It was a sapphire afternoon in early March at Montana Snowbowl nearly seventeen years ago.
One of those spring skiing days that you try to savor as the season winds down, pushing little waves of slush under your boards, dodging bare patches, stripping hats and gloves, staying high on the hill to seek out the last of the best snow.
I was teaching Julie to ski, and this was just her second time on the mountain. She was picking up the basics quickly. It happened in the blink of an eye, really.
I was following close behind when she took a slow-motion and awkward tumble into the soft stuff on the side of a run under the LaVelle Creek chairlift. I knew it was bad when one of her bindings didn’t release – we didn’t know exactly how bad until later.
A passing Samaritan sporting a red jacket and with goggles strapped to a bare head (how do you remember these things?) stopped immediately. He, too, knew the score and went quickly to find the ski patrol. They didn’t take long (Snowbowl’s ski patrol has to be one of the most over-staffed patrols in the country). Velcroed to a toboggan, and escorted by four Knights of the Red Cross, I watched her disappear down the mountain. I was, quite frankly, crushed.
When they removed the splint at St. Patrick’s Hospital ER, and the x-rays came back, the carnage was impressive. A spiral fracture of the tibia – starting at the top of where the ski boot had been, and descending all the way into the ankle. It would require nearly three months in a hip-length cast and a surgery mid-way through to reset the bone before Julie was fully mobile again.
Later that spring, under an elm tree on the University of Montana campus, Julie still on crutches, I asker her to marry me. The long-running joke in the family and among friends is that guilt and shame over that day at Snowbowl drove me to the proposal. She said yes anyway.
This is of course, not true. But I still feel badly about it – far worse than she does, or ever did.
This is all a very long way of introducing the news that Julie’s leg is broken once more.
The University of Botswana campus is a minefield of fractured pavement, deep drainage gutters, oddly placed stairs, undulating, strangely cambered walkways, and uneven brick work. In many places, sidewalks disappear entirely, replaced with bare patches of dirt. It takes a lot of concentration just to walk there.
During her run on Wednesday evening Julie took another tumble, and wiser with past experience, knew deep down it had happened again. We held out hope, but x-rays on Thursday morning revealed what Dr. T. Dima called a “fracture of the lateral malleolus – undisplaced”.
What does that mean? It’s apparently one of the most common ankle injuries – a clean break of the fibula near the ankle joint. The key word here is “undisplaced”, meaning the the bones are still where they are supposed be, and should knit together quickly. Happily, she has only four to five weeks in a fiberglass cast that reaches mid-calf.
It sure looks gnarly, though.
So, let’s take a tour of the Botswana health care system.
The MedLane on Chuma Dr. is a private walk-in clinic (there are also government-run clinics and hospitals). It is modern, well-staffed with affable orderlies, and has radiology and pharmacy branches on site. When we first came to Botswana in July, the University brought us here to endure an archaic British empire-era examination required for our residence permits. (Thankfully, we were certified as not “imbeciles” *wince*).
We waited only 5 minutes to see the doctor, who after some manipulation of Julie’s ankle, sent her to radiology immediately. Thirty minutes later, we had the diagnosis, and Dr. Dima – a calm and cheerful young guy with excellent bedside manner – set about preparing a cast.
Finding his supply of fiberglass a little short, the clinic sent one of the orderlies out to the affiliated hospital for more. Thirty minutes further on, Dr. Dima was casting.
Excluding the wait for the extra casting materials, our entire stay at MedLane would have clocked in at just about one hour. The total cost out-of-pocket for three x-rays, two separate consultations with the physician, and clinical supplies?
It was all downhill from there.
The one key piece to the broken ankle puzzle that was missing was a pair of crutches. MedLane sent us to the pharmacy down the road at the Riverwalk Mall. Told they had none, they in turn sent us to “Doctor’s Choice” in another part of the shopping center – ostensibly a medical supply store. I was greeted with this, and a literal chain on the door:
The store was ransacked, and I saw, with no small amount of despair, several pairs of crutches strewn across the floor.
Onwards. A Google search returned Mediland across town. This turned out to be a medical supply wholesaler. “Oh yes, rra. We have crutches, lots of them, but we can’t sell you any.”
“Please try Delta Pharmaceuticals, near the funeral parlor across the road.”
Having arrived at Delta Pharmaceuticals, and after convincing the security guard to let us through the giant metal gate: “Oh yes, rra. We have many crutches, but as wholesalers we can’t sell any of them to you. Try the pharmacy at Molapo Crossing – we sell crutches to them.”
Molapo Crossing is a newer shopping mall on the northwestern end of Gaborone. Julie said wistfully as we pulled into the parking lot near an athletic club, “Look at those guys playing soccer…”
The Clinicare pharmacy had one pair of crutches left in stock. The price? $27 USD. Each. We split a candy bar.
It seems absurd that the crutches themselves were literally half the cost of our visit to the clinic, but there you have it. I thought maybe the physiotherapy department at the Gaborone Private Hospital (MedLane’s affiliate) might have some less expensive options. I made the mistake of showing up at the hospital during the lunch hour, and had to return later in the afternoon. The price there? $43 USD. Let’s look at our route in pursuit of a simple pair of crutches:
Julie is bearing up well under the circumstances, though the four flights of stairs up to our apartment are a bit daunting, and the campus is now extra difficult to maneuver around. She hates having anything covering her feet, and is just generally mad at the world. Fair enough.
However, she will be out of the cast before we head out on our long trip in December and January to Namibia and beyond. So, there is some light at the end of the tunnel, and at least this one isn’t my fault.
Let us part with the words of Marcus Aurelius from his Meditations:
Be like a rocky promontory against which the restless surf continually pounds; it stands fast while the churning sea is lulled to sleep at its feet. I hear you say, “How unlucky that this should happen to me!” Not at all! Say instead, “How lucky that I am not broken by what has happened and am not afraid of what is about to happen. The same blow might have struck anyone, but not many would have absorbed it without capitulation or complaint.”
She does not complain. She does not capitulate.