MS. DIANE REHMThanks for joining us. I'm Diane Rehm. In Gail Caldwell's last memoir, "Let's Take the Long Way Home," she chronicles the loss of her best friend to cancer. It's also about her love of dogs and the animal's power to challenge ourselves. This theme comes up again in her newest memoir, "New Life, No Instructions."

MS. DIANE REHMThis time the dog is Tula. Her challenge is how to deal with acute pain from what she believes is her result of her childhood polio. Gail Caldwell talks about what happens when the story you've told yourself turns out to be not quite true. Gail Caldwell is here in the studio. We'll take your calls, 800-433-8850. Send us your email to drshow@wamu.org. Follow us on Facebook or send us a tweet. Gail, it's good to meet you.

MS. GAIL CALDWELLI'm so glad to be here.

REHMGail, let's start at the beginning, how your parents actually discovered that you had polio.

CALDWELLWell, they discovered it by default because I didn't walk. I was -- we now know I was six months old when I was hit in the epidemic of 1951. And my mother remembered that I had a probably 105-degree fever and lay on a carpet for six weeks. But they didn't know what it was.

REHMWow.

CALDWELLI think because I was too young to manifest the physical signs that most kids or adults would. I couldn't say, I have a headache. I couldn't -- my legs didn't buckle because I was an infant, so I wasn't anything but crawling yet.

REHMAnd that was really the end -- toward the end of the polio epidemic. I can remember, in the '40s, my mother saying, you may not go to a swimming pool.

CALDWELLMm hmm.

REHMYou have to be so careful here, here, here, and there. I mean, polio was everywhere.

CALDWELLI think it was terrifying. And I think one of the things that inspired me to think about this and write about it was that people have forgotten that. They don't understand what a cultural and social phenomenon it was until the vaccines, which was in the mid-1950s.

REHMExactly. How did your parents finally learn that you had polio? And what was their reaction?

CALDWELLIn some ways, I think we were lucky because the scariest part had already happened by the time they realized it. I didn't walk until I was 2 1/2. And back then, the pediatricians in the Texas panhandle were much more laid back than the helicopter medicine of today. And they said, oh, she'll walk when she's ready. Don't think anything about it.

REHMHmm. Oh my.

CALDWELLSo I'm not sure if anything different could have been, had they known that. What finally happened was, when I stood up -- and my mother remembered my trying to get up and falling. And I actually remember -- I remember holding on to a low table. I can remember the visual aspect of that, and then falling because I could stand up, but I couldn't take my first step. And when I did, I was 2 1/2, and I walked with one leg slung out behind me. And so -- but they finally began to put together that this was the legacy of the fever that I had had two years earlier.

REHMYour mother plays a very important role in this book. Tell us about her.

CALDWELLWell, God love her. She's partly what I think led me down the half-conscious course to write the book. My mother was so devoted in a very tough-minded Texas pragmatic way. I mean, I don't think she was particularly sentimental or brokenhearted. She just saw a job that had to be done and did it. And when I was probably in my 40s, I asked her how much time she had spent -- she basically oversaw my rehab as much as it was.

CALDWELLAnd that included doing floor exercises with me for what seemed to be an infinite amount of time because I was 3. And I asked her, probably 40 years later, how long she spent doing those leg lifts and heel walks and toe raises. And she said, oh, a couple hours a day for about three years as though there were nothing to it.

REHMHmm. Wow. Yeah. 'Course those were also the days of the iron lungs...

CALDWELLThe -- yes.

REHM...for those who literally could not breathe. That did not happen to you.

CALDWELLNo. I, in fact, feel very blessed that I had a relatively mild case. But I remember the feeling -- I remember the iron lung and the -- I even think the county fairs, they had the polio exhibits, what happened to the boy in the iron lung. You know, this was a really intense mid-century sort of horror show for a lot of the Western world. And now we don't think much about it because it's over for our part of the world. But I met a woman in the last two weeks whose husband in rural China had suffered polio in the '70s. So it's...

REHMIn the '70s.

