Praise for
WALK IT OFF
“A page-turning and inspiring journey of recovery . . . Hilarious and hopeful.”
LISA GENOVA, bestselling author of Still Alice
“I can’t remember the last time I’ve liked a character in a book so much—only this one is real. . . . Ruth Marshall’s story is filled with heart and courage and heaping spoonfuls of humor.”
GLENN DIXON, #1 bestselling author of Juliet’s Answer
“Funny, heartfelt, and well written . . . Profound and witty. I could not put it down.”
KARMA BROWN, bestselling author of Come Away with Me
“A moving and hilarious portrayal of what happens when our bodies get the best of us and life is turned upside down . . . Wry and honest and wickedly funny, Walk It Off is a wonderful debut memoir from a writer to watch.”
AMY STUART, bestselling author of Still Mine
“A hilarious account of the kind of thing we all pray doesn’t happen to us . . . An epic journey of recovery that is equally scary and funny.”
MICHAEL REDHILL, two-time Scotiabank Giller Prize nominee
“Ruth Marshall writes with unblinking honesty and intimate charm about the challenges and triumphs of medical calamity. The pages practically turn themselves.”
TEVA HARRISON, award-winning author of In-Between Days
“So funny, so achingly poignant . . . Ruth’s story is riveting, her warmth and honesty irresistible.”
JAMES CHATTO, author of The Greek for Love
“Revelatory, human, gutting, and funny . . . Taking a simple step will never feel the same. One of those books you can’t put down and you will insist that everyone you love has to read. Ruth is us, at our worst and most brave.”
DIANE FLACKS, actor, author of Bear with Me
CONTENTS
PART ONE: OUT OF STEP
1: Losing My Footing
2: Spinal Shock
3: Forgetting (How to Pee)
4: Forgetting (How to Be)
PART TWO: NEXT STEPS
5: My New Life in Rehab
6: Step 1—Learn How to Walk
7: Step 2—Learn How t Have Sex Again
8: Step 3—Standing Up for Myself
9: Step 4—Be the Mom
10: Progress, Practice Makes Perfect
11: To Pee or Not to Pee
12: A Taste of Home
13: Walkabout
14: Working Girls
15: These Feet Were Made for Walking
PART THREE: THE ROAD HOME
16: Walking Papers
17: The New Normal
18: Walk It Off
19: Something Old, Something New
Epilogue: A Rich Life
Acknowledgments
For Rich
And for our boys, Joey and Henry
PART ONE
out of step
1
Losing My Footing
MARCH 2012, 4:30 A.M.
I watched as my parents pulled into the driveway right on schedule—fifteen minutes early. I moved down the stairs as quickly as my confused feet would allow, trying to beat my dad to the house before he knocked and woke up Rich and the kids, but I was not quick enough. He rapped on the door as if it were mid-afternoon; a nice confident knuckling. I opened the door.
“I’ll just be a sec, Dad. Everyone’s asleep. I’ll meet you in the car.” I closed the door.
My father’s smile was too wide, his eyes crinkled unnaturally, his stance was uncertain.
I was in the clothes I had laid out the night before: black sweat pants, black T-shirt, black hoodie, black trench. Christ, I thought as I looked in the mirror, I’m a vampire. I was even wearing a black bra. Most mornings when I am hooking my bra into place, Rich, my husband of sixteen years, perks up. “Whoa!” he’ll say, as if seeing my boobs for the first time instead of the ten thousandth. But on that morning, his response was more sober.
“I doubt you’ll be able to keep your bra on during the MRI,” he said.
I gave him a look. Decorum, plus the size of my breasts, dictates that I wear a bra, in every situation, always.
Rich wanted to take me to the hospital, but I didn’t want to leave the boys alone at such an early hour of the morning, even though, at eleven and fourteen, I’m sure they would have been fine. “Besides,” I told him, “my parents need something constructive to do with their concern.” I knew my mom and dad had been secretly talking to everyone about me, consulting the Internet, matching up every theory they had with what Google had to say, commiserating with their friends, taking stock of their own bodies’ failings to see if anything I had lined up with anything they had. It was almost laughable how one innocuous observation had snowballed to this moment.
