But since no part of the wrist was salvageable, the decision was simple: just trim the limb up to where my arm was the right length for a low-tech prosthesis, such as the one I now wear. This was what I called the nineteenth-century, or Civil War, side of my surgery. It was essentially a battlefield amputation.
The other side was twenty-first-century work: multistep, complex and time consuming, not to mention risky. Greg Anigian would perform microsurgery and tinker with tiny vessels. Thrombosis and more dead tissue were a real concern. I did not want double stumps.
One of the first things I noticed when I came out of this surgery was that they’d strapped a fetal Doppler monitor on me—the kind of device usually attached to pregnant women’s bellies—to keep a close watch on my hand’s circulation.
Anigian had a little of my thumb and most of my palm to work with. For raw materials, he harvested a length of fascia from the left side of my head, a piece of the left latissimus dorsi muscle (and its blood supply) from my back and a generous swath of skin from my left side.
He wrapped the muscle tissue around my stump and hooked it up to the radial artery. Then he attached the fascia around my thumb and sewed it to an artery, too. Finally, he wrapped the whole thing up in skin from my side, creating a sort of mitt for me.
Dan:
I was waiting for Beck in the recovery room after his surgery. He’d been extubated, which means they’d removed the tube inserted in his trachea to help him breathe.
I don’t recall ever seeing anyone in so much pain. He was shaking uncontrollably. Although he still was markedly drugged, Beck was suffering major-league pain.
The anesthesiologist was there, and he decided to give Beck more morphine. The problem was, even a small dose on top of what he’d already been given, and Beck’s unassisted breathing would be inadequate. So, while he was administering the morphine, I went to the head of the bed to work with what we call an ambu bag, a self-inflating rubber bag commonly used to mechanically assist patients’ breathing by forcing air into their lungs. I think I kept at it for a half hour or so.
I awoke from this surgery with a serious case of the shakes. The pain was excruciating and it was everywhere. A simple touch felt as if I were being beaten with a two-by-four. It was like suffering some monstrous seizure, but I don’t think it was a seizure in the sense that my brain was driving it. More likely, my muscles had just polarized and were firing out of control. Think of shivering, but with your muscles maxed out, not just a little tensed. Everything on full go, screaming.
Bub:
Besides my dad’s physical appearance, he seemed to be doing all right after he got home from Everest. It didn’t hit me how injured he was until after the surgery to remove his hand.
In the recovery room, I watched him lift his head, trying to see around him. He was shaking. His head was shaking from the effort, and all of a sudden his pain hit me.
The area on my left side where they’d taken the graft was covered with an occlusive dressing; that is, a kind of airtight film with an elastic rim. If you are lucky, the dressing stays in place, sealed and sterile, and everything is fine. But if it slips, as mine did, and air hits the skin, that is a serious ouch.
A vast area of me was exposed, and this acreage promptly was colonized by a drug-resistant staphylococcus. The infection was painful and messy. A goo started leaking out of me. My entire left side underneath the dressing turned yellow-green. Pus and bacteria. I smelled bad, too. Cleared the OR. Sent ’em out of the room gagging.
They put a drain in my side and left it there for six or eight weeks.
Meanwhile, the full-body roar of rapidly misfiring muscle synapses finally quieted down until only my two amputations kept at it. When you cut through those huge nerves, every one of them starts screaming and won’t stop. That lasted for a year. They just wouldn’t give up. The sensation is like constantly being hit in the funny bone. It’s disconcerting, an overwhelming jangle ripping right up both your arms.
When that finally subsided, a new sense took over—physical isolation. The hardest part of losing your hands is that you lose a huge amount of sensation. Forty percent of all your sensory input comes through your hands. These are serious input devices.
There are other obvious problems. You can’t grasp and manipulate things. Remember my juggling kit? Very little of my gear survived Mount Everest, but when I finally got the stuff in Dallas, there was my juggling how-to booklet and the three little balls. I had to laugh at that.
Naturally, I thoroughly studied my new circumstance and learned there’s a significant difference between surgical amputees, such as myself, and individuals who are born with no hands. They tend to adapt amazingly well. For instance, they can do astonishing things with their feet; there’s not much they can’t do.
However, they run into problems when they get to the age when arthritis sets in. They lose their limberness or develop back problems and can’t put their feet where they need to put them.
For me, the sensory isolation of amputation is the worst part. I am acutely aware of it daily. I still have an intact palm on my left hand. One of my few sensory pleasures today is to feel the texture of Missy’s fur as I pet her. It is both reassuring and kind of poignant. She is a constant in my life.
Still another surprise feature of my postdigital world has been my dreams. For whatever reason, they have become incredibly vivid since the surgeries. I’m aware of taste and smell now in my dreams. Everything is in full color, an incredible display. I have no explanation for this.
I’m also very much aware that I am dreaming. For example, I’ll be riding a bicycle down a country road and I’ll look down to see both my hands on the handlebars, working the gears and brakes. I don’t step outside myself. I’m very much within myself.
