Lessons Learned From A Fall: That's Going To Leave A Mark

and in the end, it doesn't matter all that much to me

At this point in time, I’m about two and a half months beyond the fall I took that shattered my hip socket and the emergency hip replacement surgery that I underwent two days later. Hip replacement is a major operation, and recovery from it takes a while for a number of reasons. Most of them these days are fairly routine. People suffer from, for example, worsening arthritis in their later years, schedule the surgery, go in and go under, and then go home from the hospital fairly soon. When the patient is younger, like myself, and the need for the operation stems from serious trauma (the head of my femur was completely shattered, with bone fragments moving around in the hip joint, and my leg shortened by over an inch because it went up into the hip socket).

I’ve already written several pieces reflecting on what I’ve been learning living after the fall and surgery, going through the long process of recovery and rehab (which you can read here, here, here, and here), and I’ve been holding off on writing this one for a bit as things heal up, for reasons that I think will be apparent shortly. It has to do with something quite literally more superficial, a matter of appearance, as well as my attitudes towards and reflections upon it. This time, what I’ve got in mind is the incision scar the surgery left on my body.

The surgeon explained before the operation that there are basically two main options in present practice for going in to do the pretty drastic work required to replace the hip socket and portion of the femur. You can cut in the front, through the quadriceps, or you can cut in the back, through the glutes. He preferred the front, and was also in favor up spreading the tissues rather than simply slicing through them, and all of that sounded good to me. Not only do they go in and take broken or shattered bones out in order to replace them with titanium and ceramic, there’s a good bit of work they have to do with and on the femur sticking out of the incision during the surgery.

We would find out after the operation that after putting in the new hip socket, sawing off a good portion of femur, and replacing it with the titanium femur “head” (really about the top 1/3 of the bone), the surgeon was unhappy with the range of motion of the new socket assembly. So he had the titanium replacement head pulled back out that incision in my upper thigh, and replaced with one that fit better. It lengthened the time of the operation considerably, but I’m very glad he chose to do that. Who wants a new, not entirely up to snuff, hip joint?

What I saw when I came out of surgery was a massive bandage on a place that was hurting quite a bit, the incision spot, connected with a thin hose to a portable pump mechanism that presumably was there to suck out whatever mucky stuff was emerging out of the fresh wound. So I couldn’t really see much. But a few days later, they took that bandage off to swap it out for a longer-term one, and I got my first look at the newly made hole in my flesh, before they placed the new big dressing over it.

The easiest way to describe it was that, to me it looked like someone had bunched up some sliced deli ham and sewn a series of big stitches into it, going down from the crease of my hip five or so inches straight down my thigh. The skin on both sides was puffy, as you’d expect, probably sticking up a third of an inch from the rest of my thigh. I thought to myself: “Well, that’s going to be quite a scar when it heals.”

Later on, at home, when we got that big second bandage off, and replaced it with a fresh one whose adhesive I unfortunately had a minor allergic skin reaction to, we got another look at it. A good bit of healing had occured. There wasn’t any sign of infection. The flesh of the stitched up incision didn’t exactly look “angry”, but it certainly wasn’t in a good mood, you might say. It wasn’t long before we left bandages off and I was just careful not to catch the stitches on the pajama pants I tended to wear much of the day.

When we went in for the first followup with the surgeon about three weeks after the surgery, he was quite happy with the healing that had taken place, explained a lot of the particulars about the operation, answered some questions about what I could be expected to be able to do and when, and then ordered that the stitches could be removed. Up to that point, I had resigned myself with having a scar going forward that would effectively stick out of my thigh, a raised blob of healed skin that would be about 1/2 an inch wide and protrude about 1/4 of an inch. And then they came in and cut the stitches.

To my surprise, as each stitch was snipped and pulled, the skin on each side relaxed, revealing a thick purple scar that had healed from the incision under what turned out to have been sheltering skin, which in its turn now spread out, showing the suture holes (a few of which bled a bit) in neatly punctuated lines abut 3/4 of an inch from the central scar. I wouldn’t have the rather ugly long blob of protruding skin that I had already reconciled myself to looking at. Instead, I’d have three parallel scar lines, one straight one down the middle, and two dotted ones down the sides.

It’s quite noticeable and rather distinctive, and I can well imagine that it’s going to look more or less the same decades from now. It’s far from the only scar on my body, indeed not even the only surgical scar. When I first came in the ER with my shattered hip and they had me change into a gown, the nurse asked me whether I’d been stabbed previously, pointing at the four scars on my abdomen from a laproscopic surgery early last year. This one, though, is big enough that you could put it up against all the other many scars I’ve accumulated in my 55 years, and there’s more scar tissue in this one than all of the others combined.

So it will leave a mark, quite a mark. If I was particularly concerned with how my body looks, as I was in some ways when I was younger, in my teens and 20s, I might find this lasting reminder of my surgery a bit upsetting. It’s really just an odd-looking modification of my flesh, not what one might view as a “cool scar” from some adventure, conflict, or accident. It will always remain just ugly. I tend to wear trunks when swimming or at the beach, so it won’t be visible then, but I suppose in the locker room in the gym anyone who wants to see it will be able to.

I find myself at this point in my life not really caring about any of that, though. There’s only one person whose views on the attractiveness of my body I actually care about, and that is my wife, and she isn’t bothered by it any more than I am. It’s a reminder not only of my fall, and the damage some random concatenation of chance events can do to the body, but also of the skill of my surgeon and as the phrase goes the “miracles of modern medicine”.

It’s one of many matters that I in the present, I can place into a proper perspective with other matters, some of which are of lesser import, others of which are of much greater value and significance. I don’t know how easy or natural that would have been for an earlier version of myself. And that index of gradual, even largely unnoticed progress, is something that I can take some small joy in.

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Gregory Sadler is the founder of ReasonIO, a speaker, writer, and producer of popular YouTube videos on philosophy. He is co-host of the radio show Wisdom for Life, and producer of the Sadler’s Lectures podcast. You can request short personalized videos at his Cameo page. If you’d like to take online classes with him, check out the Study With Sadler Academy.