CALDWELLWe like to think of -- in the 1970s.

REHMWow.

CALDWELLSo the vaccines, you know, we -- of course, the U.S. got the vaccines first. And there's -- I think there are still -- you know, Melissa and Bill Gates have tried to eradicate it, I think, from the world. But there are still places where it exists.

REHMGail Caldwell, in a very short period of time, you lost your best friend, your parents, and your dog Clementine.

CALDWELLMm hmm.

REHMSo did this book come out of those losses?

CALDWELLI think you're precisely right though I would not have put it that way. I'm glad you did. I think that that's exactly what happened. On the other side of six years to the day, I -- my best friend died in early June of 2002, and then both parents and then my beloved Samoyed, the same day as Caroline had, six years later, in 2008. And I was blundering through life and decided that the only thing anyone in her right mind would do was get another puppy and throw some life into my heart, which really felt stomped upon. And I began this book around the same time.

REHMYou got yourself a Samoyed.

CALDWELLI did.

REHMTell me -- I don't know the breed. Tell me what a Samoyed looks like.

CALDWELLWell, they're big, beautiful, fluffy, clownish white dogs, so they look like giant goon teddy bears. And I often find that...

REHMLots of hair.

CALDWELLLots of hair. I find that children who are afraid of dogs love my dog because they think she looks like a stuffed animal, even though she's 55 pounds.

REHMWow.

CALDWELLAnd they're known for loving children. They used to breed them -- the name comes from the Samoyed tribe in Russia. And they apparently bred them partly to sleep inside the tents with the children because they have so much fur. So their temperament is very gentle and very affectionate.

REHMSo it would seem almost that the book is also a thank you to that dog.

CALDWELLOh, I think you're right, a thank you and a shaking of my head at the same time, because she put me through all kinds of paces.

REHMInteresting. Now, you found out in midlife that what you had suffered from was not actually polio. What was it?

CALDWELLWell, I have -- I found out I had suffered from polio. But, in fact, what happened was that the decline that began in probably my late 40s, I think, was a legacy of polio. But until about three years ago, I didn't know there was anything I could do about it.

REHMI see. Isn't there a disorder that does come after polio in later life?

CALDWELLYes. But they call it post-polio syndrome.

REHMAnd in your case, how did it manifest itself?

CALDWELLWell, I was, in fact, terrified of that. It's a subject that people have several opinions about. The National Institutes of Health says that it's a matter of -- the more severely affected people were to begin with, the more likely they are to suffer the effects of what they call post-polio syndrome.

REHMIn midlife.

CALDWELLIn midlife, yes. And I knew -- a friend of mine's mother had wound up in a wheelchair after having had a slide limp throughout her life. So I was afraid of this, partly because there's nothing that can be done. I think that one of the interesting medical things is now that polio is mostly over in the Western world, they're not very interested in doing any more research about it because it's over.

CALDWELLSo any manifestations of later syndromes is seemingly, medically, insignificant. In my case, I was afraid that's what was happening to me. And then I was fortunate enough to find a wonderful doctor who said there's something else going on, too, which is that you don't have any hip left.

REHMNo hip.

CALDWELLAnd I still remember talking to him. And I said -- he said, do you have any questions, after he'd given me a long medical litany. And he was a new physician in my life. And I was so shocked, and I was standing in my kitchen taking notes. And I said, well, my first question is, I guess I want to know how you feel about this. And he seemed startled because it was such a non-kind of medical question. But I actually think it was a smart thing to say because it took him off guard. And he said, well, I'm relieved to tell you the truth because we can do something about his.

REHMHmm. Had you, throughout childhood, been limping a great deal?

CALDWELLI had been limping a little bit. But I had always -- I think partly because of my parents' incredible sort of fortitude and one-way arrow pointed forward, I had ignored what seemed to be polio's legacy or found a way to make it work. I still remember an editor in the newsroom at The Globe, where I worked for years, saying to me, why are you limping? I was probably in my late 30s. And I said, you know I always limp. 'Cause I know I had told him. And he said, oh, I always thought that was a swagger. And I thought, well, I'm glad I convinced someone.

