Then Mike would serve me my lunch while I visited with my mom. The afternoon activities included a reappearance by the rehab staff. Sometimes the occupational therapist would get me up to walk, she on one side and my mom on the other, helping me take those halting steps. Then I’d be returned to my bed and prepared for evening wound care. Dinner would come and go, visiting hours (and my mom’s time at my side) would end, and Mike would say good night.
It went like that until one beautiful, bright Texas morning when I greeted Mike with a request. I’d had enough of the pain. I wanted to know what was causing it, why it hurt so badly when Mike cleaned my skin.
“I want to see my face and body.”
Mike kept moving as if he hadn’t heard me. He checked my chart, chatting about the usual stuff, news bits he’d heard on the radio, sports. The San Antonio Spurs had a good chance of winning the championship, he told me.
I repeated my request. He looked up from my chart. “Not now, man. You have plenty of time and many more surgeries. It’s best to wait a while.”
“Yes, now,” I said. “I might as well see what I have to live with.”
Mike stopped, thought for a second. “Okay,” he said. “Give me a minute to get things set.”
He reached for the pink Cadillac and rolled it to the window. He slid over the dining tray and opened the mirror compartment. He lifted me from the bed with the help of a therapist and settled me down into the seat. Somewhere below me, outside and in the distance, was Interstate 35, the cars moving along like Hot Wheels toward downtown.
“Whenever you’re ready,” Mike said, and moved away.
I took a deep breath, willing myself to turn my head toward the mirror. Still, it took many minutes to look, and when I finally did, the shock was physical.
I had seen someone like me once. I was with some buddies at a Mexican restaurant in Dalton when I spied a man who was dining with a couple of other people. His face was shriveled, mottled with ginger-colored spots and stringy scar tissue, his nostrils and eyes misshapen. His jaw swung at an odd angle. I’d never seen such a sight, and I tried to pull my gaze away. But I was curious, so finally I approached him.
“Sir, can I ask what happened to you?” I asked.
He looked at me, this cocky teenager who was busting in on his evening, with a kind expression. There had been a house fire, he said, and he’d gotten caught inside. We spoke for a minute or two.
“Sir, thank you for taking the time to explain what happened to you.”
I returned to my friends, shaking my head and muttering, “There’s no way I could ever go through that.”
And now I was that guy.
Questions flooded my brain. Why did this happen to me? How can I live like this? Why was my life spared if I have to live this way? What girl will like me with looks like this? How could I reach any of my goals? Now I would never be a pro football player, and I wouldn’t be able to be a good soldier, either. I couldn’t feed myself with these clawlike hands. I couldn’t even go to the bathroom in private. Would I always have to depend on my mother?
That night, I lay alone in the dark with the worst kind of insomnia, a mixture of sorrow and agony, wide-awake nightmares throwing me back into the explosion again and again, feeling the flames melt my flesh.
I woke, shaky and clammy, to find the night housekeeper cleaning my room. She was a familiar presence by then, although I had no idea what she looked like because she was wearing the same protective gear as everyone else who came into my room. She was just another set of eyes peeking out behind a mask. But I was comforted by the way she hummed softly as she worked. The tune sounded like a hymn, or maybe a lullaby. I closed my eyes and listened, and then I whispered, “Hello?” I hadn’t initiated a conversation with anyone since I’d looked into the mirror that morning.
The woman apologized for disturbing me, but I wanted to talk. I asked her about her day and what other floors she cleaned.
Then another question tumbled from my mouth, out of nowhere.
“Has life been fair to you?” I asked her. I confided that I was in a bad place. “I think I would’ve been better off dying,” I said.
She stopped her work, leaned over me. “You’ll be fine.” I could see the outline of her mouth beneath the sterile mask. “Everything is going to be all right.”
“But why did this happen to me?” I asked her.
“I don’t know,” she said. “One day you’ll find out.”
I had told my mom I loved her nearly every day of my life. But I stopped telling her that after I saw my face. Instead, I’d shout at her: “Why? Why? Why?”
