This Suturing of Wounds or Words

Arianne Zwartjes

I. Skin
My friend Nina archives and restores old films. Their bodies accumulate everything from dust to mold to dirt, shrink and become brittle, crack or start to break apart. They’re decaying from old age. The sprockets along the edges rip open. 

They store the old films in what basically amount to caverns in a cliff wall. The temperature is kept at thirty-six degrees, moisture at ten percent. The archive is buying time. Trying to keep the film-bodies from aging, from decaying any further, before they can be copied onto another body. 

There are so many ways we try to buy time as well. Not caves at thirty-six degrees, but almost everything else you can imagine has been attempted at some point. 

Serums made from placentas. Cell injections from the tissues of fetal animals. Elixirs, ointments, drugs, hormones, dietary supplements. Cryonics. Alchemy and the use of precious metals for eating utensils. Monkey gallbladders, bathing in beer, bathing in special springs. Injecting human growth hormone, or injecting botulinum toxin into the skin. Rubbing in honey, or balm, or ejaculate, to keep the skin soft.

The prospect of brittleness is terrifying. 


The collagen microfibril—left-handed helices twisting into a right coil, triple-helix filament—this protein crosslinks into the weaving that is our skin. In growth and repair, in development and disease, our skin stays soft, elastic, supple because of collagen. When the body is damaged, it lays down new collagen fibers and makes a scar: a pale, thin, vulnerable layer of skin.

As we gather years to us, some of the collagen in our bodies is lost, and some becomes more rigid, decreasing function. 

Collagen’s life is cyclical like most other things in our bodies. We produce it and break it down all our lives. At some point, though—somewhere around forty years in—the balance tips: more breaking down, less producing. On top of that, collagen in the skin can be damaged by outside factors, distorting its coherent, orderly structure. The sun’s UV rays, chlorinated water, smoking, and other types of pollution all do their damage.
Nature takes us from conception through our years of procreative possibility with robust vigor. After that, our body’s role, in an evolutionary sense, is done. 

There are varying theories about aging. One holds that aging events are random, cumulative, and microscopic. That there is slow accumulation of damage to cell membranes. That chemical reactions eventually bind together those molecular structures that work best when separate: proteins, nucleic acid, and collagen. 

Another theory proposes that aging is simply genetically programmed into our cells: they have a set life span, a genetic timetable. When melanocytes, the cells that give our hair its melanin pigment, wear out during midlife, they are not replaced. Grey hairs ensue.        


(The prospect of brittleness is terrifying.) 

This year I watched my grandmother shrink. She’s forgotten how to eat, almost how to swallow; so tiny now, somehow she’s hanging on. Brittle. Barely in her bones. What tenacity keeps her there still, keeps ventricles moving, messages pulsing to nerves? 

In the same year I watched my grandfather pass, unexpectedly, still so much more vital in his body than she. His eyes had gotten wider, his skin thinner; in the photos I look at now his smile seems a conjured motion—muscles of the face remember how, but the mind has started its own distance from the plane the rest of us walk on. 

He was a firm believer in reincarnation and metaphysical knowledge. I remember, from very young, his stories about his submarine experiences in World War II. About the men who came to him and knew they were about to die. In the retelling, he would say my name, and then pause. “Arianne… I can’t tell you how many times I had one of the guys come to me before we went into battle, and say, ‘George, I’m scared. I think this one’s going to be it for me.’ And they were always right… they were always the ones to go.” 

His voice plays in my head still. His younger voice, solid, just a little bit of gravel. 

We pump tissues full of silicon, needles into lips to keep them plumped, as though they were pillows to be propped up. Even after bodies are de-animated, we push fluids through the veins, for some reason trying to hold them plumped, inflated. 

II. Laceration

In older age, as our skin thins and becomes more delicate, more easily wounded, we may sustain “wet tissue paper” tears as a result of fairly minor trauma. But even before the skin thins and brittles with time, it is such a vulnerable body layer: soft, pliable, thin. We wound like ripe fruit, bruised and leaking open. 

Lacerations to the skin may be clean and linear if they are caused by a knife, glass shard, or other sharp object. They may be caused by slicing at an angle, separating an entire flap of skin like a peninsula. Crushing injuries, caused by a direct blow or impact, may cause a stellate laceration, irregular in its course. If deep enough, a laceration may reveal underlying tissues: fat, muscle, tendon, or bone. 

Deep wounds sometimes accompany underlying bone fracture; it’s even possible for the broken bone to cause the laceration to the skin, sharp, splintered ends jutting through what was intact. 

But broken bone is not the only way we are shattered or sliced. Whole worlds can fracture in an instant, leaving us reeling with lacerated ribbons of flesh or self. Whole worlds can fracture without a word of warning. 


The most striking thing about fracture is the way it arrives. You can be going about the most mundane day you’ve ever experienced in your life. Nothing unusual. Nothing to give you pause. Indeed, it’s like every single other time you’ve ever done this particular thing you are doing—walking home in the evening, biking to work on a sunny morning, stepping into the car. You are thinking about other things. You are smiling at something your students said this afternoon. Or you are feeling your legs as they push against the pedals and extend, feeling your bike soar as you coast downhill. And then, suddenly. Like a dropped fruit splitting open. 

