Jeremy, Part 6

Hey, this is Jeremy, the doc (well, resident) with no legs, just in case you forgot all about me. I lost both my legs nearly at the hip from a car accident back when I was in medical school. I haven’t posted any stories in a while, but I actually have a very good excuse. The last time I wrote, I was dating a really cute medical student named Claudia. I was really crazy about Claudia, but I managed to blow it. I guess it was a bad case of trying too hard, which meant that I didn’t give her the space she needed.

I got farther with Claudia physically than I had with a girl in a few long time (like since back before my accident). Now that I’ve had time to analyze this a little bit, I feel that this may have contributed to a lot of the insecurities I had. To be explicit, we made out a few times with her in just her bra and panties, me with no shirt and just my boxers (which actually nearly cover my stumps).

Because I’m an idiot, I analyzed the whole thing to death, trying to figure out if she was grossed out by my stumps. At first I decided that although she never actually touched my stumps at all, she also didn’t make any effort to avoid them. Then one time when we were kissing, my left stump started sort involuntarily rubbed up against her, and she actually moved to get away from this. I felt so hurt by that at the time.

My insecurity really wound up screwing me over because I was constantly questioning whether or not Claudia actually liked me. Like one Saturday night she said she was studying and couldn’t see me. I of all people should have been sensitive to the fact that a third year medical student needs to study, but instead I became convinced she was lying to me and using this as an excuse to see another guy. A lot of stuff like that.

Finally, Claudia decided to do an away elective out of the country and she said she thought this was a good opportunity to reanalyze our feelings separately and that we should see other people if we wanted. You can imagine that really killed me. I got so mad at her and told her she should just break up with me if that’s what she wanted to do so badly.

Claudia said, “Jeremy, that’s not what I want to do.”

But I was a huge bastard and accused her of cheating and all this shit I now feel sure she never did. So in conclusion, I made it so that she had to break up with me.

In analyzing the whole thing afterwards, I tried to figure out why I did the dumb things I did. I never ever did that with my ex-fiance Wendy. I always trusted Wendy but I couldn’t seem to trust Claudia. Finally, I decided that it all went back to feeling self-conscious about my stumps and the fact that I have to rely on a wheelchair, and I am the only doctor in the hospital who does.

That’s when I made the very important decision that I wanted to try to walk again. I know it sounds weird to decide something like that after five years of being in a wheelchair full time. I just thought back to when I tried prosthetic legs after my accident and how excited I had been to be walking again. Then when the legs didn’t work out because my stumps got infected, I was really disappointed but I think I always felt in the back of my mind that I would give it another try again later. Prosthetics are probably better now too. I heard about that guy who lost his legs in the Staten Island ferry accident and they got him prosthetics that were just like little computers.

I didn’t mention this idea to my friends or family yet, but I did see a doctor, Dr. McNally, who specialized in rehabilitation of amputees. He got me into the examining room and I stripped down to my bare stumps and he examined them as I looked on nervously. He tested their strength, which is pretty bad now. I’ve got flexion contractures of both my stumps, which basically means that since I have no hamstring muscles, I have a lot of trouble just straightening out my stumps. I probably could have prevented this if I had worked at it, but it’s not like I had the time. I think I winced once or twice when he pressed on the scars, which he shook his head at. My stumps are not those nice, smooth ones you hear about. It took forever for them to heal after the accident. They are very badly scarred and tend to look a little inflamed just at baseline, even when they’re not infected. They also tend to get a little dried out, which I have not done a fantastic job trying to prevent. The best thing I can say about them is that I didn’t have any open sores.

Dr. McNally asked me a bunch of questions about my stumps, such as about pain and phantom limb stuff. Despite how bad my stumps look, I don’t have much pain. I do have some phantom limb sensation though. It’s very weird... sometimes I feel like my feet are still there and I can move them, but they’re much shorter than they were. It doesn’t really bother me all that much though.

He then started asking me about all these social issues, like about my job and how I manage with my wheelchair. Obviously, I have a very good job and I do everything for myself, including driving a car with hand controls. I was getting a little sick of the questions.

“So what do you think?” I finally asked him.