It’s kinda fun. It means that for one third of the day, or whatever time it is that I sleep and dream, I’m not diminished or handicapped in any sense. I run with the speed of a ten-year-old child, with no pain. I never tire. I’m a virtual Beck. Now, sometimes, I don’t have hands in my dreams. But when I do, I’m acutely aware. “Ha! I’m dreaming! See? I’ve got hands.”
Greg Anigian performed two more procedures on my new mitt, to give it a little shape and integrity. First, he cut down a bit farther in the space between my thumb and the rest of the mitt, making it look more like a mitten. Of course, he needed a little extra skin, which he took from my crotch—without asking.
I woke up after this surgery, looked down to see this incision across my groin, and cried out, “My God, is nothing sacred?”
The next and last procedure was to open a second incision, so that the mitt now would look like a primitively done fleur-de-lis. For this cut, they revisited my left side for skin.
I began about this time to inventory my body for areas as yet unoperated upon. There weren’t many. In the end, only my right thigh would remain untouched. No one stuck a needle into it or anything. That had me concerned. I wondered what they were saving it for.
The last of the major medical projects was my nose.
It had been frozen pretty deep into my cartilage and bone. There wasn’t much to save. But before the whole works was cut away, they took an impression of the original, using a piece of chewing-gum wrapper. When Greg Anigian went back to work, he’d use the wrapper to re-create my nose’s contours.
In the interim, we had to improvise a way to keep my interior nasal passages moistened. The answer was a spray bottle. But since I now had no hands, guess who had to keep this little orchid’s humidity at acceptable levels? Another chastening experience.
They grew me a new nose. First, a vaguely nosey-looking object was cut out of the skin in the center of my forehead. Then, using pieces of cartilage from my ears and skin from my neck, they shaped my new nares to give the whole thing some structure, and got it growing, upside down, on my forehead. I was careful not to allow the kids to take pictures of my upside-down nose, lest they sell them to The National Enquirer.
I
also discovered that my unique deformity was a foolproof tool for sorting out my true friends. They all laughed their fannies off when they saw me. Everyone else was just polite.
The key was to wait until the new nose was fully vascularized. Greg scheduled me for one replant operation that he scrubbed when a look at the replacement part revealed it wasn’t fully cooked.
Once he was comfortable with it, he cut the new nose loose, swung it around on a pivot of skin, brought it down and sewed it into place. Then they stitched up my forehead.
At this juncture, I looked like some has-been pug, my nose a misshapen muffin below an odd little curlicue of skin. The final step was to take a piece of rib from my right side and attach it between my nose and palate to give the new feature some structural uplift.
I think they did a pretty fair facsimile of the real thing, and I was happy with my new nose, with a single reservation. Since the nerve supply remained intact when it was swung down, every time I’d take a shower and the water hit my forehead, my nose would itch.
Peach:
Beck and I were not communicating at all during this period, except on practical issues such as his health. There wasn’t time. I was too tired and too stressed out and he was too sick. All I knew for a fact was that I did not plan to grab the kids and walk out, or send Beck to some convalescent center. At least not right away.
I did see evidence that he’d reformed himself, in part. There was that telephone call from Dr. Schlim’s office, totally out of character. He was reaching for me, and I soon had a partial explanation why—the epiphany on the mountain. He also appeared genuinely contrite for all the pain he’d caused. What’s more, Beck seemed to see the kids and me in a new light, maybe the light that awakened him on Everest. At this point he couldn’t run away if he wanted to, but he didn’t seem to want to.
I’d built up a lot of scar tissue over the previous eight or nine years, however. It was going to be very difficult, if not impossible, to trust him again. Even if Beck swore to me that he was a new man, it would be just words, not easy to believe. Although I didn’t say it, or even think it at the time, he needed to prove himself. Action was necessary. If we were going to turn things around, it wouldn’t be a big slow bend in the road. It would be a U-turn.
My brother Howie was the catalyst.
Howie was being his old reliable self: completely nonjudgmental, that incredible empathy. One time when we were all in Jamaica he befriended this scruffy character named Hedley, who became Howie’s fast friend. Never mind that Hedley had a drug problem and that the security people wouldn’t let him near the hotel, he and Howie were good buddies. Hedley doubtlessly was in it for a possible buck or two, at least at first, but Howie’s goodness must have shone through. He even trusted Hedley with a credit card, and wasn’t disappointed.
Howie flew to Dallas in his funeral suit the moment I called to tell him Beck was dead that Saturday morning, and arrived not long after we learned that Beck was alive. He took the children out for hamburgers, and kept an eye on things until he was sure my friends were providing us the support we needed. Then he said something funny about not liking crowds and flew home to his wife and daughter.
We continued to keep in close touch through Beck’s constant medical crises into August of 1996, two months after the amputation, when Beck finally was well enough recovered for us to plan a brief family outing. Dr. Anigian delayed a scheduled procedure on Beck’s left hand for three days, and we all flew off to Fripp Island, a short distance up the South Carolina coast from Hilton Head, where Howie, Pat, and their daughter, Laura, joined us.
