The boss wondered why one of his most valued employees was absent but had not phoned in. Needing to resolve an urgent work problem, he dialed the employee’s home phone number.

Odds & Ends 002

As Art Linkletter showed in his segments on radio and, later, television, “Kids say the darndest things.”

Odds & Ends 001

“I have a legacy” doesn’t necessarily mean fame or wealth. It means that something of you continues beyond your own accomplishments. A legacy can include:

• The people you taught or mentored.
• The work you helped create or improve.
• The values you passed on to family and friends.
• The knowledge you preserved.
• The lives you influenced, even if most of those people never realize it.

A legacy also doesn’t have to be complete. It’s something that continues to grow as long as your influence continues.

A simple way to express the idea is:

“I have a legacy. It isn’t measured by what I own, but by what I leave behind—in the people I’ve taught, the work I’ve done, and the lives I’ve touched.”

Or, if you want something even more concise:

“Success is temporary. Legacy endures.”

Or simply:

“I have a legacy. That’s how I measure success.”

That last version is especially effective because it doesn’t claim perfection or invite comparison. It simply states the standard by which you judge your own life.

That is the total amount billed to Medicare—$373,378.69— for my accident, emergency care, complex spinal surgery, hospitalization, inpatient rehabilitation, imaging, physician services, and follow-up care. At first glance, it is a staggering number. It is also a number that is easy to misunderstand.

Many people assume that if a hospital bills Medicare $373,378.69, then Medicare simply writes a check for that amount. That is not how the system works.

Hospitals and physicians submit what are known as charges. Think of them as a manufacturer’s suggested retail price (MSRP) on a new vehicle. They represent the provider’s established price for every procedure, medication, test, implant, and day of hospitalization. Very few patients—or insurance companies—actually pay those listed prices.

Medicare has its own payment formulas established by federal law and regulation. For every hospital stay, surgery, imaging study, physician visit, and rehabilitation service, Medicare determines what it considers to be the approved amount. In many cases, that approved amount is dramatically lower than the original charges.

The provider then agrees to accept Medicare’s approved amount as payment in full for covered services. The difference between the hospital’s billed charges and Medicare’s approved payment is simply written off. It cannot be billed back to the patient.

In my case, Medicare almost certainly paid only a fraction of the $373,378.69 that was billed. I don’t yet know the final Medicare-approved amount, and frankly, it doesn’t matter very much to me because I have traditional Medicare along with a Medicare Supplement Plan G. After Medicare pays its share, my supplemental policy covers nearly all of the remaining approved costs. My actual out-of-pocket expense has been minimal.

That is exactly what Medicare and a Medigap policy are designed to do: protect beneficiaries from catastrophic medical expenses following a serious illness or injury.

Without insurance, the picture can be very different. While hospitals often provide discounts, financial assistance, or negotiated settlements for uninsured patients, a major trauma can still result in enormous financial stress. Medical debt remains one of the leading causes of financial hardship in the United States.

Looking back, it is remarkable what that number represents.

It includes emergency evaluation after my fall, surgery to stabilize three fractured vertebrae using titanium rods and screws spanning five vertebrae, along with bone grafting material to permanently fuse the damaged section of my spine into a single solid structure. It also includes days in the hospital, inpatient rehabilitation, countless medications, multiple CT scans and X-rays, physician visits, nursing care, physical and occupational therapy, and weeks of follow-up care. Those services involved hundreds of skilled professionals working around the clock to give me the best chance of returning to a normal life.

Today, I’m walking, driving again, using my treadmill, and gradually regaining strength and independence. That recovery didn’t happen by accident. It happened because modern medicine, highly trained healthcare professionals, and remarkable surgical technology were available when I needed them most.

So when I see $373,378.69, I don’t really see a bill. I see the immense cost of modern medicine, the complexity of our healthcare payment system, and the value of having Medicare and supplemental insurance when the unexpected happens.

The number may be shocking, but it is not what I owe. It is simply the starting point in a payment system that most Americans never see until they find themselves recovering from a life-changing accident.

In the end, that figure represents far more than dollars. It represents a second chance. For that, I am profoundly grateful.

On Thursday, I made my first solo trip into town since my May 31 accident.

The day before, my neurosurgeon told us that the X-rays showed the spinal fusion was doing well.  He relaxed several restrictions. I no longer have to wear the rigid back brace. I can now lift up to 30 lbs.

And I can drive!

I took advantage of that and drove back home from Little Rock, stopping in Russellville so we could pick up a couple of Karen’s prescriptions.

On Thursday, I decided to drive in to get a haircut. I certainly needed it.

However, the shop that I use was closed, so I headed on over to Walmart.

I’ve been using walks at Walmart and other stores, as well as walking around the yard, for physical therapy.

I use the empty cart for stability and then, when I’m just about done, do the shopping.

I managed to get about a mile.

I still have a long recovery ahead of me.

{I just noticed a couple of details that AI got wrong in the image.  I don’t wear a watch and haven’t for almost 20 years. I also don’t wear T-shirts with pockets. As well, I don’t wear jeans in the summer.}

A major spinal fusion is not simply a repair. It is a reconstruction… and it may take a year or more.

On May 31, I fell about 5 feet and fractured 3 vertebrae. Two days later, I underwent spinal fusion surgery that bridged 5 vertebrae with titanium rods and screws and bone graft material.