“Your stumps are in pretty bad shape,” Dr. McNally said. “You’re going to really have to work at it. But the good news is you’re young and in good physical condition otherwise. I think you have a decent chance of being able to walk again.”

That was all he had to say and I was sold. Unfortunately, it wasn’t so easy. I told my parents what I wanted to do and they were pretty supportive. Actually, I think my mom was really thrilled because I know she avoids looking at my legs and she hates the whole wheelchair thing. But they didn’t have the money to help me pay for me to keep my apartment while I was taking off from residency, plus the expenses of rehab that my insurance didn’t cover (which was surprisingly very high). So I made the decision to move back in to my parents’ house.

Understand I love my parents and I have never had a problem with living with them, but it just didn’t feel like a step in the right direction to be moving back in with my parents. When I was first injured, that had been my big fear: being some sort of pathetic cripple living with my folks. It was some consolation that I had already made it on my own, but I didn’t want to backtrack. I’m really aware of the fact that in urban areas, a lot of the homeless people you see are in wheelchairs, and it makes me self-conscious because I wonder if I hadn’t gone back to med school, who knows what might have happened to me. Would I be sitting out on a street corner in my chair, begging for change?

Anyway, I entered a rehab program that was aimed at getting me to walk again on prosthetic legs. Dr. McNally ran the program, which usually took about twelve people at once, all of whom were young and in good shape (I know from my own experience that the vast majority of amputees are older diabetics). The program wasn’t supposed to start for about a month and in the mean time, I was assigned some exercises for my stumps and given stockings to wear over them that was supposed to “mold” them into shape.

Dr. McNally sent me to see a prosthetist, who took a cast of both my stumps. He talked to me a little about the legs he was going to make for me. I wasn’t going to have the little computer knees because my insurance didn’t cover it and they are very very expensive, but he said the knee he would give me would have a lot of stability, which is important for someone with a double amputation. He said they would attach using a suction device, which would minimize the amount of movement of my stump within the socket, so it would be least likely to get irritated like last time.

Like I said, the other people in the program were all relatively young and otherwise healthy, like me. It was a pretty vigorous program, designed to get us all walking with the prosthetics as soon as possible. Most of the other guys, however, had only recently become amputees. I think one year was the longest ago any of them had their accident. When I said I was using my wheelchair for five years, most of the other guys were pretty surprised.

The other thing that separated me from most of the guys was that they were mostly single amputees. Of the twelve of us, four were single below knee amputees, five were single above knee, and only three of us were double amputees. And of the three of us doubles, one of the guys had both his knees still. Only one other guy, Patrick, was a DAK amputee like me. He had lost his legs about six months ago.

Dr. McNally told me when I started that I should try not to gage my progress by the other guys. He said of all of them, I’d probably walk last but I shouldn’t let that discourage me. I assured him it wouldn’t. Really, after all this time, I knew it wasn’t going to be an easy thing to get myself walking again, but I was willing to put in the effort.

I will never forget the first day I was supposed to try out my new legs. I was so excited about it. They told me to wear shorts to make it easier to fit the legs on. The upper thigh was made of plastic, but the knee and the pylon (the part that connects the knee to the foot) was all metal. They told me that I could cover the metal piping with a soft cover later. Two of the PT’s helped put them on and they helped me rise into a standing position in front of a set of parallel bars. I was literally shaking with excitement that I was actually doing this after thinking about it for so long. I was actually going to be walking again.

Unfortunately, that day didn’t turn out to be as good as I had hoped. Dr. McNally told me not to get discouraged if I made very slow progress at the beginning, so I wasn’t expecting much the first day. But what I hadn’t been expecting was to make no progress. Even though I had been faithfully exercising my stumps, I found that I had a lot of trouble straightening them out, so the entire first session was dedicated to just helping me stand upright successfully with the legs while holding onto the parallel bars. And I couldn’t even do it. I had to use my arms entirely to support my weight.

McNally told me he wasn’t that surprised. “You haven’t been exercising your stumps for over five years,” he explained to me. “You can’t expect to make up for that in a month.” He assigned me some exercises to help build the strength in my stumps. He said I needed to build the muscles up before I could walk.

