by Scott Martin
43
The Measure of a Man Rebuilt
Time, as it would turn out, was in shorter supply than I had imagined. Or at least Dr. Brandacher seemed to think so. With my being a bilateral amputee, the team at the University of Pittsburgh Medical Center (UPMC) –Dr. Brandacher in particular – seemed quite eager to have me in their program. By the following week, Ellen and I had already booked flights for our second trip to Pittsburgh and my final round of tests. Far more extensive (and invasive – ugh!) than round one, these tests would last three days and, according to the detailed itinerary SaraBeth sent me, acquaint us with nearly every department of the university’s medical center.
When we exited the Pittsburgh International Airport for the second time, it was to a blue sky so clear it seemed to glow, causing us to blink and wince as our eyes adjusted from the dimmed fluorescents of the arrivals terminal. The allure of uninhibited sunlight proved deceptive, though, and Ellen quickly found her way beneath my left arm as we picked up our pace to the rental car parking lot on the lower level of the garage across the street. It may have been a solid twenty degrees warmer than our last visit, but that wasn’t saying much.
We hustled through the slow but steady stream of cars at the beckoning of a yellow-vested official with enough facial hair to obscure any recognizable features. I found myself fervently wishing we had gone back upstairs after collecting our bags to use the moving walkway with its insulating glass walls. The air held a distinctive bite to it which I was bitterly coming to associate with Pittsburgh. I could only hope summer would prove more agreeable seeing as Ellen and I had chosen June 1st as our ‘green light date’ when I could be officially placed on the transplant list.
Knowing my luck, it probably rains here in June, I mused sourly as we strode through the entrance to the parking garage, following signs for ‘CAR RENTALS’ to the shadowy, back corner of the ground floor.
Summer seemed the logical time for the real fun to begin; not just because it would mean warmer weather in Pittsburgh (hopefully), but also because the kids would be out of school and it would give us a couple more months to solidify the arrangements for my rehabilitation.
‘This is it!’ Ellen practically whooped with relief, making a dash for the passenger’s side door of the red Nissan Sentra we had just rented. I smiled at her while I hung back, waiting for her to pop the car’s trunk so I could load our bags.
Over the past couple weeks I’d begun emailing our family and friends who lived the closest to the Pittsburgh area, trying to gauge their interest in staying with me during the three months after surgery. While the response had been nothing but positive, I couldn’t shake the haunting images of me as dependent and helpless as when I’d come out of the coma, requiring their nearly constant care. I knew it wouldn’t be the case – a twelve hour surgery couldn’t possibly wreak the havoc of a month-long coma – but the thought of being a burden to those whom I loved; to the very people who had been forced to sit by my side while I slowly withered away at the hands of the flesh-eating disease and then stayed there through my four months of rehab, was too painful to be ignored. They had already suffered so much because of my illness, could I really force them to confront its harsh realities all over again?
I grimaced and slammed the trunk. It was the same dour circle I’d been talking myself in for the past month, and so far I’d gotten nowhere. Pushing the thoughts aside for the time being, I climbed into the driver’s seat beside Ellen. She had already started the engine and stale, lukewarm air was wafting from the vents. Looking at me with each hand held aloft before a vent, she smiled.
‘Shall we?’
I nodded and turned to my left to visually locate the seatbelt so I could strap myself in. ‘We shall.’
~~~
I was vaguely aware of the doctor across the table still speaking to me, educating me on what to expect after the transplants. She was saying something about shock and fear being perfectly normal but I was having a hard time focusing on her words long enough to comprehend them all.
What happened to it? I thought, rifling through my mind like digging through a junk drawer. It has to be here somewhere.
‘You may feel upbeat, or you could drift into a state of depression,’ I heard Dr. DiMartini saying, her voice seeming to echo back to me from somewhere far ahead. She was an Associate Professor of Psychiatry and Surgery at UPMC who had worked with transplant teams for almost twenty years now. She and I had been working together for nearly an hour; sitting across a small, wooden table from each other; long enough for her to ruffle strands of her fine, mousy brown hair out of the loose pony-tail she wore so that a few strands poufed up over her head and another trailed from just above her ear to down the front of her neck where it caught in a button below the white collar of her shirt.
