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By S. Leif. California State University, Hayward.

He was a man of many experiments on lubrication of joints and dis- talents discount sildenafil 100 mg overnight delivery erectile dysfunction medication ratings, yet single-minded in his effort discount 50 mg sildenafil mastercard prices for erectile dysfunction drugs. Not discouraged, he continued with the low-friction arthroplasty must be the living Moore and Thompson femoral head replacements monument to a truly great man and benefactor articulating on a Teflon shell; the shell moved of humanity. It was at this stage that the concept of “low fric- tional torque arthroplasty” was conceived and he developed a small diameter femoral head replacement, which articulated with a thick shell of Teflon; the Teflon failed. Yet the short-term clinical results had been so spectacular that he was con- vinced of the soundness of this concept. From then onwards, with the fortuitous introduction of high-density polyethylene, all his efforts were directed toward a perfect mechanical solution to a biological problem. Furlong, who specialized in tendon repair, and finally by the Austrian School of Orthopedics. On demobilization he returned to the tutorship and was appointed honorary assistant orthopedic surgeon to the General Infirmary at Leeds in 1946 and surgeon to St. James’ Hospital, Leeds, Thorp Arch Children’s Orthopedic Hospital and to Batley, Dewsbury and Selby Voluntary Hospitals. His continuing interest in tendon surgery led to the publication in 1946 of his paper on “Recon- struction of Biceps Brachii by Pectoral Muscle Transplantation”—a work acclaimed by orthope- dic surgeons in this country and in France. The same year he was invited to become a member of what was then known as the LBK Orthopedic Club—later to be renamed the Holdsworth Club after its founder Sir Frank Holdsworth. He was elected secretary and he maintained a lively inter- John Mounsten Pemberton est in the club, where his astringent pertinent con- CLARK tributions were always welcome. In 1948 he confined his hospital work to the 1906–1982 Infirmary at Leeds and Pinderfields at Wakefield, where a center for the treatment of poliomyelitis J. He was invited to take charge officer days) was born in Leicester on November of this unit. His work at School and Leeds University, where he qualified Pinderfields Hospital, together with his consul- in 1931. After house appointments at the General tancy at the Leeds Education Authority, gave him Infirmary, Leeds, he went into general practice a vast experience in the treatment of in Dewsbury in order to pay off a student debt poliomyelitis, of club foot and of cerebral palsy, incurred to allow him to finish the course. This resulted in his nomination by Sir FRCS examination and returned to Leeds Infir- Herbert Seddon to advise Israel on the develop- mary as resident orthopedic officer under the ment of a similar poliomyelitis center, and he direction of R. Broomhead in 1938, and subse- attended that country on many occasions over the quently was appointed superintendent of the Chil- next 20 years. He was much in demand as a lec- dren’s Orthopaedic Hospital at Thorp Arch. His became FRCS in 1939 and was appointed the first mastery of the English language and literature tutor in orthopedic surgery at the University of made it inevitable that he was invited to join the Leeds in the same year. He also joined the Terri- editorial board of The Journal of Bone and Joint torial Army and served throughout the 1939–1945 Surgery and he wrote many papers on the treat- war, first in France, where he had experience of ment of poliomyelitis and tendon surgery. He forward surgery and passed through Dunkirk, and edited the Science of Fractures in Sir Harry Platt’s then in Malta, Italy and Austria, being awarded Modern Orthopedic Series and in retirement the MBE for his services. Pasco there came under the influence of chief interests, the treatment of club foot, of H. Seddon (later Sir Herbert), sent there by which he had previously developed a method of the Ministry of Health as civilian adviser, who medial release, which has been continued by his inspired him to develop a profound and lasting disciples in Leeds and the Leeds region. In 1968 the University of Leeds conferred 63 Who’s Who in Orthopedics on him a personal chair of orthopedic surgery and 1934. Cloward started his practice of neurology musicologist, being proficient with clarinet and and neurosurgery in Honolulu, Territory of piano. He was in Honolulu when the erature was wide and throughout his life he dis- Japanese attacked Pearl Harbor on December 7, played a great interest in all forms of art. A 1941, and was assigned by the War Department connoisseur of wine and food, he loved convers- to remain in Honolulu for the duration of the war ing with his friends about books, music and art. For his services to superintendent at Pinderfields Hospital, and this civilians and the military during the war, he led to great happiness—probably the happiest received a commendation from President years of his life.

