By Evan from Evansville

I’ve had both of my hips replaced with titanium implants. My friends and I joke about being a cyborg and being part-Terminator. Laughter is indeed medicine. I had my right leg done in the States with private insurance and the left done in Korea, which has universal health care. This is my tale.

I was a few months away from being 25 when I first noticed a problem. I had been in the States visiting family and back flew to Korea to start my new contract. Literally the day that I arrived I started to feel a tinge of pain when I put weight on it. I assumed it was the stress of travel and schlepping all of my luggage around.

I used to run 3-5 miles a day and naturally assumed it was related to that. Everyone who runs is used to little tweaks and pains. My limp increased and I just dealt with it. People kept telling me to go to the hospital. I figured it would go away and rebuffed their advice. After six months of existential pain with every step, I figured it was time to see the doc.

It only took a simple X-Ray. The doc sat me down and showed me the film. My femoral head had a noticeable dark spot on it. He told me that I needed to have my hip replaced. With cool composure I asked about the details. Turns out that the blood vessels in my femur had closed off and the bone wasn’t getting oxygen. Necrosis, he said. The bone had literally died. The pain I felt was my body weight slowly crushing the bone into itself.

He says the left hip has the same problem but it’s not as advanced.

Outlook: not bright

Most people assume that I had been hit by a car when I tell them about my hips. I tell them the docs told me it was idiopathic. This may be true, but I think I have an idea. But that theory’s for me.

Cut and dry, it simply had to be replaced. It wouldn’t ever go away, and eventually would catastrophically shatter.

I got into a cab and tried to digest this. I called into work to get the day off. It also so happened that that was the day my parents were arriving to visit me. I fought off my emotions in the taxi. As soon I shut more apartment door I bawled my eyes out. I’ve never cried so hard. I collected myself and then collected my parents outside. It was pouring with rain, which felt fitting.

We went to Seoul with my ex that weekend. I walked with them for miles that day, unable to hide my limp that I hadn’t told them about. They wanted to see a palace. I bowed out saying that I was tired and had already seen it. Truth was the idea of walking over gravel for a few hours was too exhausting to think about. We later got pizza. While I was in the bathroom my parents asked the ex what was wrong. To her credit she didn’t say, per my wishes.

I flew back to the States to get the surgery done about a month later. I had three hour-plus one-on-one visits with the doc. He explained everything that was going to happen and what to expect. Being a young patient, he took a special interest in me. “This doesn’t happen to people as young as you,” he said. Not words you want to hear.

I had to go to group meetings to get prepared for the operation and what I need to do afterwards and what I won’t be able to do. After the surgery I wasn’t supposed to bend my hip past 90 degrees. It might dislocate, they said. I was easily 30 years younger than everyone else present.

Time for surgery. I was the first of the day and arrived early. I was given Valium and the nurses were very sweet. I was put under and don’t remember anything for the first 24 hours or so. I awoke in a spacious, private room. My bed was a lot of fun. I was pumped up with pain killers and felt incredibly stiff but no pain to speak of. I had a menu and could call at any time of day and get whatever food that I wanted. Having good food and calories were very important and comforting. This turned out to be very different than Korea.

Perhaps I should explain the surgery. First they had to sever three thigh/ass muscles. Then they dislocate your hip. Then they saw about 6 inches of it off. They shove the implant down through the bone marrow and pop the new head into one’s pelvis. Then they screw it in place through the bone.

Again, I don’t remember the first 24 hours. But I stayed at the hospital for three days and two nights. I don’t remember it being too unpleasant, other than how unpleasant being stuck in a hospital bed inherently is.

I was released home and was given a boatload of pain pills. I was encouraged to get out and about as soon as possible. The abject swelling and stiffness is hard to explain. But I dutifully would go out and walk 100 feet and back to the house. When going on stairs, the rule is: Good Leg up first; Bad Leg down first. Also—always use the cane on the opposite leg. Movies get that wrong so frequently. I notice it constantly now, just like I’ve always noticed when someone is left-handed.

I took my recovery very seriously. Eventually I got down to the end of the street. Then I went a block further. Soon enough I got to the nearby forest and tested myself walking over uneven trails. There was a real sense of accomplishment.

After a month the pain was still there but certainly manageable. The stretches I had to do were a terrifying new flavor of pain. It’s hard to explain. Your entire body is saying that this movement is absolutely unacceptable. It was a cold, desperate pain. It felt like something was going to rip. That tends to dampen your enthusiasm to your new regime. I probably didn’t do them enough. It’s still very difficult to get my right leg over my left knee into Newspaper-Reading stance.