A rough voice on the sidewalk behind you. Or the shrieking scrape of metal against metal. Or the unexpected thud of something heavy hitting the sidewalk. 

Once I was biking home through a grocery’s parking lot in New Mexico. A large pickup truck hit me from behind. What I remember was the disorientation: an inexplicable physical impact, the instantaneous rupture of normal, the sense of being violently jolted apart from everything that I thought I was doing. 

Trauma is a shear in ordinary blacktop. A fissure in the everyday fabric. 

Like flannel being ripped. The shredding of each fiber in a mostly-straight line. The frayed edges that result. The way the cloth loses its flat plane, becomes irregularly stretched and taut, gaping and baggy.


When you get there on the ambulance you can see it in their eyes. The shock of it. The rupture. Like everything they’ve ever known to be true just dissolved into nothing.

A snowy road in Wyoming with red rock upthrusts on all sides. And then the wind swirls and the road is gone and all you can see is white. You can feel you’re still moving. Posts swell into sight and then disappear again, just missed in the slide. Are you moving forward? Sideways? 

Riding home and the bicycle and the ambulance in the street. The man with his patella torn open and apart. The foot so shredded it’s no longer a foot.


My brother’s girlfriend called him the three times she cut herself. Long streaking slices in the arms. He the bandage. The clotting agent. There are many questions raised of Quik-clot and other commercial clotting agents. One type has been known to stay in the bloodstream, forming clots long after the need has passed, traveling eventually to the brain and causing cerebral embolism and stroke. Another, in powder form, blew into the eyes of other soldiers in desert winds, damaging their vision. All clotting powder must be removed from the wound before physicians can suture, a lengthy cleaning process. Blooming wound on this terrain of skin. 


Sometimes fracture is a clean slice. Sometimes it is ugly. Unbearable to look at. 

Unlike a house, there is something behind the drywall. When a hand is blown open there is so much tissue still hanging there. Bones and connective tissue, sponge of the flesh soaked in red. Looking nothing like a hand but in the space where a hand should be. 

Sometimes you approach the scene and a man hangs upside down between the crumpled metal of two cars. Sometimes other rescuers are already walking past him, as though he were not hanging there, as though no body upside down and hanging had once contained a person, an individual. 

Sometimes whole legs sliced open, like cut fruit, melons spilling out of their cask. In the calf is so much muscle and so much flesh. Skin rolled back like curtains to a theatre of what is beneath. The soft and furled shine, the deformity. Visit a meat counter and you’ll see what lies beneath. 


Fracture is a sudden rupture in the skin of the afternoon. A crack, a tear, a rendering apart of what once was whole. A violence. 

III. Debridement

And after. After we are wounded, after our world is shattered by loss, reassurance is hard to come by. The precipice is still a precipice from the other side. From the bottom. 

We find ourselves a shaky, knitted-together place to stand. Are, perhaps, a little purified, like rising from flames, by the absoluteness of it: by having lost what was unbearable, unsurvivable to lose, and finding ourselves still breathing. 

But that’s all we are, at this moment. Still breathing but broken, and at the bottom of this very tall precipice, with no clue as to how to ascend. Back to the flat plains of the living. 

Back, with at least one foot, into the land of pretending again: we are safe, those we love are safe, there is no precipice. 


Though some nights I wake fearful, wishing this city had less heroin and fewer gunshots, the truth is that fracture is everywhere. Our hearts are our whole bodies and our wounds are visible. We are atoms in a fragmented universe. Seen this way, individuals begin to blur. Journalists use the term compassion fatigue. What Ernest Becker called the denial of death is a kind of reality fatigue. And yet. And yet. 


Doctors may choose to surgically remove dead or damaged tissue to promote the healing of a laceration. This is known as debriding the wound, and is most often done to create clean wound edges and decrease scarring, or to remove infected and necrotic tissue. 


What is it that happens as fracture occurs. If it doesn’t entirely break us. Though sometimes it does. But. Sometimes the shattered vessel fills with light. Sometimes the fracture opens us. Sometimes we become not less but more alive. Like the discomfort of standing on a high ridge, soaked in slicing grey rain, scoured by wind. Bracing. Perhaps this scouring can shed what isn’t needed, sloughing off the dead skin built up over years of living, in fear of breaking, our faces turned away. Throughout my whole life, wrote Teilhard de Chardin, during every minute of it, the world has been gradually lighting up and blazing before my eyes until it has come to surround me, entirely lit up from within. This is a man who has known fracture. We live steeped in its burning layers.

IV. Clotting Cascade

The human body has a vast, astonishing capacity to repair itself. To heal. Wounds to the soft tissues of our body, to the skin, heal through a number of complex, overlapping phases. The clotting cascade, in which a net of collagen fibers forms and is pulled tight to stop the bleeding. Theinflammatory phase, to cleanse the wound of debris, bacteria, damaged tissue. The proliferative phase, in which all sorts of small miracles take place. 

