The Long Way Home

by Roslyn Bane

  She ignored the tugging on her skin as the adhesive was peeled off the rest of the way, and two cold pads were placed along her ribs. “What day is it?”

  “It’s Wednesday, a little after eight in the morning. You arrived late last night. How are you feeling?’

  “Confused. My ribs hurt, and you’re a little blurry. My leg is gone. It’s not a dream. Why can’t I remember?”

  “I’m sorry, Major. It’s not a dream. You’re in good hands here. Your confusion is due in part to your concussion. You have a lot going on right now, so feeling confused is normal. I’ll let the doctors know that you’re awake. Would you like some water? You’ve been given the okay for that.”

  “Yes. Thank you.”

  The nurse finished reconnecting the leads prior to writing a few notes on her chart. “Your vitals look good. I’ll go speak with your medical team and get some water for you. Are you hungry?”

  “No.”

  “Someone will be back in with the water soon. Here’s your call bell, and the TV remote. The phone is here if you want to call your family.” She pulled the phone over, and placed it on a stand, moving it next to the bed. “Ring the bell if you need anything.”

  ***

  LANDSTUHL, GERMANY

  “Kris, how are you feeling?”

  “Vicki? What are you doing here?”

  “I arrived a few months back. You don’t remember talking to me yesterday?”

  “I thought maybe I dreamed it. Yesterday is pretty blurry.”

  “You are in Landstuhl. Do you understand what happened to you? How you were hurt?”

  “Landstuhl? How long have I been here?”

  “This is day five.”

  “Five? What happened? Why am I here?”

  “Do you remember anything?”

  Kris was silent for several moments and then spoke hesitantly. “I remember finishing up in the operating room.” She closed her eyes thinking back. “We did a turnover, I grabbed my gear and went back to my quarters to get some sleep.”

  “Hmm. Okay. What about your injuries? Do you understand what happened?”

  Shaking her head “I don’t.” She was quiet for several seconds, as she stared intently at the wall, “You said I was hit, and my arm was hurt. And that my lung collapsed. I don’t understand how that could happen. Everything is a little confusing.”

  “That would be the pain medications. How is your pain level today?”

  “If I don’t move it’s a seven. Vicki, what’s going on?”

  “You were hit by shrapnel in your left shoulder and chest. You have severe chest trauma. You had a collapsed lung. The shoulder damage was surprisingly mostly superficial. You had some penetration there, but overall the nerves and muscles did well. No bone injury either.”

  “You’re not telling me something.”

  Vicki reached over and took her right hand. Kris looked down at their joined hands. “You have a wound vac on now, trying to help pull the skin edges closer, and the chest seal, drawing out fluid from the chest wound and your lung.”

  “A wound vac?” Kris reached up and felt the plastic bandage across her chest, touched the tubing, and followed it with her hand until it disappeared over the edge of the bed. Tracing the tubing back up, she ran her hands over the plastic again and laid her hand flat on it. “Oh, my God” She jerked in bed trying to sit up but was easily pushed back down by Vicki. “My breast, it’s gone! It’s gone?”

  “Shh. Kris, calm down. You had a blast injury. One piece of metal made it all the way into your lung and collapsed it. That was removed and your lung re-inflated quickly. But the rest, you had fifteen shards, removed from the chest muscles and your breast tissue. You’ve had four surgeries here, and one at the field hospital. It’s been almost a week since you were hurt. They were able to repair the major blood vessels under your arm, that’s why you’re in the sling. To let that rest and heal. You almost bled out. Kris, your corpsman, saved your life. He kept you going until the medevac returned.”

  “What? Why was I in a medevac? I work at the hospital. Were we attacked? Was there another suicide bomber?”

  “No. You had to go out to the field. Do you remember that?”

  “No.”

  “Hmm. Let me go make a few calls. I want to get a neurologist down here. I spoke with your parents last night. I told them that you had been awake and that you were confused but doing better. I couldn’t get a hold of Shelly, but I left a message on your home phone.”

