the process, again and again, the cold slab of metal chills my skin. He X-rays my knees, my ankles, my hips, my elbows, my wrists, and my spread fingers, and when, two hours later, I am given the large red folder containing these pictures, I pass this to the orthopedic nurse, who promptly thanks me and tells me to wait again, adding that the doctor will see me momentarily. I sit. The girl with the cast and the man with the sling are gone, but the boy now sleeps with his chair parked against the waiting room wall. My head feels light, my stomach empty, and I curse myself for not stopping for something to eat after the X-ray. It is now well into the afternoon, and my lunch isn’t holding me. I should have been more prepared and brought something: a granola bar, a pack of crackers, a juicy steak.
When the orthopedist and his resident—a foreign medical student with oil-black hair, dark eyebrows, and a thick accent—arrive in the room where I wait, storm clouds gather in the dark sky, casting an ominous glow on the late day. I am again pulled and twisted, bent and straightened, measured and assessed. The orthopedist requests that I walk down the clinic hallway, so I remove my shoes and socks, roll up my jeans, and walk as best I can. A nurse hurries by with her quick and easy step, and the steady patter of her soft white shoes echoes through the corridor. My body gives on my left side, and my knees do not straighten as they should, but I walk (limp), turn around (yaw like a ship), walk (limp) more.
“Okay. That’s good enough,” the orthopedist calls out.
When we return to the room, he clips a few of my X-rays to the lightboard and places a thoughtful finger to his bottom lip. His eyes have a faraway gaze and are deep in study.
“It looks as if you’ve suffered more damage to your knees and ankles, and you’re losing rotation in your left hip.” The medical student takes notes. “I suspect this is due to several things. For one, you have hemophilia and this is its nature. For another, you are now at college and, well, you’re probably walking more than you used to. This increased activity is probably adding further aggravation to your joints, which are already under strainfrom hemophilia. This isn’t an ideal situation and we have to consider ways to counteract this deterioration of your joints.” He again places his finger to his lips, removes it. “A cane could help relieve some of the stress you’re experiencing, especially on your left side, which seems to be deteriorating more rapidly.”
“A cane?”
“Yes. A cane.”
“But I’m only eighteen. Nobody has a cane at eighteen.”
“I understand the stigma, but you’re different. You know that. And you’re now walking with a noticeable limp. We don’t want your gait to worsen too quickly.” He gathers my X-rays and returns them to his folder. “As for the cane, you don’t have to use one, of course. I only think it could help. You’ve had an increase of bleeding episodes this fall, and I think you need to consider ways to reduce those. Each one does more and more damage to your joints, and if too much damage occurs . . . well . . . we’ll have to consider other methods for treatment.”
I understand his meaning here, and I’m certainly not wishing for another operation. Not now. Not ever again.
“Think on it,” he says, shaking my hand on his way to another patient.
Outside, a storm begins. The wind chafes my cheeks as I walk to the parking lot, so I tighten my scarf around my neck, it binding round me like a noose. The sky—heavy and pregnant with winter—begins to sift freezing rain upon me.
On the highway to my parents’, as the cars edge forward with caution, the sleet pings on my windshield and gathers in the corners as grains of translucent white. It salts the grass and tar-black roadside while the trees—having become hazy and borderless—are washed flat against a gray sky. I