In one of my meetings with Dr D, she said that I was a fighter. I believe that was the word she used; my memory may be in error.

She was making reference to the fact that I am actively engaged in trying to get better. This is in contrast to a patient who is entirely passive, one who simply submits to the injury condition and makes little attempt at improvement.

I have been mulling over this remark and realize that, not only is it true, it also applies to much of my life.

I was a breech birth. The delivery was complicated and my upper arms were deformed. Until the age of four, I slept with my arms pinned over my head in a device that resembled a tennis racket. I hated that thing. Wearing it was a form of torture. Despite this torture, my arms remained weak and I was incapable of playing sports. Or, to correct that last sentence, I was only capable of playing sports extremely badly. Baseball was my nemesis. I could neither hit, nor catch, nor throw.

In high school physical education, when the class was being divided up into teams, two team captains were selected. They then took turns to select their line-ups via a process of alternating picks. I was frequently the first player chosen. Not because of my abilities, but because my incapacity as a player gave me significant worth as trading bait. The side that deigned to host me would immediately demand the selection of the two very best players to compensate for the burden of carrying me on their roster. I do not remember feeling humiliated by this selection process; I remember being glad I was accepted to play at all.

Of course, once the team took the field my position would be to play bench, or to be so deep in the outfield that it would take forever to return on a change of inning. If I tried to move in, I would be exhorted to go deep and await the long ball. But I was already so far back in the outfield I could have been standing in another province. I hated baseball.

This experience affects me to this day. I have always exerted myself to achieve the best possible performance. It is my way of trying to fit in and gain the acceptance of my peer group. When I entered the world of work, I was constantly trying to see how I might improve, or restructure the work in a way that delivered superior results. Almost invariably this was recognized by employers and I was promoted and given additional responsibility.

I now observe a similar dynamic taking place within the context of my injury. My response is to attack it, to vanquish it, to prove to myself, or to others, that I can master the problem, that I can prove myself the equal of everyone else.

The depression arrives with the realization that, despite my checklists, despite my watchfulness, despite my best efforts, I continue to make the same errors. Over and over again.

Consciously, or unconsciously, I have become aware that my life-long strategy to overcome my deficits is no longer working. That my increased effort no longer pays dividends. My effort to “fit in” and be the same as everyone else no longer produces results. And when I come to this realization, I have great trouble in dealing with it.