What I Learned from Breaking My Pelvis for the Second Time

When I venture outside, which is rare considering the bitterness of the winter, I plod the sidewalks with a cane, my eyes downcast, searching for impediments that might trip me up, like a fugitive seeking a safe route through enemy territory. “Oh, did you have a knee or a hip replacement?” a neighbour from up the street asks empathetically as I make my halting progress around the block. An obvious question, given that more than 175,000 Canadians traded in their aching joints for mechanical versions in 2024–25, a number that is likely to soar as the baby boom ages.

“Nothing so simple,” I reply. “I’m collateral damage in a cheap thriller about an ambulance that appears mysteriously on a weekday morning in a rural cemetery.” The neighbour looks at me blankly, edging away from what he fears will be a meandering narrative better suited for a beverage in a cafe than a conversation on a frigid street corner. But like the ancient mariner, I persist in my tale about breaking my pelvis in three places at a grave site.

On a sunny and warmish late-November day, my husband and I were meeting some close relatives to deposit our brother-in-law’s ashes in a columbarium beside the remains of his late wife, my husband’s only sibling. She had died during the pandemic, and her husband had subsequently moved away, but none of us were going to let the grim reaper separate a couple who had been conjoined by a lifetime of shared experiences. They had met as teenagers in a prairie city in the late 1940s, married when he was a medical student, raised three children, and welcomed two generations of new family members.

As a hematologist, he had always been an incisive decision maker. We had talked several times about aging and dying based on what he had learned from taking care of patients. He knew how he wanted to live and how he wanted to die: on his own terms.

As somebody who has written extensively about assisted dying, I had heard about self-exit plans from healthy folk—only to see the resolve dissipate as serious physical and cognitive disabilities manifested themselves. And so it was with my in-laws as they approached their nineties. After she began to fail, he cared for her at home, even though he was legally blind by then and had serious mobility issues. When paramedics responded for the third time in the same week to a MedicAlert because he had fallen in the middle of the night while helping her to the bathroom, they took him to the hospital for observation.

The invincible doctor had now become a patient. I will never forget sitting beside this kind man’s hospital bed, the expert who had shared so much medical knowledge with me over the decades, as he admitted defeat. “I can no longer take care of her,” he said sadly about his wife. Or yourself, I realized.

After her death, my brother-in-law moved to Vancouver to live in an excellent and expensive care facility organized by his devoted daughter. She and her husband visited him frequently and helped him stay in phone and video contact with relatives in both British Columbia and Ontario. He seemed happy and content, but I never had the opportunity to ask him how he felt about giving up his independence after he moved into care.

My niece, who was holding her father’s hand as he died peacefully, reported that he described seeing someone beckoning him, a person she chose to believe was her mother. I visualized that image and treasured it in my own grief. Rather than a bright light, as Tolstoy described in his novella about the death of Ivan Ilyich, following a protracted, painful, and lonely decline, it was the welcome completion of a love story lasting nearly three-quarters of a century.

The cemetery, a ninety-minute drive from our house, was older than Confederation and a designated Commonwealth War Graves repository. The website boasted that it was dog-friendly, so we decided to bring our English cocker and take her on a wander along the historic pathways that we remembered from our earlier visit to attend the inurnment of my sister-in law’s ashes. So, there we were again, watching the proceedings, with the exhausted dog sitting quietly off to my left, when something, most likely a rampaging squirrel, caught her eye, and she bounded in pursuit, pulling me with her off the platform on which I had been standing. I can still feel the thump as I landed on the hard ground, knowing I had broken something, an injury that I could have avoided, if only I had been paying attention.

In retrospect, my fall reminded me of watching a parade, my senses focused on the passing spectacle, while absentmindedly holding a small child’s hand. On a grander scale, it was like that moment of distraction in Ian McEwan’s novel, The Child in Time, in which Stephen Lewis, a children’s author, is unloading the groceries at the cash register and doesn’t notice somebody abducting his toddler from the cart; or that scene in Alice Munro’s story, “Miles City, Montana,” when the mother, wanting a moment’s reprieve from parenting, neglects to supervise her daughter as she wanders from the shallow to the deep end of a swimming pool. No matter the outcome—the child is lost forever, or happily rescued—the shame, the remorse, or the relief is life altering.