REHMGail Caldwell, her new book is titled "New Life, No Instructions." And when she came into the studio today, I asked her to walk. I wanted to see her walk. And I wish you could see it as well. It's beautiful. Short break here. We'll be right back.

REHMAnd if you've just joined us, Gail Caldwell is with me. She is a New York Times bestselling author of "Let's Take The Long Way Home," winner of the Pulitzer Prize. Her new book is a memoir titled, "New Life, No Instructions." And, you know, I'm fascinated with the cover, which shows of 4" of a tape measure with a beautiful cabbage butterfly walking along. Tell me the symbolism there.

CALDWELLWell, we were thrilled when we saw this cover. My hat is off to the woman who designed it. I just think it's exquisite. She read the book and manuscript and then this just appeared without any interaction between her and me. The fat is that the surgeon who worked on me also lengthened my leg by about three-quarters of an inch, which was a phenomenal thing, medically, for him to be able to do.

CALDWELLAnd I think that she landed this butterfly right about where I got that extra length of leg because she saw it as a transformation. And it's really very simple and quite lovely. And I…

REHMJust beautiful.

CALDWELLYeah.

REHMI agree. Tell me about childhood experiences and whether you found yourself being sort of made fun of or harassed in any kind of way because of the way you walked.

CALDWELLYou know, interestingly, not at all. And I wonder -- I don't know how much that had to do with where I was raised, which was the Texas panhandle, the attitude that I had been bestowed upon me by both my parents, or in fact -- I mean, there's one moment in the book when I say that the first time I went skiing I was in Ruidoso, N.M. and I fell down I think after my nine strokes on the skis.

CALDWELLAnd the boys all started laughing and started calling me Grace. And it was -- and all through high school they'd be like, "Oh, here comes, Grace." But it was almost that cool thing that boys do.

REHMYeah, yeah.

CALDWELLSo it was a moniker that stuck and was half flattering.

REHMNow, a little later on you went through a period of alcoholism. Was this before the doctor discovered that you had no hip?

CALDWELLOh, yes. You know, I wonder sometimes, in the constellation that makes us who we are or how much of it is genetic and how much of it is this sort of environmental legacy. I, in fact, went through for almost 20 years of drinking way too heavily. And it started when I was a teenager. And I don't know that the two have anything to do with each other, but they're certainly big parts of who I am.

CALDWELLAnd I have stopped drinking in my early 1930s (sic). I think if I had learned anything and put it to use and what's happened to me medically, it's that I knew what recovery -- I learned so much about recovery and that you can only do it a day at a time. That you can't get sober any faster than anybody else. And I think that was a hugely humbling thing for me to learn about physical rehab as well.

REHMDo you think that the pain you began to endure and the falling that you began to experience played a role in your beginning to develop a yen for alcohol?

CALDWELLI don't because I drank before the pain. I really -- I don't think that I was in pain until I had already stopped drinking. But by then maybe I knew how to deal with pain better.

REHMHow much pain are we talking about?

CALDWELLYou know, I wonder now. I think people's experience of pain is so subjective. I have a friend who I think of as enormously stoic. And she wound up with an emergency trip to the dentist. And he asked her what kind of pain she was in and she said, a three. And she -- I think she -- because they always ask, "What is it on a zero to ten?"

REHMYeah, of course.

CALDWELLAnd she said a three. And I said, "Huh?" I said, "Middle age to me is a three all day long." But I think for it was an emergency. So I think in some ways the most wearing thing in my situation was that I adapted to chronic pain. And that had gone on. And I write a little bit about this, but I think I was so intrigued by the universal fortitude that so many people are able to possess, even in the wake of despair, that we just keep going. And for me the chronic pain was you get used to it, which in some ways is the part that you have to be careful of.

REHMAnd the chronic pain you were experiencing was because one leg was shorter than the other. As a result, not just of polio, but the fact that your hip…

CALDWELLRight.

REHM…was no longer there.