I would say after six months my walking life was pretty much back to normal. No more running, though. No more jumping. They don’t know how long these will last on me because I’m not the average patient. But because I was young and fit they were encouraging. But they had no real answer. That I will almost definitely have to have another operation—one that I’m told is much, much worse– in x years is something that I try not to think about. It brings about feelings that I prefer to push out, given I have no control over them, I get sad when I make the mistake of dwelling on it.

I flew back to Korea. My life went about pretty normally for six months or so. My ex would help me with my grueling stretches. And then, in 2014, I started to feel the same pain in my left leg.
That was a fun day.

I decided to do the second surgery in Korea. My retired mother flew out to be with me. The surgeon spoke English but I only talked to him for maybe a minute at time. If I spent 5 minutes total talking to him I would be shocked. But I did have a Guardian Angel as a nurse.

And her name was….well I forget, sadly. She had studied in San Francisco and was my English aide throughout. She was the only competent person in the building. Every room had soap dispensers. She was literally the only one who used them. The only one. I’ll get back to that.

I paid extra for a private room, because I couldn’t handle that shit. Everyone else was in rooms with 6-8 patients. Cloth curtains, noxious smells and Korean food that even the locals didn’t eat. I was prepped for the op and I was wheeled down to the theater.

I got gassed and I went under.

I woke up sometime later, groggy and unfocused. They started to wheel me out. The anesthetic wore off shockingly fast. As soon as I was wheeled out into the expansive main floor of the hospital, all of the pain hit my acutely aware brain.

Torn muscles. Dislocated hip. Sawn off bone. Titanium thrust into my femur. Screwed back in.

I am screaming in the hospital. I’m talking taking-a-Minie-ball-to-the-leg-at-Antietam screaming. I couldn’t control it. Couldn’t hear myself. Couldn’t think. I was wheeled in front of patients, women, children….and my mother.

My mother had to hear her youngest scream like that. I’ve never talked to her about that moment and I never will. I can never forgive them for that. Never. Ever.

We got into the elevator. Again, my mother present. The echoes of pain must’ve been haunting in that steel box. I’m glad I don’t really remember it. We got to my room. Instead of picking me up by the sheet I’m on, they grabbed me limb-by-limb and flop me into the bed.

Then, and only then, did they inject me with more anesthetic. Let that incompetence sink it. Infuriates me to this day. Again, never, ever can I forgive.

That sadly, was only the beginning of my troubles. I had tons of drainage tubes attached to the bed. All in all I spent 10 days tied to that fucking bed. Shackled. They had people come a few times a day to turn me over and hit my back to prevent bedsores, which I eventually did develop, but thankfully they didn’t become a problem. Hilariously, those back-slappers were the only people that wore gloves, even when dealing with my stapled wounds and drainage tubes. I’ll come back to that, as well.

My mother was a saint. A Subway just opened up in Daejeon and it was really busy. I wanted actual food and she would wait in line for an hour to bring some comfort to her youngest. I liked getting her out of there. I didn’t like being so helpless and needing everything done for me. My friends wanted to visit and I told them no. I would visit them when I got out. I didn’t want to be seen like that.

My humanity was spiraling.

One thing made me happy. I would trudge along until 6pm. That was always the goal. Deal with the shit and you can make it to six. That’s when the Korean baseball games would come on. I don’t care about the teams here—I’d flip through channels 44-48 trying to find the best game. Whatever game was the most interesting, I would watch. For those 4 hours I knew I could kind of escape myself. And at 10:00 or 10:30 when the games ended, I had to deal with reality again. Cold, painful, lonely nights.

I didn’t take a shit for 6 days. They started to get nervous and would give me laxatives every meal. Still, nothing. Sometimes I would think that I had a shipment to deliver and I’d get the bedpan. My mother would leave and I would painfully struggle to pick myself up enough to get it under me. Usually I had Top Gear on to distract me from the desperation. I had two days of false alarms. When I finally did take a shit it was hands-down the foulest thing my body has ever produced. Had the consistency of daub. The Mississippi Indians could’ve built a duplex with that load.

I had to give that vitriolically foul deposit to my mother to deal with. Again, a Saint.

A week after the op came Sunday, Bloody Sunday.

