Last autumn I fell off a horse and on to a rock, and, in one of those millisecond moments that feels like a small eternity, cleverly managed to break my right arm. No great calamity, to be sure, nor in ordinary circumstances anything really remarkable, except for the fact that this was not the first time, nor even the second, that I had broken it. This was the third time that fate had chosen to smite my bone asunder, and by this time the evident vulnerability of my right humerus was getting to be, if I can be permitted a lame pun, distinctly unfunny.
The first time, at least in retrospect, was moderately amusing. It was the summer of 1964 and I had a holiday job in Oklahoma, working with an oil company. One afternoon in Tulsa I met a man in a bar. He was an enormous brick-outhouse-sized Texan from some agriculture school in Arkansas and, to cut a long story short, he said something and I said something and it all became a little heated. There was drink involved and, rather than going quail-hunting with the vice-president, we ended up one-arm wrestling.
Subsequently, there was a dramatic moment that started when I realised I was losing, with my arm about five degrees back from the vertical. I didn’t want to fall victim to a mere Texan, so I exclaimed To Heck With This, cried something further about For the Glory of Olde England, grabbed the end of the table with my other, free, left arm and, well, cheated. There was in consequence a sharp snapping Crack!, which onlookers said later could be heard all the way down in Bartlesville, and lo!, my right arm was suddenly lying flat on the table, immobile and curiously shaped. When I looked up, my Texan friend had the stricken expression of a man who had unexpectedly discovered a skunk in his trousers.
Things became a blur. Someone hurriedly dialled a number on a black rotary wall-phone. Within moments, sirens were sounding in the distance, police cars screeched up on to the gravel driveway like in an episode of Highway Patrol, and a score of private ambulances, eager for work, arrived in explosions of blue flashing lights.
Backstage, lawyers were alerted, accountants began turning calculators and there was a blur of rather intimate activity involving someone reaching in to my breast pocket and removing from its wallet my brand-new and quite virgin emergencies-only Barclaycard. Being declared solvent I was then promptly taken, at a lick of speed, to one of Tulsa’s many hospitals. (I can’t remember which, but safe to say it was probably not a Shadow Mountain Behavioral Health centre or the more appropriately named St. Francis at Broken Arrow.)
Hosts of chisel-jawed doctors examined me - worried-looking Amoco officials in serried ranks behind them - and the injury was swiftly diagnosed as a comminuted fracture of the right humerus, meaning that the Texan, who was named Lenny no doubt, had managed to twist the bone as though he was drying a towel and had broken it in five places, no less. I remember wondering if he kept a mouse in his jacket pocket.
But then someone showed me a needle and said it might prick a bit, and I was promptly sent off into a deep and dreamless sleep - only to be reawakened some time that evening by a pretty teenager, wearing a pink-and-white candy-striped outfit, who told me cheerily that I now had three shiny American steel screws holding my useless English bone together, and I could go home the next morning, and so Have a Nice Day! The bill came to about $2,000. My card turned out to have a credit limit of only a $100 - quite a lot in those days - and the insurance coverage I had proved similarly inadequate, with clauses in five-point feint forbidding competitive sports and vigorous arguments with Texan drunks. It didn’t pay, basically.
And so, back home in Hampshire my father was so vexed by the bill he soon received - having been noted as next of kin on my admission form, and thus fully liable - that he refused all communication, saying in the true spirit of the welfare state that to have to pay for medical treatment was perfectly intolerable and immoral and just horribly American. I can hear him now, shaking his stick and uttering phrases like “The very idea of it”. But then a couple of stern lawyers’ letters arriving by registered post from Tulsa and he coughed up most of the money, paying the bill long before my cast came off, which it did shortly before Michaelmas Term.
I rowed in Torpids at Oxford that year, and without pain, so those faraway doctors had evidently fixed me pretty well - which is actually the whole point of the story I’m in the middle of telling.
