I’m sitting down to write now because I finally have a bit of time to do so. I’m recuperating from orthoscopic knee surgery (it’s going very well, thank you), which overall has not been as big of a deal as I thought it would be.

I started having problems with my right knee about a year ago. It would pop and snap a lot, and eventually it started flaring up while I was walking. At first I would walk my dog for about a half mile walk. Then I could only go for about a quarter mile before my knee would start to stiffen and burn. Then I could barely walk down the cul-de-sac. When I first went to the orthopedist, he asked, “how’d you injure your knee?” I turned out that I had a slightly torn and ragged miniscus, and while PT could help (it did for a while) a clean-up would help significantly.

I had this question over and over again before my surgery. “Knee surgery? What did you do?” I honestly couldn’t think of a single thing that I did or accident that happened that would have caused this. The nurses and other staff usually would respond, “just wear and tear I guess.” I realized last night though where all of that wear and tear came from. That’s the knee I tend to kneel on when I’m visiting patients.

More often than not, the people I’m visiting are either in hospital beds or some sort of wheelchair. Sometimes when I’m visiting people there simply is not a place to sit next to them. I find this absolutely remarkable: some rooms are set up in such a way so that there is no place for another to sit next to someone’s bed. Sometimes there may not even be another chair in the room. Think about that for a minute and consider how this impacts a patient’s or resident’s quality of life.

When I visit a patient, even when there is a place to sit, I tend to kneel next to them to get on their level. Those who are wheelchair bound or bedbound are constantly looking up at people who are looking down on them. Having never been through any kind of hospital treatment before, I have to say that I felt more powerless and helpless on that gurney being moved and prodded by people towering over me, sometimes out of my field of vision. Getting down to a person’s level helps to equalize our experience. Sometimes, especially during a first visit, I may even get down below his or her eye level so that I appear a little less threatening as well as to give them a sense of control and respect. Sometimes I’m down on that knee for a long time. When I thought about how long I’ve been doing hospice care, I realized how long I’ve been down on that knee and just how much wear and tear it’s had just from that.

Of course, there are parallels to my own experience.

“Wear and tear” is a nice shorthand for “getting old”, “overuse” and “neglect”. When I couldn’t think of anything that I did, it must be “wear and tear”. However in retrospect, it was the cumulative effect of a small action over a long period of time. I never considered what that action was doing or that I needed to take care of myself in the process. Like many caregivers, I don’t always take great care of myself. I don’t call off work unless I’m practically bedbound or contagious. I store up vacation days until the office tells me to use them because I won’t accumulate any more, and even then I will be more likely to cash them in – which is a nice perk – than actually use them. When I’m off, I still check email and follow up on things so I don’t get behind. Even now, home recovering from surgery, I had a Zoom support meeting for family members dealing with grief and the holidays, and I have another one today.

This is wear and tear.

Now before the self-flagellation begins, no I am not sitting in front of my computer all day answering emails and responding to texts. I’m reading a book. I watched a good movie. I rested and tried to remember to use my crutches when I walked. I’m doing that today too. Actually sitting down to write something uninterrupted is a rather unique experience now.

Part of the reason for my wear and tear, both of my knee and my soul, is that I get something positive out of it. I enjoy and appreciate the connection I can make with others when I’m down on their level, even when it hurts. I value the feeling of purpose and meaning I find in helping someone, even when I overextend myself. Which is why whenever I have a physical or emotional injury like this one I can’t think back and say “oh it was this that hurt me”, because it’s been small, repetitive injuries over time that have worn through the muscles and tendons of my body and being.

So one lesson I have to learn is that I simply may not be able to kneel on that knee much more. I need to find a chair, sit on the bed, or stand. I need to pay attention to my body when it says it’s sore, aching or hurt. I also need to pay attention to those things in my work and my life that, as much as I may feel like they’re helping or doing good, I may need to cut back on.

So now I must go brush my teeth.