What had begun as a supervised questionnaire-taking session during which I answered general questions about my anger management issues (some), my anxiety level (some), if I feel guilty when I drink (no), and if I like to stay active (yes – with five kids how could I not?) among other mundane things, later turned into a structured interview during which she asked various questions to gauge my ability to cope with having the transplanted limbs of a dead man attached to my arms. I had answered truthfully and simply, knowing this to be a routine procedure and thus unfazed by her wanting to know if I cut myself intentionally, used narcotics, or felt overwhelmed by my home life. It wasn’t until the end that my answers suddenly caught up with me and I realized what was missing.
‘It’s important that the donor’s arms become incorporated into your own sense of self, Scott,’ she told me, peering steadily across the empty, square table at me. Round, wire-rimmed spectacles were perched on her button nose, somehow giving her the appearance of a kindly, cartoon mouse (likely the result of too much time spent watching TV with my kids in the early years).
I nodded along, hoping she couldn’t see the distant look in my eyes or the confusion in my expression. Is it really gone? I wondered, trying to remember the last time I had felt the drag of The Fog on my conscious. It had been my constant companion for so long, always lurking somewhere in the background of my awareness, that I had grown accustomed to its debilitating presence as if it were simply another scar to bear. Could it really have just disappeared? After all these years?
‘To accept the new hands as your own will require a great deal of psychological resilience,’ Dr. DiMartini said, holding the folder of her notes in front of her chest with both hands. ‘I want you to be aware of this and take some time to prepare emotionally for what having transplanted hands may mean to your psyche and sense of self.’
I swallowed and tried to nod again. The part of my brain still paying attention to the good doctor wanted to point out it couldn’t be much worse than what waking up to no hands did to my psyche, but my mouth was too dry to form words.
‘That said,’ she went on, drawing a breath as she shifted the folder to one hand, laying the other palm-down on the table, ‘after your previous experience with necrotizing fasciitis, I see no reason not to encourage you to pursue this program.’
I cleared my throat with the rasping sound of dry twigs cracking and managed to croak, ‘So I pass?’
Dr. DiMartini smiled knowingly at me, her lips curving into a grin in such a way that her small nose became even more button-like – a rather endearing expression, I found. ‘You pass,’ she said and used her empty hand to help push herself to her feet. ‘Now, do you know where you’re supposed to be next?’
In the past day I had been through radiology, neurology, the magnetic resonance research department for a functional MRI, and now was somewhere in between the three. I tried to bring up my mental itinerary, thinking back on what SaraBeth had said about each stop along the way. Ah, yes, I thought and focused my vision on Dr. DiMartini.
‘Actually, I believe it’s my lunch hour.’
‘Oh, well in that case, I’ll accompany you to the waiting room,’ she declared with a close-
lipped smile.
‘That’d be great.’ I followed her to the door of the small, sparsely furnished room. It had been a bit of a maze getting back here and in my current distracted state, I was more than likely to get lost if left to find my own way out.
We strolled along the polished-wood hallway, drifting past the doors lining its walls in such neatly spaced intervals it almost felt as if you were a hamster in a wheel, moving forward but going nowhere. As she guided me along the corridor back to the waiting room, I shook my head softly in disbelief.
I had been anticipating an epic battle; a monumental showdown of me versus The Fog when I would finally banish it from my conscious. For so long it had been a virulent force over my emotional wellbeing that it had taken on a menacing life of its own in my perception, like the Devil on your shoulder or self-deprecating voice in your mind. At its strongest, it was as real to me as anything else in my life, its roots stretching so deep I daren’t follow them to their end. Surely something so potent and pernicious would require an active force of will to drive it out.