  “Okay. Thank you. Can I make a call? I want to talk to them.”

  “Absolutely.” Vicki pulled the phone closer, “Take your time. But don’t wear yourself out.”

  Kris waited until she walked out before laying her head back on the pillow. What the hell happened?

  Chapter Five

  BETHESDA, MARYLAND

  “HOW ARE YOU DOING this morning, Major? I’m Lieutenant Shorb. I’m a physical therapist and will be working with you the next few weeks. Today we want to get an idea of what you can do right now. Your broken ribs are going to make this a little harder so if you need to catch your breath let me know, and we’ll stop for a little while. Looks like before your injury you were in excellent shape, but with your injuries, surgeries, and inactivity you’ll have deconditioned some.”

  She bit her lip, and watched him closely, “Okay. What do I have to do?”

  “Let’s see if we can get you sitting up on your own, and getting in and out of bed from a chair. If you do well, maybe we can get you standing. This helps us find out how much assistance you are going to need getting in and out of bed, into a chair, into the bathroom, and getting dressed. The sooner we can get you moving the sooner we can get the catheter out and leave it out. Initially, we’re going to do the exercises in here, and as soon as you’re ready, you’ll start taking sessions in the PT clinic, twice a day. Before we start, how are you feeling today?”

  “I’m a little sore.”

  “A little? Sorry, Major, I don’t buy that. Most folks here right now are in a fair amount of pain. This will go a lot better if you’re honest. So, on a scale of one to ten, with ten being the worst, where would you set your pain at?”

  “A five, maybe six.”

  “Do you want something else for pain?”

  “Not right now.”

  Once Shorb explained the different things Sam would need to do to get to a seated position, he helped her transition from lying flat to a full, upright seated position. She did it several times, occasionally grimacing from the pain in her ribs. “Damn that hurts.”

  “Like I said, your ribs are going to make this harder, but we have to get you up and moving. Do it again.”

  Sam lay back, collapsing the last few inches. Her breath rushed out as her ribs shifted. A wave of nausea hit her, and she covered her mouth quickly with her hands.

  “Major? Are you okay?”

  “Yes. Coming back down didn’t feel too good.”

  “Try to control your descent. Don’t just fall. One more time and then you’ll try something else.”

  Sam took several deep breaths, and pulled herself up into position. The air whooshed out of her with the effort, and she bit down to keep from groaning.

  “Did that feel any better?”

  Sam wiped at the sweat on her brow, “Not really. I feel like I’m uneven and twisted.”

  “You want to be balanced. Make sure you’re sitting with your weight evenly distributed.”

  “LT, I think I know how to sit.”

  “Major, I have no doubt that you do. But since you’ve never had a missing limb, I want to make sure you’re not sitting in such a way that you start to get pressure sores on your stump or on your backside. “

  “How do I know if that’s happening?”

  “Shift around until you feel comfortable. Lift as you reposition, don’t slide. Pillows will be helpful.” The therapist wedged a pillow against her buttocks to keep her from sliding down and placed another pillow under the stump. “Do you fee
l balanced now?”

  “I do.”

  “Good. I’m going to lower the side rail, and you’re going to turn and sit on the edge. Push with your arms.” Sam wiped her sweaty palms against the sheets and followed his instructions. Soon she was sitting with her legs dangling over the side of the bed. “It’s been over a week since you last stood up, so it’s not unusual to get dizzy. I’m going to wrap this belt around your pelvis, and lower the bed a little closer to the floor. Don’t try to stand up yet.”

  “Okay. What is the belt for?”

  He wrapped his arms around Sam, positioned and fastened the thick, wide strap. “This is an assist strap. I am going to use it to help you get in that chair. This minimizes the risk for everyone.”

  “Okay, what’s next?”

  “I’m going to show you how to get in the wheelchair.” He demonstrated the technique several times, giving her several pointers she had to be aware of so she wouldn’t end up on the floor.

  “When you’re ready, go ahead.”