CALDWELLI think the polio was in the chicken and the egg line up. The polio just began to destroy the hip. The legacy of the polio is what destroyed the hip. And then the hip is what put me into so much pain. So it was a downward spiral with the two conspiring.

REHMAnd how did the doctors approach this?

CALDWELLWell, you know surgeons. I have such admiration for surgeons. They're so -- they're just -- I mean, I remember going in to see my doctor and I had a long list of questions that was half a page long. A typical writer's lament. And he threw it to the side and said, "I think you're doing great." And I thought, well, for -- and, you know, I have to trust him. I think he's right. He was very straight forward. He's a very can-do guy. And he looked at the x-ray and said, "There's only one thing to do here."

CALDWELLAnd on the worst days I have remembered over the past two years that one of the first things I heard when I woke up was his assistant in the surgical ward saying to me, "You had to do this. You had to do this." So now I think, you know, when I think, "Oh, my God, this was so hard," I think, "I had to do this."

REHMSo exactly what did they do?

CALDWELLThey did a total hip replacement. And they also managed by the design and placement of the prosthesis to buy me about an extra three-quarters of an inch leg length. And then the development of the muscle and tendon and ligament and nerves was up to me, which was pretty tough. I'm glad I didn't know, actually, what the rehab was going to be like.

REHMHow tough it was going to be.

CALDWELLYeah.

REHMBecause then you had to do how much physical therapy in order to get used to walking on a level basis?

CALDWELLA new leg. I said I kept feeling like I had gotten this new leg from Sears and Roebuck, without any instruction on how to use it. That was, I think, part of what prompted the title for this book. I'm, to tell you the truth, still doing some, but the first six months were the most brutal part. And I -- brutal and also joyous. I felt lifted up into the world in a way that I hadn't been in years. I actually felt that the world was moving faster as I was walking through it.

REHMYou could look at people in the eye that you had thought were much taller than you.

CALDWELLThat's right. I have this lovely friend who I thought of as this striking 2" taller than I woman. And I still think of her as striking, but now I think our eye level is the same, which was a thrilling thing to realize.

REHMSo how much height did you actually gain?

CALDWELLIt's probably about an inch in height, but I no longer was bending forward in pain, so it felt like about twice that.

REHMAnd your dog, Tula, who did she help you through all this?

CALDWELLI think she's sort of a spiritual service dog. She and he best friend, Shiloh, who's a Belgian shepherd who lives down the street, they stayed with me about three weeks after I got home from the hospital. And that sounds radical, except that they're both so good. And Shiloh is such a shepherd that they would stand on either stand on either side of me when I walked on crutches and walk along next to me.

CALDWELLAnd I completely trusted them. I trusted them actually more than -- I saw a toddler on the street who came up and tried to grab my crutches because he was enchanted with the metal color of them. But the dogs were very patient and understanding I think.

REHMHere's an email from someone who absolutely loves the Samoyed. Where did I put it? What was it that he said? "Most gorgeous dog."

CALDWELLOh, that they look like a Husky or a Malamute and had a smile all day long.

REHMIs that correct?

CALDWELLThat's true. They have an anatomical expression that -- I think the description in the breed standard is that they have the spirit of Christmas in their hearts year around because they're always smiling. They call them the smiling Sam.

REHMAnd how did you manage with a dog on either side? Was there -- I mean, you're on crutches.

CALDWELLWell, now I was not trying to walk with my intrepid sled dog on a leash while I was on crutches.

REHMI'm glad. I’m glad.

CALDWELLI have my -- I know. I have my friend Peter to thank for that. When I was in the house or in the yard I could walk on crutches and they would walk -- they would stand next to me. On the stairs, Shiloh stood next to me like a shepherd. And when I started to do rehab and I would walk the hills and parks nearby, I actually taught each of them. I would say, "Wait," and put my hand out and use them as a cane.

REHMYou know, even before you started feeling more pain, before you started falling, you had Tula and what did she do for you then?