Patrick, the other DAK, was able to take a few steps. I talked to Patrick a little bit. He was in his early thirties, he was married, and he had two kids. He did some kind of construction work and he had been injured on the job. He confided in me that he hadn’t had sex with his wife since his injury and he was afraid she wasn’t attracted to him anymore. Patrick was upset about his own lack of progress that first day, which kind of pissed me off, considering he still did a lot better than me.

That night when I came home, the first thing my mom said to me was, “So how much did you walk today, Jeremy?” And I of course had to tell her that I hadn’t walked at all. It was very depressing.

I worked harder than I ever did during residency during the next few weeks. I did the exercises for my stumps on my own and the PT’s also helped me to work out my stumps. I made progress, but it was ridiculously slow. After several weeks, I got to the point where all I could do was stand in the legs. I couldn’t even take a step. The legs were too heavy and my stumps were too weak and I just didn’t have enough control over them. Patrick was already able to almost walk on his own with crutches and I still couldn’t even take one goddamn step.

Dr. McNally examined my stumps. He said, “I think the muscle tone is getting better. Hopefully, you’ll take your first step any day now.”

I had to ask him the question because I had been thinking about it constantly: “What if I can’t take a step?”

His answer didn’t make me happy. “Well, you’ve been using a wheelchair for five years now. It wouldn’t be the end of the world if you had to continue using it.”

My mother said that she was having all her friends pray for her in church that I could walk again. As nice a thought as that was, I was losing hope that this was going to work. The doctor was right that I was able to function in my wheelchair so maybe I was just selfish in trying to walk again.

Then when I was able to give up, something wonderful happened: I took my first step.

I had been concentrating so hard on it for so long, I could hardly even believe it when I saw my leg move. I think even the PT’s were surprised. By that point, nobody thought I was going to be able to walk. I was so happy, I actually started crying. I don’t I realized before that point exactly how much I had wanted to walk again. We actually had a celebration that night. My parents took me out to dinner with my older sister Lily, her husband Ryan, and their four kids.

After that, my progress speeded up some, but was still fairly slow. One step turned into two and eventually I could walk all the way along the parallel bars. Patrick was now walking with crutches (and all the other guys had been walking for a while), but I wasn’t jealous of his progress because I knew I’d get there eventually.

McNally was very pleased with how I was doing. “I have to be honest, Jeremy,” he said to me, “I didn’t think you were going to be able to do it.” I didn’t think so either, but here I was.

I got my first set of forearm crutches and I made me first ventures out past the parallel bars. It was scary as hell not to have that support, but it was also exhilarating to be walking on my own. I wished Claudia could see me.

Once I got a little more comfortable with the crutches, I started taking my prosthetics and crutches home with me and I did a little walking around the house. When my mom first saw me walking with the legs, she started crying. “I knew you’d walk again, Jeremy!” She hugged me, which almost made me fall over. It was good to be hugging my mom again while standing, just like before I got hurt. I was a little shorter now (about 5’7” instead of 5’10”) but otherwise it was just like it used to be.

I started going outside a bit with my legs. I figured I should do it while the weather was still decent and there was no ice on the ground. Obviously, I limped pretty badly even with the crutches, but I still felt a lot more normal than I ever did with my wheelchair. I know it’s not my imagination that people stare at me (or avoid looking at me completely) when I wheel around, especially when they see I don’t have any legs. I’ve even heard a few obnoxious comments from people that I probably wasn’t meant to overhear. Older women say stuff like, “Oh, that poor young man.” One lady who I passed while I was with a friend said to her friend, “Look at that, he can talk.” I still wish I would have said something to her.

Everything considered, I was making very good progress. Dr. McNally said I should have goals in mind, so my goal was to eventually be able to walk without crutches at all. I was willing to use a cane. Also, I wanted to be able to go up steps. I think people who are not disabled don’t realize what a pain it can be when you can’t go up steps. I wanted to be able to use my legs the majority of the time, but I knew I’d never be able to do without my wheelchair completely. I was still mostly using my chair around the house, but less and less each day.

