17 January 2013

Arm

For six weeks, Lizzie had been taking a sailing class.  They'd go out on the Dunedin harbor and zip around in little Sunbursts, with their wetsuits making the bitter water more manageable.  When she began, I'd been worried that some disaster might happen, like the boom swinging around and hitting her in the head.  Actually, that did happen - during her first class! - but Lizzie shrugged it off, iced it down, and happily went back the next week.

A week before Christmas was the last outing, and they had a barbecue to wrap things up.  Barbecues aren't usually that fun for vegetarians, since we could have any of the sausages ("saucies" - Kiwis love a good abbrevo).  But there was salad and pasta, and the sun was shining, and everyone had a good time chatting over their food.  It was a wonderful Sunday.

Afterwards, Lizzie and I walked over to the nearby stadium, where there was a combination farmer's market/flea market.  Forsyth Barr Stadium is a hideous and expensive mistake, but the little market that huddles at one end of the rugby pitch is adorably bizarre.  Among the stalls are a table of books (coffee-table books about rugby and Sidney Sheldon paperbacks), a card table vending Indian food, the inevitable bacon sandwich cart ("bacon butties"), and plywood racks with someone's handmade concrete sculptures of birds and hobbits.

We watched a soccer game for a few minutes before becoming bored (apologies for the redundancy) and headed outside.  I had my bike and Lizzie had the car, so we decided to meet at my office, where I could lock up the bike and get a ride home with her.

"I bet I beat you there," I said, grinning.  But I didn't.

The route from the marina to my office only takes five or ten minutes.  Up past the stadium, down the footpath across the sluggish Leith, take a left on the one-way, and then a right turn to the university.  I've been commuting everywhere by bike for a couple of years now, and so I zipped easily along.  As always, I kept a sharp eye out for cars and their lax drivers - only six months ago, I'd been tapped and run off the road by an SUV full of teenagers that had turned into me without looking.

As I came down off of the sidewalk by the university's fitness center, dropping down onto the street to cross, my bike's front tire slid along the curb for a moment.  And, as it happens, there's a lip of asphalt sticking up there slightly, and the space between concrete and asphalt was just slightly smaller than my tire.  It rammed into place and stopped, like it was seized with pincers.

Front tire stopped.  Bike stopped.  I kept going.  I went forward over the handlebars, mouth agape.  I had time to notice what was happening and produce a single thought: Oh!  Huh.  Then I landed like an arrow, slamming into the street on my elbows and face.

I lay there for a moment, and I think I groaned.  My arms and head hurt, pretty badly.  But I was also lying in the street, so I got to my feet, with one false start of spiking pain when I tried to lean on my right arm in the process.  I wasn't afraid of being run over, but just extremely embarrassed.

I got back on my bike, making a small sound of pain (my dignity does not permit the word "whimper"), and pedaled a few minutes more to my office.  On the way, Lizzie passed me in the car, beeping a hello.  She might have waved.  I did not wave.

Once at the office, I went into the bathroom to assess the damage.  I picked gravel out of my elbows as best I could, and washed away the blood with hot water and soap.  My head and face were unharmed, so while I distinctly remember landing on my left cheek, I might have just been confused.

Lizzie was alarmed, of course, but I assured her that everything was okay.  A little accident, stiff arm, some pain, no big deal.  Okay, my elbows were swelling up and I couldn't much move my right one, but I was sure that it was just a little scrape-up.  If it got worse, I said, I'd see the doctor tomorrow.

It got worse, of course.  I'd broken one of the bones in my forearm, the radius, at the radial head - where the knobby end of the bone sits in its socket.  By the next day, my right elbow was frozen and swelling up badly, and I went to Student Health.

Weirdly, I was worried about the cost of my injury.  I'd been brought up in the American system, where a broken arm means that you're going to be out of pocket for your co-pay.  It's a habit of thinking that's hard to shake, even in New Zealand, where the Accident Compensation Corporation (ACC) takes care of everything.  ACC is a government program that Lizzie and I had been paying into with every paycheck, so I suppose it's a good thing I eventually got some use out of it.*

Here in New Zealand, though, they saw me immediately and directed me to the Fracture Clinic at the local emergency doctor.  It was the standard emergency scene, pale children and sullen young men, but after only a few minutes they ushered me back for an x-ray.  Upstairs, a gruff Irish doctor looked at it for a few seconds, then pronounced, "Well, you've broken it."

