind getting hurt. Besides, when he’s not answering texts, you will now have more time to do your work in the library and you will be able eat your regular salad from West Side without having to worry about him wanting to go out and without having to order and pick unconvincingly at restaurant food-mysteries.

13.) Meanwhile, at PT, your recovery will continue. You will progress from arm-bike to elliptical to treadmill to outside. See, time passes. They will take you off crutches at exactly twelve weeks. It will not feel right. On the first day, you will walk outside and three blocks over to the Subway station, and your leg will feel impossibly heavy, and your heart will be pounding with the exertion. Don’t walk all the way to the Subway. Turn around and go back to the office. Look at your red face in the mirrored elevator and instead of telling yourself that you’ll never run again and that your body is turning on you, tell yourself to believe you, not them. Don’t believe them when they say the feeling is normal. Everyone feels this way. You’ll see. When Rock Doc appeases you by sending you off for another MRI and when he puts the films up on the lit-up board, when you, this time, feel nothing at your white-and-black pelvis, when your trained eyes will locate the spot of the fracture, which is now a white blur, fuzzier than the rest of your smooth, white hip plane (“Calcification,” Rock Doc will name it), don’t say nothing. He will say that after a stress fracture, the bone grows back thicker and stronger than before, and full calcification, which you’re looking at, means you are healed. You will feel the small, tolerable pain beating in that spot, the spot on the lit up board. Don’t look at the image of the spot you are feeling and believe that the image is your body, that the visible blur, the sign of calcification is more real than the small, tolerable throb, that because it’s up there and readable, it’s true. Disregard the image. Disregard the lit-up board. Later you will believe that these kind of authorized imaging technologies are ways to alienate you from your body. You will say that if you ever have a baby, you won’t get an ultrasound. You will love the certainty in your voice, the impression of conviction. But for now, you’ll go along with it even though I’m telling you not to. Rock Doc will say, “Hop on your hurt leg.” He’ll ask, “Did it hurt?” You’ll say, “A little.” He’ll say, “Normal.” 

14.) When you do go to Chris’s apartment, your mum’s voice, never far from your mind (work on that), will be there saying, If you have any doubts about having sex with someone, then don’t do it. Saying, If you sleep with someone right away or hold off, it won’t matter if he really cares about you. Chris’s apartment is nice, with a doorman and elevator, and spacious; he moved here originally with and for his recently ex-girlfriend who is a dancer. Don’t look her up and then you won’t find her name and photo listed under performances at Lincoln Center. People often mistake you for a dancer. Let me guess, a swimmer? There will be remnants of her everywhere. An entirely unfurnished room with a folding mirror. A leopard print broom, the fact that the first night you spend over, he will say, “Would it be ok if we sleep on the couch? It’s actually really comfortable,” and, he will tell you, he just is still feeling weird and raw about things, and—don’t interrupt him before he even has a chance to trundle through his explanation, don’t tell him that is totally fine, don’t tell him, the worst, that you understand, don’t stay and sleep on the couch, don’t say, “It is really comfortable!,” don’t think that the worst thing in the world is him thinking you inexperienced, don’t think that you’re helping him, that he is hurt and your role is to help, don’t stay the night, and don’t do it again, and again.

15.) Don’t have sex with him. When he fades back into the city, you’ll think that you shouldn’t have. But your sister, two years younger, is rapidly surpassing you on number of partners. Your first real boyfriend Jeremy will be intrigued. He will ask you the same question on different occasions, how long did you go out with PT guy? And it took you how long to sleep with him? Why? He will want to know why it took you so long to have sex with someone. You’ll say you don’t know. You were busy. He’ll have so many questions. The way you would talk and talk to Chris on the E train, that impulse will have dried up by the time Jeremy comes around. It won’t feel right, but for him, for Jeremy, you’ll try to think of a story, to invent a memory, to connect the sketch marks of your own remembered life into a better, a made-up memory. A memory complex, troubled, tangled, also hot.

16.) You’ll squeak in just under your mum’s benchmark, but, no, it won’t be anything special. You’ll be on the mend from your second stress fracture now, your tibia this time, recently off crutches, skinnier than even before, getting asked not just if you’re a dancer but if you’re a model, and even though you’ve switched PT places, you still see Chris from time to time. This is how dating is in New York. It will be back at your apartment; no leopard-print mirrors or fold-out mirrors to silently chastise you, to mock your feigned ignorance. Your first real boyfriend Jeremy will want to know about it, but you will hardly remember anything. You’ll remember the morning after. That morning, you will leave him behind in your dorm to go to practice, which, for you, will still mean the pool. That morning’s aqua-jog workout will be crystalline-clear in your memory. You will remember meeting your teammates. You will remember wearing the black TYR suit with the purple straps, which will soon turn brittle, the suit no longer wearable, and you and your teammates will do a ninety second on/thirty second off workout, and it will feel great.

