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Limping Across the West

Thursday, September 14th, 2017: Trips.

The Legendary Ordeals

I put a lot of miles on my aging body while exploring the wild places I report on in these Dispatches, and in the past three years, I’ve started to discover that my body isn’t really built for this kind of abuse. I started life as a relatively weak, undersize boy who was often sick and didn’t qualify for sports. Instead, I came to rely on my head and heart, developing into an artist and scholar. It wasn’t until I was almost 40 that I started strengthening my body, developed a fitness regimen, and entered the physically active phase of life I’ve come to treasure.

With this gain has come an increasing level and frequency of pain, and accumulating damage to my joints. In 1990 a poorly-advised strength training regimen resulted in a stress fracture to a sesamoid bone in my left foot. Pieces of the bone were surgically removed, but the pain has recurred periodically. In 1999 I developed acute lower back pain, due to damaged lumbar discs, and this has become chronic. When I started rock climbing in 2000 I noticed limited range of motion in my right hip, and in 2007 I developed acute pain there, which was eventually diagnosed as a minor congenital deformity, requiring surgery. Beginning in 2009, I had recurring episodes of plantar fasciitis in the right heel, and after recovering from the latest bout early this year, I had a recurrence of the sesamoid problem in the left foot, which become acute and brought my activity to a halt for the fourth time in two years. Finally, in the meantime, I suddenly developed tennis elbow in my right arm, which involved sharp pain that was pretty much constant.

So far, these conditions have all been treatable, but the frequent pain puts me under chronic stress, while often depriving me of the means to relieve it by doing what I love – hiking in wildlands. Less of my time is spent doing what I love, and more of my time is consumed by maintenance: physical therapy, icing, stretching, foam-rolling, etc. And my local, rural, small-town healthcare system has proved itself inadequate to address the problems of an aging athlete. I’ve had to take matters in my own hands, seek outside help, and sometimes develop my own diagnoses and treatments. Part of the problem is poverty – New Mexico is one of the poorest U.S. states – and practitioners are simply not used to seeing active older adults. Their experience is dominated by the health problems of poor Americans: drug abuse, malnutrition, obesity, diabetes, and lung cancer.

When the sesamoid problem recurred this spring, our local podiatrist was unable to help me, and I had to do a nationwide search for specialists in this rare condition. I eventually found Dr. Richard Blake in San Francisco, and arranged a road trip to the Bay Area, during which I’d also have the chance to visit old friends, both coming and going. I was in the midst of my epic book project, which was only one scene away from its first major milestone, but I’d have to put that on a frustrating hold for a few weeks. In the end, this trip became an adventure full of ordeals that tested me, my friends, and our relationships, in the midst of natural spectacles that spanned the continent: a solar eclipse, a record heat wave, and catastrophic storms. In the end, I found the proverbial rainbow in, of all places, Las Vegas, and realized that as hard as it’s become, my life in rural New Mexico is still much healthier than it would be if I lived in a big city.

Everybody Hurts

Over the past thirty years, my weekly fitness regimen evolved into six workouts per week: two peak hikes totaling ten miles with 3,000′ elevation gain, two one-hour strength-training workouts focusing on core, and two one-hour stretching sessions. After hip surgery and the recurrence of foot problems, icing, stretching and foam-rolling became a daily requirement, taking up to three hours per day, and my visit to San Francisco added another hour and a half of foot treatment. This all adds up to nearly forty hours per week on physical maintenance (not counting personal hygiene). The goal of all this maintenance is to keep me active as I age, but clearly, I wouldn’t be able to do it if I had a normal job or a family to take care of. So at this point, fitness is my full-time job, and pain is the new normal.

But as I’ve become mired in my physical limitations and the treatment of them, my friends face their own formidable challenges. In one home I visited, household clutter had grown until the only open space consisted of narrow pathways between dusty piles of accumulated debris. Some homeowners expressed admiration for the “tiny house” movement, while renters were forced by the astronomical cost of urban housing into cramped apartments that wouldn’t accommodate everything they needed. Like so many urbanites, they had to commute to a distant storage locker that housed the essentials they couldn’t fit in their apartment.

Back home, I’d already come to view pet ownership as an epidemic disease after failing to get neighbors to take responsibility for their barking dogs. But on my trip, I found that more people are coming to accept pet urine and feces on the floors of their homes, because they’ve taken on pets that are either non-house-trained or incontinent. One friend was recovering from a series of battles with pneumonia – no surprise since she inhabits a dusty, cluttered, cat-frequented house. I’m allergic to cats, but almost all of my friends have at least one feline in the house, so I always have to travel with antihistamines and steroid nasal sprays. Pet ownership is at an all-time high, increasing our ecological footprint, displacing wildlife, and harming society as owners fail to train or otherwise take responsibility for the impacts of their pets on others.

