Shark Attack
I got back to the room too soon. Two nurses and a physician crouched at the foot of Erin’s bed, attaching a vacuum system to the bottom of her leg.
She looked at me, “It’s not too pretty down there.”
Past the nurses’ heads, the inside of Erin’s leg lay bare. I looked up, understanding I had just invaded her privacy. Erin asked me to step out when the nurses came in and I waited in a nearby sunroom for what seemed like a long enough time. But when I returned, the wound was still exposed and I had for all practical purposes walked in on her naked.
The reality that Erin would have to have her left foot amputated came about slowly. Other than one blunt doctor at the rehab facility who took one look at her leg and said, “You’ll lose that foot,” every other doctor and nurse approached the subject with studied tact. Her vascular surgeon raised the possibility during an outpatient visit one month after her discharge from MGH. Her PCP thought her foot could rally and sent her for a consult with Plastics. Plastics wanted to know what her PCP thought. The discussion went back and forth for days and then Erin’s PCP called her at home. It appeared that too many nerves and tissues in her foot had died. Waiting for the foot to heal, and it might never heal, would keep Erin on the couch, the sidelines of her life, indefinitely. Rob explained to their daughter that Mommy’s real leg wasn’t working anymore so she was going to get a pretend leg and they set the date.
Three days after her son’s eight-week check up, Erin returned to MGH. The amputation would require a weeklong admission (estimated) and two surgeries (definite). Her foot and ankle were taken during the first surgery. Now the medical team could look inside and see what was going on. They could drain fluids that had built up in Erin’s leg and prepare a clean site for the next and final surgery, which would leave her knee and the ten centimeters below it. I wondered why the cut had to go so far up her leg. Ten centimeters, she explained to me, would reduce the risk that the remaining bone would break or shatter when she started walking on a prosthesis.
I kept my eyes on Erin’s face and made small talk while the nurses finished attaching plastic film and tubes to the bottom of her leg, suspended a bag from the edge of the bed, and re-wrapped her wound in layers of gauze. Rob told me that more than once, he saw nurses come out of Erin’s room crying but to a fault, the nurses at MGH remained reassuring and professional around her. She knew all of their names and key facts about their lives. I could see them warm to her whenever they walked in, and linger by her bed talking about her life and theirs.
Soon after the nurses departed, the vascular surgeon, an athletic Indian man, appeared. Gangrenous gasses, he told her, escaped from her leg during the surgery. “This was definitely the right choice. If we had waited, the gangrene could have moved up your leg and we might not have been able to save your knee.”
By then, Erin knew the difference between amputations and their acronyms. An above-the-knee amputation (AKA) is much worse than a below-the-knee amputation (BKA). It’s one thing to replace a limb, another thing to replace the angles and mobility of a joint. Erin would have to live without her ankle but at least she’d have her knee. However undesirable in their own right, BKAs inspire envy in many people with AKAs.
“Good,” Erin said when we were alone again. “If people question my decision, I can tell them I had no choice.” In fact, at least one person had questioned her. After she posted a blog saying the decision had been made, the surgery scheduled, she got an emotional phone call from an acquaintance begging her to reconsider. “This is a very big decision, Erin. You shouldn’t rush into this.” Though messages of support came pouring into her blog every day, the phone call rattled Erin. She worried that people considered her decision rash, not well-enough thought out. Perhaps she could have allayed her fears if she had the mobility to look for more evidence but by then her world was a tunnel of medical visits, hospital beds, and impossible choices.
***
It had to start with Erin. In the days leading up to the surgery, she and Rob started looking for something simple she could say when people asked what happened to her leg. Together they came up with several possibilities: freak storm, motor cross accident, farm equipment, killer bees, shark attack, and Kilimanjaro. She posted the challenge and a stream of suggestions came pouring in:
Swine flu
Worm hole
Jenny Craig
Gitmo
Taxes
Radioactive spider bite
Hokey-Pokey mishap, forgot to take the left foot out
Someone else needed it
Snow Leopard
Disco fever
"The Very Hungry Caterpillar and Mommy's Leg"
Piranha pedicure
Monster maggots
Tsunami
My foot achieved Nirvana and I got left behind
The invitation to humor could only come from Erin. When it did, friends, teachers, Erin’s head nurse, step mother, and yoga teacher all chimed in, relieved and thankful for the chance to lighten up. The next time I visited Erin she remarked, “Yep, pretty soon I’ll be footless and fancy free.” I spent a day focused on the simple brilliance of Hokey-Pokey mishap, wishing I’d thought of it, and forwarded it to a close friend whom I called almost daily to air my own range of emotions. He called me immediately and laughed for a solid minute. When he could speak, he said, “Oh thank God. I needed to laugh about this.”
And then, as soon as it started, the fun ended. Someone forwarded an email of stump jokes and that was that. Erin could laugh about piranha pedicure and Kilimanjaro but “stump” was off limits. In her next post she wrote,
I officially have a disability now. I know all the PC stuff got super annoying for folks in the 80s and 90s. But just like I don't let people call me a girl (am I 16?) I do not want people to call what is left of my leg a stump. Since I am the person being talked about, I have the right to decide how I will be named. Almost all the literature I read about being an amputee describes what is left over the "residual limb." So I am going to call it just that. Sometimes people take back words, like some in the gay community took back words used to hurt them and now use them proudly. But stumpy, I will not be. I can joke about how this happened to me, and I think I will say shark attack when asked why I don't have two legs, but I will correct everyone who calls my residual limb a stump. I am a woman, not a girl. I have a disability, I am not disabled. I have a residual limb, not a stump. I will certainly call my prosthesis my pretend leg, however, because that makes sense to our little bean.