CALDWELLWell, I really think she held my feet to the fire in a lot of ways. I write about realizing that I was -- of course I didn't know yet what was happening to me. I didn't understand that my hip was failing and what I was about to go through when I brought her home. I think I was 57 and I also thought what -- have I lost my mind. I'm getting sled dog puppy at this age. And I remember housebreaking at 3:00 o'clock in the morning and thinking, I'm about 20 years too old for this.

CALDWELLBut of course I knew it would be over soon. And I think part of what inspired this book, even before I found out the medical diagnosis, is that I started to think about the devotion and obligation and sacrifice that we make for those things we love, whether it was my mother with me or me with my young intrepid sled dog. And that sort of became -- I remember calling my editor and saying, "You know, my mother is insinuating herself into this narrative.

CALDWELL"I'm waking up in the middle of the night and thinking about her and what she did for me when I was young." And so that became the subterranean book that began to emerge.

REHMAnd you then began to take care of Tula.

CALDWELLExactly.

REHMBut then Tula began to take care of you.

CALDWELLWell, that's the joy of dogs, yeah.

REHMSo it moves absolutely full circle. When you were going through all this pain, before you knew that there was a possibility of healing, you had a great deal of pain and falling. I want to hear about what you thought was going on. And you're listening to "The Diane Rehm Show." Tell us.

CALDWELLWell, you mean before I understood the diagnosis that was coming?

REHMExactly. What did you think was going on when you kept falling and you had all this pain? What did you think?

CALDWELLYou know, it's funny, because I think of myself as a very observant and sort of self-attentive person. I don't think that denial is my M.O. But in this case it's shocking to me now what I was willing to look away from because I kept walking two miles a day. And my friend Jean says to me, "Don't you remember you were holding onto the fence in pain? That you would stop and hold onto the fence."

CALDWELLAnd I remember just thinking, "Well, this is just what one does. I just have to do this." And I finally -- when I got to the first orthopedic surgeon I saw, I said, "I've fallen." I said, "I stopped counting at 13. I think I've fallen 13 times in the past year." And that got his attention. But even then there was no x-ray, so it took a while to figure out what this was about. I was afraid that it was post-polio syndrome. And the reason I think I wouldn't look into it is there's nothing you can do for it.

REHMAnd you knew, did you not, that one leg was shorter than the other?

CALDWELLI did, indeed, but it was getting -- I knew that with age I felt that I was getting weaker and more uneven.

REHMDid you have custom-made shoes that…

CALDWELLI had a lift that I wore in my shoe. And I think my left leg had become so dominant, that I sort of felt like I had found a way to make it work. I just used my strong leg to pull my weak one through.

REHMInteresting. All right. We've got lots of callers. Let's go to the phones. 800-433-8850. Let's first go to -- let's see -- Marie, on Long Island, N.Y. You're on the air, Marie. Go right ahead.

MARIEGood morning, ladies. I do appreciate you picking up my call. A real quick story and simple, in 1937 my mother's brother was born first and he had crippling polio. He was sent to a special hospital on Long Island, during most of his youth years. They told him he wouldn't walk. And well, anyway, the man live to 76 years old, healthy. He needed a little oxygen in the end, but he came home and it was hard with my mother not seeing her brother a lot of the time.

MARIEThey used to go visit him at the hospital. I believe it was Pilgrim's State Hospital in the '30s and '40s and '50s. But polio -- he was saved, thank God. And he did live a long time and he had his own business. And your book is very inspiring. I think I'm going to buy it for my mom.

CALDWELLOh, thank you.

REHMAll right. Thanks, Marie, for calling. You know…

MARIEDiane, you're the best.

REHMOh, thanks so much. You know, this idea of living with polio, so many people diagnosed during those years and having to live with it and move through it. You are lucky.

CALDWELLOh, I think I'm very lucky. I think I'm very lucky. And, you know, I was thinking, when Marie called, that of course FDR was a polio victim. And in the 1930s and '40s, until his death, he -- from what I understand -- mostly refused to be photographed in his wheelchair because we wanted, obviously, to be seen as a strong, upright man and would hold onto the podium when anyone was taking his picture.

