I saw them when the ambulance brought me to my room in the hospital, the ward was filled with men, they were the silent men I had already heard much about, the men who get open heart surgery – it is mostly men – but who do not talk about it, not ever.  Women talk about the silent men all the time – wives, daughters, mothers, sisters.

I saw it right away in the room I was in and the rooms around me. The men were quiet, they seemed depressed to me, they did not wish to bother the nurses with requests, they seemed too embarrassed, but they asked their wives to make their requests for them.

Few of them got out of bed unless prodded, and even then, they did not go far. They had no interest in walking, or talking much. They submitted humbly, even meekly, to the prodding and poking that are the routines of hospital wards.   Some were younger than me, some older. Several of them told me they were “low,” they were stunned to have their hearts fail them, stricken at being unable to to do the things they had always done, uncertain about their lives, their health, their recovery and their future. “I couldn’t walk to the barn,” one told me, shaking his head. “I walked to the barn every morning for 60 years.”  None of them wanted to talk about their upcoming surgery or even hear much about the details. They seemed discouraged to me, even defeated.

When their wives came to see them, the women often pulled up chairs next to the hospital beds, and the men and their wives would sit in silence mostly, looking up at the TV screens above the beds – the hospital charged for them to be turned on, I did not want mine turned on. The couples would sit quietly, on the eve of their great change, their great fear, sometimes holding hands, usually not, sitting in silence as they often did at  home, I suspect, watching television.

I am not a silent man, mostly, I think, because I am a writer, and I have written a bunch of memoirs and talked openly about my life for many years. I had not encountered too many of the silent men before going to the hospital. In the ICU, I would see some of the same men in the recovery rooms all around me, they waved to me, cheered me on, wished me luck, applauded when I did my laps around the ward. They did not wish to get up, they did not wish to talk, they seemed depressed even broken to me, a state the nurses told me was very common after open heart surgery. Several of the nurses prepared me to get ready for it myself.

I talked to some of the silent men, they reminded me of the farmers I photograph sometimes. Men carry so much baggage, so much weight. It is sometimes impossible for them to feel so diminished and off-balance. They feel intensely responsible for their lives, for providing. It is crushing for them to have their bodies invaded and violated in so brutal and personal a way, degrading to have their bottoms wiped by young men and women, bewildering to be so helpless and dependent, often for the first time in their lives.

There is no more asexual feeling in the world than waking up in an intensive care unit with tubes and lines sticking out of your body, catheters in your private parts, monitors attached to your heart. It is hard to imagine ever making love again, or being a whole man again in any way. I visited Don in his recovery room, and I asked him how he was. “I don’t know what will become of me,” he said. “Will I ever be myself again? Can I take care of my work, my family?” A heart is a tough thing to break for anyone, I think it hits the silent men in a particular way, they have no vocabulary with which to handle it.

They do not know how to be scared, how to be vulnerable, how to ask for help and take it, to keep moving, to get up and walk and walk and walk, to turn off the TV, things that are all essential to recovery and healing. I think one of the most powerful moments of my recovery was when I had to go to the bathroom and looked up at my beautiful young nurse, younger than my daughter, standing there with some wipes. “Just do it,” she said, “I’m a professional.”  I did it. At that moment, I surrendered to the process of healing, it was bigger than me.

I talk to Maria about how I am feeling all of the time, and another friend on the phone every day or so, and I value all of these conversations. I have become a silent man in some ways, I don’t talk about my surgery either, but I write about it every day, and that is often how I learn how I am feeling. I too feel violated and broken sometimes, bewildered and unsure. I feel for the silent men, they have plenty of feelings.

Healing is not, of course, just about medicine and walking, it is a state of mind. It is so hard for many men to do the very thing they most need to do to heal – to understand what they are feeling and to share what they are feeling with the people they can trust.  Women seem to know how to do this, few men do. The silent men have hearts just as tender and sensitive as anyone, they feel the same things everyone feels, they do not have the words or the experience to talk about them. In my hospital ward I came to understand this, the silent men were eager to be with me, to listen to me, to talk to me when they could and in the way that they could. We understood one another, we shared something quite profound, even when we did not have the words.

There is a difference between being a silent man and unfeeling one. Silence, like fear, is just a space to cross. In open heart surgery, I think we all feel pretty much the same thing. We were a brotherhood bound in life.