Fibroblast cells proliferate, and help create a rudimentary layer of new, living tissue in the wound. Epithelialization forms a barrier, the epithelial tongue, between the wound and the outside world. Epithelial cells actually migrate across the new layer of tissue, advancing in a sheet across the wound site and also rising from skin appendages such as hair follicles and sweat glands. They climb over each other in order to migrate. The next time you cut your finger, imagine these tiny cells, scrambling one over the other to help you heal. The more quickly this migration takes place, the less scarring will occur.

At the same time angiogenesis creates whole new blood vessels to carry extra sustenance to the cells fighting to repair you. This concentration of new capillaries is why the tender young tissue in wounds appears so deeply pink. 

Finally, the maturation and remodeling phase, which can last a year or longer. In this phase, unneeded blood vessels gradually disappear, and the scar becomes less pink. The early, disorganized network of collagen laid down is replaced by a rearranged, cross-linked section of tougher collagen; as the wound heals, it becomes stronger, up to 80% as strong as the previous, normal tissue. 


Definitions for the word “recover” include: to get back something previously lost. To bring the self back to a natural condition. To return to a suitable or correct state. To return to a previous state of health, prosperity, or equanimity.

But healing from wounds actually changes us. We are a different cluster of cells, blood vessels, and tissue once remodeled.


How we choose to respond to the fracture all around us can be transformative. What we make of our own wounding. Which narrative we choose to believe. 

One of today’s prevalent stories is that of no-narrative. That everything is simply fracture. But I believe a different narrative is also seeping into things. Starting to clot and thicken. We take these stories to make sense of things. We take them to give us meaning.


We are generations in conflict with ourselves: want to believe in a clear narrative and at the same time find we can’t. Or, we spent so much time not-believing. And not without reason. As we get older I think we begin to want—and to be torn. We understand fracture too well. Understand the shiftiness of any narrative, how slippery it is, how fickle. We’ve seen the places it can lose its hold, its meaning. The places where it’s hollow. The places it avoids saying what needs to be said. Like making love to reweave the frayed lace intricacies of a lie. We were skeptics from the beginning. Still, there’s this certain ache coming into place for us. An ache for something to supplant the narrative we don’t believe in? Something coherent instead of cynicism, instead of a kind of social and relational nihilism.


The possibility that philosophical inquiry might confirm our worst fears(do we turn away). This heritage of relinquished blooms. 

You can only relate what you saw a bold and almost incredible answer. 


We’ve seen the speed with which images bombard each other, overlap, replace. The speed with which cultural amnesia takes hold. We know thatself is a slippery thing. That the I can be no one, anyone, everyone all at once. Nonetheless, I think we’re slowly finding we want it still to mean—as we drag this anchor across the bottom we want it to catch somewhere.


If I say things thaw the tap of salt water am I trying to be optimistic. Though today a thaw is a frightening thing. There is the question of how to (hold to) optimism within the present world narrative.

Stitched and torn, cut and spliced, the surgeon’s hand is never empty. If you watch you can see the huge floes of ice, like buildings, come crashing down.


In the one hand I balance a brown egg: each generation has thought its world was going to end. Paul of Tarsus called his days “these late times.” He lived in the first century. In the other, a speckled blue: scientifically it seems this time around we have reason to believe it actually might. 

Where do we put that in the narrative? If we are thinking say of children. If we’ve re-gathered that much faith. It all splits back open again.Sutures today are made of specialized thread that will eventually dissolve into nothing.


p. 49: This is a very slight paraphrase of E.M. Forster, as he is quoted in Annie Dillard’s For the Time Being.

    David Roy, “Dying and Death—Late in the Twentieth Century,” from 
    Awareness of Mortality, ed. J. Kauffman

p. 49-50: Information on the collagen microfibril comes from Structure, Stability and Folding of the Collagen Triple Helix, by Jürgen Engel and Hans Peter Bächinger.

p. 51: Information on theories of aging comes from Human Growth and Development Through the Lifespan, by Kathleen Thies and John Travers.

p. 54: Journalists use the term compassion fatigue. What Ernest Becker called the denial of death is a kind of reality fatigue. (Annie Dillard, For the Time Being)

p. 55: Our hearts are our whole bodies and our wounds are visible. (Fannie Howe, Indivisible)

    Dillard quotes Teilhard de Chardin as writing: Throughout my whole life, 
    during every
 minute of it, the world has been gradually lighting up and   
    blazing before my eyes until it has 
come to surround me, entirely lit up 
    from within. 

    And Chardin on the divine: We imagined it as distant and inaccessible,
    whereas in fact we 
live steeped in its burning layers. 

p. 57: Like making love to reweave the frayed lace intricacies of a lie(Boyer Rickel, Remanence)

p. 58: Paul of Tarsus called his days ‘these late times.’ He lived in the first century. (Annie Dillard, For the Time Being)