The Weird Little Story of My Big Toe
The human body is amazing — and also somewhat exasperating.
For the audio version of this article, read by the author, go here.
At some point last year, I stubbed my toe on a door sill. It hurt — wow, I really jabbed that sucker! — but I knew it would heal, just like my body always had before.
Except it didn’t. Or, rather, it healed, and then I’d bump it again, and the pain would come roaring back.
This happened over and over again.
Is this thing ever going to heal completely? I thought.
I’m lucky to have a weird ability to tune things out, so I mostly stopped thinking about it. But sometimes the pain got too bad to ignore.
Once I was fiddling with it, massaging it, and the pain disappeared completely. Had the toe-joint come loose, and I’d popped it back into place?
Maybe so, but a week later, the pain came back again. And this time, jiggling my toe-bone didn’t make any difference.
This is so weird, I thought.
Several months ago, Michael and I arrived in Bangkok, Thailand. All along, we’d planned to get medical check-ups here (and we did, at Samitivej Sukhumvit Hospital: full physicals with a battery of tests, for about $80 USD each).
But as chance would have it, the pain in my toe was now worse than it had ever been. I was hobbling around the city, wincing with every step, and it was impossible to wear sandals or flip-flops, which is kind of a big deal in Thailand, because it’s hot, and sandals or flip-flops are all anyone ever wears here.
Since we were literally at a hospital, I figured I would have my toe checked out.
This Thai hospital, which caters to a lot of visiting Westerners, has an interesting feature. If your general doctor recommends you see a specialist, you simply go to that specialist then and there — no appointment necessary — and the department fits you right in.
It’s incredibly convenient and efficient. U.S. hospitals could obviously do it if they wanted. They’re just choosing not to.
Anyway, the doctor in the orthopedics department quizzed me about my pain and ordered x-rays, which, again, were taken almost immediately.
Thirty minutes later, after examining my x-rays, he explained that I had something called hallux rigidus, which is a degenerative arthritic condition where the cartilage between the bones in your toe and foot wears down.
In my case, the cartilage was almost completely gone.
The doctor prescribed an anti-inflammatory medication, which worked great, completely eliminating my pain. Unfortunately, it came with a very negative side effect — namely, extreme constipation. Even without that unpleasantness, the medication was only a short-term solution.
The doctor had also said surgery was an option, and a week later, I went in to see a foot specialist. I wanted to know more about the surgery, and I also wanted a second opinion.
This doctor agreed with the first doctor’s diagnosis, and explained how the surgery would work — how they would drill little holes in the bones in my foot, which the body fills with fat and tissue, usually eliminating all pain. A more extreme option, which he wasn’t recommending for me, was to simply fuse the toe back onto the foot.
But he definitely didn’t push for any surgery — on the contrary. He merely presented me with my options.
At one point, I asked him, “Is there any chance of my toe getting better on its own?”
He frowned and shook his head. “Absolutely not. The cartilage is gone.”
But the pain was finally unmanageable, and the, uh, unpleasant side-effects of the medication made that a non-starter. So I requested a cost-estimate from the hospital for the surgery, which was out-patient but would still use a general anesthesia.
It was $5600 USD, which was more than Michael and I were expecting.
I asked SafetyWing, our travel insurance company, if they would cover the cost, but they refused to give me a straight answer.
“Maybe,” they said. I had to pay for the medical care myself and submit the documentation, and then they’d let me know if was covered.
“But you know the specifics of my policy better than I do!” I argued. “Have you covered this surgery for other clients in the past?”
Pay for the medical care yourself and submit the documentation, they said, and then we’ll let you know if you’re covered.
This back-and-forth went on for a long time.
And I realized, Ahhhhhh, so this is how they keep costs down! The medical bar has to be pretty high for anyone to risk spending all that money, only to learn they’re not covered.
I was still in pain, so I was all set to have the surgery anyway, and just pay out-of-pocket if I had to.
But in the time I was going back and forth with SafetyWing, the pain in my toe…went away.
At first, I didn’t think much about it. The pain had gone away before, only to always come back a few days later.
But it had never been so bad before. I could barely walk.
In anticipation of my having that surgery, Michael and I extended our stay in Bangkok for a month, so I’d have time to recover.
But the pain still didn’t come back. Before long, I was wearing sandals and flip-flops — with no pain at all.
It’s been more than a month now, much longer than the pain has ever been gone before, and, well, it’s still gone.
Hold on! I thought. The doctor said there was no chance my toe would heal. That there’s no cartilage left!
I have a couple of different theories on what’s going on.
First, maybe merely seeing that x-ray of my toe, and having my condition explained to me, I started walking differently, changing the pressure on my foot. If so, this was all subconscious, which is pretty darn amazing, if you ask me.
Or maybe my toe did somehow heal. This would be pretty amazing too — a testament to exactly how incredibly adaptive the human body is, even if it can also be somewhat unpredictable and exasperating.
But my story isn’t quite over.
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Last week, my 94-year-old father officially entered hospice care. He’s profoundly deaf and has dementia, and lately, his body has been in very rapid decline. The doctors and nurses have told my brother and me that he probably won’t live six months.
Wow, you’re thinking. This is an out-of-the-blue twist.
But bear with me, I’m going somewhere with this.
My dad could live longer than six months — the medical staff said as much. After all, the human body is still amazing even at 94 years old.
But death is the twist we all have coming. Even if my dad survives this latest dip in his health, he won’t live forever. His body will inevitably fail him.
One day, my body will fail me too — hopefully not too soon, but definitely eventually. My body adapted to solve the problem of my big toe, but it won’t ever solve the problem of my own mortality.
On the TV show The Good Place, in one of the most brilliant lines ever spoken on television, Eleanor explains to Michael, who is a supernatural being trying to become human: “All humans are aware of death. So we’re all a little bit sad, all the time.”
“Sounds like a crappy deal,” Michael mutters. But later, he finally understands: “You said that every human is a little bit sad all the time because you know you're gonna die. But that knowledge is what gives life meaning.”
Indeed. Something is valuable when it’s rare and precious. If we had all the time in the world, time wouldn’t mean anything at all.
As for me, I’m happy my toe stopped hurting, at least for the time being. But yeah, I’m am always a little bit sad because I know I’m going to die one day.
So what am I doing in the meantime?
Well, I’m strapping on my sandals, and Michael and I are about to leave the apartment to climb to go explore Wat Arun, a temple complex here in Bangkok that supposedly pretty amazing.
Life really is frighteningly short. How stupid would I have to be to waste another Goddamn minute?
Brent Hartinger is a screenwriter and author. For more about Brent, visit him at BrentHartinger.com.
Amazing how something as small as a big toe can lead to important reflections on living and life, no?
My spouse has been on a ventilator for 22 days and is not likely to survive the week. Among the many reflections and feelings are regrets over the walks not taken and other experiences not shared.
I’m glad your toe isn’t hurting, but it’s not healed, so my advice is: get it fixed while you can and where it’s relatively affordable.
You can always get more money, but you’ll never get those hours or days back.
I’ll never forget this line from the obituary of one of our high school classmates who died two years ago: “live at once as if you have all the time in the world, and no time at all.”
I’m glad you are no longer in pain, and beyond that I understand and agree with your point about life being short. We are fellow nomads, after all, so we get that better tan some. But beyond THAT, I hope you have a plan for when/if you pain comes back. No more limping through your life, OK?