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Brian Williams on knee replacement (and why he has disappeared from TV for a while)

Brian Williams, five days after knee replacement surgery. He continues to recuperate on the Jersey Shore.

By Brian Williams, NBC Nightly News anchor and managing editor

OCEAN COUNTY, N.J. -- I am not the first person to believe that the JerseyShore has the power to heal. President James Garfield, badly wounded by an assassination attempt in the summer of 1881, asked to be taken to the JerseyShore to recuperate, because he believed in the restorative properties of the ocean air along this particular stretch of coastline. He died 13 days after his arrival. I am hoping for a better outcome.

It’s been a week since my surgery, and judging by the Twitter traffic, Facebook posts and the flood of emails I’ve seen from those who’ve been through it, I’m about where I should be in the recovery process. More broadly, I’m now part of a rapidly-growing "affinity group" -- I’ve joined the massive population of Americans roughly my same age, who have chosen to have this surgery to relieve chronic pain.

I would normally prefer to be going about this like most of my fellow knee replacement patients: quietly and privately, concentrating on rehab while catching up on my favorite movies and TV shows, only to re-emerge at work in a few week’s time...with a stronger and straighter gait. However, because nothing about my job is normal, I did not want to disappear from the airwaves for weeks on end without explanation. I didn’t want people thinking I’d gone off and had a facelift, nose-straightening, brow lift, eyelid tuck or neck-tightening. All of those badly-needed procedures will just have to wait.

Having made the decision to share my surgical news, perhaps the backstory is in order for those with strong stomachs.

This operation, my fourth surgery on the same knee, was 35 years in the making. It dates back to a hit I suffered in practice during high school football in New Jersey. It is a violent sport, and it’s a sport I love. I loved playing it, and I love watching it. It’s not for everyone, and someone probably should have sat me down prior to me suiting up. While I had a big heart and strong muscles, I didn’t have the bulk for the positions I was playing. My first two football injuries -- broken ribs and a (now rather obvious) broken nose -- should have set off alarm bells, but I was 175 pounds of screaming fury, and would have had none of that defeatist talk. So I played. And I am paying for it now.

Our team was small: 21 guys on the varsity squad, which meant learning more than one position, on each side of the ball, even those of us not good enough to make the starting squad. Because I had adequate height and OK hands, I played (poorly) at offensive end, and a small amount (even worse) as defensive outside linebacker. On the play in question, the fullback came around to block me and aimed his helmet at my knees. He did his job, it took me out of the play, and it ended up taking me out of a lot of life’s activities into middle age.

On impact, my knee went backwards, and I suffered catastrophic damage to the kneecap and the joint. My first surgery, in Red Bank, N.J., in 1977, involved trimming and rounding my thigh bone, removing all cartilage, drilling a series of holes in my damaged kneecap (on the theory that new cartilage would somehow re-generate) and tying up a ligament. It was a new (for the time) and experimental surgical reconstruction technique. When you mention it today to veteran surgeons, they remember it as an operation that was quickly discredited in the orthopedic community, and for good reason. Recovery was long and painful. Back then, hospitals weren't in such a hurry to get you up and out, and I had a plaster cast on my leg for several days, preventing me from flexing it initially -- exactly the opposite of the treatment called for today. I was on crutches for weeks. I had two smaller subsequent surgeries, and over the years the knee was drained with a syringe and injected with various substances hundreds of times. I tried braces and medications in equal measure, and I have easily consumed my weight in anti-inflammatories. Over time, I probably developed an unnaturally-high threshold for pain. The only time my injured knee brought any excitement was when I was on an overseas trip as White House Correspondent covering President Clinton. I jumped off an armored personnel carrier in Bosnia and twisted it upon landing. It quickly filled up with fluid, which the White House physician drained with a needle in mid-air in the medical office on board Air Force One en route to Aviano, Italy.

This week, a woman posted a message on our Nightly News Facebook page, saying she needs the same surgery but has put it off based on "fear of the unknown." I understand that sentiment more than most. The fear of replacing "original equipment" with something that comes out of a box...is exactly what kept me out of the operating room until recently. In the end, I decided I’ve lost too much sleep due to pain, said no to too many bike rides and hikes, and avoided stairs for too long.

My hospital stay brought back a lot of memories, some suppressed for over three decades. While the meds are better these days (I remember everything about the operating room, down to the exact details of what we were discussing, up until the very moment they put me under), post-operative pain remains the same. On the upside, I’ve been reminded of the incredible healing power of nurses. When you need someone, they are there -- dedicated medical professionals who provide comfort, support and personal care when you need it most.

Finally: a word about what this is not. It’s not cancer, it’s not bypass or paralysis or any number of life-altering surgeries or conditions that millions of Americans live with and deal with courageously every day. While my X-rays showed bone-on-bone grinding in my knee, my condition was not life-threatening and still must be considered elective surgery. Now, having elected to have it, I can’t wait to fully recover...to walk without the aid of a walker or a cane. To that end, I do my physical therapy every day, I try to set realistic goals and manage the pain as best I can. And something else needs to be said: I think constantly about the fact that I can now afford the kind of first-rate health care that my parents could not afford for me at the time of my first operation.

As I told David Letterman a few weeks ago on his show: my goal is to come back to work way too early in my recovery, and try to anchor Nightly News while gooned on pain medication. Of course I was kidding -- but it is true that I am anxious to get back in the game just as soon as I am able. I could not do any of this without the help of my wife Jane, and watching Nightly News every night is made so much easier by knowing my friend Lester is there each evening, and working with our great team every day.

I wanted to pass along my thanks to all those who have sent me their best wishes. I read them all and wish I had the time to answer each one. Mostly, I want to thank my fellow replacement knee recipients for welcoming me so warmly to their supportive club!

For now, I’ve developed an acute interest in local news -- specifically, the deaths of two dozen dolphins along the New Jersey shore over the past few weeks. It is a great thrill (and has been as far back as I can remember) to stand on our favorite beach at sunset and spot a small group of dolphins swimming together just offshore. Scientists fear that a fatal virus is spreading among the dolphins from the JerseyShore south to Virginia, and a lot of good people are scrambling to find out more and protect these wonderful animals. Worrying about their livelihood and well-being has been a welcome distraction from worrying about my own. I am confident that they will triumph and prosper, perhaps because of my strong belief in the restorative powers of this stretch of coastline.