ability to have an orgasm, from the clitoris. Minimally comforted, I left her office, with an appointment for an MRI, and a referral to Dr. Jeffrey Cole, New York’s pelvic nerve man.
I met with Dr. Cole at the Kessler Institute for Rehabilitation, which he helps to lead, in Orange, New Jersey. A calm, quietly amusing man, with an old-fashioned, reassuring manner, he had looked at my initial x-rays, had examined my posture as I stood before him, and then had urgently written me a prescription for a hideous black back brace.
Two weeks later, I went back for a follow-up visit with Dr. Cole. Azaleas were now in bloom—it was still the loveliest part of the spring—but I felt almost faint as I sped into the suburbs in the backseat of a battered taxi. I was also very uncomfortable, since, for the past two weeks, I had been wearing the prescribed back brace. It extended from above my hips to below my rib cage, and it made me sit up perfectly straight.
I was really scared to hear what Dr. Cole had to say, since I knew he now had my MRI results. The MRI, Dr. Cole informed me, showed that I had lower-back degenerative spinal disease: my vertebrae were crumbling and compressed against each other. I was very surprised, having never had any pain, or any problem with my back at all.
He startled me by showing me the additional x-rays he had taken during the last appointment; there was no way to miss or misread it: on “L6 and S1,” my lower back, my spinal column was like a child’s tower of blocks that had slid, at a certain point, exactly halfway off central alignment—so that half of each stack of vertebrae was in contact with the other, but half of each ended in space.
I dressed and sat in Dr. Cole’s consultation office. He put me through an unexpectedly tough and direct interview: “Did you ever have a blow to your lower back?” “Did anything ever strike your lower back?” He said it was a serious injury and that I must have some memory of having sustained it. I repeated that I had no memory of any such trauma. When I finally realized what he might also be asking, I confirmed that no one had ever hit me.
But after about five minutes of this back and forth, I realized that yes, I had indeed once suffered a blow. In my early twenties, I had lost my footing in a department store, fallen down a flight of stairs, and landed on my back. I hadn’t felt much pain, but I had felt shaken. An ambulance had arrived; I had been taken to St. Vincent’s Hospital and x-rayed. But nothing had been found to be the matter, and I had been released.
Dr. Cole took in the information and ordered another series of images—this time a more detailed x-ray. He also performed an uncomfortable test in which he shot electrical impulses through needles into my neural network, to see what was “lighting up,” and what had gone dark.
In our third meeting, also at the suburban facility, I was back on the exam table. Dr. Cole explained that the new set of x-rays had revealed exactly what the matter with me was. I had been born, he explained, with a mild version of spina bifida, the condition in which the spinal vertebrae never develop completely. The blow from twenty years before had cracked the already fragile and incompletely formed vertebrae. Time had drawn my spinal column far out of alignment around the injury, which was now compressing one branch of the pelvic nerve, one of the branches Dr. Coady had shown me in the Netter image—the one that terminated in the vaginal canal.
I had been unbelievably lucky never to have had any symptoms until then, he said. Given the severity of my injury, it was fortunate that, though I had increasing numbness, I had had no pain. Much though I disliked working out, it seemed that a lifetime of grudging exercise had strengthened my back and abdomen enough to have kept any worse symptoms from manifesting until then. But time had done its work: where the two sections of spine were misaligned, the