I Dream of Running by Mark Stone
February 2015. When I was younger I would, every now and then, dream of flying. These were wonderful dreams. I'd be falling from a great height, and yet somehow not afraid. Then, just before hitting the ground, I'd change direction and my body would be flying along, just above the ground while a feeling of exhilaration washed over me. Since I resumed running six years ago I never dream of flying anymore. Now I dream of running -- dreams that are spawned from the challenges of waking life.
The doctor, a specialist in neurophysiology, sits across from me in the examining room as we do a dance of words. There is a word he is too polite to say, so he instead refers to my "condition". There is a word I am in denial to admit, and so instead I refer to my "injury". A condition can be managed. An injury can heal. But the word we both dance around is closer to the truth. "Crippled" refers to a debilitation that is permanent, that no therapy, medication, or surgery will change.
In 1997 I ruptured a disk in my lower back, in a moment changing me from a bold, active young man to someone who would spend the next 10 years as a cautious, sedentary, middle aged man. I gained weight, lost muscle, and plodded my way through acupuncture, chiropractice, cortisone shots, and a laminectomy. These steps managed the pain and provided some temporary relief, but at no point was I cleared for full physical activity and the return to an active lifestyle.
In 2006 matters reached a crisis point when my ruptured disk completely collapsed. Carried out of my own home on a stretcher, I was rushed by ambulance to the hospital where two days later I had surgery fusing my L5 and S1 vertebrae. Before the ambulance arrived I lay for 45 minutes in agony on the floor, with nothing left structurally to protect my body weight from crushing my sciatic nerve.
My surgeon, Dr. Booth, did an amazing job. The surgery was minimally invasive, and they had me up on my feet and taking a few steps within 24 hours. With the aid of physical therapy I progressed quickly, and within three months Dr. Booth pronounced me 80% recovered. Frankly I felt better at that time than I had in a decade. I didn't feel any noticeable limitation in my range of motion, and my back felt sturdier than it had in a long time. I worked steadily through the months ahead to continue improving. About a year after the surgery, as Dr. Booth was discharging me from his care, we had a final conversation.
"So," I say, "You said I could expect a full recovery."
"That's right," says Dr. Booth. "Perhaps some limitations in your range of motion, but barely noticable."
"So full exercise would be okay?"
He smiles. "It would be good for you."
I start naming off activities. "Hiking?"
A long, quiet pause fills the room. With a small sigh, Dr. Booth says, "Well, I can't recommend it."
After that conversation I let two years pass with very little change in my activity level. Then, approaching my 50th birthday, my attitude changed. 50 seemed like a milestone, and I didn't want to pass it continuing to be that over the hill, middle aged guy. I needed to eat healthier. I needed to get active. I needed a structured fitness plan I could follow.
Running had always been what I loved the most, so it's what I decided to try. I figured if my back began to bother me I could always switch to another form of exercise, but I knew I'd feel regret if I didn't give running another try.
I had concerns. For all Dr. Booth's miracle work, no surgeon has a cure for the damage to a nerve exposed by a collapsed disk. He told me to expect some permanent numbness in my right leg, and some occasional "wandering pain". This centered mostly in the ball of my right foot, sometimes shooting up my right calf. So I worried about the stability of my right foot. But you don't know anything until you try.
Over the next few years, running went well. I didn't have the speed (5 miles in 40 minutes, 5K under 20 minutes) I'd had when I was younger, but that was okay. Running at all was a joy and an affirmation that I had conquered my injury. I did 10K runs, a 15K, and several half marathons. My mileage steadily increased to a routine 20 miles a week, more if I was peaking in training for an event.
Finally, 3 and a half years in, I took the big step. I trained for and completed my first marathon, the Seattle Marathon in 2012. That's when I began to sense the depth of the limitations on my body. Quite simply, I cannot push off with the muscles in my right calf. The nerves responsible for firing those muscles are dead. Look at the video here. This is my attempt to walk on the balls of my feet. As you can see, my right foot simply collapses with each step, unable to support the weight.
As a runner I am challenged. Running a steep upgrade is difficult because I get no push from my right leg. Running a steep downgrade is precarious because none of the braking action or shock absorption that should happen below the right ankle is happening. The knee is the first joint on that side to properly engage, leaving me vulnerable to runner's knee or worse. At high mileage training levels my left leg fatigues from doing so much of the work. In fact the circumference of my left calf is an inch and 3/4 greater than the circumference of my right calf. My left hamstring gets tight; my left Achilles tendon flares with inflammation.
While I know that nerve damage is permanent, I felt I had nothing to lose by seeking a doctor's opinion.
In the process I discovered an ugly truth about the American system of medical care. While my primary care physician was willing to refer me to a specialist, and the neurophysiologist was quite happy to do a consultation with me, both made it abundantly clear that insurance coverage for my explorations would depend on one basic question: was my ability to work inhibited? That's the measure of our worth in the American system. Quality of life does not factor in; all that matters is whether we are afflicted by a condition that would affect productivity as a worker. Since I am not limited, I am outside the scope of insured coverage. I am free to pursue what I would pay for out of my own pocket, but will otherwise get no help for my quality of life issues.
And in our consultation the neurophysiologist makes it quite clear: while there are braces and other assistive technologies that can help support my weakened right leg, there is no therapy or other cure for my condition.
I am a cripple.
But here's the thing. Many years ago I read Pierre Boule's My Own River Kwai in which he discusses his experiences as a Japanese POW during World War II that were the basis for his novel and the resulting film Bridge on the River Kwai. There's a remarkable passage towards the end where he talks with one of the other survivors post-war. They talk about the camaraderie they found, and the journey of self discovery the ordeal forced upon them. And Boule comments that he does not regret the experience. Indeed Boule affirms that he is happy with person this experience has made him become.
In a small, small way I can relate. When you are lying in the back of an ambulance, wondering if you will ever walk again, you experience a kind of rebirth. Slowly you discover that every day you can not only walk, but run, is a gift. But it's more than just that. I genuinely have no regrets about my back injury, and in an odd but profound way I'm glad it happened to me. In the naivete of youth I remember thinking that someday I wanted to run a marathon, but never having the focus or discipline to see it through. I was scattered, easily distracted. I was active, but dabbled in many sports without fully committing to any. While that young man might have had raw running ability far beyond what I can muster today, that same young man also squandered his ability with a lack of discipline.
Really, that's the decisive point: today I do not run in spite of my injury; I run because of it. My collapsed disk in my back is my gift. It is where I found my focus, my discipline, and where I find the ever renewing joy with which I run.
And in my dreams I run. In my dreams my running is effortless. I am never tired, I am always fluid and fast as the wind. I run with a freedom of spirit that is unbounded by physical limitations. And in the morning when I wake and lace up my shoes, for all the limitations the world places on me, there is still a dreamer in my heart, running free.