I didn’t know who to blame, so I blamed everybody. In one instant, I’d morphed from a personable, cooperative patient to a mean, despondent shell. I grieved. I only spoke when spoken to; ate when fed. I wanted to torture everyone. Who the hell cares, I thought. I blocked everyone out. My mom felt sorry for Mike, having to put up with the nasty me all day long. As bad as those days were for me, they were nearly as bad for her. My care team called in reinforcements: a psychiatrist, a social worker, an occupational therapist, the hospital chaplain. Bonnie Jackson, the charge nurse, came in to flush me out.
“Nope, I’m not feeling it,” I told her. “I don’t want to be bothered.”
She tried her usual burn patient logic on me: “You’re so much more fortunate than so many others,” she reminded me. “You’re still the same person you were before you were injured. You can’t afford to have that attitude. You’ve got to get up out of that bed.”
But nothing stuck. I’d sit in that pink Cadillac every day hanging my head, eyes downcast or closed. I didn’t want to look at anyone or answer anyone. I didn’t tell anyone I wanted to die, but I did.
My mom was distraught. She didn’t know how to help me; if the professionals couldn’t rescue me, then who could? I’m just his mom, she thought. She didn’t know what to say to me.
She went to the hospital chapel and prayed. Kneeling in a pew, she said: “Please, God, help me. Put special words in my mouth. Let me say your words and make him understand.”
Emerging from the chapel, she heard the elevator ding. She got in and there was Mike. He was red and hot. He shook his head at my mom.
“He isn’t ready to listen,” he told her.
My mom came to my room and went straight over to where I was sitting in the pink Cadillac.
“Hi, baby,” she said. “How are you?”
No answer.
She got on her knees and put her arms on my legs. She put her face right under mine, so I’d have to lift my face. “Son, what’s wrong?” she asked. She knew what was wrong, obviously, but she wanted to get me talking.
“My whole damn face has been burned!” I screamed. “Why are you asking me what’s wrong?” I was crying.
She winced, fighting back her own tears. “Yeah, baby, and so is your body,” she said. “Why do you only worry about your face and not your body? The problem is girls, right?”
I brought my eyes to hers. I nodded. “Yes, Mom.”
She exhaled. “Listen, Jose Rene Martinez. If somebody is going to be in your life, it will be because of what you are inside,” she said, pointing to my heart. “Not for what you are outside. If a girl or a mother or a friend wants to be by your side, it’s for what you are on the inside. Many people are beautiful on the outside, but only God knows what their spirit looks like, because they carry that inside.”
Her words somehow penetrated my brain. My mind traveled back to high school and all the friends I’d had then. I wondered who’d liked me for what I’d been on the outside with no regard for the inside. Her words kindled a challenge in me: Now I’d find out who liked me for me. Really, it made sense.
“That’s true, Mom,” I told her. “I love you.” My tears came again. We looked at each other and smiled.
As I was reconciling myself with my new face, I was still enveloped in loneliness, a feeling of isolation, like a speck of dust flicked off a world that was spin
ning along without me. At night I stared at the glass of the window, my vision blurred by tears. Each spring the city rolled out the welcome mat for the San Antonio Fiesta and thousands of visitors flooded in to enjoy live music, art, ceremonies, and events. Although I couldn’t see out, I knew people were there, laughing, strolling down the River Walk, listening to the mariachis, munching their chips and salsa, floating on barges down the San Antonio River after their visit to the Alamo.
“Mike, tell me about it. What food is San Antonio known for? What do people do at Fiesta? Does it stay open late?”
I could hear the festivities—at least I thought I could—and the brilliant lights glittered through my window. I brooded about these unknown, unnamed people out there. Why were they able to have so much fun while I was up here in this hospital room, burned beyond recognition?
“One day,” he said, “you’ll get out of here and see Fiesta for yourself. Great food and music. Maybe by that time you can enjoy a margarita.”
I wondered: Will that ever happen?
