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Trail Injuries and Self Identity: “Death of the Hiker”

3/10/2021

9 Comments

 
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Me, during my 1994 thru-hike of the A.T.
When I was in my early twenties, I tore the meniscus in my left knee. For several years thereafter the knee would swell up periodically and reduce my range of motion. In the winter of 1993-1994, while contemplating a 1994 through-hike of the Appalachian Trail, I decided I should get it evaluated. The orthopedic surgeon I consulted told me that I should have the knee operated on, and that I’d be laid up for as long as six months. 
I ignored the advice, through- hiked the A.T. end-to-end and the leg was fine-- in fact, it was made a lot stronger by the experience. But the knee still troubles me from time to time. It's been a bit of a rollercoaster: some years I don't seem to have much trouble with it, other years I do. ​Going on thirty years of vigorous hiking since the initial injury, It's held out far better than I'd expected. The injury has changed my hiking over the years: it has slowed me down a bit on the downhill and flats, made me more careful of how I walk, and make me reasonable about the miles (I rarely will do a hike of more than 16 miles in a day). I have also taken up barefoot hiking (long story; fodder for a separate post) which has taken some stress off the knee during hikes (one must step more gently on the downhill when shoeless, which reduces wear and tear on the connective tissue). ​
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I took up barefoot hiking,
in part to reduce impact to my knee.
​. . .you may ask yourself: Who am “I” when my days of obsessively and relentlessly hiking Ultras, Grids, and Redlines are officially over? Who am I when hiking a 4,000-footer is out of reach?  Who am I when I can no longer easily walk down a flight of stairs? 
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My left knee vs. my right knee. The left is larger due to chronic injury.
My left knee looks different than my right knee: it is thick with internal scar tissue and musculature which, I imagine, have insulated and buffered it, not unlike how a tree will grow gnarly around an old wound. I imagine that my careful hiking practices and regular strengthening have extended the life of my knee beyond the threatened diagnosis (every doctor that looks at it reminds me what a mess it is). I have not yet submitted to the knife. I rarely wear a brace and I use just one wooden hiking stick for support. But it would be foolish to imagine that knee replacement surgery is not in my future. ​

​Just this week, I had a fall on a short hike up tiny Mount Agamenticus in Maine, where I cracked my kneecap on rock, injuring the chronically-injured knee in a new way. I’m writing this the day-after as I prepare to call the doctor for an X-ray and evaluation. It hurts to walk down a flight of stairs. My immediate hiking plans are on hold. I’m hoping that I did not do any further lasting damage to the knee. 

​It’s impossible to hike for as long as I have and not sustain an injury here and there. Because I hang out with a lot of other hikers, the stories I hear about injuries sustained during hiking or sustained in other ways but impacting hiking are legion. A friend with a difficult knee-replacement surgery. Another friend who had an incident with an ax (while conducting trail work) and not long thereafter, a bad fall and concussion while on the Great Range of the Adirondacks. A friend who broke her leg twice while skiing and couldn’t hike for two long stretches. Another friend who got frostbite in Baxter State Park and had to be snowmobiled out. The endless accounts of ACL tears and plantar fasciitis, shredded meniscus, dysfunctional rotator cuffs. Minor frostbite of the toes, blisters, bunions, sprained ankles, broken ribs, arthritis, asthma. Through-the-grapevine stories about people I didn’t know: the guy who wore his knees down to raw nubs while obsessively doing multiple Grid hikes—last I heard on his second round of knee replacement surgery and not letting up. The injured A.T. through-hikers who had to get off the trail and not see their dream all the way to Katahdin. The SAR stories of careful people injured happenstance, and foolish people injured foolishly (and visa-versa), some severe and life-changing, some brief, inconvenient, and embarrassing. And (what was once politely whispered about but is now routinely sensationalized and profited-upon through books and blog posts, and opinion-whipped raw on social media) the rarer and tragic instances of hiking-related deaths. 
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Above: Hikers share photos of  injuries (caused by hiking and/or impacting hiking). Top to bottom: Iva Blazina Vukelja, with crutches on Mt. Washington; Anonymous, broken ankle; John Myers, crutches and cast; Danny Hughes, fractured patella; Howard Aronson, frostbite.
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Trail sign, Lebanon, NH
 ​If you hike a lot and are passionate about it, the question isn’t will I become incapacitated and unable to hike? but when, and how bad will it be? And, more importantly: how will I handle it? That is, how will I handle it emotionally? That’s the rub, isn’t it? Our bodies can recover from all kinds of insults, and modern medicine can prop up a lot of self-abuse. But if hiking is your passion, being out-of-service can be hard on the mind and spirit. If one dares, one can take the line of questioning further than just coping and rehabilitation strategy: what has this injury taught me about myself?
The easiest and most common conclusion to that question, post-recovery, is bragging: I survived such-and-such, I’m a such-and-such badass, look at my badassery and tremble. Not to demean the value of celebration or the power of positive thinking, but if that’s your only tack and reward you’ll find plenty of back-pats on social media to help prop it up—you won’t even need to do it yourself; others will be glad to inflate your ego for you and help you dismiss your mortality. Ego-props as an end-goal are cheap prizes, however. It’s like hiking partway up a mountain and turning back, not because the weather is evil and I can’t reasonably go the rest of the way but because I am lacking in a fundamental kind of ummph that has nothing to do with hiking ability or trail conditions. It means I was never forced (or never conceded) to move beyond the denial stage (I’m not subject to the Law of Entropy the way other people are) or the anger stage (I “beat” my injury) before I was fortunate enough to recover. 

