The Cane and I

A cane fighting class for seniors.

A legend is an old man with a cane known for what he used to do.
I’m still doing it.
-Miles Davis

I was irresponsible, had the wrong priorities, moving too fast and not thinking things through. Thus I slipped as my bare, wet feet met my tile foyer. There was a sound like tearing wet jeans. There was pain and the total certainty that I had just broken my foot.

Turns out, no, I had only torn the ligaments of my foot. An injury which, they told me during three hours at the ER, hurts just as bad but heals quicker. Still, not fast enough, as I pen this nearly a month later and glance at my cane.

The cane. The doctor wanted me in bed for a week. Not possible. On crutches, then. Not possible. I chose the cane. I didn’t know it at the time, but that choice, and this injury has brought me closer to my patients than any other life experience.

The cane, you see, is my Residential Treatment Facility. It’s my Rehab. It’s my outpatient. It’s my therapy. And I hate it.

According to a Surgeon General report “Today, the majority of those who need mental health treatment do not seek it” despite the overwhelming data that “appropriate treatment can alleviate, if not cure, the symptoms and associated disability of mental illness. With proper treatment, the majority of people with mental illness can return to productive and engaging lives.”

So, why? Why avoid treatment if “mental illnesses exact a staggering toll on millions of individuals, as well as on their families and communities and our Nation as a whole” like the Surgeon Genny says?

Now I know.

Stigma not Stick-ma

I’ve said it—“The stigma of having a mental health disorder”—but I never lived it. Though I still don’t suffer from mental illness, I’m now the guy with the cane. Sure, most people are kind to me, or curious what happened. But inside I wonder. Do I look old, to them? Are they judging me because I’m overweight and out of shape? Are they thinking “Poor Keith?”

I’ve learned to push those thoughts aside and, quite literally, just keep moving. Those stairs aren’t going to climb themselves. Still, it’s just a cane. To have depression, anxiety, social phobia, an eating disorder and have to deal with stigma must be like being treated for a gunshot wound and having the doctor hand your assailant a shotgun.

The Patience of Patients

Healing takes courage, and we all have courage,
 even if we have to dig a little to find it.
-Tori Amos

I’ve worked with a kid who could only say, to the reasons which brought him to therapy, “It’s not fair—I should have been out by now!” Then he would cry. He grew to be able to very calmly say “I’m frustrated that this process takes so long.” I would empathize. I would process the depth of that statement with him and praise his new born ability to articulate. I wasn’t wrong, but I didn’t get it.

The healing process always seems like a joy to me. Watching a patient adapt, applauding the small changes, sharing accomplishment. That’s because I wasn’t inside it. Healing from my leg injury is an exhausting, sweaty, frustrating exercise in humility, patience and adaption while always pushing to the next hurdle. It is a drain on my healthy emotional and cognitive reserves; to do so without those reserves is truly a heroic effort.

I want it healed now. I want my cane gone now. So I push myself. There’s a high probability that pushing myself is what helped me to injure my back, washing my face this weekend and miss two days of work. Much like my patients, I have felt the sting of pushing too far, too fast.

A Double-Edged Cane

Wisdom is nothing more than healed pain.”
-Robert Gary Lee, Baptist Preacher

The worst part is that it’s not all bad. I get to park in handicapped spots. Sometimes, I dance a little jig to make people laugh. I hook the handle around doorknobs to pull doors shut from a distance. I use a similar technique to pick up clothes from the floor, turn off light switches and turn on the dishwasher. Those who know me also know that I will make a toy of anything I touch, and now I have one all the time. All the former is besides the overwhelming positive benefit; It let’s me walk when I would only be able to in extreme pain.

This cane is support, reliability, structure and safety. Just like a hospital for mental illness. It can be kind of fun. Just like the hospital which I am at now. Incidentally, I am utterly grateful that Foundations integrates healthy fun into their curriculum. I’ve worked at places which have a more condemning, solemn air, and, though well-intentioned, it is unkind.

Eventually, I will say goodbye to this cane. I long for that day as I contemplate the stilted, groaning moment that will come when I use it to lever myself from this chair. But, in some ways, it will be like giving up a part of myself. Like saying goodbye to a stern friend, though the relationship only lasted months. I work with some kids who’ve spent years loving and hating but knowing and feeling safe in the hospital. The twinge in my heart, the slight tearing in two, must be wrenching in theirs. We, as service providers, celebrate a successful discharge—I know I do. Perhaps I should spend a bit more time grieving the loss of support as well.

“The health of the American people demands that we act with resolve and a sense of urgency to place mental health as a cornerstone of health,” sayeth the Surgeon General, “and address through research and education both the impact and the stigma attached to mental illness.” I believe the General to be correct. I think acting with “resolve and a sense of urgency” is awesome.

I would add “And we will begin by passing out canes.”



Reader Feedback

5 Responses to “The Cane and I”

  • zanne says:

    What a thoughtful piece…i liked your gentle tone and the insight about how the return to health is both wanted and feared…i remember having similar feelings about childbirth. I found a related article on PubMed id #8969016 Psychological impact of injuries in athletes ‘

  • Keith Karabin says:

    Thanks for the eloquent feedback. The link is interesting, too.


  • Sandy Sue says:

    I think I have to disagree with your premise, at least from a personal point of view. It’s not the stigma that keeps me away from treatment, it’s the ineffectiveness and, in my case, detrimental outcome, of treatment that keeps me away. Medications turned me from bipolar 2, to bipolar 1 with rapid cycling. Electroshock only wiped my memory and gave me a reading disability. My therapists have been sweet, supportive, and encouraging, but *never* taught me new ways to manage my illness. It wasn’t until my third hospitalization that I heard about exercise being as effective if not more effective than meds.

    What works for me is my dedication to consciousness, which I learned through meditation and by studying Buddhist teachings and other teachers of awareness. Dialectical Behavioral Therapy seems to be embracing these concepts, so I have hope that treatment will one day actually treat those of us with mental illness.

    Thanks for your caring and considered thoughts, Keith.

  • Keith Karabin says:

    Please disagree! Different perspectives are always what I’m looking for, especially from someone who’s been there.

    I’m saddend to hear that it took so long for a counselor to focus on managment, though I’m glad you found one. Both exercise and DBT have shown to be valuable in living with Bipolar.

    I must add that the mindfulness which you show in your comments and your blog may be your best asset. Just the ability to examine your emotional state critically and be able to adjust your day accordingly, not with hopelessness but with direction and purpose is powerful and must have taken years to build.

    Thank you for the interest in this little corner of the internet, your insight is valuable.


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