But no such clash had occurred. And yet, The Fog had slid away, dissipating, unnoticed, as fog is apt to do. I couldn’t remember the last time I had felt it holding me back from experiencing life. Had it been there when the Romanian courts continued to mercilessly hold our children just out of reach, prolonging the torturous waiting period for over a year and a half? When I waded into the Black Sea with my wife and children, boldly standing in public arm-free for the first time? Or when I had watched my children play a ballgame in the local park and realized I could never be the “normal” father they deserved because I was exiled to the sidelines by my illness?
Thinking back, I found each of those experiences residing in my memory with vibrant clarity. I could still feel the pangs of grief and longing that hulked around me during those seventeen months of the adoption process. The contrast of the icy waters of the Black Sea lapping at my legs and Nadia and Danny’s tubby warmth clinging to my upper body was as striking as it had been eight years ago. And the remorse I felt for my handicap making me unable to be the father and husband my family deserved; that was as raw and unforgiving as ever.
No, The Fog was absent then, and The Fog was absent now. But what it had left in its place was scarcely any better: Guilt, pungent and devastating, twisted its gnarled fingers in the stagnant waters of my decimated self-image, fueled by the knowledge that the ones hurt most by my illness were those who were closest to me. I couldn’t be the father, husband, brother, or friend they deserved because I was an incomplete man. But there was a way to change that, now – at least to a degree. I didn’t have to be handless forever. This program would bring me one step closer to being the man my family deserved me to be. The Fog was gone and my self-deprecating guilt needed to go with it.
~~~
Ellen and I were walking into the final meeting of the final day of my final trip to Pittsburgh before the trip. My steps faltered for a second as I realized that those premises led to the conclusion that this was the last step before my business in Pittsburgh was finalized. After today, I had until the Green Light Date to get the rest of my affairs in order. Ugh, don’t make it sound like you’re dying, I chided myself as I followed Ellen through the open doorway of the conference room.
‘Scott, Ellen,’ Dr. Brandacher greeted us with a smile, straightening from where he’d been leaning over a sheet of paper on the elongated table. ‘Thanks for meeting me here again. I’m sure you’re eager to be heading home by now.’
‘More or less,’ I replied evasively. It was definitely more – very much more. Three days of tests had felt like a month of drudgery. Even if it couldn’t compare to rehab after the coma, colonoscopies and two-hour MRI sessions never failed to be abhorrent.
‘Yes, well, thankfully the preparations are over. Er, that is, they will be as soon as we get your measurements,’ he said with a one-shoulder shrug and flash of a smile. ‘Please, you can take a seat.’ He gestured towards the black leather chairs in front of us. Ellen and I each slid into their encompassing embraces while Dr. Brandacher unrolled a long, flexible measuring tape of the type always draped around tailors’ necks in movies.
‘And, Scott, if you would remove the prosthetics, please.’ He flipped a manila folder open as he spoke, glancing through the pages stapled within it until he found the one he was looking for. I scooted my chair back so I could trap each wrist against my thigh with the opposite arm and slide my forearms out of the myos one at a time, depositing the heavy prosthetics on the table between Ellen and me.
This could be one of the last times I’ll be doing this, I realized, the thought striking with such potency I nearly doubled over. My days with the myos are numbered.
I gazed at the prosthetic arms, the left one frozen with the first two fingers still pinched against the thumb. Two months from now it would be ‘any day now’: ‘any day now could be my last day with prosthetic arms.’ I wanted to laugh with giddy exuberance; to dance and sing and hug everyone I saw at the thought of my ensuing freedom. But I couldn’t breathe. The air seemed to have clogged in my chest somewhere between my lungs and my throat and I couldn’t for the life of me get it flowing again. My days were numbered.
‘Okay, now if you will just set your elbows and forearms on the table,’ Dr. Brandacher said. I focused on shallow breaths as I did as I was asked, resting each arm on the cool wooden surface of the conference table. I had a fleeting inclination to follow suit with my head – there was too much heat suddenly accumulating in my forehead – but resisted the urge.
Dr. Brandacher shifted the chair to my left out of his way so he could lay the tape measure alongside my arm. When he had murmured a number to himself which I couldn’t hear over the thrumming in my skull, he asked me to lift my arm towards him so he could measure the circumference of the amputation.