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Michael Blair being escorted out of the Great Range with supplimental oxygen, after suffering a concussion.
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Blair, who now experiences occasional post-injury lightheadedness, has been wearing a safety helmet on hikes.

​In his book Who Dies? the late Stephen Levine, famous for his series of books on conscious suffering and dying, asks the reader to imagine they are terminally ill, unable to care for themselves in the most basic of ways. Levine poses a series of questions: [paraphrasing here] when you are no longer able to do the things that most defined you, and others have to take care of your most basic needs (on the extreme end: buying your groceries, rolling you around in a wheelchair, bathing you, wiping your ass) what are you? who are you? where is that “I” that you were in previous years: the father, the attorney, the bicyclist, the carpenter, the doctor, the mother, the caregiver, the football player, the rock-climber, the skier. . .the hiker? ​

​Along those lines you may ask yourself: Who am “I” when my days of obsessively and relentlessly hiking Ultras and Grids and Redlines are officially over? Who am I when hiking a 4,000-footer is out of reach? Who am I when I can no longer easily walk down a flight of stairs? 
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Post surgery, after having impaled myself
on a tree branch on "The Trident"
. . .the easiest and most common conclusion to that question, post-recovery, is bragging: I survived such-and-such, I’m a such-and-such badass, look at my badassery and tremble.
​This line of questioning automatically awakens my old friend Despair—maybe he (or she) is a friend of some of you, too. A few years back I impaled my leg on a sharp tree branch while on a long hike through the Mahoosuc Range (a side bushwhack up the now-appropriately-named “Trident” peak); little bits of wood were imbeded deep in the wound; the wound became infected and I went in for surgery. I thought: what if they can’t fix this? What if I lose my leg? Can I live with that? I won’t sugarcoat it for you: a little, dark piece of the hiker in me was quietly engaging suicide scenarios even before I went in for surgery. I’m not mentioning this to set the stage for judging that kind of thinking. The beloved and brilliant White Mountains author Guy Waterman, who suffered debilitating (albeit hidden), lifelong mental health issues, ended his life by committing intentional hypothermia on Franconia Ridge—for a hiker, quite a way to go out. I cannot know his suffering and so cannot judge it or the outcome he chose. I can only use it as a mirror as I observe my own thoughts during the times I’ve had to question the continued existence of my identity in the face of a contrary or unacceptable reality. Any forced change in one’s self-identification is itself a kind of death. In preparing for "death" the mind grapples with the stages of coping with loss: denial, anger, bargaining, grief, and acceptance. Some of us move through those stages more easily than others; some get stuck. 

If I can no longer hike big mountains, but can still hike, the “big mountain hiker” must die to make room for a different kind of hiking identity. If I can’t hike anymore but can swim, kayak, bicycle, whatever, then the hiker must die and make room for those new identities. There is a loss and grieving inherent in that even if you work hard at burying the emotional labor—don’t let anyone tell you different. But beyond the endless morphing of identities lies the deeper question: what is this “I” that I keep creating? Is it important? How? When I strip it away, what is beneath it? In terms of hiking, one can ask more focused questions: what exactly IS a hiker? What does it really mean to be a hiker--beyond mere goal-posting and exploration? What is the kernel of that identity—and does it really even exist? 
I don’t have answers to these questions (and all answers will likely be subjective and privately individual) but I do think it’s important to ask them sooner than later. In some aboriginal cultures there is a practice of “preparing for death” which begins at a young age and continues until the end of biological life. The process, which involves song, vision quests, prayer, and other practices, is really a delving into the question of self-identity and what lies beyond it.  As I understand it, if it is done well it can prepare the mind for the “little deaths” of identity that occur throughout life: changes in occupation or role, loss of loved ones, tribal warfare, change of physical ability and mental acuity. And in modern life in America, also divorce, unemployment, foreclosure, empty nests, pet death, failed business ventures, stock market crashes, hospitalizations, breakups, house fires, car accidents. . .and hiking injuries.

