by Scott Martin
But it had hurt. Seeing my arms – what was left of my mauled and mutilated arms – had shaken me into disbelief. Somehow, even though I’d known half of each forearm and both of my hands were gone, not seeing it in its entirety had been a sort of security blanket. It was as if nothing was set in stone just yet; I still had to heal and maybe once the healing was done they would look better, less like discolored stumps and more like arms.
Each time my arms had been re-bandaged, I’d sighed with quiet relief. I could file the images of what I’d seen in a box labeled ‘Deal With Later’ and tuck it back into the recesses of my mind. But this time I’d be left with my fully-exposed, marred arms; left to see them for what they were. No more palliative fantasies about miraculous healing or the prospects of change. This was reality: finite and irrevocable.
Dr. Molin uncovered the left arm first; perhaps as an act of grace. Underneath the tape, bandage, and gauze was a cleanly severed limb. They had amputated my left arm in the middle of my forearm and done a nice job as far as I could tell because the end was smooth and well-mended. I lifted it towards my face and forced my unwilling eyes to focus on its image. My skin was back to its normal beige tone (no longer bluish-black or nauseating yellow) and the sutures were gone, leaving a smooth, white seam in their place.
He clumped the gauze and bandage together and dropped it at the end of my bed as he walked to my other side. My right arm was a half inch shorter than my left and not sewn together as tightly. I swallowed the bile rising in my throat as I studied the excess skin puckering at the end of my arm. Lifting the right as I had the left, I brought the wound to eye height and stared at it, studying the ridges and crinkled skin of scar tissue that bisected the end into top and bottom. My mind revolted at the sight. I could feel my subconscious trying to block out the image.
Hideous.
‘Everything’s healed nicely,’ Dr. Molin said, his voice calling to me from somewhere far off. I closed my eyes briefly and let my right arm fall back to the sheets.
‘It looks like they considered the possibility of myoelectric hands during the amputations because of the amount of muscle tissue left intact,’ he went on. I listened without really hearing at first. His voice came to me like an echo in the shock of my grief.
As if sensing my distance, he added in a firm, definitive tone, ‘That’s good news, Scott.’ I looked at him and nodded. He wanted to instill hope for the future in me, but I was still grappling with the consequences of the past. Besides, I didn’t even know what my-o-whatever hands were.
‘Have you heard of myoelectric hands?’ I blinked, a little taken aback by his semblant ability to read my mind.
‘No. Are they like the hooks?’ I asked, grimacing. There were no words for the dread that encompassed me at the thought of those Captain Hook-inspired contraptions.
‘Much, much better.’ He grinned. ‘Myoelectric prostheses use electromyography signals to control the motion of the prosthesis. Whenever you open or close your hand, for instance –’ he demonstrated by opening and closing each of his as I tried not to let my mind follow the dark hole watching him use his hands wanted to lead me down – ‘electrical signals are sent through the contracted muscles of your forearms. Typically, those signals travel down your forearm to your hands to tell them what to do.’ He ran a hand along the length of his forearm as if tracing the path of the signals he was talking about.
‘The myos have specially designed sensors which can read those signals off the surface of your skin and translate them to the electric hands. No straps or cables. And the best part is you’d have hands instead of hooks.’ He paused and looked at me for a while. An alternative to the hooks? I didn’t care if I only got three of five fingers, it’d still be better than none.
‘The downside is just one of those things costs about as much as a new car.’ I winced. A new car? Each? And I’d need two. How could I afford that? ‘You should look into how much your insurance is willing to cover and consider it. Not everyone has this option, you know.’
I nodded. I did know: It was a gift from the surgeons who’d saved my life and I wanted to accept it. My brother Rick worked as an insurance agent. I could ask him to look into making the cost of the myos acceptable to my insurance company, I thought. A flicker of hope was beginning to take shape and it scared the living daylights out of me. If this went South. . .
