Recovery!

The long and difficult process of getting over...myself.

Success is survival.*

*Attributed to Leonard Cohen as cited by Naomi Morris

My next long-form writing project is currently a rambling Pages document entitled “Recovery.” When I started journaling on the topic, I was asking the question, “what does recovery mean in the context of chronic illness?” I started researching, thinking I’d find the words fairly quickly.

As I wrote and pondered, I also lived. I had good days and bad days, hopeful days and despairing days. Often, as soon as I declared myself recovered in this way or that, some new trauma, circumstance, symptom, or reminder of a forever-illness reared its head. Recovery, it turns out, is a moving target.

What recovery means also depends very much on the perspective one takes. Am I interested in what a chronically ill person feels when they’ve accepted and/or adapted to their condition? Or is recovery a medical determination? Often, I wonder if the benchmark is less how I internally feel, or what a doctors measures—but instead, being considered fully rehabilitated by the people around me. Will I regain my previous social markers of success? Will I ever again know what to say I “do,” when meeting new people? Is my goal supposed to be taking it easy, and living in line with newly identified priorities—or returning to some previous level of outward productivity?

There’s also this question: is recovery even something to strive for when the context is a chronic illness or disease, something which, by definition, medicine doesn’t hope to cure? The word recovery is used in most chronic contexts, from Alcoholics Anonymous to accounts of Long COVID. It’s mentioned less in the context of my own diagnoses, namely migraine, heart failure, and epilepsy. When it is used, it somehow feels like a stretch. So I tried on many other words. One fascinating article suggests the term “unrecovered” as a protest against the narrow understanding espoused by today’s most celebrated recovery memoirs:

Not everyone can get well in the way endorsed by recovery narratives. By its very nature, chronic illness resists having a beginning, middle and end. To imagine that surviving was an accomplishment in itself was a great comfort.

Comforting, indeed. This idea of simply striving for survival hit a nerve. But I wasn’t ready to toss out the popularized term yet. Recovery is what I set out to explore. Recovery is what I want to experience.

After thinking and journaling about all this for weeks, it was Nature herself who answered my inquiry. I saw recovery, in the wild. I saw recovery in the form of a rare pink ladyslipper flower.

Pink ladyslipper, black pinecone. Bird Knob Trail,

It happened like this. I was hiking through a patch of George Washington National Forest that was badly burned in the epic Shenandoah Valley wildfires recently. The normally lush, wildflower-lined trail was open and barren for the first three miles, much of which are rocky and straight uphill. While walking along the hot, blackened ridge, I suddenly saw a splash of green at my feet. After a double take, I noticed several more tiny chartreuse leaves popping out of the scorched forest floor.

I often hike with some people who are very knowledgeable and observant about wildflowers. I’m new to noticing such things. As I knelt down to take a photo of the orchid-like plant sprouting out of the pile of burnt pine needles and pitch-black pinecones, I looked forward to getting back to cell service so that I could look up what this lovely thing was called. I wondered if it was a special or rare flower. Was it one of the species my new hiking buddies are chasing?

As I continued on my solo nine-mile hike, curiosity about the flower deepened. I even started to…relate to it. I thought about the symbolism of such spring newness pressing out of the wreckage this mountain so recently withstood. I marveled at the brilliant life arising right where firefighters recently worked to keep human structures and infrastructure safe; such beauty born of the same fires that erased an acquaintance’s home and shut down a major road for a several days. I thought about the fact that I was hiking so many miles on a perfect, sunny April day, alone but for my dog, without any hint of the tremors, stumbles, palpitations, or numb extremities that felt they would never end a few short months ago. Now, the picture of health in a body once visited by death, I felt in common with that flower a resurgent hope. It wasn’t hope for either one of us, exactly, but hope that it again made sense to believe in the mere fact of Possibility and the concept of an existent Future. This is what I mulled over while placing one foot in front of the other for 18,000 steps, easily and efficiently and without pain, after a year of feeling almost exclusively an oppressiveness from the past.

Later that night, before I had looked up my photo, I saw a ladyslipper posted on social media. It was unmistakably my wildflower friend. I started Googling to learn more, and found out that the pink form is the rarest of dozens of slipper varieties. They are indeed members of the orchid family. They are literally late bloomers, taking as many as 16 years to flower for the first time, and require a specific fungus and the bumble bee to live (Source). Survival, for them, is no small feat. Ladyslippers inspired various legends across several Native American tribes, all of which share a common symbolism (Source). I was far from the first to sense, from naked observation, that the pink ladyslipper signifies recovery.

Recovery from sudden cardiac arrest is like trudging slowly and laboriously up a steep mountain. I spent many months on the slow, unrewarding incline, seeing nothing but the patch of earth in front of my next footstep and using all my energy to stay upright. Then recently, I crested onto a flat ridge trail. I can afford to look beyond myself for the first time. I can see for miles, in the light spaces between the trees. I take my next step, and my balance, for granted most of the time. I breathe easier.

One model of chronic illness, proposed by S. Kay Toombs (1992) and cited in a 2021 article by Yael Friedman, suggests that my uphill journey has been one of confronting five losses:

1. Loss of wholeness—no longer being able to take one’s body for granted

2. Loss of certainty—increased vulnerability, fear, and anxiety

3. Loss of control—becoming more dependent on others

4. Loss of freedom—new constraints preclude the person from living according to their values

5. Loss of familiarity—daily life changes drastically

I lost a lot of myself in my cardiac arrest. I was obsessed, for a while, with picking up the pieces. Only now, when I’m regaining some confidence in my potential, continued survival, is my system free to relax my grip and enjoy the scenery.

Friedman suggests that moving to a new “sound state” (a term I much prefer to the more common “new normal”) can happen from three different perspectives: the individual themselves, the social, and the biomedical. Therefore, three possible interpretations of “recovery” are:

1. To heal: Meaning originally “to make whole,” healing is a process of expanding one’s world and perspective until a sense of wellness and being at home in oneself is possible again.

2. To habilitate: This path refers to the social perspective, and regaining the ability to function in society. Habilitation depends on help from social institutions, other individuals, and policymakers, and the process can easily be thwarted by “lack of empathy, discrimination, and stigma” (Friedman, 2021).

3. To cure: When tests, scans, devices, and pharmaceuticals lead to a sufficient, measurable biomedical improvement or cure, this form of recovery is achieved.

I’ve experienced some measure of all three types of recovery. They also all still need work. My messy “Recovery” document has a long way to go. In one way, though, my question is answered. The natural embodiment of recovery, the image provided by the pink ladyslipper, told me what I need to know before I quite have the words for my experience. Noticing that flower, whose crowning achievement is its mere existence this spring, reminded me that I share this same primary achievement.

Actually, we all do.

I may never fully re-habilitate. And getting over my narrative self—both the mask I wore for so long in social settings, and the hope that my cardiac arrest story can grow into something resembling the hero’s journey—is perhaps the hardest hurdle still facing me. Meanwhile, my heart valve issue slowly deteriorates. Mysterious seizures may at any moment return. Some cancer or car accident I’m not even worrying about right now might take me out. And no matter what good things happen along the way, the losses I experienced from chronic illness will never really be recovered. But I am not a victim, because I can learn to redefine my success.

I survived. Monday, on my hike, I remembered that Nature considers that everything, and I already felt enough.