THE MEN IN OUR little group of mourners clustered round, reaching out hands for me to grasp and leverage myself upward. The chagrined dog, tail wagging ferociously, came sprinting back, nosing around my sprawled body as she tried to lick my face. I was having none of it because intuitively I knew this was not a simple fall and that I had probably broken my pelvis, as I had done more than a dozen years earlier by tripping and falling in an intersection as I hurtled home from work, a bag of books in one hand and my purse in the other.

Back then, as a passerby helped me up, I had felt the bones in my torso clunk back into place before I took a tentative step, leaning on my Samaritan’s arm. Together we stumbled the three blocks to my nearest refuge—my son’s house—where I managed, who knows how, to climb the front steps and ring the doorbell. I could hear my toddler grandchildren squealing in delight as they raced to the door, thinking it was Daddy home from work early. Instead, as my daughter-in-law jokingly suggested later, it was Granny and her boyfriend. Once safely inside their house, I collapsed into a chair, adrenalin spent, and begged for an ambulance to take me to an emergency room. Lesson learned: Swagger is not a substitute for medical care.

Arriving at the nearest hospital, I was delivered to triage on a gurney and quickly X-rayed and diagnosed. I was lucky. I didn’t need surgery. The cure, as is true of most pelvic fractures, was rest and time while I waited for the bones to meld again. Because I had an able-bodied partner, a two-piece bathroom on the ground floor, as well as a chesterfield in our family room that I could convert into a temporary bed, I was given a prescription for painkillers, told to buy a walker from the hospital supply centre, and discharged.

Fear of falling has stalked me ever since, particularly since I can’t take bisphosphonates, the standard osteoporosis medication for bone deterioration, because I have suffered at least two serious side effects from them. No matter how many calcium supplements I take, how careful I am about holding on to railings, wearing sensible shoes, putting my heels down first so I won’t stub my toes, practising tai chi (however lackadaisically) to improve my balance, lifting weights, turning on lights before I get out of bed to go to the bathroom at night, never walking around my house in slippery socks, removing throw rugs on which I might trip, slowing my pace while composing sentences in my head—despite all of that, I am afraid of falling, because I know if I do, I will break something.

The World Health Organization estimates only traffic accidents top falling as the cause of death from an unintentional injury. We all know the nightmare scenario: Granny falls in her kitchen, nobody finds her for three days, she is admitted to hospital for surgery and develops an antibiotic-resistant infection. By the time she is discharged several months later, she is deemed too frail to live alone. Her family places her in a “safe” institution that soothes their anxiety but robs her of independence, speeds her decline into fractious dementia, and results in many more hospitalizations at a huge cost to the already overburdened health care system.

I don’t want to be that person. Nor do I want to be dependent on my grown children, or worse, grandchildren. Sometimes when I wake in the middle of the night, I torment myself, knowing the shifting balance of aging’s teeter-totter, with hypothetical questions about which one of us—my husband or I—will survive the other, and if it is me, am I the one my loved ones want to care for in their complicated lives?

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KNOWING I HAD PROBABLY broken something and fearing it was the big one—a hip—I declined all efforts to haul me upright and asked somebody to call an ambulance to the cemetery, however weird a repository for the dead sounded as a destination for a distress call. While we waited, one of my nephews stretched out on the ground behind me and cradled my upper body so that my head would be off the cold ground. My husband captured the scene on his cellphone, a photograph that is now dubbed: “Granny with her new boyfriend,” or “Eddie and his cougar.” The picture is more than a record of a spontaneous act of kindness. It makes me laugh, a commodity that has been in short supply over the past few months.