Things were going great until the beginning of October. I woke up one morning and I just felt like complete shit. I knew I had to get to PT, but I couldn’t even get out of bed. I felt very tired, hot, and nauseous. My mom eventually realized I wasn’t up and she came into my room to see how I was doing. She started freaking out when she saw me and took my temperature, which was 104. She thought I had the flu (I never wound up getting a shot like I usually do because of the vaccine shortage), but I knew why I was sick.

When she pulled back the covers, it was obvious that once again, my stumps were infected. I think this time they looked even worse than last time they got infected. Truthfully, I had noticed them not looking so good for the last few days but I hadn’t said anything because I didn’t want to stop using my legs.

My mom drove me to the hospital and they immediately admitted me and started the IV antibiotics. At least this time it wasn’t the hospital I worked at, so I didn’t have to worry about the staff. I was feeling pretty out of it for most of that time but needless to say, I got very very sick. The second day, I got a rash over my whole body and nobody was sure if it was from the infection or a reaction to the antibiotic (as much as I love giving Vancomycin to my patients, it’s not the most fun drug in the world to be on). I think my parents thought I was going to die or something because everyone in my family came to visit me.

By the end of a week and a half, I was getting better though. My fever was down and I was starting to feel almost normal again. Dr. McNally came to see me in the hospital, which I thought was pretty classy of him, considering I’ve heard these rehab docs almost never set foot in the hospital. Unfortunately, what he had to tell me wasn’t good news.

“I don’t think I would make another attempt at prosthetics for at least several months, ideally longer,” was his opinion.

Then, before I had a chance to protest, he said that if I did decide to try prosthetics again, he thought it would be better if I chose another doctor to work with because he didn’t want to be responsible for me dying (although he didn’t say it like that). “Your stumps are apparently hypersensitive even to the suction socket. If you try it again, you’ll have to take meticulous care of your stumps and even then, there’s a good chance they could get infected again.”

I’m a little embarrassed to admit that after he left the room, I started crying. This whole experience was very emotional for me and after all the work I put in, it looked like I was going right back to the wheelchair for the rest of my life. It was very frustrating.

When I came home to my parents’ house from the hospital, I got very depressed. I always had some depression issues, but I was so depressed that I couldn’t even manage to get out of bed in the morning. My parents got rid of the prosthetics so I wouldn’t be reminded of them, but I still thought about it a lot. My father was encouraging me to try to go back to work, which I did sort of want to do, but I just felt like I didn’t have the motivation to do it. I had expected to be walking by the time I went back to work and I didn’t want to go back in my wheelchair. So I mostly just cried a lot.

I feel like I have to thank my friend Michelle for pulling me out of it a little. She visited me once in the hospital, then she came to see me when I was home. She’s doing a psychiatry residency now, so she was very sensitive to how depressed I was. Before she left, she insisted on giving me a script for an antidepressant. “Promise me you’ll fill this, Jeremy,” she said.

It was sort of funny because I started making all the same excuses that my patients always make when I try to give them antidepressant medications. Like, “Oh, I can get through this myself.” But the truth was that Michelle was right. I needed something.

Michelle reminded me, “You know SSRI’s have some mild sexual side effects.”

I said, “Ha ha, that’s not a problem, believe me.”

I got my mother to fill the prescription for me and I started taking the antidepressant (in addition to the oral antibiotics I still had to take). Maybe it was my imagination because I know they don’t usually work right away, but I did start feeling a little better. I don’t know.

This was the first Thanksgiving in three years that I had been home for. (I got to be on call every day of the Thanksgiving holiday last year.) I had been looking forward to it, but I also knew that I had been expecting to be walking by now and I wasn’t. Holiday are a really good time to get depressed.

Thanksgiving is a big deal in our family. When I was dating (and later engaged to) Wendy, I used to bring her home for the holiday every year. I was all excited the first time I brought her home, because I remembered how my older brother and sister used to bring home their significant others starting in college.

This year the house was completely full, mostly with kids. My sister Lily has four kids and my brother has three, the littlest being only six months old. Lily lives relatively nearby, so in the last few months, I’ve gotten reacquainted with her kids. They pretty much only know me as being in a wheelchair and not having legs, so it’s something they’re very comfortable with. I give them rides on my lap and they love it. I love kids and I’m pretty good with them. If I were still with Wendy, I’m sure we’d at least have one or two kids by now.

