By PLS
Note: Pix follow the order of the narrative.
Acupuncture. Homeopathy. Ayerveda. Such beautiful polysyllabics! Standing alone, they sound like mantras, and they’re intoned with reverence, in Santa Fe, where I live. In fact, any cure that’s non-allopathic has cachet these days, but I am in the mood for extolling modern western medicine. I’m talking about arthroscopy. I’m talking about refinements in anesthesia. I’m talking about MRI technology. 
Once upon a time I could hardly pronounce that sublimely ugly word: ar-thrós-co-py. I still can’t make it sing, but I’ve experienced it. Two weeks post surgery the tiny knife slits in my knee were barely visible. A week after that I was walking, albeit carefully, up and down the foothills of the Sangré de Christo mountains, three miles, then four miles, then more. In short: this approach to surgery fills me with awe.
The story begins in Bhutan. I stumbled carelessly, stupidly over a rock and fell, downhill and face down, landing on teeth, elbows and knees. The good news was dental. My upper lip was cut and I could taste salty, sticky blood, but my incisors were intact. Equally encouraging, as soon as a wave of wooziness passed and I’d been helped to my feet: I could stand. Tibia and ulna were unbroken, evidently, but my right knee screamed with pain. There was this, too: a twist of my left arm produced a worrisome twinge in the elbow area. But the knee agony permitted no serious competition for attention.
The tumble was bad luck well timed. We’d been trekking for nine days through sparsely-populated yak and blue sheep country. Our route had taken 
us along roaring, glacier-fed rivers and hairpinned us up and over several passes that granted mist-veiled glimpses of the snowy enfilade along the Tibetan border. But the hard slogging was done. We’d circled back to our starting point, and now we were taking triumphal group photos as our gear was lashed to the roof of the bus that would deliver us to a guest house in Paro. Soon we’d be soaking and soaping and getting ourselves cleaned, shaven and combed enough to present a reasonably civilized facade during our last two days in Bhutan.
But the hot showers would have to wait, our guide decided. There’s a hospital in Paro. We’d stop there first, to have my knee attended to, he said. The alternative was worse: a three and a half hour drive back to the capital Thimpu, where the only x-ray clinic in the country was located. 
We’d already enjoyed several days in Thimpu (altitude 7000 ft.), partly to acclimatize, partly to learn something about the history and culture of the country. We attended a dance festival, watched traditional weavers and sculptors at work, haunted folk art sales rooms and explored ancient monasteries. We also visited the national center for traditional Bhutanese medicine, which is similar to Tibetan medicine. Watching patients coming and going, we learned that the country has a well integrated approach to heath care. Traditional medicine is seen as complementary, not superior or inferior to western medicine. Because it's 
cheaper, it’s the treatment of first resort in this poor country, whose policy it is to encourage research into folk remedies with a view to ensuring efficacy and standardizing dosage.
Meanwhile, my leg was turning blue and swelling grotesquely. I could hardly bend my knee, which looked like raw meat when I rolled up my hiking pants to show the damage to a doctor member of our band of intrepid, good-natured trekkers. (I won’t give his name but I am enormously and forever grateful for his assistance.)
“Lacerations and contusions,” he observed. “Contusions are deep bruises. They hurt like hell and they last for months.” He put to me the who-are-you? where-are-you? questions physicians usually ask when they fear concussion, then eased me to my feet and helped me to the bus.
Since I was ambulating, however painfully, my doctor friend thought it might be okay to delay the x-rays until I got home. I happily agreed, which made everyone else happy, too.
The staff at the hospital emergency room in Paro did all they could. They cleaned me up. They disinfected my wounds. They applied sterile bandages. 
They offered a tetnanus shoot, which I didn't need, and apologized for having no pain killers. They were calm, efficient, cheerful and friendly, and they let me take photos of the emergency room, which was neat enough and very clean and totally innocent of fancy equipment.
Back on the bus my doctor friend extracted some Percodan (I think) from his own first aid kit and gave it to me. Those little white tablets made the next two days manageable. I could sleep. I could navigate the path from my cabin to the mess hall and back. I could climb in and out of the bus and limp from shop to shop in Paro. Above all, I could laugh. When agony finally gave way to mere pain, I returned the container, more than half full, along with a big hug and only one regret: I hadn’t been able to climb up the long, steep trail to the monastery known as the Tiger’s Nest, the cliff-perched highpoint of a visit to Paro. I consoled my self by taking zillions of pictures from below and I'd show one, if I hadn't somehow lost them all.
When I finally reached home, my right leg looked like a loan from a blue elephant, but x-rays revealed no fracture. My left arm was another story. It had broken near the elbow. Full recovery required a week in a cast, a few weeks more in a sling and many weeks of rotory and bending exercises.
The knee was not so cooperative. Five months later it was still somewhat swollen, bluish and sensitive to pressure. When I tried to ski, it refused to make controlled swoops and turns. Contusions might be slow to heal, but this, I thought, was ridiculous.
The mystery was solved by an MRI-–another miracle of modern medicine that I celebrate here. A fascinating image of tendons, cartilage and muscle revealed a torn medial meniscus, which is why the pain had been so excruciating.
A miniscus, I learned, is an internal knee pad, which in my case couldn’t be repaired–-not enough blood vessels-–but could be trimmed to reduce irritation. The operation under general anesthesia in an ultra-modern OR took less than an hour, not much more time than it took to clean me up in Paro. I spent maybe fifteen minutes in the recovery room, and then I was being wheeled into the parking lot for my drive home, thanks to the assistance of another friend, to whom I am also grateful.
At home I put ice on my knee, consumed a pint of Haagan Das (my reward after nearly 24 hours of fasting), read the latest NY York Review of Books, watched reruns of The West Wing, popped a pill to minimize pain and went to sleep. The next day I was working at my computer, cooking my own meals and hobbling around the house with the aid of a crutch. The day after that I could drive without effort and I got rid of the crutches. Already the nearly full container of pain pills had been tossed into in a drawer for future contingencies.
Of course, I'm still not up to tromping over the 16,500 foot pass I crossed in Bhutan last fall, but I’ll manage the equivalent, next year, somewhere in our wonderful world. This fall I’ll schedule something a little easier, maybe a 100-mile hike around Mt. Blanc--and much as I thoroughly appreciate modern medicine, I'll be a little choosier about where I plant my feet.
Some insurers think MRIs are overused and too expensive (mine cost an astonishing $1600 for about ten minutes’ exposure). However, when an MRI is used to make pinpoint, same-day surgery possible and that surgery allows people to get back to life and work in a day or two, the overall savings to the economy and to the individual are huge.
The problem, it seems to me, isn’t the cost of the imaging per se, but the inadequacy of an accounting system that doesn’t begin to comprehend that a population of healthy, fully functional people is a very good investment and a bargain at that.
As for me, I'd have been much better off if my doctors here at home had ordered an MRI along with x-rays on day one. Were they practicing good medicine by not doing so--or trying to save bucks for the system?
Unlike many of my New Wave friends, I deeply respect western medicine. Like them, I have serious doubts about the way it's practiced.