Content warning for medical trauma, hospitals, self harm
Somewhere in the gloaming of that first, un-houred night, sitting beside Jake’s bed in the ER, my own body bent awkwardly across theirs in search of an uninjured patch of skin to stroke, they looked up and to the side of me and confided to the drop ceiling and fluorescent lights: After the ladder started to fall and before I hit the ground, I thought, “This is going to be bad."
They weren’t wrong. These weeks since Jake’s fall from a height of 15 feet have been unequivocally, singularly bad. For Jake, they include the most painful hours of their life, dozens upon dozens of them stacked one upon the other without meaningful reprieve, as they cycled through preparing for, receiving, and recovering from spine and wrist surgeries. For me, they include the hardest moments I have had as either a parent or a partner, the constant feeling of being caught in a mirrored funhouse of reflected suffering.
At the start I was entirely stuck on this moment, this image in my head of Jake falling through open air. Their thought, “This is going to be bad,” which easily could have died along with them, tracing the selfsame path through space and time, one beat behind their body. In the first couple of days after (or whatever counts for days when sleep and sunlight barely enter the equation), this image kept playing on a loop—forward as the ladder slipped sideways and they released it, then rewinding back up to the moment just before the ladder began to slip. Down and then up again. Down and then up again. I think it’s safe to say I know the landscape of my spouse’s face better than anyone…even without being there, I felt I knew what flow of expressions had crossed it from the apex of that arc until its end.
Sitting vigil at Jake’s bedside while we waited the interminable hours between imaging, between doctors, between doses, between hospital transfers, between the start of a spasm that would splay their face into a rictus and the moment sleep would release them for a minute or ten, the movie playing in my mind gradually took on a new, fantasy dimension. Unable to free them from their pain, from the sensory overwhelm of cacophonous beeps and screaming alarms, from the gripping hunger and dread of waiting 36 hours for a surgery that could come at any moment but never does, my mind turned itself towards fixing all of this at the outset.
We’ve all seen the slow-motion replay of a cat falling from some great height, each freeze-frame elaborating the precision moves necessary to twist its long spine from nearly any angle into that perfect posture: each leg pointed downward, spaced evenly, ready to absorb the energy of impact in equal fourths. What if Jake, called “cat-like” on more than one occasion, could twist just-so and avoid this outcome? Didn’t our own primate ancestors once live in trees, swinging from branch to branch? Surely they knew how to fall. Might that inheritance be hiding somewhere, deep in the cells of my beloved, waiting to be activated in that moment of need…If I could only turn things back, we could see. Maybe we could see.
As the hours wore on into days, my grief phase-shifted out of magical realism. “This is going to be bad” gave way, as a rockslide gathering material downhill, into, “This IS bad.” And then sometimes, because bad has relative, not absolute value, our situation did not even seem so bad…not in unavoidable comparison to the other human tragedies unfolding around us. For both of us, these weeks exposed a reality which we had mostly only perceived in sterile, occasional snippets from media, only briefly touched into empathetically in conversation.
It is one thing to hear about the “nursing shortage,” and another thing entirely to spend days sharing rooms and halls with people very literally screaming for their basic human needs to be met, screaming for the attention of a fraction of the staff necessary to the task. To oscillate between freezing, fawning, and fighting instincts as we attempted to advocate for Jake’s needs, and their roommate’s (who had no one else to fight for him), with a rotating cast of nurses and other hospital staff—some of them uncannily upbeat and amazingly helpful under the circumstances, but others so obviously, visibly burnt out that I felt genuinely scared to have to leave these bed-bound humans when visiting hours came to a close.
On one evening I can recall with perfect clarity, at the second of three hospitals, I left Jake’s bedside with just enough to time to make it back for the last half of our 5-year-old’s bedtime routine. This consistency was a small but crucial concession I could offer her most nights. As the front doors rolled open, the smell of the air outside was so wild, so fresh and oh my god, so fucking alive compared to where I’d been, that tears blinded me within a few steps. I had to stop. The animal urge to reject my responsibilities to other people, to my own child, crashed down on me bodily. I wanted nothing but to drive straight to anywhere with moss and lay face-down upon it. To plug my nostrils up with sweet earth. Better yet, to find some herculean, car-on-a-baby reserves of maternal strength and go back into that hospital, tear the wires out of my mate, and carry them out the door.
Instead, at home and scrolling my phone in bed with my kid asleep beside me in the big bed (all house rules tossed out the proverbial window), I came in hot with a google search: Why don’t hospital windows fucking OPEN? The results were varied, and nearly every answer as depressing as the last. One common response was, Bats and bugs might come in, which would be a completely rational reason to keep patients smelling nothing but effluvia and disinfectant for days or weeks on end in a society that had not yet invented screens. Another explanation, Patients might be negatively impacted by air pollution, I found depressingly reasonable. Except, of course, any windows that can open can generally also close when needed. Open windows wreak havoc on heating and cooling. Sure, but also, see above..? Moreover, many medications do wild things to one’s sense of temperature, so offering patients the agency to slightly alter the room conditions by cracking a window would seem to be a low-effort comfort measure?