REHMAnd, of course, he had to wear braces…

CALDWELLRight.

REHM…as well. We're going to take a short break here. Gail Caldwell is with me. She won the Pulitzer Prize for "Let's Take The Long Way Home." Her new memoir, "New Life, No Instructions." Stay with us.

REHMAnd welcome back to a conversation with Gail Caldwell on her new memoir titled "New Life, No Instructions." And here's an email from John who says, "My story is similar to yours even including a hip replacement. I was one of the lucky ones. I contracted polio at age 3 visiting my deceased grandfather. My polio doctor ad me walking within three weeks. He painted faces on my toenails and told me when I could move my toes I could go home. I am now 71. I skate, downhill ski and have lived a long and very active life." Isn't that wonderful?

CALDWELLThat is a beautiful story.

REHMRead for us from your book, if you would, Gail, and set it up for us.

CALDWELLOkay. I started swimming when I was 3 years old. And it's one of my earliest and still most wonderful kind of ageless memories. And I think, of course, this is very connected to my medical self, so I'll read a little bit of that. For years I fantasized about being a mermaid, my imaginary Olympian life of easy movement. And I remember synchronized swimming with a delirious out-of-time pleasure that my body still responds to, flip, arms spread, feet kicking, the other girls in perfect harmony around me.

CALDWELLThe lights were on in the pool. Was this a nighttime performance, little girls giving their dance recital in the water? It was the era of Esther Williams, the Hollywood swimmer with the chin strap cap and dazzling smile mugging for the camera while pedals of swimmers unfolded around her with military grace.

CALDWELLSo my recollection of this event is probably mixed up with my imagined want of it, but I know it was the one activity I could do that my sister could not, and that that water itself, sweet and infinite shelter, was a place where all legs were created equal, where balance wasn't mandatory and no cruel ground or gravity reached up to stop me. Impossible to fall down in the water.

REHMHow wonderful. And I remember those wonderful Esther Williams movies.

CALDWELLYes.

REHMWeren't they great?

CALDWELLJust still I can still see them in my mind's eye.

REHMAll right. And this from Sarah Lee who says, "While the Bill and Melinda Gates Foundation has devoted several billion dollars to the global polio eradication effort, they have partnered just in the last decade with the primary organization working since the late 1980s in this monumental work Rotary International. Rotary has been the premier civic mover and shaker in the world wide work to end this scourge which has sadly experienced a resurgence in the last year.

REHMThanks to fellow West Texas native, Gail Caldwell, for drawing attention to the disease itself which is a faint memory for some Americans and just a photo or a word on a page for most." And with that we can certainly agree. Let's open the phones, 800-433-8850. To Amy in Olney, Md. Good morning, you're on the air.

AMYGood morning, Diane. Thank you so much for this program and for your show. I've been a listener for years.

REHMI'm so glad. Thank you.

AMYGail, our stories do parallel although I'm not a polio survivor but I do live with chronic pain. And I have fibromyalgia osteoarthritis and I recently had a join fusion done, my sacroiliac joint. And they thought for a while it was a hip height difference. Went through about 20 years of that, but I have a question about the canine aspect of your story.

AMYI, two months ago, lost my very beloved Pembroke Welsh Corgi.

CALDWELLOh, I love that breed. I'm so sorry.

AMYThey are also the smiley breed.

CALDWELLExactly.

AMYThey smile chronically. But he came down with acute liver failure about two weeks after I got a corgi puppy as a gift. It was a gift from the breeder. I did not pay for her. She has top lines in case you registered of course. And for a long story short, she was this gift. And I thought, why did I do this? Why did I accept this? I'm recovering from surgery in past July. This is October when I got her. Like I said, two weeks later, my older Pem at 12-and-a-half got very sick. And I'm out there at 2:00 in the morning, 3:00 in the morning wondering what this is all about, what it's all for.

CALDWELLWhat have I done?

AMYAnd she's going to have to go back. I've got an elderly dog. Again, long story short, he passed, like I said, two months ago. Now I have the corgi puppy.