The second break came nine years later and in rather less glamorous circumstances. I was in England, driving on a main road across Salisbury Plain, in the late summer of 1972. I had just completed a three-year reporting stint in Northern Ireland - surviving lots of bombings and shootings and riots with barely a scratch. I had a lunch appointment with one of the Belfast generals at the headquarters of UK Land Forces in Wilton.
I was early, and stopped briefly to wander around Stonehenge, as one does. Then I squeezed back into my Hillman Hunter, drove west on the A303 and a few miles later turned left on to the A360. I switched on Radio 4, and was listening idly to You and Yours, then a fairly new programme. There was an item that caught my attention: a new report by the RoSPA, the Royal Society for the Prevention of Accidents, showed conclusively that the wearing of safety belts in cars cut the fatality rates by some undeniably impressive amount. I pulled into a lay-by, buckled on my hitherto overlooked seatbelt, and drove off again.
And five miles later, near an otherwise unsung village called Fugglestone St Peter, an oncoming car with two elderly men on board turned without warning across my path. I was doing about 50mph. There was an almighty collision, my car skidded, turned over three times and rolled on its side into a ditch. It was immediately clear I had broken all sorts of bones. Clearly there was going to be no lunch that day.
As it happens I was the only casualty. The old-timers seemingly sat blinking in the sun, wondering what had happened. I was cut out of the ruined car, taken by a screaming ambulance to the Odstock Hospital in Salisbury, and my right arm, the most badly injured part of me, was promptly put into a very large cast. I can remember very vividly a large god-you-are-ugly matron wiggling the limb about and hearing the broken ends of the bones scraping together, whereupon I apparently swooned.
But that was all. Later that day I was released into the care of my then wife and she gingerly drove me back home in a borrowed car to our home outside Oxford. I was told to keep my arm in a cast and a sling for three months. There would be no charge. There was some later dispute with the insurance company, which tried to weasel out of paying the bill for the car, but there happened to be a policeman following me at the time of the crash. He wrote a letter saying it was the other driver’s fault, and the insurance company, for once, backed down.
In October, I took my slimmed down, pale and rather wrinkled arm out of its cast and flew off to an assignment in Washington, typing with one hand for a month, before reverting to normal service, more or less. Until, that is, last autumn - a period of some 31 surgically uneventful years during which, so far as I recall, I had suffered no orthopaedic traumas at all, and an era in which all limbs and joints had functioned precisely as they were designed to. But everything came unstuck in September, when two house guests came up from New York to spend a weekend on my little farm in the Berkshires, and, the autumn leaves not having quite reached their peak and so there being nothing much to do, I took the couple down to a neighbour’s field to meet a pair of horses I had once owned.
It would be nice and manly to say that I fell off some noble Arabian at speed, or that I had tumbled 20 hands off some mighty one-ton Belgian. Nice, but quite untrue. My old horses are in fact a pair of grumpy, low and chubby Norwegian Fjords, by name Elsa and Magnus, who these days earn their keep hauling timber and being lashed to a cart to bring pigswill to the farm from a store in our local market town. They are slow and shaggy, like harmless old dogs. Thelwell horses, as it were.
On the Saturday in question they stood in their paddock, cropping grass tufts into their mouths, and when they saw us they came trotting over for a stroke and an apple. What I didn’t at first notice, but should have, was that both horses had recently had their manes shaved - Fjords having an aptitude for growing long and shaggily unkempt manes in the summer. It was a critical mistake, for I saw no immediate reason why I shouldn’t show off to my friends and ride around on Elsa, bareback.
Someone helped me up, and off we trotted. Elsa may be grumpy, but she is not frisky, and to show me her displeasure at having to bear 200lb of human on her unsaddleblanketed back, she promptly rode me deep into a thicket of blackthorn. She then turned out of it, having given me a jolly good scratching, took off at a canter across the field and, without warning, turned to the left. I reached down to grab her mane to steady myself - only swiftly realising, and to my considerable dismay, that because of the shaving there was no mane there. And so slowly, agonisingly slowly, I fell off the horse, to the right.