The paramedics arrived quickly in a white van with blazing lights, a strident contrast to the sombre spectacle of a black hearse ceremoniously transporting a coffin in a delegation from a funeral to a gravesite. Another nephew, who lives in the area, negotiated with the paramedics about the best ER destination—not just the closest but the least crowded and best equipped. Luckily, the dispatcher agreed. I only remember one other patient in the rural ER that Friday morning. My treatment was excellent—an example of how efficient health care can be in this country—but I wanted to be at home, and I was convinced that with my husband’s help I could handle another broken pelvis, even though I was a dozen years older than the previous time, and I had three breaks on the left side of my pelvis, which severely compromised the functioning of my thigh. It was as though the muscles at the top of my leg had hibernated.

Before the doctor would agree to discharge me, he made me pass a mobility test. Desperate to use a bathroom and fuelled once again by adrenalin, I swallowed a painkiller, and then, accompanied by a nurse, managed to push a walker down a hallway to the lavatory and back again to my bed. A pyrrhic victory, as I learned on the long drive through heavy traffic back to Toronto, followed by an excruciating climb up our front steps, clinging to the railing that I had installed after my previous pelvic fracture.

Exhausted, I collapsed on an upholstered armchair in our living room, eyeing the nearby chesterfield as my new recovery bed. Three days later, despite loving attention from family, digging out the walker from the back shed that I had used the last time I had broken my pelvis, and purchasing a raised toilet seat online, I admitted defeat. The pain was agonizing, my brain was so befuddled I couldn’t read, let alone write anything coherent, and I needed more physical help than my dutiful but octogenarian husband could provide—an abject lesson in the limitations of aging in place, especially after an unexpected crisis, a realization that reminded me of my brother-in-law and his decision to move into care.

I CALLED MY FAMILY DOCTOR, who told me to go to the emergency room of a major hospital before 7:30 the next morning to get ahead of the crowds. What I needed was a course of in-patient physical rehabilitation, not acute care, but the way in was through the ER, the most overburdened section of the health care system. For the next three days and two nights, I languished in pain on trolleys and hospital beds, including being transported to another ER, before I was finally admitted to a rehab facility. What an oasis that proved to be: safe, clean, and quiet. I learned how to hoist my immobilized leg into bed, to shower myself and take care of other bodily functions, to climb stairs with a crutch, and to wander the halls under supervision with my walker. Instead of taking care of me, the team, including physiotherapists and nurses, trained me to take care of myself while my body healed. After two weeks, I was ready to go home, although three months and counting since the great distraction, as I have dubbed it, I continue to have trouble rolling over in my sleep, rising from a seated position without pain, and walking with my former effortless gait.

I still congratulated myself on not breaking a hip, until I had a conversation with a sympathetic friend who happens to be a doctor. “I bet after a few weeks you wished you had broken a hip,” he said, “because you would have had surgery for either a partial or a full replacement and been up and walking the next day.” I looked at him in stunned silence as his point penetrated: the intervention I fear the most—an artificial hip—would have been better than being laid up for several months while my pelvis healed itself.

Will I ever walk my beloved dog again? That desire is only one of the reasons why, after I graduated from physio—a.k.a. torture—I continue to stretch and hone my muscles and work on improving my balance so I can be ready if the unexpected happens again—as I know it will.

Going along to get along is no longer an option, as Prime Minister Mark Carney pointed out in his Davos speech. A freak fall in a cemetery is what I should be anticipating on personal as well as national and geopolitical levels. I’m more than a dozen years younger than my deceased in-laws. I need to be planning now for the last third of my life, however long it turns out to be because, as Carney said, if you aren’t at the table, you risk being on the menu. By table, I mean taking an active part in planning and preparing for the certainty of my own infirmity. Otherwise, I will be at the mercy of other people’s decision making, however diligent and well-meaning.

Politics and the personal inevitably coalesce. We want independence, but that involves risk. Our loved ones, in the fervour of busy lives managing children, careers, and their own problems, want us to be safe, and that means predictable—a word that gives me hives. Seeking a compromise between risk and safety, independence and mundanity, is my new goal as an aging boomer.