Taking a Broader Perspective

Another shared post -- this one from Mahlou Musings where, among other things, I post excerpts from a book of vignettes that I published in 2003. Since the post included both Noelle and Shura, whose stories are part of the life of the clan of Mahlou, I thought it made some sense to double-post in this case.

Far too often, we consider the impact of the moment only. How things affect us right now tends to be more important than how they fit into the bigger scheme of things. In fact, when one is irritated, angry, disappointed, or threatened, it is very difficult to see the larger picture. Yet, that is precisely when it is most important to keep things in perspective.

My younger daughter, Noelle, copes with spina bifida, a neurological defect that, among other things, has left her with full paralysis below the waist. However, she has nearly always kept matters in perspective. Taking a broad perspective has allowed her to lead a fairly normal life -- attend local schools, go to college, work part-time, play (including roller-skating), and the like. In fact, her ability to take a broader view of things has at times quite surprised the medical profession.

A few years ago, she was sitting in a wheelchair, not paying much attention to her feet. First, she was not used to a wheelchair, having used long-leg braces for ambulation up until that time, and second, she does not feel her feet. As a result, when she accidentally caught her small toe in the spokes of the chair's wheel, she did not notice and ended up tearing the toe nearly off. Amputation was the only resolution of the problem.

Clearly, the doctor who amputated felt sorry for Noelle and wanted to help her through her feelings of loss. However, Noelle had no feelings of loss.

"Are you missing your toe?" asked the doctor. What she meant to ask was whether Noelle was feeling bad that the toe had to be amputated.

Noelle, already looking at the situation from the broader perspective, took the doctor's words literally. "Yep," she replied. "It's all gone."

Somewhat taken aback, the doctor clarified. "No, I meant, do you miss having a toe there?"

To that Noelle replied, "I have never felt that toe. How can I miss something I never knew I had?"

I learned the lesson of acting within a broad perspective even more dramatically from Dr. John Blanco, an orthopedic surgeon at the University of Virginia Hospital (referred to in some of my writings, those that are pseudonymized, as Virginia State Hospital). At the time, I was the American guardian for Shura Ivanovich, who illustrated my vignettes book. I had brought him to the United States from Siberia, where he was not being adequately treated for spina bifida. Like my daughter's, his legs were also paralyzed but not as extensively. He was able to ambulate with crutches alone. However, as a result of inadequate care, both of his legs had become gangrenous, and the flesh on his feet had been eaten away.

Bringing Shura to the United States took nearly a year. The American Embassy in Moscow required incredible amounts of paperwork -- notes from the doctors in Siberia and notes and faxes from American doctors. Even then, the visa was denied, and I went to Moscow personally to intercede. Some of the embassy personnel were former students of mine, and they vouched for my sincerity and honesty to the consular officers. Finally, we had the visa, but Shura's condition had worsened. He was in the hospital. It took another couple of months before he was stable enough to move, during which time the gangrene worsened.

Once in the United States, Shura's first need was orthopedic care, which Dr. Blanco donated. What was needed was unfortunately very clear: a double amputation. The gangrene by then had taken over both legs, requiring amputation at the knee for one leg and amputation at the calf for the other. Shura took it in stride and readily gave permission. I, however, was devastated. I had to know the impact of the delay in getting the visa on the need for amputation.

"Could you have saved Shura's legs if we had brought him here a year earlier?" I asked. I thought I knew the answer. However, Dr. Blanco understood what was behind the question and gave me both an honest answer and a broader perspective.

"Perhaps I could have saved one of the legs," he replied. "The other leg was probably in poor shape even a year ago although I might have been able to save more of it. The important thing, however, is not whether getting him here earlier would have saved his legs. Rather, getting him here now saved his life."

A leg or a life -- that is a rather vivid way to describe what a broader perspective means.