  Sam placed her foot on the floor and pushed with her arms to a half standing position. She started to pivot toward the wheelchair, and the room faded to gray. Her knee felt like a sponge, and she swayed. A tight pull across her waist got her attention, and she was pushed back against the bed.

  “Sit down. “

  “I got lightheaded. Why?”

  “Because you have been lying down for almost ten days. It will get better. Take a few seconds, and we’ll do more.”

  She took several deep breaths, grimacing against the grinding of her ribs, “Let’s do it.”

  After several more attempts, she was performing the maneuver relatively quickly. Ignoring the sweat that ran down her face, she sat down on the bed.

  “Only a few more minutes until the morning session will be over. I want to see if we can get you standing all the way up.”

  He unfolded a walker and set it up in front of her. She scowled and grumbled, “That’s for old people.”

  “It’s for injured people. We can’t get you on crutches until we know you can stay balanced using a walker. The harder you work, Major, the sooner you’ll get up and move on your own. Ready to do this?”

  “Yes.”

  He positioned the walker for her, and showed her how to stand and balance with the device. After a few tries, she could perform the maneuver without difficulty. “Okay, Major, that’s it for the morning.”

  “Already?”

  “It’s been an hour. You’ll have another session this afternoon, possibly with another therapist. You’ll do these exercises here. After that you’re going down to the therapy room. I think you’re strong enough to start doing more. Do you want to sit in the wheelchair or get back in bed?”

  “The chair. By the window.”

  “Okay. Ring the call bell if you need something. Do not try to get in bed by yourself. Not yet.”

  “I understand.”

  He watched as she got into the wheelchair and rolled herself over to the window. He moved the water pitcher and tumbler closer to her, “Remember to drink, Major.”

  Sam nodded her head and watched as he walked out of the room. The door closed and she sucked in a breath and tugged at her hair. Dear God can I really do this? What am I going to do? I have no strength. What if I can’t fly? I can’t stay in. I can’t go back. Not again.

  Her eyes filled as she fought back the despair. Two steady breaths quieted the hammering in her chest. She concentrated on controlling her breathing and gradually her muscles relaxed, and her head fell forward.

  “Hi, Sam. Welcome to your new home. I know you’re a little scared right now. You’ve had sleepovers here with Lauren. Now instead of leaving in the morning, you get to stay.”

  “Thank you for letting me stay here until my dad comes back.”

  “Of course, honey. Mr. Jim and Justin will help bring in the rest of your things. Lauren is upstairs waiting for you. You two will sleep in the same room. Whenever you’re tired of being in her messy room, you can help us decorate your own room.”

  “Okay. But I think my dad will be back soon. He’ll be wondering why we aren’t at home.”

  Sam jerked awake, and tugged at her hair. She muttered, “Why did I dream about that?” Uncomfortable from sitting so long she shifted in the chair and flinched from the discomfort of the catheter. “That’s it. This comes out.” She wheeled over to the bed and pressed the call bell. The nurse arrived quickly. “I want this catheter out. Now.”

  “Yes, ma’am. Lieutenant Shorb said you did well today. Let’s get you in bed, and I’ll get it out. You’ll need help getting to the restroom later though.”

  “I don’t care. Go ahead and get it out.”

  Chapter Six

  LANDSTUHL, GERMANY

  “DR. MATTHEWS?” A TALL, dark-haired man came into her room. “Hi. I’m Dr. Rohrden, one of the surgeons here. How are you feeling?”

  “Weak. Pain is a seven.” Kris spoke slowly avoiding the deep breaths that increased her pain. She pointed to the monitor that was keeping track of her vital signs. “My oxygen saturation is good. It drops a little periodically. I have to remember to take deeper breaths.”

  “Any leg pain?”

  “No.” She knew he was asking her questions, assessing her risk for a blood clot. “I feel good. What is your plan for taking off the wound vac? I could move better if I didn’t have to be tethered to it.”