I pursed my lips. I couldn’t afford to be crushed. Not again.
‘In the meantime, the prosthetist will be by in two days to cast you for the hooks.’
Out blew out my little flame of optimism.
Gathering up the bandages, he said, ‘Stay strong, man,’ and left me to my thoughts.
~~~
Two days came much too soon. I spent the morning of the casting lost in my own dour mind. I didn’t want the hooks, yet, or the reality they signified. Even with the potential of the myos down the road, I couldn’t come to terms with the fact that I needed prosthetics. In the same way that seeing my arms un-bandaged forced me to confront the fact that three-quarters of an arm was all I had left, donning prosthetics would mean facing the true consequences of my amputations. I would be one of “those” people you saw on the street: part human, part robot. The kind of people you gave a slightly wider-than-necessary berth to as if amputation were a contagious disease; whom you would lie to and say you hadn’t even noticed the prosthetic hand or missing leg while inside you were cringing at the mere mention of such things. No one liked to face reality when it came to prosthetics because the reality was it could happen to anyone. It had happened to me.
The prosthetist was an older gentleman who had clearly moved past the emotional side of his job long before meeting me. He was very matter-of-fact and did little talking other than explaining how to place my arms for the casting.
I was thankful for his silence, as I’m sure he was aware. While he positioned my arms and wrapped them to just above my elbow in the plaster casting material, I stared dejectedly out the window. I wanted no part in this process, necessary as it might be. I preferred the image of the outside world – the world unaffected by my paltry existence – and thought of nothing; felt nothing.
The entire process took less than thirty minutes. By the time the plaster had dried enough for the prosthetist to use a Dremel tool to slice each molded cast from my arm, I had managed to detach myself from the present just as cleanly. I watched him pack his things and heard him say his good-bye, but I wasn’t cognizant enough to register any of it until long after he had slipped from my room.
I would recover from that withdrawal. Life would go on and I would persist in my recovery, strengthening what I could and learning to cope with what I couldn’t. For the brief respite between casting and fitting, thoughts of the hooks would again fade to the background where I’d allow myself to box them up and think exclusively of simpler things. Unfortunately, like all reprieves this one, too, came to an end. It was a meager week later when I was forced to confront the things I’d been avoiding in an onslaught of trepidation.
He came shortly after the breakfast dishes had been cleared while I was resting contentedly with my USA Today spread on the bed table before me. I hadn’t been expecting him, so I turned to the motion of someone at the door with a welcoming smile spreading across my mouth. After breakfast was always my first training session with Kathy.
You’re early, I’d been about to quip. Go away until I’ve finished digesting.
When my eyes lighted on the same elderly prosthetist who had done the casting, though, the words froze on my tongue.
‘Good morning, Scott,’ he called in greeting, his voice breathy and bland. I tried to swallow the loathing that was overtaking my mood. It was unfair to hate the messenger, I knew, but I had to direct my abhorrence somewhere. And this particular messenger came baring the future bane of my existence.
I eyed the mechanical contraptions he toted as he walked to the right side of my bed and muttered a half-hearted greeting in reply. He laid the hooks
at my feet and I fought the urge to kick them from the bed. Instead, I stared them down, studying the cylindrical tube which would be my new forearm and the shining, claw-like hooks which would be my new hands. My heart sank like a leaden weight, plummeting to the pit of my stomach faster than a hawk in dive.
‘Mind if I move the table away?’ the prosthetist asked, still with that banally pleasant tone. I nodded once and gestured with my right arm in a sweeping motion as I turned away from the hooks at my feet.
He swung the table to the side, wheeling it far enough from the bed for him to move between it and the side rail.
‘Do you have a T-shirt with you?’ he asked next. I motioned to the closet to my left. As he made his way across the room, all I could think was how I didn’t want to be there – didn’t want him to be there. Please, just go away.
