The human cloth
The end of physical growth is I suppose a sort of rite of passage. High tide. They measured me at the hospital twice in one day, just for the record books. In the morning I was four foot nine and one eighth inches. Comfortably taller than Edith Piaf. They measured me again at the end of the day — since the spine compresses in an upright position, even an upright position as approximate as mine. At the end of the day I measured four foot eight and seven eighths inches. Still just a little taller than Edith Piaf. She was the lady on the radio who had no regrets (and showed you how to roll the French r correctly, at the back of the palate), but wouldn’t she have wanted to be a tiny bit taller? I couldn’t see that she could object to that — in which case she must have at least one regret, about being so diminutive without the robust excuse of bone disease. This was logical, but human beings, as Mr Spock was not the first to point out, are not logical.
There was logic, though, to the plan laid out for me in my next phase of life, logic in abundance. I would be having artificial hips installed, first one and then the other. There would be plenty of recovery time between. More than the standard period of rehabilitation would be required. I would spend whole months after each operation learning to use my legs. I wasn’t starting from scratch, exactly, but the last time I had the benefit of functioning hips had been when I was three. It would be a long process learning to manage such amenities again. For my years of bed rest I had lain down, then gradually I was able to add standing up to my repertoire, but there hadn’t actually been anything in between, unless you count lying rigidly at an angle in one wheeled contraption or another. Now whole teams of professionals would be devoting themselves to extending my world of movement. It would be a year-long crash course in flexibility.
So I had a good long time to wait before going to Burnham Grammar School, which wouldn’t happen until the autumn of 1967. Educational normality wasn’t bearing down on me at any great rate. 1966 was an interregnum, a sort of premature gap year, but I wasn’t exactly going to be idle. That gap would be filled to bursting with activity — even if it was largely activity that would be visited on me, namely surgery and physiotherapy. Cutting and then stretching the human cloth. My diary was empty but my days would be full.
The good news about the hip operations was that they were allowed to hurt. Ansell was clear about that. The pain from my epiphyses had been unauthorised. The medical authorities had not accepted its bonafides. It didn’t meet their standards, and they threw it out of court.
Of course pain is unreal, and naturally it’s easier to be sure of this when the pain is someone else’s, but I felt it was a little presumptuous of medical science to be so selective, to single out my knee-pangs as bogus with such confidence. Now, though, I was going to have some respectable pain, licensed pain, pain that could hold its head up and have its docket stamped, its credentials accepted by the British Medical Assocation.
Ansell didn’t use the word ‘pain’, not out of squeamishness but professional exactness. The phrase she used was ‘a certain amount of discomfort’. This would be alleviated briefly with Pethidine and then with Panasorb. Pethidine a strong jamming signal blocking the reception of pain, Panasorb a soothing background hum in the nervous system. Ansell was optimistic, telling me that for the operation to be successful all I needed was a little muscle. And thanks in part to my childhood GP’s advice on flexing the quadriceps, that’s exactly what I had. I had a little muscle. Bless you, Dr Duckett! Bless your isometric cotton socks.
Physiotherapy, to take place before the operations as well as after, would help to build that little muscle up into a rather more competent bundle of fibres, able to fling my new hip all over the shop, or at least to steer me around nimbly enough.
Artificial hips — arthroplasties — were more or less new technology in those days. Spare parts for the human body! Running repairs. The stuff of science fiction, like the moon landing that hadn’t happened yet, like the automatic doors that still haven’t. Nowadays everyone’s auntie has had hip replacements, but back then people didn’t even call them that. Nobody said that I was going to have hip replacements. I was going to have ‘McKee pins’.
The idea of mending joints goes back quite a long way. The challenge for those who set themselves to repair nature’s failings (above all for the benefit of arthritic patients) has always been to come up with a material that was compatible with human tissue, but strong enough to stand up to the great forces brought to bear on the hip joint. Early candidates included gold, magnesium and zinc, muscles, fat, and pig bladder. None of these cut the mustard. A home-made joint is a tall order.
McKee’s breakthrough came while he was tinkering with cars and motorbikes. He thought it was a shame that you couldn’t simply replace components in the body that wore out or broke, and he wondered if it might not in fact be possible. His was an engineering perspective, and he set out to solve a medical problem in those terms.
The first operations to install McKee pins were done at the Norwich and Norfolk hospital in the 1950s, but it was years after that before they became anything like routine, and then only in certain cases, rather extreme ones like mine By the time I came to be a possible candidate for the pins, only a few hundred operations had been done. It was still a big step.
The new hip joint would be metal on metal. Partly plastic joints were being installed by Sir John Charnley, but they were still experimental. Metal on metal was tested and predictable. Metal on metal joints had been shown to work well and would last for literally years.
Nothing ages more quickly than progress in medicine. Soon this year’s startling new technique resembles nothing so much as a blood-caked saw from two centuries back.
Up to the arseholes in bliss
Mum had her worries and I had mine. Mum was worried about the operations, though she wasn’t worrying as an ex-nurse, but as a practising needlewoman. She knew from Dorothy Foot’s sewing circle and the skills which she had developed there that sewing three pieces together was always tricky. Two was a doddle, and four not much harder. But three was no joke, whatever the material, whether it was corduroy or human tissue. In the case of actual surgery, a neat piece of darning wouldn’t just be a matter of wanting things to look nicely finished off — it would be about securing a strong supply of blood to every part. Arthroplasties weren’t plain sailing and they weren’t plain sewing.
I wasn’t worried about the surgery in store for me so much as the nursing. I would be lying motionless in bed for considerable periods of time. It wasn’t the return to childhood confinement that I feared, though it would certainly test that elusive thing, my illusion of making progress in life. It wasn’t even my hips that I was worried about — there was no worldly oracle I trusted more than Ansell — but my bottom. I dreaded a return to CRX conditions of bottom-wiping. My worry could be summed up with a quartet of terrible words: Standard Hospital Bedpan Procedure. In my days of bed rest, Mum had been there to attend to me, Mum who was a dab hand with a kidney dish, but she wouldn’t be on duty now. Besides, I was a teenager now, too old to be babied in that way, but not ready for the psychic sandpaper of having my tender parts wiped by someone for whom it was the most degrading part of an unrewarding job.
In the end Mum made enquiries. It turned out that the bedbound life was going to be much less of an ordeal in the 1960s than it had been before. Hospitals were better equipped now. There were special mattresses made in three sections. All the nurse had to do was slide out the middle section and place a bedpan underneath. Bob’s your uncle and Fanny’s your aunt! I would be in heaven, comparatively speaking.