I’ll bet you never thought you’d feel that old at 20, even though you lived in a war zone that made all young men and women feel old. You couldn’t know you’d still be alive fifty-three years later, prosper, experience love, heartbreak, depression, crazy joy, success and abject failure – you know, all the things a full life throws at you. Because, while you lay shaken and face-up on a concrete floor with your spine losing all feeling, all you could imagine was darkness and despair.

In February 1969, the Viet Cong attacked the Long Binh Army Base in South Vietnam. Sometime after midnight, Charlie lobbed a rocket over the perimeter and into your company area. It hit an overhead utility line and exploded, raining shrapnel down on the metal barracks where you and 277 other men dreamed of going home. The explosion woke you. You grabbed the edge of the mattress in your upper bunk and rolled out of bed, falling four feet and landing flat on your back on the concrete floor, the mattress flopping on top of you.

At that moment, you didn’t think about broken bones or pain, but checked instead for bleeding wounds. Finding none, you tried to sit up, but couldn’t. You waited and tried again, pulled yourself up on the bed poles. Nothing hurt. But you couldn’t control your legs. In the darkness you grinned, thinking the injury just a bad bruise…just a sprain. It wasn’t until the next morning that the fiery pain began.

In the months that followed, the Army doctors treated you like a freak, a faker and a malingerer. They understood flesh and muscle wounds, head trauma, mangled organs, and burned skin and lung tissue. But excruciating hip and back pain with nothing broken was a great mystery for them. And if they couldn’t put a cast on it, stitch it up, graft skin to it, cut it off, or smother it with pills, they were stumped. The doctors made you feel guilty for complaining about the pain that sent you hobbling about like a drunken garden gnome and woke you several times each night.

A year and a half later, after rediscovering love and then the freedom of civilian life, a young doctor who treated mostly old people gave you your diagnosis: Ankylosing spondylitis – spinal arthritis. You asked the doctor what happened over time to people who had the disease. He pointed out an old man in your town, bent over at the waist, humpbacked, hands stuffed in his pants pockets, shuffling along, barely able to see forward. You’d been a distance runner, a sports cyclist, an aspiring guitarist with nimble fingers and a good ear. Would all that disappear, leaving you to shamble about, gritting your teeth from the pain and accepting the pitying looks from upstanding citizens?

You lucked out. A particular non-steroidal anti-inflammatory drug helped cool the pain. But the fire never went away, flaring up at the most inopportune and embarrassing moments, like the time in the movie theater when the chest pain felt like a heart attack and took your breath away. The pain always followed you, made you dance along that top fence rail, balancing, balancing, never forgetting it, always there…ready to attack if you did too much exercise, or throb as a depressing ache in your stiffening joints if you did too little.

One afternoon, about a dozen years later, you climbed onto yet another fence line and became a Type 1, insulin-dependent diabetic. The constant inflammation from the arthritis had killed some important cells in your pancreas, made you shove insulin-filled syringes into your legs every day, stab your finger tips with sharp lancets to test your blood sugar levels, and dance along a second fence line that wove around the first. If you got too much exercise, your blood sugar dropped, your arthritis hurt, and you needed to eat more. If you got too little exercise, your glucose levels rose to dangerous heights, you injected more insulin, your body stiffened, and you gained weight, putting more stress on the damaged joints.

Your doctor told you, “You’ve been dealt a couple of bad hands. Don’t let the arthritis and diabetes control your life. Live beyond them.” At first, you didn’t appreciate what he meant. But as time passed, his words proved invaluable. You became proficient at dancing along fence lines, falling, climbing back up. But after 35 years, the arthritis drugs failed…in a spectacular way.

One morning, after rising to make your wife’s breakfast, you turned your kitchen floor into a crime scene – splashes of dark blood everywhere from a perforated ulcer. You nearly bleed out before the surgeons could stitch up the hole in your stomach lining caused by the arthritis meds. So now at 55, you were legitimately old enough to have an old man’s disease, but with nothing but acetaminophen and opioids to treat the inflammation and pain.

And on you danced, living a full life but never far from other challenges – gallstones, prostate cancer, kidney stones, shingles, cataracts, and psoriasis. Science advanced new drugs, new treatments, new promises of cures. But none seemed to fit. Yet, you have gotten used to the challenge, to the dance. At 73, you walk throughout your town every day. We meet at restaurants and music shops with our friends. I play guitar, write short stories, enjoy my wife and her art and poetry, and consider what might come next. The view from the top fence rail has been wonderful, painful, often exhausting. I’ve met more than a few others like myself. In times past we’d have been long dead, and without affordable health care, who knows. But the inexorable pull of life keeps us dancing, dancing, dancing.