On My Mind: Thankful

It had been a month since I’d cantered through the hills and fields astride Tex — a giant, almost black Percheron. Over many years, he and I have had a special friendship, and have developed our own language. That morning was misty and cool, with scents of spring, the forest almost luminescent with green moss and lichen radiating against the brown leafless trees as a friend and I rode through the new Land Bank trails behind Nip ’N’ Tuck Farm. Tex was filled with energy, and he seemed to enjoy being out again as much as I did.

After an hour, we turned homeward. I asked my riding partner, Laura Marshard (Tex’s owner), if she ever thought about the fact that we take our lives into our hands when we ride horses. “Not much,” she said. I, on the other hand, am always aware of the danger. I have been riding since I was a child, and started riding bareback before I was 10. I actually feel safer bareback, more connected literally and metaphorically to my horse. I think I’m more vigilant without a saddle.

That morning, though, toward the end of the ride, I was talking and paying more attention to the story I was telling than to Tex. As we reached the crest of a hill, Tex spooked at the sudden sight of a large steer; he bucked and took off, and I was thrown off balance. I managed to stay on, but in working to draw myself upright, I felt something strain in one leg. When Tex stopped, I dismounted and discovered that I couldn’t stand. I lowered myself to the ground and lay down on my back. Laura, who I later learned thought I might have had a heart attack, took Tex back to the barn to get help. I called my sister, a nurse practitioner, who urged me not to try moving without professional help, and encouraged me to call 911.

And so began a saga in which Laura, her husband, Bruce, their daughter Charlotte, about a dozen first responders (dispatchers, EMTs, police, and firemen) rescued me. Later, dozens more nurses, doctors, physical therapists, and family members helped with my recovery from a severely torn hamstring.

One of the first people at the scene was an EMT named Peter, who had a gentle way about him that I found both comforting and reassuring. He seemed to arrive minutes after my call, and stayed with me as I was lifted into a Fire Department ATV and driven from the field, placed into an ambulance, driven to Martha’s Vineyard Hospital, and finally, wheeled on a gurney into the Emergency Room.

In the U.K., response to an emergency call like mine would, on average, take more than 30 minutes. In Haiti, there would likely be no technologically advanced response at all. My team, on the other hand, arrived in minutes. On Martha’s Vineyard, the sheer numbers of skilled professionals — equipped with all the latest technology — who are at the ready almost instantly is astounding.

The field of medicine has long been the scaffold of my intellectual and emotional life, and a large part of what gives my life meaning. I am always impressed by ER doctors, who have such a broad range of knowledge and competencies. I was grateful for Dr. Currier’s decisive plan of what tests I needed, and how best to treat me. The workup revealed that nothing was broken. I was sent home with crutches, instructions to stay off of my feet, keep my leg elevated and iced, and take high-dose Tylenol round-the-clock.

I followed instructions to a tee. But later that evening, I noticed that the back of my thigh was ballooning, and the pain was excruciating. Finally, I asked my wife to take me back to the ER. When I tried to stand up, the pain was severe, and I felt lightheaded. The next thing I was aware of was hearing my wife on the phone with 911. Apparently, I had fainted and fallen back onto the sofa.

The first person to arrive at our house was Officer Connor Bettencourt of the West Tisbury Police Department. I recognized him from my earlier rescue. It turned out that he is a neighbor. His warmth, concern, and professionalism put me at ease. Minutes later, EMTs Amend, Diane, and Henry arrived. I cannot imagine three more competent, thoughtful, patient, and knowledgeable people. After some preliminaries, which happily included a dose of fentanyl for my pain, they moved me onto a stretcher and into the ambulance.

It was probably only having lost consciousness that bought me a night in the ER. But frankly, given the immobility, pain, constant need for icing, and challenges with getting to a toilet or commode, I don’t know how my wife and I could have managed back at home. I won’t forget my nurse, Donna. Throughout the night she was constantly available to help me through my myriad challenges. Donna, who commutes from the Cape and could easily get work there, comes here because she likes the esprit de corps and beauty of our hospital and Island. I am more grateful than I can easily write that she does. In fact, what really awed me over several days in and out of the hospital was the nonstop availability, common sense, and expertise of the nursing staff. Sarah, Scott, and Heather were other remarkable nursing professionals who made me feel safe and cared for.

In the morning, it seemed likely that I was ready to go home, and with Donna’s help, I crutched to the bathroom. But there, once again, I felt lightheaded and faint. Donna, my knight in shining armor, suggested to the ER doctor that I should be admitted to the hospital.

Almost all the hospital rooms at MVH have views of big skies, the sea, and outdoor gardens. The rooms are spacious and comfortable, and a perfect place to heal. My nurse for the next day was Pam Knight. I have known her for 30 of the 35 years that she has been working at MVH. She loves her work and the institution, and like her predecessors, made me feel altogether safe and cared for. I learned as a medical student never to question the judgment of an experienced nurse like Pam. Her advice and advocacy for me was impeccable, and she helped me learn how to dress, toilet, and move about.