  “That’s what I wanted to talk to you about. It is not ideal to send you across the Atlantic with it on. Certainly, we’ve done that before but not usually on the chest. You have minimal drainage from the chest wound now. We would like to do a skin graft to close the wound here.”

  Kris shook her head. “Here?”

  “Yes. We would take the graft skin from your thigh. The procedure itself doesn’t take long. I’m sure you’re familiar with the technique.”

  “I am. I’ve done them back home.”

  “You would be here a few more days. As soon as it looks like the graft is healing, we’ll get you home. Your oxygen levels are consistently dropping through the night.”

  “I wasn’t aware of that,” she murmured as she looked over at the monitor.

  “With the reduced air pressure when flying, keeping you here a few more days while everything heals will help you tolerate the flight better.”

  “I see. When would this be done?”

  “We hope to do it tomorrow.”

  “All right let’s do it. How much of a gap in the wound is there now?”

  “The largest gap is three inches by about two inches. There are several areas where you have had great results with the wound vac. However, there are still a few spots where there is a half inch gap, a little like you had been hit by buckshot, Commander. I think for the long run its best to remove the damaged skin and get a healthy flap on. I don’t want to leave those tissues exposed much longer and increase the risk of infection.”

  “Tomorrow,” Kris whispered.

  “How is your shoulder?”

  “It doesn’t bother me at all. I think the pain from the chest is completely overshadowing the arm discomfort.”

  “Good, I see you’re eating solid food again. Enjoy your dinner tonight. You know the routine, nothing to eat or drink after midnight.”

  “I do. Thank you.”

  “I’ll see you tomorrow.”

  Chapter Seven

  BETHESDA, MARYLAND

  SAM SAT ON THE edge of a low padded table, her foot bouncing on the floor. Around her was a flurry of activity with therapists and corpsmen helping other patients, several were missing legs, one was missing both. A cheer went up as a young Marine climbed up a flight of six steps, his arms raised in triumph.

  “How are you feeling?” Lieutenant Shorb asked.

  “I’m okay. I was tired after this morning’s therapy session though. I fell asleep in the chair afterward.”

  “It’s normal for you to be tired. Your body is working hard to recover. This morning was to
get an idea about what you could do and to teach you how to move around safely. We’ll keep working on those activities, but now we’re going to start to get your leg, your residual limb, ready, for when you get your prosthesis.”

  Sam furrowed her brow and bit down on her lower lip. “When is that usually?”

  “There is no set timeframe, Major. Everyone is different, and there are many factors. How much of the limb was lost? Are there other injuries? Was the patient in shape prior to the injury or were they overweight? Two things are definite for every limb loss. One, swelling must be reduced so you can get a good fit with the prosthesis. Two, the loss of flexibility will greatly limit what you can accomplish, and it will affect the type of prosthesis you will receive. Also, a prosthesis for someone who wants to run is different than one for someone who is going to be less active.”

  “Our goal is to keep the muscles in both your legs stretched out. So, we’re going to spend a lot of time with flexibility exercises. You’ll do strengthening, and we will start desensitization training also. That will help with some of the strange sensations you’re experiencing now. Since you have on shorts and a T-shirt, are you ready to get started?”

  Sam thumped her hands down on the table, “Let’s do it.”

  “Okay, lie down with your legs out straight.”

  Sam lay down on the padded table, her head resting on a thin pillow.

  “Do you see how your left leg is fully straight but your right knee is bent? Straighten that.”

  Sam tried but couldn’t. “I can’t, it’s stuck.”

  “That’s what we’re going to work on. A lot. Let’s go through the exercises. Some you’ll do on your own, others you will need help with, especially the first few times. Remember, if you’re not sure how to do something, ask someone first. We don’t want you getting hurt.”

  She nodded, “Okay, let’s do it.”

  Thirty minutes later drenched in sweat, Sam lay back on the table, “How is it possible to be this tired? I haven’t moved from here.”

  “Because you had an intense stretching session. Your hamstrings are incredibly tight.”