PHOTO SECTION
CHAPTER TEN
Burn Paradise
I had a long road ahead of me before I could seriously think about parties and cocktails. For now, I set my sights on something much more local: getting transferred from the ICU to 4E, the step-down wing of the burn unit.
I’d been hearing people talk about that place like it was burn paradise. Although it was just down the hall, it seemed a world away. The nurses told me that once I made it over there, the care wouldn’t be as intense. I’d have a phone line in my room, so friends could call me. I’d have a TV right by my bed and be able to watch whatever, whenever. I already planned to have the hospital chow hall on speed dial.
The best part, though, was that I’d be able to get out of my room and walk around the ward. No matter how much pain you’re in, no matter how much you worry about permanent disabilities or disfigurement, being left to stare at the same four walls day in, day out, week in, week out—that was the worst torture of all.
The dangling carrot of even that limited freedom turned into a daily question: “Is today the day?”
“Not yet, J.R. Soon.”
And then, forty-one days after I’d arrived in ICU, the time finally arrived. Hallelujah.
I could never have imagined how the sight of an orderly steering a wheelchair toward me would fill me with such profound joy. I said my goodbyes to the ICU staff. Even though I’d blamed Nurse Mike for all the physical pain I’d felt in debridement and for the psychic pain of seeing my face for the first time (although I knew neither was his fault), I was going to miss him.
Once I arrived in my new room I got to my feet and walked around, testing out everything. I checked out the bathroom, picked up the phone to hear the dial tone. My first order of business was to call the kitchen and order a Gatorade and a PBJ sandwich, my favorite hospital meal.
That said, while Unit 4E was better than ICU, it wasn’t any nirvana. For starters, I contracted some kind of a bug, so I wasn’t permitted to leave my room. The best I could do was stand inside the door, toeing an invisible line, calling out to the hallway traffic like I was some kind of Walmart greeter. The nurses’ station was right in front of my room, so I entertained myself for hours watching the nurses come and go and visitors entering and exiting the ward. Other patients strolled the corridors, getting their exercise or heading to the gym for therapy.
Over time, other patients’ families became familiar to me, and we’d say hello to one another.
“Hi, J.R. How are you doing today, baby?” someone would ask.
“Great,” I’d reply, trying to keep them lingering with me as long as possible.
My mom spent about twelve hours a day, every day, at my bedside. One of our daily pastimes was looking at the mail that came into the hospital for me. I received letters from the guys in my unit back in Iraq, including from my lieutenant, the one who’d smoked me for dissing the Army brotherhood. I also got letters from people back in Hope and Dalton. Even schoolkids wrote to me. Those cards and letters made me so happy. They reconnected me to life outside the hospital walls. My mom and I read them together and shared the memories that some of them evoked.
One afternoon I told my mom about a bizarre dream I’d had: I was at a NASCAR driver’s house for a barbecue, but I was inside, sitting on the couch in the living room, isolated, unable to join the other guests outside. I spotted a snake sliding across the rug toward me. I looked around wildly to see if anyone would rescue me. In an instant, the snake flung itself toward me, right into my mouth. I wrapped my hands around its slick body and yanked. My mother rushed to my side, but instead of helping me, she just stood there and cried. The other guests crowded into the house. As a group, they pushed the snake deeper into my mouth as I gagged.
After I told my mom this story, the two of us analyzed it and figured out that it was about the doctors treating me. Anyway, in that room we talked about pretty much everything under the sun—my recovery, the pain I was still experiencing, my mom’s current living situation, whether her bill payments were up-to-date, and how much money she had in her bank account. Her absence from work was hitting her hard in the pocketbook, so we spent time figuring out how to rob Peter to pay Paul. I’d nap, we’d watch TV, and every evening we’d watch the Spanish soaps.
At night, the entertainment options dried up. My mom went back to her room across the street from the hospital, the therapy and technician appointments ceased, and the halls got real quiet. The night nurses came in for their shifts, talking in low voices so as not to disturb sleeping patients. Lucky bastards.