If I can muster the courage to step beyond the props of the ego, the most important question might not be "when will I recover and hike again?" but "when the hiker can no longer hike [eventually, whether temporarily or more lastingly], what is left? Exactly who is this 'hiker' I have come to imagine I am?"  
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Thanks to those who submitted photos and stories of their injuries.
[Photo credits, by name in caption].
Postscript: my recent knee diagnosis is “badly contused ligaments/tendons /patella.” I consider it a deferment.

9 Comments
Michael Blair
3/11/2021 07:43:53 pm

Well done.

Glad the outcome is “only” a contusion.

I think the “how will you respond” during the event is also an important questions that you need to ask yourself, since the wrong response during can have long lasting ramifications of how well you bounce back after

Realizing that there is a certain limit to what your body and mind can handle helps prepare you for the inevitable. I always expected “physical” injuries like the dislocated shoulder that I suffered in a fall on Blake in the Adirondacks, the ten months I spent in a walking cast to resolve an Achilles tenon problem, and even the flesh wound after losing the battle with ax, but the less physical post-concussion stuff has been a lot more difficult to handle. The body says keep going but the dizziness and constant tinnitus suggests a different story. Worrying about when it will happen and where I’ll be has forced me to reconsider some of my more ambitious plans.

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Danny Hughes
3/12/2021 07:00:40 am

Nice writing. Very thought provoking on the 'what if' side of injury. What stuck with me is that you do go through all the phases of grappling with loss, denial, anger, etc. and each phase you have to convince yourself of an alternative path. I call them "your demons" and if you let them they will get the better of you creating doubt and so ultimately it is a mind game to force them out or at least reconcile to wait and see until you pull yourself through a tough time. In the absence of information humans like to conjure their own ghosts. Making lemonade by finding other pursuits while injured helped me find time to cope through uknowns and the uncertainty of injury. It also changed me where I now am more empathetic toward others injuries and help lift their spirits to get through their tough spots. There's always something else to do so tying your identity to one thing is very limiting and while seemingly important ultimately constrains you from being you.

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Roberta DellAnno link
3/12/2021 12:58:12 pm

This blog floated across my FB page at a time when I have been pondering my own ‘death as a hiker’.

Do I continue to beat up my knees, hips, rotator cuffs, neck, endure scratches, bruises, and cuts, to finish the remaining hikes on my “last” hiking list? Is it time to put these endless bushwhacks to rest and focus on other outdoor explorations? I can’t answer that yet. It’s a struggle between the ‘high’ I get when I come out the other side of what seemed impossible, and the little voice in my head telling me to move on.

This blog is an interesting read no matter what side of the hiking fence you are on. Thank you for posting, and it’s good to know I am not the only one struggling with this.
🙏🏼🥾

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Conor Rafferty
3/12/2021 08:54:56 pm

Very deep post.
I strongly relate. In the 90's I defined myself as a mountaineer. I spent 50-100 days a year in steep places. In 2001, an auto-immune arthritis struck. I went from being somebody who climbed Denali to somebody who needed help getting from where the car was parked to the front door. I was in Manhattan at the time, that walk might be 10 blocks. I'd walk a block, and sit on a kerb or a hydrant or whatever came first, because I couldn't go any further, and I would cry at what I had become.

It forced me to confront the question "who are you? what are you for?"

Clearly that question has a lot of answers! I found a few that worked. About a decade later, modern medicine made the auto-immune thing go away. I can hike again, on a good day I can climb.

We all have in us to be many different people. We are large, we contain multitudes. The immobilized decade had some of the best years of my life.

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Paul Gagnon
3/12/2021 09:43:26 pm

Thanks, everyone, for your feedback and great responses!--Paul

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Toolbox
3/13/2021 05:31:49 pm

Doc- my 1st reaction is where is mount agamentus and when can I hike it? I rebound from meniscus tear and appreciate the Phoenix aspect little deaths. Pot holes will be filled and it is not just physical injury that can pause the action but the pressures of fatherhood and feeding the little birds...how can I mantain until a return to the mountains? Steve Toulmin Hanover sspitting distance from AT brings me comfort..

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Paul Gagnon
3/15/2021 08:36:24 pm

Good to hear from another class of '94-er :-)

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Philip Werner link
3/13/2021 07:17:41 pm

Started to write something and then decided I needed to think about this more. Nice piece though, I appreciate good writing. If you can't hike, you can always write!

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Paul Gagnon
3/15/2021 08:35:36 pm

Thanks, Philip! You were an inspiration in creating this blog.

Reply



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