It was the pop heard round the world. At 1:20 a.m. on March 14, President William Jefferson Clinton slipped on a dimly lit wooden step outside the home of Greg Norman in Hobe Sound, Fla.—landing in the golf pro's arms. Instead of breaking 80, as he had hoped to do during a charity golf tournament later that day, the First Duffer, like an estimated 7,000 Americans each year, had ruptured his quadriceps tendon—the connective tissue that binds the powerful muscles of the thigh to the kneecap. Instantly, the presidential patella became the most closely scrutinized kneecap since Nancy Kerrigan's, with pundits speculating on how a famously active Chief Executive would weather such a setback.
From the beginning, the President seemed determined to rise to the challenge, which, in light of such other woes as Whitewater and Paula Jones, appeared to add injury to insult. His orthopedic odyssey began with a brief trip to the emergency room of St. Mary's Hospital in West Palm Beach. (He had made the Florida trip without the First Lady, who had remained in Washington.) After having the knee stabilized there, he was transferred to Air Force One and flown to Andrews Air Force Base in Maryland. By 2 p.m. he was being prepped for surgery at Bethesda Naval Hospital.
Clinton, 50, made it clear he would accept only painkillers that would allow him to remain alert during the two-hour procedure. Given an epidural, he was able to appreciate the music he had chosen—Lyle Lovett and Jimmy Buffett—while the surgical team drilled four holes in his right kneecap, stitched through the torn edges of his tendon and pulled the thread through the kneecap to reattach it. "He had a great attitude throughout," reports his personal physician, Navy Capt. Connie Mariano. "They put a sheet in front of him so he couldn't see what they were doing, but from time to time he would ask me what was going on."
Two days after the surgery, Clinton returned to a transformed White House. In the private quarters, carpets had been taped down, the Clintons' bedroom had been rearranged, and handrails had been installed in his bathroom. A team of physical therapists was on hand to help the President dress, master his knee brace and begin exercises to keep his knee from stiffening.
On March 19, Clinton flew to Helsinki for a meeting with Russian President Boris Yeltsin. (Though his surgeons had misgivings, says Captain Mariano, "I told them, You can't talk him out of it.' ") The three-day trip made him aware of just how painful it was to be immobilized in a wheelchair with his leg extended, and he subsequently cut back his schedule—canceling a jaunt to Baltimore to throw out the Orioles' season's first ball and postponing a South American visit.
Fortunately, the President's overall fitness and commitment to physical therapy speeded his recovery, and he graduated from crutches to a cane three weeks ahead of schedule. On May 23, the President met with PEOPLE'S Washington bureau chief, Garry Clifford, to talk about his recuperation. Leaning on a handcarved cane presented to him May 7 during his visit to Mexico, he took great delight in showing off a new adjustable brace. "Now I can bend my knee!" he crowed. "lean basically walk like you!"
IT WAS JUST A LITTLE STEP, AND MY foot came down on the edge. I sensed I was slipping. I pulled back so my foot was turned in and my knee went out, and it popped real loud. It was so loud that Greg Norman, who was about 8 or 10 feet in front of me, turned around and caught me as I fell. He saved me from a much more serious injury because I could have hit my knee or torn the whole thing. As it was, I tore 90 percent of the quadriceps. When I was lying on the ground I was just praying I hadn't torn it. But I thought it had to be something terrible because the pop was like a thunderclap. It felt like someone was pulling my leg off. I don't know if this is the most intense pain I've ever had. I had a kidney stone 30 years ago that hurt. And this hurt.
My anesthesiologist said he'd done the surgery for 20 years, and he'd never seen anybody have the operation without narcotics. But I didn't want to take a powerful analgesic and have to sign over the authority of the Presidency. There had already been such a stir about the injury, I didn't want to cause any more and convince people that there was something terribly wrong. So I just did it.
At Helsinki, we thought the safest thing to do was to use a wheelchair because I was fresh out of the hospital. I wasn't very strong, and I hadn't had a lot of experience on crutches. I didn't have pain then—it was discomfort. It's a lot of strain on your hamstring if you've got your leg straight out all the time and you've got to sit.
In the beginning of my rehab, I was just trying to make sure I didn't fall. The first thing we started practicing was going up and down stairs. And the therapists also did a lot of work on having me move around safely with the crutches and dealing with the fact that the movements caused a lot of muscle discomfort in my back.
It was difficult for me in the beginning. I couldn't dress myself; I couldn't get to the shower without help getting my brace off. I've always been self-sufficient. I was an only child until I was 10, and my parents both worked. I was 29 when I got married; until then, I basically did everything. I cooked, I took care of my house, I did all that kind of stuff. Hillary always laughs that she married me because I didn't mind making the beds and going to the grocery store. So accepting not being able to dress myself was difficult for me.