‘The original surgeon was quite good,’ he commented, eyeing the end of my left arm which had been neatly stitched together by the expert hands of Dr. Mixter. I nodded, coughing on a sound that was meant to be affirmative and fixed my eyes on Dr. Brandacher’s work. This could be one of the last days I see these as the ends of my arms. Soon, Dr. Mixter and Dr. Henrickson’s meticulous care of my limbs would be obscured by the minute stitches of another.
What would Dr. Hendrickson think if he could see me now? I wondered. I hadn’t spoken with my old doctor since the medical trial and my spontaneous trek westward. What a different man I had been then, with my ambitions and sense of self still tied up in soccer. I had fancied myself to still be an athlete and losing soccer equivalent to losing my self. How narrow-minded such thoughts seemed now that my life had evolved into so much more. I still looked upon soccer like a long-lost friend, but it was one I knew I’d never become reacquainted with. Yet there was no longer any remorse at knowing such a thing. It was behind me; it was ‘then’.
Back then, when I left everything behind in Wisconsin, I had imagined soccer as the vehicle which would allow me to build myself back up after breaking myself down. It was always soccer, in my mind. Soccer would save me. Soccer was me. I was soccer. There couldn’t be a me without soccer. In the end, although moving West had served its desired purpose, decimating the remaining pieces of Old Scott’s identity to make way for New Scott, soccer hadn’t played the leading role in my rebuilding. My children had. They were the protagonists in this story. It was each of them who had slowly and tenderly shaped me into the man I became – the man I was still becoming. What was soccer compared to them?
‘All done, Scott,’ Dr. Brandacher said, crumpling his measuring tape in his left hand as he jotted notes on top of the already-compiled notes from my prior tests. ‘Thank you. You can put your prosthetics back on.’
I glanced to my right as Ellen drew the pull sock and stick from her purse for me to don the myoelectric hands. Pinching them between the ends of my amputated arms with a smile of thanks for my wife, I went through the motions of sliding my forearms into the open sockets of the pr
osthetics with robotic detachment. This is one of the last times I’ll be doing this. ‘Putting my hands on’ will cease to have meaning in my life after this summer.
‘So, that’s it,’ Dr. Brandacher said as he closed the folder and replaced his pen in his coat pocket.
I looked at him, meeting his green eyes through the lenses of both of our glasses.
‘That’s it,’ I repeated.
‘You’re all done.’
I pushed my chair back and got to my feet, standing between leather office chair and table as Ellen did the same. I looked from my doctor to my wife and grinned.
‘Ho-ly cow.’
~~~
It was down to the grey, fourth generation UW-Oshkosh sweatshirt (I had worn through three prior versions of the same sweatshirt already and by the looks of the fraying collar and cuffs, this one was on its last threads) or the navy blue, Seattle Sounders one. Nadia was patiently waiting for me. I could see her pony-tailed head popping in and out of view from the master bedroom window as she bounced on the trampoline in the backyard. Good, I thought, reaching for the Seattle Sounders sweatshirt. Let her warm-up for the soccer match.
Her morning recreational soccer matches usually meant sitting on the sidelines beneath a cloud-laden sky, but I didn’t care because this was sweatshirt weather – my favorite.
‘Tata?’ I turned, the left myo still clutching the Sounders sweatshirt as it hung on the hanger and catching me as off-guard as Andy’s voice came from just outside the closet. I released the sweatshirt and turned to face my son inquiringly.
‘Why will you need to take medication every day?’ he asked, a dimpled furrow creasing his brow. He no longer had to peer up at me; it never ceased to startle me when I found his eyes nearly in line with my own. He’d grown so tall since he first came home seven years earlier.
‘Well,’ I breathed and leaned against the doorframe of the closet. I could feel Ellen watching us through the mirror of the vanity, brushing her teeth a tad quieter than before. ‘Because if I don’t take the medicine my body could reject the new hands.’