Such meetings are often awk- ward cheap 75 mg sildenafil overnight delivery impotence klonopin, and after several forays order sildenafil 50mg otc erectile dysfunction prostate, conversation finally focused on travel. The new boyfriend recounted well-researched ventures to distant, exotic desti- nations. In concluding, he asserted that he wanted to travel while he still could, before he got too old and slow. Such con- fident pronouncements tapped into my uncertainty as a relative newcomer to disability. Weakness, imbalance, and fatigue made getting around with the cane tough; I could only go so far. The minute-by-minute realities of my bodily sensations seemed leagues away from the empowering assertions of disability rights advocates—that “disabil- ity is something imposed on top of our impairments by the way we are un- necessarily isolated and excluded from full participation in society” (Oliver 1996, 22; cited in chapter 1). This chapter examines how people with progressive chronic conditions feel about their difficulty walking. No interviewees expressed happiness, joy, pleasure, or glee as their walking failed. But hope is complicated, as people with chronic illness “are im- pelled at once to defy limitations in order to realize greater life possibilities, and to accept limitations in order to avoid enervating struggles with im- mutable constraints” (Barnard 1995, 39). Disability rights activists might urge them to frame their experiences within the broader social context 66 How People Feel about Their Difficulty Walking / 67 (Oliver 1996; Charlton 1998; Linton 1998; Barnes, Mercer, and Shake- speare 1999; Albrecht, Seelman, and Bury 2001)—“it is not the inability to walk which disables someone but the steps into the building” (Morris 1996a, 10). And as Jenny Morris, who had a spinal cord injury, wrote, Insisting that our physical differences and restrictions are entirely so- cially created... Even if the physical environment in which I live posed no physical barriers, I would still rather walk than not be able to walk. Tobe able to walk would give me more choices and experiences than not being able to walk. This is, however, quite definitely, not to say that my life is not worth living, nor is it to deny that very positive things have happened in my life because I became disabled. We need courage to say that there are awful things about being disabled, as well as the positive things. Once in control, now constrained; once fear- less, now fearful; once mobile, now “stuck”; once working, now “on wel- fare”; once busily occupied, now at loose ends; once engaged, now isolated; once athletic, now on the sidelines; once stylish, “loving high heels,” now wearing “flat, sensible shoes. It was June four years ago, and I was literally doing cartwheels in the yard teaching my daughter. I was diagnosed in October with rheumatoid arthritis, and by December I had difficulty walking. I walked everywhere; I ran everywhere; I rode a bike; I did every- thing. I was foolish enough to believe that arthritis only happens in older people.... But it can be a challenge to help me grow rather than sit by and say, “Pity poor me. My father always told me, “Just go to work, and everything will be all right in your life. I can’t catch the bus because I’m scared I’m going to fall, and if I trip, I know I can’t get back up. People’s feelings about their walking difficulties do vary by medical condi- tion. Recently diagnosed with progressive ALS, which carries a grim, short- term prognosis, a woman in her mid forties said that she most feared becom- ing unable to swallow and breathe. Nevertheless, the daily frustrations of her current walking difficulties are stressful and have fundamentally changed her life. She recently quit after working with the same company for over twenty years. Before detailing the perceptions of interviewees, I must acknowledge an important limitation of my project. Yet, by definition, this book is about change—progressive chronic conditions. About three to five years after disability begins, peo- ple typically stop talking about how it happened—“it’s a moot point” (Olkin 1999, 60). People’s perceptions evolve, although research suggests that atti- tudes are unrelated to the extent of physical impairments. The value that peo- ple place on their physical abilities shifts over time, as they become used to progressive impairments (Eklund and MacDonald 1991; Kutner et al.