For me, sleep was as elusive as the parking lot outside. I had too much energy and there was nothing to do locked up in my room all day. I made myself into a pest, calling out to the staff, straining to get their attention. I was like a pound puppy, trying to get people to notice me.
“Watch out, I’m coming out!” I’d threaten, waving a foot over the threshold.
“Martinez! Knock it off and go to sleep!”
My food and liquid intake was carefully monitored, so if I’d used up my Gatorade allotment for the day, I’d try to cajole one of the young male staff to duck into the supply room and bring me out a drink.
“Hey, man, just do it this once,” I’d plead. “Get me an orange one!”
Sometimes they’d do it, just to shut me up.
I underwent seven of my thirty-three operations during my thirty-two days in 4E. I’d already endured many rounds of excision and grafting, a primary technique that calls for the dead tissue to be excised, or cut off, from the burn, and transplanting healthy skin onto damaged areas. Whenever possible, they harvest the patient’s own skin for use, a technique called autograft. Prior to the procedure, a technician uses a special device to slice healthy tissue from the patient’s donor site. The surgeon grafts the healthy skin onto the clean wound bed, stapling it securely and blanketing it with medication and protective dressings. The goal is to cover all the wounds so that the patient doesn’t develop an infection.
If doctors have to use skin from a tissue bank, they try to match the skin tone to the patient’s. (Allograft, or cadaver skin from tissue banks, normally only serves as a temporary dressing. When the patient’s immune system begins to function again, the skin-bank skin is rejected by the body as foreign.) For an area where there’s lots of hair growing, for example, doctors will choose a section of donor skin where hair would ordinarily grow. Tissue is used from all parts of the body. They sometimes even use scrotal tissue on the eyelids because the tissue at that location is thinner. Small mercy, I was spared that particular procedure.
Like most burn patients, I welcomed the corrections, but sometimes they felt like setbacks. Just as I was starting to feel more human, I would be in for more pain and discomfort. If they harvested skin from one leg to graft it on the other, both legs would come out hurting. If the skin was coming from the bank, there was an additional blood draw, called a “type and cross,” to determ
ine compatibility between patient serum and donor red blood cells. Then the patient is designated NPO, meaning nothing by mouth, for eight hours prior to surgery. If an emergency crops up and surgery is pushed back, a patient could end up NPO for twelve hours or more. Calorie intake is critical in burn patients, so it can be an impediment when someone doesn’t receive the proper nutrition, even for eight hours. Antibiotics usually are ordered, so the patient has to have an IV hooked up while the drugs infuse. And depending on what part of the body is being worked on, patients may temporarily lose the mobility they had worked so hard to regain.
So yeah, I got irritable about it, even though I knew that each surgery would get me closer to feeling and looking better.
Dr. Barillo surprised me once in a way that was almost funny. He explained one surgery to work on my eye and my hand, adding that he’d do an “ear trim” as well. I assumed that my left ear hadn’t been severely burned, but nearly every morning I’d find tiny pieces of skin that had flaked from my ear onto my pillow. Ear burns usually are deep because the skin is so thin. They also are prone to a special type of infection called chondritis, because the cartilage of the ear does not have its own blood supply and must depend on the skin. Ears are difficult to reconstruct, so surgeons try to leave as much tissue in place as possible. In my case, it became obvious that the external ear wasn’t alive, so Dr. Barillo would try to trim back to living tissue. Rather than do this at my bedside a little every day, he elected to trim the dead stuff off under anesthesia along with these other operations. Unfortunately, by the time he got to healthy tissue, all of the external ear was gone.
When I woke up from the surgery, I looked in the mirror. My left ear was missing. “They said this was a trim, but it was an amputation!” I shouted to my mom. All we could do was look at each other and laugh. While this had been the clear plan to the surgical team, I guess I hadn’t understood it well beforehand.
Full of Heart: My Story of Survival, Strength, and Spirit Page 11