It was only a few days after the Newtown school shooting, so as I sat in the clinic and a nurse began to trim a thin gauze sleeve to fit my arm, they asked me about guns in America, and demanded to know why American politics were so insane when it came to firearms.  I wasn't in much of a mood to be an emissary, so I changed the subject to Christmas vacations, which gave the doctor an opportunity to glower around with a generally baleful look and pronounce everyone else a shiftless reprobate who got to go on vacation while he had to stay and work.

My arm had to be twisted slightly so the bone would sit right.  I felt a slight grinding, but mostly it just hurt.

After the nurse covered my arm with the gauze, she brought over rolls of plaster and a bucket of water (I asked about it and was told it was not a special medical bucket) and began wrapping my swollen, painful limb in sopping bands of plaster-infused fabric.  Immediately, the chemicals in the mix began to react and heat up, and within a few minutes it was hardened.

It was necessary to put the whole arm in a cast, from hand to shoulder, to stop me from both bending the elbow or twisting the wrist.  Try putting your hand palm-up, and then swiveling it to palm-down.  Notice how the bones in your forearm twist over each other?  If I had done that, then the radial head would have moved and set improperly.  This type of movement, I have learned, is called pronation and supination.  Motion of the elbow is extension and flexion.

I walked out of the clinic not a penny poorer, but with one arm covered in rock.  It was heavy and primitive, but they couldn't put on the fancy fiberglass cast for a week.  They had to wait for the swelling to go down, since my arm was half again as large as normal.  Unfortunately, the plaster would disintegrate in water, so in order to use the shower I had to wrap my arm in a towel and then a huge plastic bag.

One thing that was strange was that they gave me no medicine.  After speaking with a few natives, I discovered that this is apparently normal.  I took some Tylenol.  It was insufficient.

A week later, I returned for another short visit, where they replaced my cast with a fiberglass, waterproof, bright-red new one.  It was immensely lighter, much easier to take into the shower.  Even with this one, I couldn't type very easily and my back still hurt from the weight, but I quickly got used to it - even if my arm sometimes seemed like some alien, inanimate thing hanging stiffly from my shoulder.

After three weeks, they took the cast off.  The bone was only half-healed, but leaving the elbow fixed in one position would have limited the speed of recovery.  The tool they use to cut off the cast looks very strange, and if I had to name it, I would call it the Murder Weapon That They Will Use To Kill Me To Death.  It was a small circular saw, but rather than spinning and slicing, it just moves very quickly back and forth.  It was extremely effective in slicing through the sturdy layers of fiberglass, yet when it brushed against my skin I only felt a slight warmth.  Buy one here if you want to terrify someone.

To replace the cast, I am now the happy bearer of a mysterious bionic device that straps onto my arm and lets me move it, but stops me from just snapping the poor bone again.  The brace gives me about 45 degrees of motion, although when I take it off I can extend my arm almost straight (less 10 degrees or so). Again, this has been provided for me at no cost.

I have had to pay a few dollars for the two physiotherapy sessions that I needed - I learned that I can only lift 3 kilograms with my right arm now! - but even then the bulk of the cost was paid by ACC.  The receptionist at the physio was astonished to hear about the American system, where an uninsured person would have had to pay hundreds of dollars for a simple accident.

In two weeks, I'll be submitting my thesis, shouldering a backpack, and heading off to India with Lizzie for three months.  By that time, my arm should be completely healed and movement should be mostly recovered.    It would be difficult for me to say too much about ACC and New Zealand healthcare, but it was as good of an experience as anyone could have with a broken arm.  Prompt, kind, efficient, and nearly free: one of the best things about New Zealand.

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*This is actually a bad way to think about the social safety net, and I know it.  It's not a transactional relationship between you and the state, but the tax-price of a social safety net.