Last week I got a personal perspective of Utah’s health care system from “under the knife” of one of our state’s best orthopedic surgeons. I chronicled this experience the morning after my surgery in an email sent to family and a few close friends and colleagues. This week my staff voted - almost demanded - that I share the possibly pain-killer induced email describing my knee surgery as this week’s blog post. I’ve guardedly conceded.

You will certainly not want to read this if you have anything productive to do.

They didn't get me into surgery until about 8:00 p.m. last night. I was back out and conscious around 11:00 p.m. It's now 4:30 a.m. I haven't slept much at all, but haven't needed to. I've started back on liquids and soda crackers and now on to my favorite food, Lorna Doones. Can you imagine endless Lorna Doones? That makes it worth the whole trip.

I have a Greg Bell-specific knee apparatus fabricated in Belgium to match exactly my knee as shown by an MRI. (Six weeks ago I had rather proudly refused Valium for raging claustrophobia to lie inside a small tube for eight harrowing hours or maybe it was 45 minutes.) Little Belgian watchmakers chisel cobalt/steel to make the top implement and titanium for the lower, with their little golden hammers. They do piece work for Santa Claus, too.

They actually don't create a new joint as they do with a hip; rather they simply wrap the metal fixtures around the end of the bones in the knee. It typically takes a three-month intensive rehab period to improve above the pre-existing knee condition because there are no muscles to work with, only ligaments which are harder to rehab and strengthen.

Who would have speculated that I have the biggest knee size, comparable even to a famous Jazz player, the doctor said. And of course we all know how remarkably big his knees are? The doctor was really enthused when he saw my knee because my bones are long and my leg is skinny, which apparently creates the optimum operating conditions. (It's kind of hard not to brag actually.) Disappointingly, I have lacked sufficient appreciation for my own knees. I'll certainly be forearmed should I ever do the left knee.

[Truth requires me telling you that the doctor at his visit the next morning clarified that it wasn’t the Jazz player but his in-law; but who is also Russian, which makes a big difference to me, and (this almost redeems the whole change in facts), he was an international Russian athlete. So my embarrassment is that at the last minute, without informing me or getting my consent, because I was under chemically-induced sleep, they only used a size 10, which they say (who knows for sure???) fit better than the record-breaking size 12 implement on me. Seems like I'm always No. 2.

They offered me local nerve blocks as principal anesthesia, one for the main nerve on the front of the leg, one for the nerve on the back of the leg, and a spinal block as the general agent. They will either then put you in semi-consciousness or completely asleep, at your option. The first allows you to do without the ventilator and other major negatives of general anesthesia. I unhesitatingly chose complete La La Land. The pull of scientific observation was very weak and did not overcome my aversion to seeing my leg opened up, pulled apart and re-manufactured, with flecks of my own bone and sinew showered across an operating room as so much sawdust by a Skil saw. Cowardly, I know! I did not raise the possibility of simply biting on a stick like John Wayne so I could see and feel it all unimpaired, but that may have been open to me.

So far all my nurses have operated at the angel level. They are wonderful people and certainly found the right job. And my wife, JoLynn, as always, knows what to do and how to help even in the face of my storied inarticulateness in such matters, i.e. to know and to explain what I want. I looked over at her little couch bed where she "slept" during the night for a maximum of two and a half hours and saw there the sweetest angel of all. I don't understand how she stays tethered to this world.

For some reason my emotions become so tender and open at times like this, which brings me to see and feel my affection and appreciation for my family, my colleagues, alcoholics and even some Democrats, but so far not Rick Santorum. So forgive me my over-the-top expression, but I do feel such fondness and affection for you all. I feel great warmth and appreciation for each of you. Please know of my gratitude for you and what you do and the sweet association we share.

NOTE: Please respect my privacy by forwarding or sharing this ONLY with those who also have nothing productive to do.

The Eljee