All the Way Home

 Shelly calls me at work and says they just found out I need to have an x-ray taken before insurance will approve an MRI. “They may as well just lop the fucking thing off,” I snarl. 

“Don’t say that,” she whimpers.

Luckily the diagnostic imaging center is open late, so after work I wheel across town to the medical center across the street from the hospital. In the waiting room I think back on all the different departments I’ve been in. It’s confusing; some of the offices are actually outside entities that rent the space, and some are part of the hospital. I’ve had x-rays done in this same office, and blood taken across the hall. I’ve used the pharmacy and eaten at the café when they used to actually make food. I got my COVID boosters and flu shots in the room directly above where I now sit. I’ve been in infectious disease and orthopedics and ophthalmology and innumerable podiatrists back when they had a podiatry department. I’ve had shoes and orthotics made and adjusted and adjusted again. I’ve spent a lot of time in this ugly building.

The next day the hospital emails me the results. 

Lytic destruction of the fifth toe PIP joint consistent with septic arthritis/osteomyelitis within the adjacent soft tissue ulceration. 

Post infectious/inflammatory changes along the second metatarsal head. 

5 mm needlelike foreign body within the plantar soft tissues along the distal fourth metatarsal. 

Up to this point, my only hope had been that the bone was not, in fact, infected.  To be sure, it had been a microscopic hope, but with its removal a sinkhole yawns in my stomach and I feel myself fall into it, sucked into myself, through myself, turned inside out, down and down into the darkness. 

The second item on the list is obviously the toe that has just been healed by the hyperbaric treatment, as this one theoretically could be. I should be comforted by this, but I’m not. My work schedule will be completely upended; I will have to go on medical leave again, with the nightmare of paperwork that will entail. Maybe I can work another shift; they are desperate for night guards, though I fear the twelve hour shifts will annihilate me, never mind having to work all night. And even if the two months back in the chamber work their magic, who’s to say my ulcers won’t flare up again the moment I’m out, like they did this time, and the time before that, and…

The third item is the most puzzling. This foreign body showed up in the x-rays I had in the hospital and podiatry office as well. No one had any theories as to what it could be or how it got there. 

The same thought keeps spinning through my head: I can’t believe this is happening again. I can’t believe this is happening again. I can’t believe this is happening again. I try to change this droning mantra to: everything is going to be okay. Everything is going to be okay. Everything is going to be okay. I don’t believe it for a second, but maybe if I repeat it enough I can brainwash myself. 

I hoped to have a year free of foot problems, and would’ve settled for six months, but I don’t even get a single goddamn day. The unfairness of it makes me want to scream, but I’m afraid that once I start, I’ll never stop. 

My appointment is the next day. I wheel into room one and sit down and pull off my walking boot and shoe and sock. I am an automaton, doing as I am programmed, feeling nothing. Aaron and Gladys join me. 

“I thought you were off Thursdays,” I say to Gladys. 

“I’m usually in the chamber but they needed me out here. Also I’m highly over-caffeinated and have been making fun of Aaron all day.”

“She has,” he says. 

“Where are your little protégés?” I ask. 

“They’re working remotely. You get the O.G.s today,” says Aaron.

“A patient told me he thought I was thirty five today and I almost hit him,” says Gladys. “I’m twenty-five dammit!” I knew she was young, but…twenty-five?

She makes short work of the cast and looks at my foot and says, “Oh.” 

There is a huge burst blister on the end of my foot. 

“I thought the cast was supposed to prevent that,” I say, my voice flat. 

“It is,” she says. “Have you been walking on it a lot more?”

“Not really.”

“Maybe it got wet in there somehow. This whole thing’s macerated.”

I’m beyond crying, beyond being upset. I have burrowed deep into myself.

As they wait for the doctor they prattle on about the Democratic Convention. I didn’t watch any of it, but I’m glad it was a positive affair, giving people a moment of hope when the world seems to be teetering on the edge. 

“Don’t worry, Trump will fix everything once he gets elected,” Aaron deadpans.

“Don’t you even start,” warns Gladys.

Doctor Ronda comes in and looks at it and shakes her head and cleans it up. She tries to pull my chart up on the computer. 

“Dammit, I hate these things.” Aaron can’t get it to work either.

“I’ll put in a ticket to IT,” says Gladys. 

“I really wanted to show you the x-ray,” Doctor Ronda says. She hobbles over to the drawing board. I ask her how her broken foot is doing and she says it hurts.

On the whiteboard, she draws a foot with six toes. 

“So each toe has three bones in it,” she says, drawing some lines to represent them. “On your little toe, the main bone is great. That’s the one you put all your pressure on, unless you’re like me and curl your toes when you walk. Do you curl your toes when you walk?” she asks Shelly, who has suddenly appeared. 

“I don’t think so,” Shelly says. She takes a step. “Oh, I guess I do.”

“The second bone is the one that’s infected. Your third bone,” she points to a tiny dot, “is no longer there. At all. It’s just gone.”

“What?” I say.

“It’s weird, but sometimes they get absorbed by the body. Or maybe it’s because of the infection, I don’t know. But it’s no longer there. So what I’m thinking, and I almost never say this, is that we should just remove the whole thing.” 

“I thought you might say that,” I say. 

“I know it’s not ideal. But you should be able to walk just fine. And you have really good circulation. Alternately, we could throw you back in the chamber for forty days, but I don’t know if it’s worth putting you through all that again.” 

“Well, I guess it’s okay, since I already have a spare,” I say, pointing at the drawing. She shakes her head and rubs out the extra toe.

“And then there’s this foreign object,” she says. “I don’t know what to make of that. I guess you must have stepped on something at some point. Maybe that’s affecting all this, but I doubt it. We need to get you an MRI and I am going to get your antibiotics refilled. Then I am going to put in an order for a wheelchair.”

“So I need to be in a wheelchair all the time,” I say, my voice a featureless horizon. 

“Well, both of your feet are having problems,” she says, “so yes.”

“But not forever, right, Doctor?” Gladys says loudly.

“Oh no. Just temporarily. You should be able to walk again with no problem.”

“See, that’s what I wanted you to hear from her,” Gladys says, touching my arm. “I heard when Dr. Rochelle said you’d be in a wheelchair for the rest of your life and thought that was asinine.”

Dr. Ronda looks confused. “What’s that? No, we’ll have you walking again. But it’ll be a couple of months.”

“Dr. Rochelle can get a little overexcited,” says Aaron. “Kind of like when a certain somebody has too much caffeine.”

“Hey,” says Gladys.

The doctor asks if I have any other questions. I say no. “You will. I just threw a lot at you. We’ll discuss it more next week.” 

Jenny is suddenly beside me. Has she been here this whole time? How many people can cram into this tiny space?

“We’re here for you. Just call us anytime,” she says, patting my arm. I thank her, feeling myself turning to stone. To lose a toe so suddenly, after having spent months saving its neighbor, doesn’t feel like a sad irony. It feels like an inevitability.

Gladys wraps my foot in a soft cast instead of another hard one. It looks like shit. “This looks like shit,” she says. The caffeine is wearing off. “Here, I’ll show you a trick. KC taught me this.” He folds a piece of foam in cotton batting and wraps it neatly around itself. They redo the cast with the foam inserted underneath, then strap on a new post-op shoe. They bring me my scooter and I wheel away without saying goodbye.