“Could I take this test on a pass/fail basis?”

This gets a laugh. I need a laugh. It is 1993, a year of marital and psychological disintegration, and things are not exactly lighthearted. In fact, they have not been so for quite a while. The last time I had a good laugh with a physical therapist was roundabout 1973, and he was a physiotherapist at Britain’s spinal cord injury center in Buckinghamshire. In the earlier instance, I can’t recall why we were laughing. But in the UK laughing, that is to say irreverence, comes much more easily. That’s only by way of background, for now it is 1993, and someone is actually laughing over my life of neuromuscular decline.

A muscle test, by the way, is routine for a paralyzed person. The therapist asks you to lift this, bend that, extend here, flex there, noting your performance step-by-step. There is nothing to pass or fail, naturally, just a score of your available strength in each function. The joke was necessary relief. By then, I had had 25 years of such tests under my belt, and a certain spiritual fatigue was setting in.

Neuromuscular decline had set in long before. When I emerged from a Los Angeles hospital late in 1968, limping down a linoleum corridor to my father’s waiting car, decline wasn’t exactly on my mind. Relief was the thing. But within 20 years, the muscle picture began to fall apart. The only person who had predicted this was a French physical therapist who told me that much of my mobility was going to disappear in my forties. He was entirely correct.

So let us jump forward to this very day when a doctor with Kaiser health care is giving me a video examination. What is a video examination? Before the coronavirus era it would have been mostly a concept. Telemedicine was used here and there, now and then. Now it is a constant. This morning my helper Dennis handled the video in a live studio broadcast starring my left foot and right knee. The cast did brilliantly. The script, entirely improvised, sparkled. Although laughs, I must confess, were in short supply.

Things have gotten grim during the Covid-19 lockdown. Still I was able to recall the old days, the lighter moments when running through my worsening neuromuscular picture was even grimmer. Then and now, it amounts to a physical medicine person with a clipboard or its electronic equivalent, noting that things don’t work as well as they used to, quantifying that strength is poor here, balance there. Tomorrow and tomorrow.

So there I was with Doctor Lynch asking me to lift my knee, raise my foot, and how’s my sensation? Why is my right knee collapsing? Arthritis. A fair amount detected in my last x-ray. Oddly, I found this a sort of relief. At least it wasn’t something I was doing wrong. As for the future? Knee surgery not to be ruled out. Unless I ruled it out, which I did.

In short, I got through my August, 2020, muscle test, neither passing or failing. Nor laughing, which would have been optimal. Or maybe not.