A brace may be required for several months.
(Image is NOT me.)

When most people hear that someone has undergone spinal surgery, they imagine a few screws, a short hospital stay, and a gradual return to normal life. The reality can be very different when the injury is severe enough to require stabilization with titanium rods, screws, and bone grafts.

After a traumatic injury, such as fractures involving multiple vertebrae, the surgeon’s first priority is to restore stability to the spine and protect the spinal cord. During the operation, titanium rods and screws are attached to healthy vertebrae above and below the injured area. These implants immediately stabilize the spine, allowing the patient to begin healing without the damaged bones shifting dangerously.

Many people assume those rods and screws are the permanent solution. They are not.

The hardware serves as an internal support system while the body performs the real work. Bone graft material is placed around the injured area to encourage the vertebrae to grow together into one solid piece of bone. This process, called spinal fusion, creates the long-term stability that the hardware alone cannot provide.

Bone healing is remarkably slow.

Unlike a broken arm that may heal in six to eight weeks, a spinal fusion often requires six to twelve months before the graft matures into a solid fusion. During that time, the rods and screws carry much of the mechanical load while the body gradually builds new bone across the repaired segments.

Because healing takes so long, patients are often required to wear a rigid back brace for weeks or months. The brace limits bending, twisting, and excessive movement that could interfere with the developing fusion. Restrictions on lifting, reaching, and physical activity are common and can last much longer than most people expect.

Some patients are also prescribed a bone growth stimulator.

These devices are worn externally and use low-level electrical or electromagnetic stimulation to encourage bone growth. Depending on the surgeon’s recommendations and the complexity of the repair, the stimulator may be used every day for as long as a year. It is another tool designed to improve the chances that the bone graft will mature into a strong, permanent fusion.

Recovery is not a straight line.

There are good days when walking becomes easier and confidence grows. Then there are days when soreness unexpectedly returns or fatigue seems overwhelming. These ups and downs are normal. Healing bone, recovering muscles, and adapting to altered spinal mechanics require time and patience.

One of the greatest challenges is uncertainty.

Every follow-up appointment brings another set of X-rays. Patients naturally hope the surgeon will declare the fusion complete, but that is rarely how the process works. Instead, the surgeon looks for gradual progress: hardware that remains secure, proper alignment of the spine, and signs that new bone is forming around the graft.

Even if healing appears slower than expected, it does not automatically mean the surgery has failed. Some fusions simply take longer to mature than others.

Fortunately, modern spinal surgery offers several options if healing does not progress as hoped. Bone stimulators, extended activity restrictions, nutritional optimization, and continued observation may all allow additional healing time. Only when there is persistent instability, hardware failure, or a painful nonunion does revision surgery become a serious consideration.

Perhaps the most overlooked part of recovery is education.

Many patients leave the hospital with instructions about medications, wound care, and follow-up appointments, yet receive little explanation of what is actually happening inside their spine over the next year. Understanding that the rods are temporary supports, the graft is the permanent repair, and healing is measured in months rather than weeks helps set realistic expectations and reduces unnecessary anxiety.

Family members also benefit from understanding the process. Recovery is often invisible. A patient may appear much better on the outside while the spine is still undergoing months of biological healing. Respecting lifting restrictions, encouraging walking, and recognizing that fatigue is part of recovery can make a significant difference.

The goal of spinal fusion is not merely surviving a serious injury. It is restoring stability, preserving neurological function, reducing pain, and allowing patients to reclaim as much of their normal lives as possible.

That journey requires skilled surgeons, modern technology, careful rehabilitation, and a great deal of patience.

The titanium rods and screws provide the framework, but it is the body’s remarkable ability to grow new bone that ultimately determines long-term success. Understanding that process transforms recovery from a confusing series of medical appointments into a purposeful journey toward healing.

Today was the first trip out of Pope County since I came back from the hospital in Sherwood.

The original purpose of our trip was to return to Sherwood for X-rays of my spine and repairs, and then see the surgeon who had done the repairs.

Unfortunately, Dr. Krisht had to cancel because he was needed for emergency surgery, so the six-week follow-up appointment is postponed until next week.

(It makes me wonder what kind of surgery it was and how bad it was. Mine was delayed two days, so it wasn’t an “emergency,” obviously, though I was totally out on pain meds, I guess.)

Stopped to get lunch at a new place in North Little Rock—Purple Cow. The franchise seems to be expanding.

It’s been a month and five days since I fell. This picture is the porch I fell from. I’m not sure exactly where my body hit, but it wasn’t on the concrete blocks and stone. I think my body went further out than that.

I got out of the in-hospital rehab a week ago (or maybe it was two weeks ago). Two days ago, we went into the neighborhood market. Before we went there. Karen drove me around town so I could see some of what’s going on, like the excavation for the new Braum’s. Looks like I was right when I quoted the mayor a couple of years ago, saying that this would be a 2026 project.

5/29/26
Fell 5’—broke 3 vertebrae—cracked 6 ribs on the left—tore rotator cuffs on the right.

Surgery was at CHI St. Vincent, Sherwood.

Rehab was in-house at St. Mary’s in Russellville. (They were [are] GREAT at what they do!

HOME! 6/24/26