•
“Why do you keep staring at your shoes?” the soprano beside me had asked just a few weeks earlier.
Every Thursday night, a bunch of middle-aged Jews gathered to sing in the sanctuary of our local synagogue. Somewhere between the beginning of practice and coffee cake break, I became aware of my feet. “They’re asleep,” I said. “I feel like they’ve been asleep for a few days now.”
“You should see my doctor,” she said, without hesitation. “Actually, he’s a chiropractor, but he’s also magical.”
I took down his name.
The next morning, I woke up, but my feet didn’t.
“They’re still tingling,” I said to Rich before the alarm went off. He wasn’t technically awake yet. I kicked him a little.
“Mmmm,” he said.
“Weird, right?”
“Mmmm.”
“But not that weird.”
“Mmmm.”
“Oh, forget it.”
“Mm-hmm.”
The following week I told my mother about the weird feeling, and the week after that I interrupted the arm-buffing part of my personal training session to tell my trainer.
“You should have an MRI,” she said, reacting swiftly to my tone, which caused me to react swiftly to hers.
“Do you think it’s MS?”
My trainer sat back on her heels and studied me. “I think your feet shouldn’t be tingling.”
I saw my GP, Dr. Bright, the next day. Remembering her weakness for pretty shoes, I was quick to comment on the new cherry-red ones she was wearing. She looked both flush and fresh, as if maybe she had just had sex with her boyfriend in the patient file room moments before our appointment. I had never noticed all the posters on her office wall. I commented on each one. I asked about her daughter, and her daughter’s boyfriend, and her daughter’s job prospects, and her daughter’s boyfriend’s job prospects, and if she thought the weather felt uncharacteristically dry for spring.
Eventually, Dr. Bright cut in. “What’s up, Ruth? I usually see you only for strep throat.”
“Oh, it’s nothing. It’s nothing. It’s stupid actually.”
“Okay . . .” Dr. Bright said, waiting.
“Well, my feet have been feeling tingly and numb for the past, oh, few weeks now, and I looked up some stuff on the Internet and I know I’m too old to have MS—nice to be too old in some cases I guess—haha! So I know that’s not the problem but it does seem a little weird so I thought maybe you could poke me or something and also, just a side thought, I wondered if maybe I should have an MRI to rule out the possibility of MS—not that anyone even suggested that to me but anyway is your hair different?”
Dr. Bright didn’t answer. “Is one leg giving you trouble or both?”
“It’s not my legs,” I said. “It’s my feet.”
“So your legs aren’t bothering you?”
“Well, the strangeness does seem to have moved up my legs somewhat. Somewhat.”
She asked again if one leg was mor
e problematic than the other. It felt like a trick question where neither answer was incorrect but one answer was more correct than the other. In the end, to stop her questions and to stop myself from saying anything more, I decided to cry. Dr. Bright stood over me for a moment with her arms crossed, observing me. I am not a crier. She went to her computer and started tapping. A piece of paper shot out of the printer. She passed it to me, still warm.
“What’s this?”
“A requisition for an MRI. I’ll book the appointment right away.”
I looked at Dr. Bright. Her face was redder than when I’d arrived. “Do you think I have MS?”
“I really don’t know, Ruth, but we should probably find out. And here’s a referral for a neurologist.”
She ripped a piece of paper from her prescription pad.
“And I’m red because I’m having a hot flash,” she said, putting the backs of her hands against her cheeks. “Try to relax,” she said as I got up to go. But I wasn’t sure if she was talking to herself or to me.
•
My MRI was booked quickly, only two weeks out from my appointment with Dr. Bright. To offset increasing worry in the days leading up to it, I decided to change my perspective. Maybe having tingly feet wasn’t so bad. It’s kind of cute, I told myself. No one ever died from the tingles, right?
I asked around.