REHMSure.

AMYAnd she is just a delight ,but I must say, I do understand how these dogs can pull you out of the mire and keep you going. I'm training her in obedience.

REHMGood. Amy, do you have a question for Gail?

AMYYes, I do. Sorry, Diane.

REHMThat's okay.

AMYMy question is this, with that background in mind. My little puppy Kinsey is doing some medication alerts for me. She's a great little hearing dog for me. She's a nose. She may be able to check some blood sugar.

REHMGood. Good.

AMYNow my question is, Gail, are you training your Samoyed to do any further service dog tasks for you or is she just going to stay, like you said, your spiritual service dog, which I loved?

CALDWELLWell, you know, I actually said in the book that I thought for a while about getting a border collie. And my comparison was that the difference between a border collie and a sam was the difference between a fly pilot and a rodeo clown. And I really think that Tula had done just about as much as she could do.

REHMYeah, yeah.

CALDWELLIt's all good humor from here on out.

REHMWell, I must say, training a new dog takes a lot of work. And I hope you have a garden.

CALDWELLI do.

REHMAnd an easy way to every half hour take your little dog out and make sure that that dog becomes quite clearly and easily accustomed to the outdoors. Thanks for calling, Amy. Let's go to Claire in Oklahoma City. Hi there, you're on the air.

CLAIREThank you so much. I'm a long-time listener and admirer.

REHMThank you.

CLAIREAnd I certainly give great kudos and admiration to you, Gail.

CALDWELLThank you.

CLAIREI just wanted to put forth a caveat. I know you had suffered not knowing what was wrong for a long time. But for people who do know what's going on and anticipating joint replacement, if you haven't had it that long and you can do some of the exercises prior to the surgery, the rehab afterwards isn't quite so arduous.

CALDWELLOh, I think that's totally true. I think I was an extreme case. For some people, I think it's like changing a tire.

REHMWell, and in your case, the lengthening process...

CALDWELLRight.

REHM...had to make a huge difference because in your balance, it would change everything.

CALDWELLI think the caller is quite right. And one of the things that I've learned, it's sort of like pregnancy. You know, you have a bell curve of ordinary and then you have people on either extreme. And I think that joint replacement is a wonderful and often very uncomplicated procedure that the most important thing is to do the rehab. And I think if you go in with good musculature then your chances of it being a pretty pain -- I shouldn't say painless but pretty straightforward and terrific recovery is -- your chances are very good for that.

REHMAll right. Thanks for calling, Claire. Let's go to Kathleen in Naples, Fla. You're on the air.

KATHLEENThank you so much, Diane. I don't know what I could do without your show every day. I appreciate you so much.

REHMOh, thank you. Thank you.

KATHLEENMs. Caldwell, I am beyond saying this from the heart and asking you to kind of get your feedback. I have an extremely dear friend in Northern California. She's only 56. She is now in stage 4 cancer. She deals with pain on a regular basis day in and day out, has tried everything and literally is a human guinea pig and has been approved for treatments that basically are all experimental.

KATHLEENShe's had -- it started with foot cancer. She's had her toes removed, melanoma, lymphedema. She now has two lymph nodes removed from her groin area. I would love to know A. -- she also has a dog. Thank God for Rosa, who's getting older, much older and sick as well. How have you A. spiritually, aside from your wonderful dog, which I'm a firm believer in helping everyone, gotten through this?

KATHLEENAnd B. I'm a huge believer in holistic medications as opposed to someone -- God bless her, she's wanting whatever help she can get these days -- holistically medical treatments that you may have tried that have helped you. Because I'm trying to help her...

CALDWELLOf course.

KATHLEEN...long distance and emotionally as well.

CALDWELLWell, I can say two things that may be of a little help I hope. For one thing, having lost the number of people that I did starting -- and I'm so, so sorry about your friend...

REHMI should say.