17.) If you want to stay with Chris (which you don’t): don’t cut your hair short to just below your ear. Something new, you’ll think. He’ll say he likes long hair. He’ll still come over to your dorm after he gets off work and, if your roommate is at her desk folding cranes, will still make out with you in the upstairs printer room until you hear the elevator beep. But your make-outs will be numbered. Don’t invite him for runs with you in Central Park, assuring him that you’ll be going so slow, just starting back, that of course he’ll be able to keep up. The first run you attempt with him, don’t stop at the top of Harlem Hill and sit on your knees in the old grass and cry because you will feel horrible, because you will feel heavy and sluggish and impossibly immobile, your leg a dragging appendage, because you’ll be out of insurance-covered PT appointments and because your coach will have told you that you should be up to thirty easy minutes now and you can hardly do twenty. Crying in front of him, you’ll remember crying in the examination room and your lit-up dip and the impending walk to the Imaging Center and the three of them, PT’s, columned and identical against the back wall, and how you didn’t know their names or care. Other runners and walkers will ask him, “Is she ok?” and he’ll try to do a better job of looking like he’s there for you. You should just tell him then to go, but he’ll do it soon enough on his own. So, I think what I mean is: Do.

18.) If you had just ended it then, then you wouldn’t have gone out with Chris that evening after you left the literary agency and he met you in Union Square with the greeting, “You’re limping.” A phrase from your mum: What’s that hitch in your giddy-up? As usual you will ask eagerly about Terrance and Rock Doc and his day—always with him, this sudden need to talk, to tell—and then you will tell him about manuscripts you read and your paper on Christian martyrs, which might be getting published in a journal, and books you’re reading for your other classes and how your rehab exercises are going and that you’ve upgraded from white ankle weights to red and when even that conversation runs out, you will begin dividing your pad thai into what you’ve always called perfect bites, and you will prattle to him about your concept of the perfect bite, how, for instance, this bite right here has the perfect ratio, four noodles, one peanut, and half a bean sprout, and then you will continue to subdivide your pad thai into these perfect bites, explaining how the real thing is to make sure your last bite is the best and then how your mum—you always fall back on your mum when you run out of things to say—always does this, too, except one of her bites is always partitioned off for the dog because—and then he’ll interrupt to say, “Maybe you spend so long separating your food because you have an eating disorder.” You will stare at him. You will probably look offended, but really you’ll be thinking: finally. Finally someone has read your bone-jutted wrists and knobbed spine, the handles of your hips, your laddered ribs, the blonde fuzz on your stomach, your wall of rejections to Domino’s, victory, your adding up of the calories they so helpfully print in New York menus, and you’ll feel a kind of buzzing closeness that is like but even better than that buzzing euphoria you reach when you haven’t eaten all day and you’re still in your tucked-away study carrel, so hungry you don’t even feel hungry and reading and feeling like your head could float off away into a more complete understanding of everything, but this fizziness, this closeness, will be different, and you’ll think that you’ve lived all of this so that you could show it to him, so that he could read it and tell you the why, the diagnosis, the prognosis, what is really going on and what your reasons are and what will happen. But I’m getting your hopes up. At the Thai place, he’ll look away from you and then back at you, he’ll say, comfortingly (which is unusual, don’t get used to it), “It doesn’t matter, sorry. Every girl here has food issues.”

19.) A similar feeling to come: a year later, you will read Susan Bordo writing that our bodies are constituted by culture and that anorexia, obesity and bulimia are crystallizations of our current culture. You’ll read that our current cultural ideals are best encapsulated in and produced by the slender body because the slender body perpetuates a behavior system of self-containment and control over desire and impulse. You’ll read that both the anorectic and the obese are resisting this ideal, socially acceptable body, and that the bulimic is striving at all costs to embody our cultural ideals, consumption and repulsion. You will hole away with the book in your self-claimed carrel all Saturday, you will feel close to knowing something, you will enthusiastically crutch to class on Tuesday, where your professor will say, “Susan Bordo, she’s ok, but she is so ’90’s. When eating disorders were absolutely the thing.”

20.) You will never have told anyone except doctors—blank siphons so numerous in your life they no longer resemble people—the specifics of what you ate during those years. You were also never one that your coach said needed to see the nutritionist and design a plan for gaining weight; you weren’t the worst. When others—your mum, your sister, future boyfriends—will ask about what exactly you ate, you will answer, “Too little,” even though your daily menu will never be something that you will forget. One night, you’ll tell Jeremy. Maybe you shouldn’t do that. Maybe you should keep the numbers and specifics between you and the doctors, because when you tell Jeremy, he’ll say, “That’s not so different than what you eat now, right?” and when you stare at him, he’ll make it worse by saying, “I’m kidding!” You’ll say, “I ate hardly anything.” It’s been your secret for so long. He’ll say he knows, he’s sorry, and then he’ll tell you about the girl he went out with one girlfriend before you and about how when she ran for Princeton, she tried to get by on 700 calories a day, which was—I can tell you not to calculate, but you will—less than you, even at your least.

Photo by mckaysavage on Flickr.

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