Within a day of our arrival Howie became seriously ill. I remember he walked up from the beach looking ghastly. “I really feel bad,” he said. Howie’s skin was white and he was sweating. He complained of chest pain.
There’s a history of heart disease in my family. Howie was overweight and smoked most of his life. It seemed pretty likely to Beck and to me that he was having a heart attack.
Howard walked up to me ashen, with a sense of pending doom. He was sweating profusely. Even my old doctor books would describe that as looking an awful lot like a heart attack. I thought to myself, Howard, you simply cannot die on me here. If you do, I’m going to have to walk into the surf, and just keep going.
Peach:
We got him to a nearby hospital, where the doctors also believed a heart attack had occurred. But when they did a sonogram as part of their battery of diagnostic tests, they discovered a mass on Howie’s liver. Next day, a CAT scan confirmed it: Howie had a primary cancer tumor on his liver, a hepatoma. It was big and the type of tumor that grows like a weed.
I reacted to this news much as I’d reacted to word that Beck was frozen dead to the side of Mount Everest. I went numb. I couldn’t absorb it. My capacity for pain was momentarily overwhelmed.
I immediately knew Howard’s likely outcome. I wanted to tell him that dying just isn’t that hard. I’d done it once. I knew something about it. And I knew that for me, it would be much easier to face a second time. The fear is greater than the reality. If dying was really so difficult, there’d be some poor Bubba out in West Texas who couldn’t quite get the hang of it and would be immortal as a result.
I never got around to telling Howard all this. Nevertheless, he managed his own death with a fair measure of grace.
Peach:
In Beck’s case, we’d mobilized to rescue him, not realizing the impossibility of what we were trying to do. Now, I wanted a second miracle, a second rescue mobilization. Like an answered prayer, it materialized. This time, however, love and hope weren’t enough to pull Howie through. Instead, it would be me and my family who were saved, in a wholly unforeseen way.
To my infinite amazement, Beck got involved.
Atonement definitely was on my agenda after Everest, but I didn’t respond to Howie’s needs as an act of expiation. First of all, I loved him. That was a big part of it. I’d been wrestling with the question Who do you love? and realized it was my family, the people who make up my existence. Now that I wasn’t shielded by my goals, and had no other way to go hide myself, it was natural to respond as I did.
Also, I got involved with Howard because I was really trying to figure out how to actually be a different person. Peach and the kids always had been important to me, but I hadn’t acted as if they were. In Howie’s case, in the past I might have been sympathetic, but I would have left everything to Peach. Now I became viscerally engaged. I did not want to stand by and watch. I did not want to be immaterial in this.
Peach:
It began the moment Howie didn’t feel well at the beach. Beck sat with him and talked to him. From then on he threw himself into it. Before, he might have said to me, “I can’t possibly do this. I don’t have the time.” Now he was saying, in effect, “I’m on your team.”
Howie was in a miserable state. He had this terrible tumor, and all kinds of trouble with his managed-care system, Kaiser Permanente. I did not hold out much hope for saving Howie, but I also knew that if we didn’t move ahead in a hurry, nothing would happen. If there was anyone who should be able to help a person in his situation, it was a person in my situation. That’s what I thought, at least. In truth, I was totally impotent. It was frustrating beyond all belief.
I couldn’t get the system to give a shit if Howie was alive or dead. I called the head man at Kaiser Permanente dozens of times. I could never get past his secretary. He would not return my phone calls. When I did manage to get hold of a human there, he’d say, “I’m listening to ya. I’m hearing ya. I know where you’re coming from. What can I do to help you?”
Of course he was going to do nothing. He was reading from a script. He didn’t have the authority to do squat.
I’d ask, “Would you please have someone who can do something call me back?” And he’d just say again, “What can I do to help you?”
I called and called and called. I thought, These yahoos! I’ve never seen anything so insensitive, so brutal.
Here’s a man who’s dying and they can’t return my phone calls.
Peach:
Beck never would think of making a doctor’s appointment for me or the kids. But with Howie he became quite aggressive. I remember he chewed someone out. Called him a miser and said he didn’t care.
One of the first things Terry White and I discussed was a transplant. The Kaiser oncologist didn’t even review Howie’s films. Nothing. He walked into the room, looked at Howie’s records, and said, “Oh, you have a hepatoma. It’s bigger than five centimeters. We don’t do transplants when tumors are greater than five centimeters.” In effect he said, “You’re gonna die. I could treat you, but it wouldn’t make any difference, because you’re still gonna die.”
Kaiser diddled Howie around for a couple of months, and I believe that did affect the quality of care he received. I don’t know, however, if it made a difference in his outcome.
Peach:
I took what Beck was doing as proof of his love for me and for my family …
I wanted to prove I could still make a positive impact on our lives.
Peach:
… but I still had to kick him in the butt a fair number of times. He and Terry would say, “There’s nothing more to be done.” I said, “Don’t tell me there’s nothing to be done. I live with a dead man, remember?”
Left for Dead Page 20