The physical therapists did a great thing: They rigged up my shower with pipes so that I could get myself in the shower, lift myself and then hold on. I could have that hot water pounding down on my back in the morning, which made me feel great.
I have always felt great compassion and support for people with disabilities. But now I have an understanding that I didn't before about the inner strength and dignity it takes to live when you are at least superficially disabled—when you can't do things for yourself, when you don't have the mobility that others do. You realize that your condition will change, but a lot of people's don't. And yet they still get up every day. They still go to work. They still do their jobs. They make a contribution to our country.
I spent as much time as I could working on the crutches. I also tried to wear shoes that had rubber soles. I practiced on steps a lot, but the night of the Canadian state dinner, April 9, I had some concern. I have really big feet—13C—so going down narrow stairs was tough. In the White House, there's a little carpet that runs down every step. So we had to go through and make sure the carpet was flat so I wouldn't slip. On state occasions everybody is watching, and you don't want to blow it. You don't want the story of the Canadian visit to be "President falls down stairs." I was a little concerned, but it worked out fine.
Another challenge was knowing I had to work hard to keep from gaining weight because I wasn't going to be as active as I had been. My physician, Dr. Mariano, predicted I would gain 20 pounds before this was over. I didn't think that was a good idea, especially because it would put more weight on the leg. Over the last year and a half I had dropped 10 or 15 pounds. But I decided I wanted to lose some more weight and that it would be good for my knee. I cut back to two meals a day—lunch and dinner—and started eating fruit instead of dessert. I still have one or two of those wonderful bagels my assistant brings in on the weekend. I weighed about 210 when I got hurt, and I weigh around 200 now. I'd like to lose a little more and weigh what I did when I went to college, between 192 and 195. When I'm lighter, I just feel better.
When this happened to me, I decided I was going to use it as an opportunity to learn about how my body was aging. Every day is kind of interesting. The most important thing I've learned is how to do the proper stretching exercises associated with not only running but just moving through the day. And because of my physical therapists, I know a lot more about how to do the right kind of weight work. Before, I wouldn't start with light enough weights, and I didn't do enough repetitions. I did a lot of things that might help your strength but don't help your flexibility. And as we get older, most people lose an awful lot of their flexibility.
Another thing I learned was that even people who have good upper-body strength lose it as they get older. They have back pain and neck pains because the muscles in their back get weak. Working at a desk, we tend to roll our shoulders forward. So right from the beginning the therapists had me holding a little piece of rubber hose in front of me, pulling on it, and that would push my shoulder blades back.
As a federal employee, I have a good health insurance policy. I pay 20 percent copayment. It would be terrible to have this happen to you without any insurance. But the thing that has enabled me to recover so well is not available to most people. I've had great physical therapy every day. Six days a week, I do two sessions a day. A lot of times people have these knee injuries and they have to go back to work too soon. Maybe they get physical therapy once or twice a week. I'm convinced it's not enough. Now that I've been through this, if I could do anything, I would like to see people's health insurance policies cover an adequate amount of physical therapy.
I still have to ice my knee all the time. My good knee is 41 centimeters around, and my bum knee is 43 in the morning when I wake up. But it has been as high as 48, and that's a big difference. There's a lot of edema because of the brace. They tell me that even after six months, when I can jog again, I'll only have about 80 percent of my strength back in my knee. But if I start off 10 pounds lighter, I think I may have a quicker recovery.
I was on the crutches eight weeks before I graduated to the cane. Now that it's warm I miss running. I miss golf, because when the weather gets warmer, for me it's like a tonic out there. The other day I tried out the White House putting green. I just wanted to see if I could do it. I must say I wasn't very good. But otherwise I'm doing fine. Even though I can only kick one leg, I can swim. And I can do most everything else. On May 22,1 got a new knee brace, which is going to make it better still. With it, I can bend my knee, and it takes the pressure off my back. They tell me they're hoping to take my cane away the first week in June, so I'll just walk with the brace for a couple of months after that.
People have asked me if I get crabby being cooped up. About the only time I get crabby is when I'm too tired. If I'm tired and I have a lot of heavy days in a row and I don't have any free time, then I get—you just want a little elbow room. I told somebody the other day I knew I was growing up, because if this had happened to me 10 years ago, every morning I'd probably have gotten out of bed mad. And I haven't felt that at all. I've learned about how our bodies work, and how we deal with trauma. It's been fascinating to me.
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