My oldest niece (Lily’s daughter) is Amber, who is thirteen now and she is actually really beautiful (and I’m not just talking as her uncle). Amber is probably the only one who remembers me at all from before my accident. Apparently, Amber had a boyfriend now, which her ten year old brother Duncan wouldn’t stop teasing her about.

Of course, with all the boyfriend talk, I was worried Duncan was eventually going to say something to me. He said, “Hey Uncle Jeremy, how come you never have a girlfriend?”

He didn’t mean it like that, but him saying those words kind of hit me. He’s too young to remember Wendy and all that. I just got to thinking about how I felt like I was never going to find someone like her again. I was never going to have kids and a family of my own and I was probably always just going to be “Uncle Jeremy.” I was tired of it. This wasn’t where I expected or wanted to be at age 28. I had to excuse myself to my room before I broke down.

I guess my brother-in-law Ryan witnessed the whole encounter, because he knocked on the door to my room a few minutes later. I was crying (again), so I tried to compose myself quickly before I opened the door for him. But when he saw me, I think he realized I was very upset. He was holding two beers and he handed me one of them then he sat down on my bed.

Ryan said to me, “Jeremy, I’ve known you a really long time. I don’t have any brothers, so I kind of think of you like a brother. I hope that’s okay.”

I nodded that it was. I always liked Ryan. He’s a good guy.

The next thing he said kind of shocked me. “Jeremy, when was the last time you got laid?”

I just kind of stared at him in surprise.

“Don’t tell me you haven’t had sex since Wendy. I might have to kick your ass.”

Of course, Wendy was the last woman I had sex with. And that was before my accident, when I still had my legs. I admitted that to him finally.

Ryan sighed really loudly. “Jer, you’ve got to get yourself some action. Whatever the cost. I know you’ve got this idea that you’ve got to settle down with a woman, have a bunch of kids, and all that, but you’re still very young and there’s plenty of time for all that. You don’t have to settle down till you’re forty if you don’t want to. I love Lily and my kids very much, but sometimes I think it would have been nice to have had more time to play the field and not have settled down so young. Not that I’m saying it was a mistake, but... I’m kind of jealous of you, being completely free. You can sleep with whoever you want.”

“Girls don’t respond like that to me,” I tried to tell him.

“Your problem is you’re looking for Wendy,” he said. “There are a lot of girls out there and none of them are Wendy. You’ve got to forget about her. You’re a doctor, women love that. Just please quit feeling sorry for yourself.”

Ryan and I talked a little longer and I got to thinking maybe he was right. Yes, I did think I’d be married to Wendy at this point and I’m not, but I have accomplished my career goals up to this point. I know Ryan had wanted to get a PhD but he was never able to do it because he had to provide for his family. I didn’t have that limitation. In a lot of ways, I was very lucky.

My mom came into the room and interrupted our conversation. “Jeremy, phone call for you,” she said.

Ryan excused himself and I picked up the phone. “Hi, Dr. Andrews.”

It was Claudia. She sounded really cute on the phone. I was surprised to hear from her because the last time we had seen each other wasn’t on the best terms. “Hi, how are you?”

“I’m in England!” she said, which explains why the connection was so fuzzy. “I miss the states. You know, there’s no Thanksgiving over here!”

“Really?” I guess that makes sense. “We’re having a big thing over here at my parents’ house.”

“I know!” Claudia said. “I remember you mentioned your family had a big Thanksgiving dinner. That’s why I called. I wish I could be there! I’m lonely over here.”

“When are you getting back?” I asked her.

“Two weeks.”

“Well, maybe I could take you out for sort of a make-up Thanksgiving dinner,” I suggested. I was only half expecting her to say yes. I was really an asshole when we broke up and I didn’t expect her to forgive me so easily, even though we hadn’t seen each other since June.

“That would be great!” she said. And I felt really happy for pretty much the first time since Dr. McNally spoke to me in the hospital. Then she added, “I really miss you, Jeremy.”

I really missed her too and I told her so. Claudia is so great. Our date is next week and I’m determined not to mess things up this time. Maybe I’ll even get laid, who knows.

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