“It’s because you wear high heels too much,” Karen, my older sister, said.
“It’s the hot yoga,” said my mom. “I don’t trust it.”
“How the heck am I supposed to know?” said Joey, my fourteen-year-old son.
And then there was Rich. “It might just be age, hon.” While this theory made the most sense, it was also the most depressing. We were walking in the ravine near our home, part of our Sunday-morning routine. “You can’t get around the fact that your body is changing.”
“I thought I was getting around that fact just fine,” I said.
We linked arms and looked at my feet as we walked; they appeared to be doing their job perfectly well. So what if some extra tingling came with age? Tingling, after all, did come with some rather pleasing effects.
But that was then. Now here I was with my parents, on the way to Toronto Western Hospital, my MRI requisition tucked inside my purse, at four thirty in the morning, an hour when nothing good ever happens. It was so early the front doors of the hospital were locked. My parents and I had to walk through the alley to a side entrance, a dark wind pulling our hair up and swirling our coats around our legs. An enthusiastic security guard rushed to meet us at the door.
“Sorry, sorry,” he said, as if he were late. He held the door for us, the wind straining his arm.
In the reception area, I filled out a form.
Do you have an eyelid spring? No.
Do you have any shrapnel in your body? No.
Did you tell your husband that your feet aren’t the only limbs that are tingling?
I blinked several times until the question disappeared.
There were other patients waiting, some also filling in forms. The MRI department was a twenty-four-hour, seven-day-a-week business, and as far as I could tell, business was booming. My parents quietly read their books: two fake pictures of calm. I left to change into a hospital gown. I was allowed to keep my underwear, shoes, and socks on, but Rich was right—the bra came off; the machine didn’t like metal or wires. I had taken an Ativan as soon as I woke up that morning so I could stay still during the MRI. Outside the curtained stall, I sat on the green plastic chair wearing two hospital gowns—one covering my boobs, the other covering my bum. The mottled black-and-white floor caught my attention and I tried, using only the power of my mind, to make all the tiny black dots converge into one giant black dot. That’s how the male nurse found me, elbows on my knees, face in my palms, captivated by the floor.
“We’re ready for you, Ms. Marshall.”
I lay down on the table and discreetly readjusted my gowns. The Ativan had melted inside me, thick and sweet, flowing straight down to my toes. They felt coated with good news. I smiled at the male nurse and the male nurse smiled back at me. He handed me a rubbery button to press in case I felt panicky, then he slid me inside the tubular MRI machine. I was content, at peace, high. This was going to be so easy.
My thoughts swayed gently, silky tendrils in the sea, sweeping lazily back and forth, reaching lower and lower. As they neared bottom, my thoughts found a little snag. The tendrils caught it, picked at it, combed it back up to me for examination. It wobbled close; I could just make out its lineaments. Yes, there was definitely something there. I tried to blink the image away, but it kept bobbing in front of me. It was bigger than an amoeba, bigger than an avocado. I gripped the rubbery panic button.
It was the size of a grenade.
•
In a matter of days, Dr. Shure, the neurologist I’d been referred to, had my MRI results. She mulled aloud over terms she’d learned in medical school but had rarely encountered since.
“Blake’s pouch cyst, arachnoid cyst, ventricular enlargement . . . Ah! Hydrocephalus!” she exclaimed.
I shrugged.
“You know those really big-headed kids?”
“Yep.”
“Their heads are like that because they have water on the brain. And so do you, although it doesn’t seem to have ever bothered you. In fact, none of these conditions seemed to have bothered you.”
Actually, I was thinking, you’re kind of bothering me.
She tested the strength in my legs and arms. She placed a tuning fork against my feet, clanged it, and asked me to tell her when I felt the buzzing stop. She pressed the palm of her hand against my forehead and asked me to push against it as hard as I could. She brushed her hand up my left leg, the leg that had become more numb and tingly in recent days.
“How does that feel?” she asked.
“Fine.”
“Normal?”
“Sure.” I hesitated. “How should it feel?”