The last explanation for entombing the sick, injured, and elderly in airless chambers was also the darkest. It came up again and again. People will throw themselves out the windows. Putting aside the too-obvious counter argument that we have as many designs for working windows that solve against this as there are architects alive today, this rationale seems to me to really sum up the deranged logic we saw at play: People seeking care from our medical system may reach a point of such profound despair that they want to kill themselves…and the solution is to make the hospitals more like prisons. Not to consider what about the hospital conditions might breed that sort of despair and re-design for the greatest impact on patients’ lived experience. Not to subsidize enough well-compensated caring jobs to meet patients’ needs within a resourced community. No. Let’s alarm the beds instead. Weld the windows. Add a fish-eye camera to every room for that extra panopticon flavor.
The human imagination is so often held up, rightly cherished as our greatest gift. But in our worst hours it’s hard not to feel it as a curse. With so much, too much time to think, Jake and I would each, in the hollows of our own minds, start to multiply out the suffering we were both experiencing and witnessing. Yes, these were clearly poorly-run and wildly understaffed hospitals, but there are so, so many bad hospitals in America.* How many people were we sharing this pain, this helplessness, this rage with, right now? And weren’t we fortunate in too many ways to count, really? To have each other to cling to? To be embedded in a big, loving, capable community that rallied around us with truly miraculous speed and thoroughness? To have this care covered under worker’s compensation? To even have access to life- and limb-saving surgeries? I mean, just to have a hospital with adequate supplies and clean water? How many people around the world living through war and famine and genocide would give anything to have what we have in this fetid, fluorescent room? We had a chance.
And yet something in me refuses to be grateful. Not even now that Jake is home from the hospital and we can navigate their long recovery in the company of birds and crickets and other living things. We can snuggle our kid and our cats all together and and we can take deep breaths in the overgrown garden and not one damn thing in our house beeps. I can’t, or maybe I won’t be grateful. Gratitude involves acceptance, and I don’t think I should accept what Jake went through, what we both witnessed in our periphery. It doesn’t have to be this way. This is true for me because it is the only real tether that holds me from the cliff of despair. If I didn’t believe in the chambers of my heart, in the warren of my guts, that another way of caring for our human and more-than-human kin was possible, I’d be in free fall right now.
Instead, when I wake in the darkest parts of some of these nights, I imagine we are all falling together—I imagine that cat, falling frame-by-frame through blackness. Which series of muscular, wise pivots and reversals can we make to come out of this—not unscathed, certainly, but alive? Maybe some of the movements are hidden deep within each of us, left to us by that shared ancestor who knew how to fall. Maybe some will be brand new, issuing from our formidable imaginations. What I know is that the right movements will always be guided by the best of our instincts. By our ability to put care—not just for our own kith and kin, but care for every soul on the other side of that flimsy curtain—at the center of the work we do, of the cultures we tend, of the world as we build it. I have to believe we have a chance.
*It’s worth noting that due to several factors (needing to comply with insurance requirements, being in an extremely vulnerable position, staff manipulation, among others), we ended up at some particularly shitty hospitals. The three we visited received safety grades of C, D, and D respectively from an independent rating organization. But then, there are a lot of particularly shitty hospitals in America. 44% received safety grades of C or lower in 2022, and four states have no A hospitals at all. My family is incredibly fortunate to live in a relatively populous, well-resourced region of the country with 15 hospitals located with 50 miles of us, but 11 out of those have safety ratings of C or lower.1 So many rural areas don’t have any hospitals at all anymore.
https://www.hospitalsafetygrade.org/search?findBy=zip&zip_code=12401&radius=50&city=&state_prov=&hospital=
Oh Chris. I am feeling alongside you and Jake. Feeling the horror and frustration at hospitals. And the wild logic of this injury that makes me want to howl for you with unfairness. How you managed to craft suh a beautiful reflection in the midst of everything is astounding. Sending so so much love ❤️🩹
Your way of telling is gold. A laser sharp articulation from the edge and the in-between, a dry heave, a slow/fast gasp and attempt to grasp the great wave that weaves us all together. I had a boyfriend fall 30 feet off a ladder that stood on an unsecured scaffolding years ago. Broke both wrists and cut up his legs. A long and winding road ensued... but the worst of it blossomed into the best period in our relationship and a major, ultimately positive, transformative touchstone.
There may not have been open windows in the hospital, but you have opened windows with your words. The air is fresh in here. Thank you for sharing. Best to you and yours as you all lick your paws.