As I hit the ground there was a sudden, sharp pain - the result of a rock, I realised in an instant - and I attempted to move my arm. No luck. People crowded around me. Oh. My. God, said someone, looking white. Your arm’s got two elbows. And while Elsa tried to crop grass around my head to say sorry, and some local farmer’s child obligingly stood in the sun so I could be kept in a cooling shadow, so ambulances were called and hospitals alerted, and within half an hour I was on a table, X-rays were being taken and the only orthopaedic surgeon on call in Berkshire County was alerted to assess the damage.
He was called Dr Bouillon, and he cheerily told me he spent much of his year in Dubai earning a small fortune by attending to injured cameleers. He looked at the X-rays, then at me. My, you’ve been in the wars, he said. All those screws. And that bend. What in the heck is that? I told him something about the limb’s previous adventures, whereupon all he said was: well, whoever mended it the second time around should have his head examined. They just put it in a cast? They let it dangle for three months? I guess that’s your National Health Service for you. Minimum work. Minimum cost. Well, we’re not going to do that this time. More screws for you, old man. A lot more screws. I hope you’re insured well. He laughed, evilly.
I was indeed insured, and pretty well. Being terrified of falling foul of America’s brutal medical system, I pay through the nose for the privilege of living here - $500 a month to United Healthcare, to give me what I hope is a no-questions-asked kind of coverage. Two days later, this policy being deemed suitable, I was down at the New York Hospital for Special Surgery, in the office of a man named Dean Lorich, said to be the Humerus King of America. If you need the best man to do the best job, Bouillon had said, as he dialled the number down in the city, go to Lorich. He costs, but he’s the best there is. He knows the humerus like the back of his hand.
It was all terrifyingly professional. Lorich knew I was supposed to be on a book tour, starting in a month. You don’t need surgery, he said. We could fit you with a special cast and leave things as they are for a while. But there’d be no shaking hands. No signing books. And frankly, he went on, if you want to be moving your arm in a week, then let me open you up. We’ll put in a plate - we’ll have to bend it around that god-awful British kink - and we’ll fasten it together with a bunch of screws. But you’ll be able to write and do more or less as you like in two weeks. Expensive, sure, but your insurance will pay. I’ve checked.
And so next morning I walked - no stretcher, no gurney - into the operating theatre. There were a dozen people standing there, all smiling happily, brandishing implements and eager to offer their various services. Hi, I’m your anaethesiologist. Hi, I’m your head nurse. Hi, I’m your assistant surgeon. I rather expected to meet a sommelier and a pastry chef.
The only absentee was Dr Lorich, who I imagined was out buying a new Lexus. I was asked to lie down, told I wouldn’t feel a thing - and then a pretty girl in pink candy stripes was cooing at me to wake up, wake up, and telling me, just like her colleague, probably her grandmother, had done 41 years before, that there were now eight extra shiny American screws in my arm, making a total of 11, and a plate duly arranged around that nasty old English bend, and that a lady doctor would be along to start me moving the arm at six the next morning, and so would I please Have a Nice Day.
Well, I did, and now, four months later, I am happy to report that the arm is perfectly fine: I may not be rowing in Torpids any more, but I can type, lift luggage, drive my tractor, cut down trees. I do not ride horses, true; and I will not one-arm wrestle; and yes, with as much metalwork as the Forth Bridge in me, I do set off airport detectors from Alaska to Arkansas, and hear the phrase Just Let Me Pat You Down Sir on every journey I take. But otherwise, it is all fading into memory. Just One More Experience. Just Life.
They’ve let me keep the pictures, in part to remind me to behave sensibly in future. And in part to serve as a memorial, said Dr Lorich, to the rather considerable difference between the two systems that have treated the arm during its four decades of adventuring. If you do it again, he said, the last time I saw him for a check-up, may I recommend that you don’t go home to break your arm in England. If you feel you must, do take care to try to break it here.
Simon Winchester is a former foreign correspondent and the author of several books including “The Surgeon of Crowthorne” and “A Crack in the Edge of the World”, which is out in paperback in the UK next month.