Before I left the hospital, I had my first experience with physical therapy. My learning curve was steep: How to use crutches correctly, how to walk up and down stairs, how to sit and stand, and how to avoid falls were all novel skills that I needed to learn. The physical therapist, Matty, was a skilled teacher. I kept thinking that had I not fainted back at home, my insurance might not have paid for the hospitalization that gave me information and skills that have been crucial to my recovery.

The next morning, I was homeward bound, and back at home, the parade of people who have helped me continued. My son, Oliver, came for the weekend to take care of me and relieve my wife. He trained as an EMT, and is currently working with people with disabilities. He contemplates a career in nursing. He is smart, generous, caring, fascinated by medicine and psychology, and would make a magnificent nurse. Nothing would make me prouder.

Cheryl Kram, RN, the nurse supervisor at the Visiting Nurse Association, gave me great suggestions, including using a compression stocking to decrease the enormous swelling in my thigh, and she sent a nurse named Brittany to check on me. Brittany arranged for physical therapist Sarah Massey to come by to continue my education on how to move, safeguard spaces, heal and maintain my muscles, and get in and out of bed. Sarah explained that while my inclination would be to keep off my injured leg, and to keep it bent, I had to do the opposite; if I did not stretch and challenge the leg, scar tissue would become a problem. Beginning to put some weight on it would help me heal. Discomfort was probably a sign of something good, though I should avoid doing anything that caused severe pain. When she left, I felt liberated to move and operate in new ways. I had no idea how much I didn’t know, and I find myself wondering how people recover from injuries without this level of professional coaching.

Most affluent countries have some form of universal healthcare. The American ethos that people should be able to take care of themselves has impeded the development of universal coverage in our country. But people over 65 actually do have universal healthcare. Medicare will pay for the bulk of my care, my crutches and other supplies, and it will pay for the Visiting Nurse staff to come to my home to help me get back on my feet. Our local tax dollars paid for the ATV, the ambulance, and the police who came to my rescue.

Our lives are maintained by countless people who are seen and unseen. As I think of all the nurses, doctors, therapists, and emergency responders who helped me — not to mention all the less obvious helpers, like the people who cooked my meals at the hospital, or who do the hospital’s laundry — I have never been more aware of that fact. A week after the accident, I counted well over 30 people who had directly contributed to my rescue and recovery; the number of unseen people who contributed is countless.

Of all of the people who were there for me, the most crucial and indispensable was my wife, Laura. She was with me in the hospital, sometimes asking important questions I wouldn’t have thought of, and she didn’t complain for a moment when I needed her help with countless little things. If I dropped something like a crutch, I couldn’t bend over to pick it up, and it wasn’t until three weeks after the accident that I could tie my own shoes or put on my own socks. Laura did all of that and more for me, helped me think through every aspect of how best to recover, and offered me sympathy when I groaned in pain.

It makes me wonder how anyone who is immobilized or incapacitated can function without a live-in advocate and companion. In a 2024 study by the American Psychiatric Association, 30 percent of adults reported chronic loneliness. I think of my patients with disabilities, and how many of them struggle with loneliness. We are social animals. For most of us, nothing makes us feel better than connection with other humans. At no time in my life has that been more apparent than now.

I decided to work during my recovery, and that need for connection is the reason. For me, the antidote to feeling so dependent and at times helpless was to be distracted and to feel that I was in turn helping others.

Nonetheless, it’s complicated to feel so intensely dependent. On the one hand, I am crushingly grateful. But being dependent on another person for almost every detail of existence has left me, at moments, feeling both guilty and resentful for being so dependent. A part of me worries that if I don’t continuously express my gratitude, help might disappear. I discussed this with a friend who has permanently lost the ability to use one leg. He sees no end in sight to his dependence and disability, and he’s experienced the same intense gratitude mixed with the less acceptable feelings of guilt and resentment of his dependence. Now, a month after the accident, my mobility has increased, and my dependence has decreased. But I wonder what this kind of dependence, immobility, and chronic pain does to relationships when it goes on for months or years with no end in sight. My heart opens to disabled people and their caregivers in an entirely new way.

Dolly Parton said that “storms make trees take deeper roots.” This storm has deepened my roots to my family, friends, and the countless Vineyarders who are always ready to help with warmth, wisdom, and knowledge. It also deepens my roots to the people I help in my psychiatric practice, many of whom suffer from physical and emotional burdens that limit their lives and their freedom. I understand their experiences from a new vantage point. Nobody enjoys being injured or ill, but sometimes the experience can give us a new lens to look through. In my case, this experience has brought into sharp focus the interdependence and the web of connections that, on this Island at least, tie us all so closely together, and help us make our way through life.

Dr. Charles Silberstein is a psychiatrist and the medical director at Island Counseling Center. He is board-certified in general, addiction, and geriatric psychiatry. He writes regularly about issues Islanders have with mental health.

Laura Roosevelt is a poet and journalist who writes regularly for numerous Island publications. She is a writer and copy editor for Bluedot Living Magazine.