Friends in the city were suffering under increasing financial stress and abuse from their jobs, in addition to air pollution, noise pollution, light pollution, and the dangerous traffic they endure in their commutes. Many burden themselves daily with TV news about a world gone mad and the reckless antics of the rich and famous. Since I don’t watch TV at home, I felt bludgeoned by broadcast media, encountering the new head of state moving and talking onscreen for the first time, and it was not an edifying experience. Stressed-out white people come to feel threatened by immigrants, other races and ethnic groups, differently-gendered people, criminals, and the poor, blaming them for society’s problems as well as their own. Like my father in his declining years, some perceive the world around them as a seething mob of evil-doers barely held in check by our valiant police and military.

I also encountered and was impacted by depression, alcoholism, and drug addiction throughout my journey – and who could blame these disorders on people living under such stressful conditions? As I navigated apocalyptic traffic across the city and its suburbs, I saw, over and over, grotesque affluence flaunted alongside nightmarish poverty. My friends are among those who’ve benefited from the gentrification that contributes to homelessness, but the homeless continue to haunt them like living dead.

The Unforgettable Super-Mega Eclipse of 2017

On the way to the Bay Area for my foot treatment, I stopped to visit one of my favorite families, a botanist and ecologist who are raising their kids in the wildfire-ravaged Sierra Nevada foothills. We enjoyed an idyllic three days hanging out in the Merced River, walking their country lanes, and witnessing the solar eclipse, before I left to face the trials of the city.

Into the Maelstrom

I knew nothing of heat waves or hurricanes when I planned my trip, but I was reluctant to return to the soul-numbing congestion, gross economic inequality, and oppressive man-made landscape of my old home, the San Francisco Bay Area. The only saving grace, beside the hope of medical treatment for my foot, was the hospitality, generosity, and good fellowship offered by my hosts. By the nature of this trip, I ended up missing most of my Bay Area friends this time around – hopefully they’ll be able to join me in New Mexico sometime soon.

The medical part of the trip quickly grew in proportions far beyond what I’d anticipated. I ended up having to drive to San Francisco’s Nob Hill from the suburbs on four separate days over a week-and-a-half period, for visits at a sports medicine clinic with a foot surgeon, a non-operating podiatrist (Dr. Blake), the radiology department, and a physical therapist. The surgeon and podiatrist ended up giving different opinions on my treatment and chances of recovery, but on my second visit with Dr. Blake, he gave me a new set of orthotics that enabled me to walk normally for the first time in months! I actually danced a jig in front of my friends that night.

I was in culinary heaven from the start, eating spectacular Ethiopian, Indian, and Thai food on successive nights. Friends took me to my old favorite museum, the Oakland Museum of California, and on shopping excursions in search of things I can’t get back home. One errand on my list was to visit an Alfa Romeo dealer to look at their new SUV, but in the end, all I had time for was a glimpse of the back of the vehicle through a dark showroom window.

My Berkeley hosts pointed out the unusual homeless encampment near their house, which they said had been established last winter and accepted by the city because the residents were self-governing, prohibiting panhandling in the vicinity and contracting for the removal of their waste. The neat, well-ordered camp included a manned information booth, and there was a free clinic nearby where residents could go for checkups.

I savored an evening with one of my old roommates from the Terra Incognita loft, and it turned out his sons, who grew up in Ireland, had arranged a viewing of the Mayweather-McGregor fight. While not a boxing fan, I enjoyed the well-played spectacle, a public ritual like something out of ancient Greece or the Roman Empire, in which the blond, tattooed Celtic challenger appeared as a Viking berserker while the African-American champion entered wearing a midnight bondage jacket and mask like a tribal fetish from the land of his ancestors. The patterns of dominant societies play out over and over again throughout history.

At the end of my stay in Berkeley, I was invited along on a sailing race in the Bay. I hadn’t sailed in over fifteen years, and I was really worried about risks to my foot, but the boat people assured me I could sit down somewhere out of the way, wouldn’t have to work, and this race would be “casual” anyway. As it turned out, all three were wrong. Anxious crew members shouted back and forth constantly and climbed over each other in the crowded boat to tack or avoid collision. I had to continually shift position in my heavy boots on a surface that leaned precipitously, as I twisted and stumbled trying to get out of someone’s way. I was suddenly put in charge of something I didn’t understand, and the stranger I partnered with yelled unfamiliar commands and freaked out when I didn’t understand. I had moments of exhilaration, but my injured foot was strained by all the desperate maneuvering, aching more than it had in months.