When he returned to my bed he was holding the freshly washed, royal blue Nike tee I’d been wearing the day I began feeling sick. I could barely remember the Scott who had worn that shirt anymore; the Scott who had led such a hopeful, happy life; the Scott who had no reason to fear the prostheses currently at my feet. What I wouldn’t give to have some of his blissful ignorance with me now.
But I was older and wiser than he had been. Circumstances had rendered me a new man and this Scott couldn’t hide from the consequences of the hooks.
‘Go ahead and remove the hospital gown above your waist and put this on for me, Scott.’ I nodded glumly and followed his instructions, shrugging my arms out of the gown and letting the top portion of it fall to my lap. He held the shirt out for me to take.
When I didn’t reach for the tee as he’d expected, he saw his error and a pink blush rose up his throat. He brought the shirt to me and laid it face down on my lap. It was the first time I had tried to dress without assistance, but I wasn’t about to share that fact with him.
I carefully slid my arms into the sleeves, lifted the shirt up to my head as I sat up and let it fall over my face. On any other day this feat would have been met with a surge of pride. Today, I simply looked to him with a blank expression, waiting apathetically to see what would come next.
He walked back to my right side and grabbed one of the prostheses by the wrist. Two loops of white straps were strung between the limbs, lacing through a metal ring at the center. He placed the straps over my shoulders and across my back so they formed an X with the metal ring situated between my shoulder blades just below the base of my neck.
I allowed him to move me with gentle nudges as he needed while I stared fixedly at the wall before me. As he held each cylinder up for me to slide my arms into, I felt like a wild Maverick horse being saddled for the first time. There was a part of me which wanted to rebel against this; to jerk my arms and shoulders from his grasp and rip the thick straps from my body. I wanted to lash out at him verbally, yelling for him to get the hell out of my room and take his damn hooks with him. But a deeper, darker part of me held fast in the face of my fury. It gradually swelled within me like a black hole, swallowing other emotions until all that remained of me was a mindless automaton. The tighter he strapped me in, the more the fight drained out of me and the greater my numb acceptance of my fate became.
Next, he turned to the wire cables which ran along my shoulders and down the outside of each new arm. Each cable was threaded through a series of loops leading from the back of my shoulder to the back of my upper arm near my triceps. It tracked along my arm to the outside of the prosthetic forearm, ending at a lever at the base of the hook itself. With my arm resting comfortably at my side, elbow slightly bent, he adjusted the cables until they were almost taught.
‘All right,’ he said when he had finished tinkering. I gazed blankly at the hooks in my lap. ‘So these are called body powered prosthetic hooks because you use the motion of your shoulder to operate them. If you put tension on the cable the hook will open.’ He reached over and took hold of the right prosthetic just above the wrist, forcing me to extend my arm out in front of me to demonstrate how the motion of my shoulder caused the cable to pull the hook open, separating it into two antennae-like apparatuses. ‘Release the tension –’ he had me draw my arm back towards my body so my shoulder relaxed – ‘and the hook closes.’
I watched it all occur with my mind shut off. I couldn’t focus on, nor care about what he was saying. As emotionally and mentally enervated as I was, it was all I could do to keep my eyes open for the duration of the session.
Still holding my left arm in his hand, he continued, ‘So the force of your shoulder opens them and these rubber bands here keep them closed when there is no pull on the cable.’ He pointed to a rubber band wrapped around the base of the hook just above the joint where they opened and closed.
‘You can see there are two separate hooks on each prosthesis which allows you to grab and hold anything a hand can hold. You can also move the hooks around and lock them into various positions with this switch here.’ He pointed to a small knob of the kind you slide to turn a flashlight on or off. Again he pulled my arm to put tension on the cable and open the hook, this time sliding the lever to lock the hooks in the open position before allowing me to return my arm to my side. In a similar fashion, he slid the latch open, let the hooks close, then rotated them at the wrist so they curved to the side rather than down and locked them in place.
