3 hours ago
2
March 6, 2026 — 5:30am
Last time I had a knee replacement, about a year ago, I had a fantasy about the moment in which the surgeon would cut into my leg and, for the first time, see my ruined left knee. Surely it would be the most arthritic knee he’d ever seen, and he’d fall into a quiet reverie about how I’d put up with the pain for so long. “Look at this,” he’d say to his assistant. “There’s hardly anything left to throw away. I’ve never seen anything like it.” The nurses, too, would crowd around, shaking their heads in disbelief.
It’s then that the full crew of the operating theatre would begin singing. Softly at first, then growing in intensity. It would be a spirited rendition of You’ll Never Walk Alone or – better – a four-part harmony version of Lean on Me. Tears would stain their cheeks, falling freely on their scrubs, as they contemplated the fallen hero that lay before them.
This time, back at the same hospital, having the other dicky knee removed, I wanted to do more than fantasise about the operating theatre and the scenes within. I decided to question the medicos when they appeared at my bedside the next day.
“I imagine you’ll be writing something for The Lancet?” I said to the anaesthetist as he loomed above my cathetered and limp body. “You’ll begin, I suppose, by describing the gasps of the nurses and doctors as they spotted the damaged joint, hardly any bone left, the worst anyone had ever seen, how was he even able to hobble? etc. Your article would then include some uplifting thoughts about the miracle of human resilience, and how this particular patient must have been enormously courageous in the weeks and months leading up to the operation. You’d then include a link to my website, just in case anyone wanted to order one of my books.”
I propped myself up on an elbow: “Anyway, I guess that’s what you are planning to do.”
A slight smile played on the anaesthetist’s face, but the real surprise was that he was already onboard with the idea.
Every patient’s ruined body part is the most ruined body part ever seen.
“We’re working on it,” he said. “It should be in next week’s edition of The Lancet.”
“Will it need to be peer-assessed?” I asked, keen to show I understood such things.
“I don’t think so,” he said, employing a crisp medical manner. “We’ve already sent The Lancet your scans, so they’ve seen it all for themselves.” With a brisk “cheerio”, he was out the door.
The scene played out again, a little later, when the surgeon visited. I mentioned The Lancet, the scans, and the tear-streaked nurses singing Lean on Me. He smiled, nodded his head, and said, “Ah, Richard”, indicating what I took to be his complete agreement.
That afternoon, I began to wonder about the way they’d both, so rapidly, accepted my proposals. Then came the sudden realisation: every patient indulges in this fantasy. Every patient’s ruined body part is the most ruined body part ever seen. Every patient’s bravery is the most incredible ever witnessed. The idea that a patient’s heroism should be recorded – preferably in The Lancet – may be the most common side-effect of any operation.
A few days later, I’m home, and facing another difficulty. How do I convince Jocasta that I’m suffering enormous pain, and yet I am being incredibly brave in the face of that pain? If I am truly brave – eschewing whinging, getting on with my exercise, achieving an upbeat manner – she might assume that the pain really isn’t that bad. What a disastrous outcome that would be.
On the other hand, if I indulge in the full Up Pompeii – “Woe, Woe and Thrice Woe” – sobbing into my breakfast cereal, yelping with every crutch-assisted step, keening for a full hour before sleep each night - she might assume I’m a weak-willed whinger who lacks character.
The trick, of course, is to yelp in a way that suggests considerable pain as well as considerable bravery. The best I’ve managed so far is a barely audible squeak, like a frightened mouse, at which point Jocasta says, “Are you all right? Can I help?” I then look up with aching eyes and say, in a rather distant and formal voice, “It’s nothing, nothing at all.” The effect is like a frost-bitten Antarctic explorer going off to die.
I repeat this scene every three minutes until Jocasta finally gets the message. “It sounds like you are in a lot of pain but are being very brave about it.”
Hurrah. Bingo. Success at last.
All the same, why can’t I – at age 67 – be treated like a seven-year-old, right from the start? Where was my fun pack of jellybeans after the operation? Where’s my Paw Patrol Band-Aid? Where’s my little red truck? Couldn’t the surgeons and Jocasta offer up a “brave little soldier” compliment without me having to work so hard to convince them?
People talk about the pain of the exercises following a big operation. Still, it’s nothing compared to the real effort of the recovery period: the battle to get a few compliments for a brave little soldier.
