• Rosalind Kaplan, MD

The Only Way Out is Through

By Rosalind Kaplan, MD

It seems our personal shitstorm has subsided, leaving well....shit...in it's wake. So now we have to clean up the mess.

'The way out is through' originally comes from Dante's Inferno. Since then, it's become one of those aphorisms used a lot in psychotherapy and addiction communities, and I hate the idea of using such a cliche. Yet, I have to say that it rings so true for so many situations.

So, let's talk about my broken bone. It's really strange, since it's the first fracture, other than probably breaking a toe or two at some point, that I've had. It happened in such a foolish way, falling while chasing a crazy dog while wearing clogs, and falling on my shoulder. I'd love to blame the dog, but he was just being a dog- he had an opportunity to run out of the yard to see his beagle friend, because I took his leash off prematurely.

It's a very unimpressive fracture- just a kind of chip off the humeral head, but it hurt impressively at the time. Then it didn't hurt so much, after about a half hour, and my biceps tendon started hurting--a consequence of blood from bruising leaking into biceps groove, where the biceps tendon attaches to the bone)--and I, being the control freak I am, and always sure I'm right, decided that I'd strained my biceps tendon. I iced it, and started stretching exercises, and walked around with pain for 3 weeks before deciding that I, in fact, was wrong.

The orthopedic surgeon, who has already operated on that shoulder once, and also took care of my shoulder separation on the other side, did an X-ray, and confirmed my wrongness. So now I've been going to physical therapy to decrease my pain level and get back to normal activity .

Anyone who's been in PT knows that it's not a lot of fun. A relative who works in medical insurance once told me that his company sets co-pays for PT very high, so people don't abuse it. Really? I can't imagine wanting to abuse PT, which can also stand for PAIN and TORTURE.

I go to the physical therapy office twice weekly for a brusque woman I'll call Helga (not her real name) to push and pull at the painful areas of my arm, and to do thousands of repetitions of painful stretching exercises using a pulley that looks like a torture rack, and then thousands more repetitions of strengthening exercises, while she yells at me not to contract my trapezius muscles (I try to listen, but don't always have control over which muscles contract!)

BUT- I'm not complaining. Or rather, I AM complaining about the process, but not about the result. Because the pain I walk around with has been getting better with each PT session, and also improves with the home exercises I've been given.

Point being, the only way out of the pain I'm in is to go through the pain of physical rehab.

This is really no different than dealing with other kinds of pain. Grief, sadness, anger...

The only way I have ever found to manage difficult feelings is to confront them and examine them and truly feel them. Eventually they start to change, to become more distant and less problematic, to become growth instead of pain (just as my bone will grow back together). Trying to avoid them or mask them or pretend they don't exist never works. Acting out (screaming and yelling when angry, or sitting in the closet when sad, etc.) might give some immediate relief but it all comes back to bite you later. Denial (like walking around with ridiculous certainty that my fracture was a tendon strain) gets you nowhere, or worse.

So there it is. Gotta get through it. It's the only way out.

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