CALDWELLWhen I lost Caroline who was diagnosed with stage 4 cancer, I remember in the first few months of my grief after she was gone and I remember thinking to myself that there was this realm of suffering which was on this side of death, and that was the crevasse that separated the dying from the people who were sort of going to be okay, but had to go through something awful. I don't think it's that black and white, but that was a response that I was having in early grief.

CALDWELLI think that the losses that I went through probably enabled me to go through the recovery that I had to because in the scheme of things I was suffering but it was all going to be okay. It was just a bum leg and I don't mean to downplay it but I had a -- it's not as though I was in the situation that your friend is, which is that she has -- is being assaulted from all sides by a number of difficult things.

REHMNot only the cancer itself but the treatments therefore.

CALDWELLThe cancer and the treatments, which can just devastate you. And, you know, I mean, I'm actually -- I'm such a believer in hope. I'm a believer in hope and effort. And sometimes one poses as the other.

REHMAnd friendship, and clearly, Kathleen, that's what you're offering your friend, perhaps the most precious gift you can offer. Thank you for sharing with us this morning. And you're listening to "The Diane Rehm Show." And to Jay in Fairfax, Va. Hi Jay, you're on the air.

JAYGood morning, Diane.

REHMHi there.

JAYI just have to tell you that sometimes I schedule my errands in the car between 10:00 and 12:00 in the morning so I can listen to your show.

REHMI'm so glad. Thank you.

JAYYeah, well, I'm a polio survivor. I'm just short of 75 now. When I was 6, I was diagnosed and I had it in my chest. And we had a doctor who -- he was a doctor, but he was also a holistic doctor. And he and my parents, you know, had to come up with the decision as to whether I should go into an iron lung or not, which was one of the big things back then. And my parents decided not to do that. Instead, they go with these little pills that he would give me and give me some of the exercises. And I came through it fine.

JAYAnd when I was in the 3rd grade, he suggested I take up a wind instrument, which I did and played the trumpet for, I don't know, six, seven, eight years. And, I mean, I'm fine. I mean, I've had a wonderful life since then. And I was watching a movie recently called "The Sessions."

CALDWELLYes.

JAYI don't know if you've seen it...

CALDWELLI have.

JAY...about the boy in the iron lung. And I just was so grateful to my folks for not having put me in an iron lung.

REHMAnd to instead have you take up a wind instrument...

CALDWELL...to play the trumpet.

REHM...to develop and strengthen your lungs. How wonderful.

CALDWELLThat's a beautiful story.

JAYYeah, and right now I'm a cancer survivor. My wife is going through cancer treatment now.

CALDWELLWow.

JAYAnd we have three dogs. We've been in golden retrievers for 40 years. And, you know, your story about how your dogs were helping you. People don't understand, but many people don't know that dogs are smarter than we are.

CALDWELLI'm sure that speaks to you, yes.

REHMI think so. Thanks so much for calling, Jay. When you think about your mother's death, how terrific an impact that was on you, really hard to get through, hard to believe.

CALDWELLYes and no. I think that this is the wonderful thing they always tell you about working through grief is that you get them back. And I think my mother is so central to my being. I sometimes wish -- she died in '06 and I wish that I could let her know that I'm back on the floor doing the same exercises that she and I did when I was three. And I think she's sort of there with me. It's been a great comfort.

REHMHow old was she when she died?

CALDWELLShe was about to turn 92.

REHMWow.

CALDWELLSo she stayed in there for a long time.

REHMAnd you had her for a long time.

CALDWELLI did.

REHMYou've not married.

CALDWELLNo.

REHMYou've not had children.

CALDWELLNo.

REHMWhy?

CALDWELLWell, sometimes I think I got lucky. I actually made a pretty concerted decision not to have kids. I think at a certain point in my life I thought, if I'm going to have kids, I want to make the decision now so I don't want to look back and regret it. My dogs and my friends have become my stand-in family. They've been pretty great, yeah.

REHMI understand that very well. Gail Caldwell, congratulations not only on the book, but on your physical wellbeing.

CALDWELLThank you so much.

REHMGail Caldwell. Her book is titled "New Life, No Instructions." Thanks for listening all. I'm Diane Rehm.