‘And then to take them off, first open your arms to the side to relieve the tension on the straps. Then bring your arms up and forward to draw the straps over your head. Once you’re out of the harness, you can secure one prosthesis against your lap with the wrist of the other and pull your arm out of the cylinder.’ He smiled. ‘Easy!’
I nodded. Operating these was going to be anything but easy.
‘Do you have any questions for me, Scott?’ he asked after a pause.
‘No,’ I replied softly.
‘All right, then. I’ll leave you to experiment. It will take some time, but many patients have had great success with these.’
I nodded again.
‘Okay. Take care, then.’
When he had disappeared down the hall, I pulled the hooks off one at a time and fumbled them onto my bed table. Part of my interest and love for soccer was my ability to read a situation and evaluate it from various perspectives. It was far too easy to read the limitations the hooks would impose on my life.
Now that I had seen them up-close, I realized with two separate hooks attached to the end of each prosthetic they more closely resembled the hands of a tyrannosaurus minus the thumbs than those of Captain Hook. Or the antennae of an insect when the hooks were curved towards the ground.
Whatever imagery they induced, the fact was they were hooks, not hands. They simply could not function to the full capacity of human hands. And I could only imagine how far the limitations would prove to reach.
Would I be able to write? Clearly I’d be relegated to a finger typist – or rather, a hook typist. What about driving? My manual car would most likely have to go. Tying shoes was certain to be trying if not impossible. And that was just the beginning. What negative impact would these bring to my coaching career?
I’d promised the team I’d see them soon, but who was I kidding? I was handless and practically footless; I could barely sit up without support, let alone stand on a field. What kind of a coach couldn’t even stand through an entire training session? I couldn’t dribble a ball and yet they were supposed to look to me to teach them. Now that was unfair – unfair to them. I had no future in soccer. I should just tell Marilyn Skrivseth (our Athletic Director) to find someone else – or step down and let my assistant coach take over as the head coach.
As I was in the midst of this downward spiral, Kathy came spinning into the room. When she stopped at the foot of my bed and realized her antics hadn’t raised a smile from me, her mouth turned down and eyebrows furrowed in concern. Her eyes fell on the hooks lying on the table beside my bed and she nodded quietly.
‘So the prosthetics arrived today.’ She sat on the
end of my bed. ‘And you’re not too excited about them.’
‘Not exactly excitement-inspiring.’
‘No,’ she said softly and rested a hand on my shin. ‘I guess not. But, Scott, think about how much more you’ll be able to do with them that you can’t do without them.’
‘I know, but they’re also very limited. How can I possibly do all the things I used to do with these?’ I spat the last word and gestured aggressively towards the hooks on the table.
‘Have you wondered at all why you feel so negatively towards the hooks?’ I opened my mouth to cite their limitations for her, but she raised a hand and cut me off before I could speak. ‘No, I don’t mean why you hate their limitations. This is the first time I’ve seen you fighting against forward progress. What is it about the hooks that are making you balk?’
I stared at her. My anger deflated like a popped balloon, leaving me with emptiness and the truth.
How have you come to know me so well? I wondered as I looked at Kathy in defeated acceptance. She was right: I had never turned away from the potential for progress before – especially not when that progress was a clear step up in my ability to care for myself. But these hooks were different. They were brazen and revolting.
I exhaled a long, deep sigh and tried to smile weakly at her. ‘I guess it’s that when I wear those hooks – or even think about wearing them – it makes me feel truly handicapped. I mean, thus far my frustration has been about being dependent on others. Now all I can see is the hooks where my hands used to be.’ They would be right there, in my line of sight every minute of every day.
‘Mm-hm. Well maybe what we need is a bit of a distraction to help you focus on what the hooks can do for you rather than against you.’ The jovial Kathy was creeping back and I watched a delightful smile play about her lips as she said, ‘Don’t move. I’ll be right back!’ She gave a little ballerina-esque leap to her feet and twirled dizzyingly out my door.