Everyday I was wheeled out into the lobby to get my bandages dressed. But on this Day of the Lord, the doctors were off. Interns and graduate students only. They were going to remove my drainage tube. I was on my side, lying away from the two kids taking it out. I felt a pinch. They had just got back from their smoke break. Reeking of Marlboro, they fiddled around this inch-long incision in my lower ass. They were not wearing gloves.

Then, all of a sudden, a lovely surprise. It turns out that that pinch I felt had nicked an artery. So there I am, lying on a hospital bed, in relative public, with blood spurting out of my ass with every heartbeat.

I actually had some fun with this one. It didn’t hurt and I wasn’t really concerned. They called the doc and were frantically asking what to do. They applied pressure. Again. Their bare hands smoke-infused. Pressure was applied for about 5 minutes. They pulled away and breathed a sigh.

To my great pleasure, the spurting returned!

I was legitimately laughing at this point in time. This felt like a bit of my revenge. I wasn’t in pain and I was gleefully inconveniencing others for a change. Their white coats were splattered with blood. Felt like justice. More pressure was applied. Eventually the bleeding stopped. I’m glad my mom wasn’t there for that one. She wouldn’t have approved of my Grinch-like grin.

After ten days of being locked to the bed (I was still attached when they wheeled me out to get new bandages), they finally let me out and into a wheelchair. To be able to read in the sun was a revelation. I got some upper body exercise speed-wheeling myself around the hospital. And I hatched a plan. I got a hold of some crutches. “Don’t walk” they said. Well, this wasn’t my first rodeo and I knew what I could handle. At night I would get down to the main entrance and crutch-walk my way out. This was a great time to pull the Foreigner Card. No one ever said anything to me.

I went across the street to the 7-11, bought smokes and booze. Smoked a celebratory cig worthy of The Great Escape and went back in. I got loaded in my room and had fun for the first time in a very long while. I repeated this every night for the next four days. The satisfaction I got by taking back my agency was worth everything. Also, I had been dramatically weaned off the pain killers by this point in time. I felt like I was keeping up the tradition of getting drunk before/after battlefront surgery. Shit works, yo.

After a total of two weeks I was allowed to leave that infernal place.

My surgery in America came on insurance and cost $80,000. With our fantastic insurance (granted my mom was a teacher with a very strong union), our family was charged $674. I was in the hospital for 3 days and was pampered and taken care of. I was given dignity. I was given the tools I needed to recuperate on my own afterwards.

In Korea the surgery cost me $6000. No idea what it actually cost to do. I was chained to a bed, humiliated, traumatized, was treated by monstrously inept staff (save, of course, for my Guardian Angel), and was given no pain killers to help with my recovery once I left the hospital. It was absolutely the worst fourteen days of my life.

Now, to compare the two systems in terms of policy. The actual price tag in the States would legitimately be out-of-reach for the vast majority of people. Insurance mitigated that, however. I actually benefited from Obamacare by still being on my parents’ insurance. That’s why I did it there to begin with. My mom still doesn’t understand how I can be opposed to a program that actively helped me. Because it’s my mother, and she’s a Saint, I don’t follow up with an answer.

In Korea, $6000 is attainable for most people, even if they have to take out a loan. The quality was absolutely atrocious, and it was very easy to see how they cut on the amenities in order to focus costs on actual medicine. That’s probably a good idea with their budget, but I learned that a lot of healing and getting better is being comfortable. Having good food, being in a clean place, not being in pain, having helpful nurses and staff, fundamentally helps you recover. It relieves your stress, the stress of your family, and the stress you feel from forcing your family to feel that stress to begin with.

I’m not going to make a policy argument of the pitfalls and perks of these two systems. The purpose of this piece isn’t really for myself to get into the politics of everything. My point was to show what the same serious operation is like in one system versus another. They both have their pros and cons and I benefited from both of them in my own way. I’ll be plain and say that the best solution would be to have an actual market, which we all know doesn’t exist when it comes to health care. If you can afford the filet mignon and lobster, go for it if that’s what you’re in the mood for. If a buck McDouble is going to sate you, then that should be available for you as well. You should always have the option to choose.

***** For what it’s worth, the second surgery was in 2014 and I felt back to relative-normal six months later. I have been walking pain-free ever since, after having dealt with existential pain every step for over three years. I sometimes catch myself getting bitter about the things I can no longer do and what I’m facing in the future. But then I try to focus on how lovely it is not to deal with that pain anymore, and how modern technology saved me from an affliction that certainly would’ve left me direly crippled or dead a hundred years ago.

Here’s to hoping further innovation and a bit of luck can help me keep walking for decades to come. Please, Washington, don’t get in the way.