A Real Hip Story

Published 2 Dec 2016

                                                           Centre Hospitalier, Saint Junien

Well, I bore the disorder for as long as I could, but in the end the torment forced me to get it done. Or rather get both of them done. My hips, I mean. For I had reached the time of life when hips can become as much a problem as an asset.

So I decided to go in for 'hip replacements'.

Since the left one was the worst of the two, I had it dealt with first in the Centre Hospitalier of Saint Junien. The operation was conducted conventionally with the aide of a general anaesthetic and when I'd recovered from it's affect I felt like I'd been blessed with a new leg.

Two years later I resolved to have the right one done. Now, medical practice in France, where I live now, is a bit different from English practice. One of the differences is that prior to surgery the patient has to see the attending anaesthetist. When I did so, he asked me an unexpected question. Did I wish to have a general anaesthetic or a local one?

I was speechless. I never dreamed that an operation aimed at chopping off a chunk of leg could be tackled while the patient was awake!   However, when the advantages of local anaesthetic were explained to me,  such as pain relief for a longer period of time after the operation, reduced blood loss and faster return to normal eating and walking, I began to be convinced, especially since I recalled  suffering headaches and nausea for two weeks after that last medical episode.

But when the time came I began to regret that decision, for I found myself being restrained in a sitting position on the operating table while the anaesthetist inserted a needle into my spine. The pain of it was excruciating, and my back instinctively recoiled from the stab. I was asked to keep still while another puncture was ventured. A second serge of pain provoked  a second recoil. The anaesthetist (a charming man really) now told me firmly that I must keep still. I felt ashamed then for having appeared so feeble and vowed to myself that I would keep still this time no matter what the pain.

By a stoic effort I succeeded in keeping still this time for the injection and the burning sensation that followed it.

Next I was given a second painless injection in the arm to induce 'drowsiness'.  This I took to mean that I would be somewhat aware of what was going on, but only in a vague, dream-like sort of way.

The reality was quite different. In the event, I felt no more drowsy than if I’d drunk a glass of wine. In fact I was fully conscious throughout the entire operation, and aware of the smallest details of the undertaking, although I was spared any sight of it by a makeshift screen that had been erected between my head, lying sideways on the pillow, and my torpid trunk, which, though completely unfeeling now, I could still sense in a peculiar sort of way. Experimenting a little, I willed a leg muscle to contract, but nothing happened. On the other hand, I could sense the preparations being made to prepare the leg for the work. It was being elevated by some means or other (a jack?) and when the elevation ceased, I thought I knew quite accurately the angle of elevation.

Although I felt not a throb of pain during the entire operation, which lasted more than two hours, I could more or less tell, by means of vague sensations and/or very clear sounds, just about where we were up to in the proceedings. Thus, when the jacking and cramping had been finished I felt I knew the exact moment when the scalpel was inserted into the thigh and a slit made. Later, when I heard the sound of a small saw spring into life, I knew that the femur was being cut.

As he worked, my doctor sustained a ceaseless chatter with the anaesthetist and the nurses while now and then calling for a tool. It was shortly after he called for a hammer that I heard a series of taps, which I construed as preparatory work - possibly hollowing-out work - on the pelvis for the reception of the ‘cup’. At this point I felt like some statue taking shape – though not of David, regrettably ;-) – under the hammer and chisel of a sculptor.

Next a stage of heavy work began. Doubtless a heavier hammer was in use – to fix the ‘cup’ in place, in my estimation of things. At each blow, or thud, as I may say, my head slid slightly back on the pillow and then slid ahead again. This work went on for some considerable time, and as it required no particular close attention, as I supposed, my doctor took to singing while he worked, as though, instead of conducting a highly-skilled operation, he were merely beating a panel in an auto body shop.

A period of quieter, more delicate, work ensued, I thought, probably involving the fitting together of component parts, and then a series of extremely fine sensations conveyed the idea that my doctor was plying his needle and thread.

The aftermath of the affair showed the wisdom of my choice. I suffered no headaches or nausea.

It's interesting to note that the hip replacement operation was pioneered by John (later Sir John) Charnley at Wrightington Hospital in Lancashire, just three miles from where I lived in England.

                  John Charnley