The rain tapers off as I leave work to catch the bus, cautiously rolling through the (possibly bottomless) puddles that darken the street corners. The bus is on time and as we ride across town my attention is laser-focused on everything around me. This may be my last trip over here for a while and I want to remember every moment. A billboard for hypnosis next to the burlesque theater. A young woman repeatedly pushing away the umbrella offered by her companion. Clouds drifting fast over the river.
Tom is sitting in the waiting area when I arrive. I go in and Shelley tells me the room’s not ready yet. “Make it two rooms,” I bellow. “It’s my last visit and I need to be able to stretch out!”
“You think you deserve special treatment?” she asks.
“After all these years? Yes, yes I do.”
I sit next to Tom and he shows me the brace. This is not the clear plastic sleeve he had brought last week, but a severe-looking black device. “You can see I cut a hole in the bottom so you won’t put pressure on that spot,” he says. “It really is strange that you keep having trouble there rather than on the side like most people. If you don’t mind me asking, what caused you to lose your toes?”
I tell him about the infection that cost me my big toe, and the subsequent infection that led to the others getting amputated four years later.
“Ah; see, losing the big toe, that’s a hard one. When the muscle no longer has anything to attach to, it can really affect your gait.”
I ask if he thinks a physical therapist could help me learn to walk differently. “There must be walking specialists, no? Doctors of mobility?”
“It might be worth looking into,” he says thoughtfully. “In the meantime, I think the AFO will help. If not, the next step is to try a custom made shoe rather than the off-the-shelf ones. The trouble is they’re ridiculously expensive. Plus they look dreadful. You’d think by now they could make them less ugly.”
I ask how he got interested in working with orthotics in the first place. He said his grandmother wore shoes with braces because she had polio when she was a child. Once, when he was a teenager, he went with her to the shoe store. He found the experience fascinating, and the man who ran it noticed his interest and asked if he would like to apprentice with him. He did, then went to school and got his bachelors degree and eventually took over the shop. “And that was thirty years ago,” he says.
“And you guys do prosthetics as well?”
“That’s mostly what we do. People like you who still have the use of your foot are kind of unusual. Well, less usual.”
He tells me about a mental illness called body integrity identity disorder, which causes people to become desperate to have one of their limbs removed, often their left leg. Apparently they don’t think it belongs to them, has somehow been attached to them mistakenly. In extreme cases, they try to cut the imposter appendage off themselves.
Shelley comes out to apologize about the wait.
“This place is popular,” Tom says.
“Everybody wants some of that sweet hyperbaric nectar,” I say.
“Hey I walk by those chambers every day and it doesn’t do me any good,” says Shelley.
“You need to be loceked inside for the full effect, you know that.” She makes a face and goes back inside.
“It’s weird that you have to be completely encased in them,” says Tom. “You’d think they would have devised something less claustrophobic by now.”
“Actually they make group ones, where you just wear a helmet.” I tell him about the chamber that recently closed at Emmanuel. He gets excited.
“That’s fascinating. I’ve been talking to one of my colleagues about whether it would be possible to develop a portable hyperbaric device that would just act as a vacuum and attach to your ankle, so you wouldn’t have to be inside a tube.”
“Yeah but you need to breathe the oxygen so it can enter your bloodstream and promote capillary repair and growth,” I say, sounding like the hyperbaric training video.
“Ah,” he says. “Maybe it could help with circulation though, or with less serious cases. Have you ever been in one of those things?”
“Couple of years ago,” I say. He seems to hang on every word as I give him the streamlined version of the saga.
Finally Karen emerges. “You coming in?” she asks Tom.
“Nah, call me when the cast is off,” he says.
“Do you want to try your hand at the saw?” I ask him.
“I’d love to,” he says.
“RRRRRRRRR!” roars Dr. Taggert, imitating the saw.
“I thought you were off Mondays?” I ask Karen as I plop down in room two.
“They were short staffed. Whoa, you were rough on this cast. There’s a chunk taken out of it.”
