Some days, I wake up exhausted, kept from sleeping all night because my legs were kicking in the wild spasms of multiple sclerosis. Other days, I’m physically fine, even moderately energetic, but I can’t remember anything that happened the previous week. Still other days, my body can’t make more than a few steps without stumbling. I’ve fallen down the stairs in my home on numerous occasions, and once even stopped my fall by cracking my head open like a bloody egg on a metal radiator.

Here is a brief catalog of some of my most spectacular falls:

I’ve fallen flat on my face while hurrying down a busy sidewalk to see a psychologist who was going to evaluate the extent of my cognitive decline from MS. My bright-green summer dress flipped up to expose my granny panties to anyone looking. My cane went skittering several feet. A kind group of boys who’d been walking behind me rushed up, each grabbing a limb, and hauled me to my feet. One of them handed me my cane. “Are you okay, ma’am?” he asked me. “I’m okay,” I said, and didn’t snip that I was only 42 years old and therefore too young to be called “ma’am.” The cane, I must always keep in mind, ages me significantly in the eyes of the non-disabled. I limped off, my palms and knees skinned raw, blood trickling down my shins. I felt like a six-year-old who’d fallen on the playground. I managed not to burst into tears until I was several blocks away.

I’ve fallen over my dog Trixie in the foyer of my own home. She had some sort of twisted spine problem (this is a thing with pugs) and didn’t usually pay attention where her own body was in relation to mine. She became completely paraplegic by age five, dragging her limp rear half around our apartment like a huffing, spitting mermaid. She died five years later.

Twice, I’ve fallen and broken my leg. The first time, I needed surgery to put everything back together. After they’d patched me up with several big metal screws drilled through my ankle at helter-skelter angles, they put me in a rehab center in an old-age home until I could learn to walk on crutches without falling again. My roommate was a babbling elderly woman the police had picked up off the sidewalk on an EDP call. She snored like a chainsaw and smeared the wall of our shared bathroom with her own feces. Down the hall was an old woman the staff called Babushka, who screamed all day and night; once, while I was wobbling my way to the public bathroom, I saw her through the open doorway to her room, stark naked and folded into her hospital bed like a fleshy white taco. Screaming again. The aide rushing past me toward her room said something about Babushka having removed her diaper. Turned out she had a debilitating urinary tract infection, but nobody spoke Russian, and she didn’t speak English, so she couldn’t explain her pain and probably looked to the overworked staff like a howling, sundowning old lady in need of a tranquilizer shot.

I’ve fallen while gardening, getting into the shower, leaving the neurologist’s office, getting out of my car, trying to sit down on the toilet, getting out of a chair, getting out of bed, and plain old walking on level ground. I’ve fallen while teaching in front of a roomful of college students (I was writing something on the classroom whiteboard, and when I fell, my wrap skirt untied itself and came partway off). Once I tripped but narrowly saved myself while getting off the stage after having spoken as part of a panel of novelists at the NY Public Library. Until that moment, it had felt like a red-letter day.

The frequent falling has roughed up my knees and hands, given me a few scars, cost quite a bit of money in medical bills. It hurts when I go down, but the pain that looms over me, haunting me like a goblin, is loss. MS eats at your brain in seemingly arbitrary ways, taking your balance, your coordination, your memory, and your ability to think straight.

I keep a wheelchair on hand for those times that my cane doesn’t work to keep me upright. I brace myself for a fall every time I take the stairs. My wife and I chose the house we live in now because we could envision how I might live in it after I can’t use stairs anymore. She and I organize a lot of our lives around loss, both what has already gone and what we expect to lose.

I’ve already started in on a forgetting problem; large portions of my life disappear from me as if they never were. My wife could win any argument simply by insisting that my version of events is misremembered. Kindly, she doesn’t, but I always have in mind that she could, that I depend on her kindness, her care and protection, that I can’t (quite literally) stand on my own two feet. The forgetting and the foggy thinking got so bad two years ago that I had to give up teaching. I’d taught college for almost twenty years but decided to retire while I could still drop the mic and go out gracefully. I’ve lost a lot of coordination, but what’s worse is I’ve lost my career, my identity, my mind. It stings. I’m trying to figure out who I am now, what I can do, how to feel useful in the world when I’ve dropped so drastically far from the person I was. I try not to think of this situation as a loss, but as one more change to which I must adapt. But I can’t help feeling like I’ve fallen tragically from where I was when I was younger and healthier.

Four times a year now, I go to the hospital to get an all-day infusion of a chemotherapeutic drug that’s supposed to help improve the symptoms of MS. It helps—my wife says she notices when the time for my infusion gets near because I get more forgetful, wobblier, more prone to accidents and falls. When I finish the treatment, all of that struggle goes away for a while. I know it’s tenuous; I know it will come back, but I’ve bought a brief respite from the forward roll of debility and loss, and I try, temporarily, to put it out of my mind and enjoy being unassailably upright.

When I go for treatments, the nurse snaps a neon yellow bracelet around my wrist that reads “FALL RISK.” I’ve begun saving these bracelets, sticking them to the door of the fridge with magnets, all in a column. They’re a reminder: Don’t take yourself too seriously, Clumsy.

Just as I’ve begun to find a workable stasis for my own body, my wife’s mother has begun to tumble into dementia. I call her every day to check in. Sometimes she’s cheerful, sometimes mournful, often obstinate and angry, swearing up and down she’ll die before she’ll let us put her in the giant retirement complex near her home where people go to die, the one into which we’d never even consider suggesting she move. “I’m staying here until the end!” she tells me, apropos of nothing.

My wife and I have talked about it and decided that for now my wife’s mother is okay where she is, with a home health aide she thinks is a friendly neighbor and twice-daily phone calls from us, but there will come a time, probably soon, when her mind will have wasted away enough that we’ll have to figure out a safer, healthier place for her to live, a place where she’ll have to trade independence for care.

Her mental decline—memory loss, illogic, emotional lability—mirrors what I’m facing now, what I’ll probably face more of in the future. It’s painful to look at. I get angry at her, though it’s no fault of hers, simply for reminding me where I’m likely headed.

Sometimes in our afternoon talk, I walk her through the steps of making herself a heated almond milk with cinnamon, just to get a few calories into her frail body. It’s like an American bastardization of a horchata: Put the almond milk in a mug, ¾ full. Put it in the microwave. Press 3-0-start. Wait for the beep. Now take it out and shake a little cinnamon in it. Are you drinking it? Is it good?

While we’re talking, I stand in my kitchen, open cupboards loudly, clank my mug against the counter, anything to signal that we’re in this together, we’re doing this in tandem despite the miles between us.

Things will change, probably soon. She’ll stop being able to use the microwave because it will be too dangerous. I’ll stop being able to carry a hot mug for the same reason. We’ll each forget what we’ve been talking about, who we’re talking to. We’re both losing our independence and our strength, and soon, we’ll both need even more care.

For now, I can do it. I can call her, I can help care for her, I can hold a hot mug steady enough not to scald myself. This is for now, but I can feel it changing for both of us.

The reminder is stuck there in a fluttering row of neon yellow on the refrigerator door:

FALL RISK

FALL RISK

FALL RISK

Alysia Constantine is a writer who lives in the lower Hudson Valley of New York with her wife, two dogs, and a cat. She is the author of the novels Sweet (2016) and Olympia Knife (2017). For more information, see www.alysiaconstantine.com

Header image: Golden Rope, Serena Aurora Day Himmelfarb. Mixed media.