“Sometimes people with nerve issues will say that it feels as if they’re being touched through cloth.”
“Oh.”
That was exactly how it felt but I remained stubbornly silent. I also didn’t tell her about my thighs.
“Does that feel hot to you?” I had asked Rich only days before, pressing his hand against my inner thigh where the sensation was most pronounced.
“I always think you’re hot,” he said. I looked at him and waited. “No, it doesn’t feel hot.”
Hours later, pressing his hand on the same spot. “Freezing cold, right?”
“Sorry, babe—not to me. It just feels like a thigh.”
“You have huge calves!” Dr. Shure said, startling me. “I mean they are really huge. But the rest of you is so small. And your arms are so skinny!”
“I know.” I have been told both these things my whole life.
“You wait here. I’m just going to slip out and take some notes.”
She came back a while later with a marked uptick of excitement, one that drew her to her full height. “I’ve got it! Neuromuscular disease!” It was as if she had been searching her office, turned the place upside down, and then found the two words attached to each other like Lego pieces under a sheaf of papers.
“No, no, no,” I said, wagging my finger. “I don’t have a disease.”
“Then let’s call it a muscle disorder,” she said, practically rolling her eyes. “But I have to tell you.” She leaned in very close, letting me in on a secret. “I’ve seen only three cases like this in all my years as a neurologist.” She was smiling, astounded, I think, by her good luck. “And you’re the third!”
“You mean, people with big calves and skinny arms?”
“Precisely!”
She wrote down the name and number of a neuromuscular neurologist and told me to make an appointment with him straight away. “I can’t just ignore this,” she said.
But I could, and I did. I left her office with the name of t
his new neurologist already lost in the detritus at the bottom of my purse. I come from a long line of short people with skinny arms and big calves. Common sense told me this was not an extraordinary condition.
I went home and told Rich and then I called my parents.
“It appears that I’m fine, but the neurologist is nuts,” I said. We had a good laugh over her skinny arms/meaty calves obsession, and then spent some time enumerating those members of our family in possession of both.
Meanwhile, in the days that followed, I became increasingly clumsy and tentative. Stairs gave me pause, as did curbs and sidewalk cracks. My feet acted like they were drunk trying to act like they were sober.
I met my friend Michael for breakfast. Before we ordered, I made him watch me walk across the restaurant. I wanted to know if he thought my gait seemed different. He claimed not to notice any change. I didn’t feel relieved, only more anxious. Was it possible that this whole tingly mess was in my head? I worried about pursuing this train of thought with my friend. Although he is a deep thinker with clever insights and a uniquely unmasculine ability to discuss a thing to death, he is also on constant alert for potential health catastrophes—his own as well as others. (Before his first sip of coffee that morning, he told me that his eye twitching clearly pointed to ALS.)
“Are you worried?” he asked me, already worried himself. “About your feet?”
“Not really.”
“Really?”
“Really.”
Believing me, he double-checked that his swallow reflex was still in good working order, then swiped the last of my bagel.
•
“It’s me,” Rich said.
“It’s not you, babe.”
“But it must be me.”
“I’m telling you, it isn’t. It’s me. Something’s wrong with me.”
What Dr. Shure had said, about patients with nerve issues feeling as though they were being touched through cloth, that was happening to me—but the area of impairment stretched higher than I had been willing to admit. Yes, my feet and legs felt covered in cloth. But there was also the matter of my hoochie. It felt covered in cloth, too—all the time—even naked, especially naked. My sex life with Rich was going off the rails. I considered faking it, just to tide us over until things sprang back to normal, but I couldn’t go through with it. I had only ever pulled that stunt once—not with Rich, but some other guy, a hundred years ago. Now, feeling desperate, I called my girlfriend Joanie to offload my worry, believing that since she lived in a different country, the friendship rule of marital-sex-nondisclosure didn’t apply. As soon as she realized where my story was headed, she began yelling frantically into her cell. “Hannah! Hannah! Hannah!” Her ten-year-old daughter was in the car and I was on speakerphone.
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