RRRRRRR and the cast comes off. Once again I feel a moment of panic that once again proves to be unfounded. “Lotta callus,” says Caitlin, and Karen puts Lidocaine on it to soften it up for the doctor. Tom enters and asks if he can have me try the shoe on now that the cast is off. “This part is a little tricky,” he says, helping me guide my foot between the bars and under the tongue. I manage to get it on without too much struggle. He pulls the Velcro over the front and wraps a strap around my calf.
“I’m getting kind of an S&M vibe here,” I say.
He takes it off and shows me how the brace slips out of the shoe, and how the orthotic slips out of the brace. “You can wear the shoe with just the insert if you have any problems,” he says. “Then call me and I’ll make any adjustments. Do you have an appointment here next week?” I tell him I don’t think so but that he should ask Taggert.
“Ask Taggert what?” asks Taggert.
“Does he have an appointment next week?”
“Do you think he should have one?” she asks him.
“Only if you think so. Otherwise I’d like to have him come out to the office. I can actually do more to help him out there than with this bag.”
“Well, since he’s all healed up, I don’t know why not. But you need to call us immediately if you have any issues!” she scolds me.
“Definitely,” I say. “I’m not fucking around with this thing.”
“Great, so I’ll see you next week,” Tom says, and exits so Taggert can do one last callus trim.
“I love Tom.” She says as she unwraps one last scalpel.
She cuts very carefully, not wanting to damage the tender new skin. “I’m kind of leaving a lot on. Did you find a podiatrist yet?” I tell her no, that I was hoping she could recommend someone. She gives me the names of two doctors I’ve tried already.
“They don’t look at the whole body,” she complains, as she has so many times before. “And they’re so eager to chop stuff off. I’ve never understood that.”
When she’s done, Caitlin puts a foam pad over the freshly-scraped area and tells me to change it in seven days. Karen lowers the chair and hands me my new accessory. I squirm into it and stand up. Everyone stares at me.
“Do you feel unsteady? Are you going to fall over?” asks the doctor, sounding worried.
“Not at all,” I say. “Do I look like I’m going to fall over?”
“Kind of,” she says.
It’s true that while I feel pretty stable, my left foot seems much higher than my right. I take a wobbly step forward and everyone cheers.
“Will you be able to ride on your scooter with that thing?” asks Taggert.
“Sure. It’s smaller than a damn cast.”
“You know, I wonder if we really have to wrap them so far up,” she says thoughtfully. “Maybe it’s time to rethink that.” They bring me my scooter and I easily mount it. “I want you to keep using this for two weeks,” she says. “Take it slow. Baby steps. And if the wound opens up again, or even looks like it’s about to…”
“I know the drill,” I say.
And then everyone is there, chattering and milling around, everyone except Jenny, who I see through the door of the hyperbaric area. I wave to her and she waves back.
“You can come see us when you visit your endo,” says Taggert.
“Are you kidding? That’s a whole other elevator,” I say, heading for the door.
“Don’t you want to ring the bell?” she asks.
“Of course I want to ring the fucking bell,” I cry. Why the hell not? After all, fourth time’s the charm.
I pick up the silver bell in one hand and the cowbell in the other and ring them as I pound on the desk bell. I try to think of a way that I can ring the bell on might handlebars as well but I can’t manage it without dropping something. I ring and ring and ring until my wrists are sore. Everyone is laughing and talking at the same time. I don’t want this moment to end. I want to live forever in this cacophony of hope and support and love.
But I also want to get the hell out of here and never come back.
Finally I put the bells down and pick up the Oscar statuette and thrust it triumphantly into the air.
“I’d like to thank my mother, and God, and of course all the kind people at wound care. I couldn’t have won this best patient award without your help!” Everyone claps and whistles. I think of slipping the Oscar into my bag, but instead I place it back on the counter and mash the blue button. The door swings open, and for the latest in a seemingly endless series of last times, I roll out of the clinic. I look back and see CK staring at me. I blow her a kiss, and then the door slowly swings shut and latches behind me.