One secondary mission of my trip was to find a solution for my beloved wooden sunglasses. A hinge wore out months ago, and repeated attempts to get them repaired had failed. I spent hours roaming the cities in search of either repair or replacement, and on the verge of giving up hope, finally discovered a guy who fixed them while I waited, for $25. He even used a laser! Check it out: All-American Eyeglass Repair, in Hayward.

Just as Hurricane Harvey was flooding Houston, a record heat wave hit the Bay Area, and I ended up staying with friends in a house without air conditioning, sharing some great conversation in front of a fan, and taking my first lengthy walk in the new orthotics in 105-degree weather. It was so muggy that I actually spent two straight days sweating continually, an experience I’ve never faced back home in the mountains of the Southwest.

The primary goal of this trip, medical care for my injured foot, achieved mixed success. After reviewing the MRI, both doctors say I have arthritis in the metatarsal and an incompletely healed stress fracture of the remaining sesamoid. They both prescribed a bone stimulator, an ultrasound device which is supposed to encourage bone healing but remains somewhat controversial, although they disagreed on the long-term plan and chances of recovery. The surgeon said the likelihood of needing surgery was 50% and a decision should be made after three months of treatment, while Dr. Blake wants me to use the bone stimulator for nine months, with a follow-up MRI after one year. Only one such device is FDA-approved, making its manufacturer a monopoly, and it threatens to cost me thousands of dollars out of pocket – how much is still TBD.

The pain I had after sailing was relieved by a physical therapist during my last visit to the clinic, when he demonstrated a series of exercises and manipulations I could do at home. So now, in addition to the time-consuming physical maintenance I’ve been doing in the past year, I have another hour and a half of work to do on the foot, each day. Hopefully there’s a light at the end of this increasingly narrow tunnel.

Escape to the Countryside

On the third day of the record heat wave, as the heat began to subside, I left the Bay Area and headed across the Central Valley to visit an old friend at the base of the Sierra Foothills. I’d already walked more during the heat wave than in the previous three weeks of milder weather, and by the time I reached my friend’s place my left foot was sore in an unaccustomed place. We went for yet another walk, again in 100-plus temperatures, and by the time we reached our destination my foot was red, swollen, and in considerable pain. And we still had to walk back.

The foot throbbed all night, and in the morning I emailed Dr. Blake, who suggested it was gout. Great! I still had at least a week of planned visits before returning home, and now I could barely walk. I reluctantly left my friend, whose tiny apartment made it difficult for me to take care of the foot, and drove two hours up to Lake Tahoe in the mountains, where I found a motel, crawled into bed, and began applying ice.

The swelling and pain subsided a bit by the next morning, and I drove down the Eastern Sierra, under storm clouds and through scattered rain, to visit more old friends, the expert on bighorn sheep and his physician wife. As I continued to ice my foot, we had some great talks about wild sheep, prehistoric tribes, and a half-dozen other topics of mutual interest, as on the other side of the continent, Hurricane Irma approached Florida, leaving a wake of destruction in the Caribbean. I drove up on the nearby volcanic tablelands to revisit some prehistoric rock art. But my friends were busy and distracted, and I was too crippled to hike, so after a couple days I continued on to Las Vegas.

Rainbow Over Vegas

With hurricanes in the South and a heat wave on the West Coast, Las Vegas had its own extreme weather – in this case, thunderstorms and heavy rain, with unseasonably cool temperatures. I was actually greeted by a rainbow when I arrived at the UNLV campus to meet my friend, another wildlife biologist. My sore foot continued to improve, and in between thunderstorms, my host took advantage of the rare cool weather to show me some beautiful springs in the low desert around Lake Mead. Although we were mainly looking for the endangered relict leopard frog, I also got to see the mysterious, almost microscopic springsnails, also endangered, and poorly known to science. So now, in addition to the biological soil crusts that recently captured my attention, I have a new tiny, humble, easily-overlooked desert life form to admire. As paleontologist and natural historian Richard Fortey has observed, it’s often the humblest and least aggressive life forms that persist, while powerful species like ours quickly rise, briefly dominate, and collapse into ruin.

No Place Like Home

I’d planned one more stop after Vegas, but at this point, I really needed to get home and start treating my foot. The swelling and pain had subsided but were still there, and I didn’t know whether I had the dreaded gout or not.

I took a detour on the way back so I could traverse the White Mountains plateau in Arizona, and my foot was feeling good enough when I got there that I went for a short hike – two or three miles at 9,000′ elevation – through the lush post-monsoon meadows and cool, fresh alpine air. After all that time in cities, finishing my trip in nature was the perfect way to restore balance.

  1. Siri D Khalsa says:

    great writing, great pictures, interesting content. Thanks, Max.

    Now get that foot completely healed.

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