How do you decide what to do with your life after losing a limb? Although you may think it immediately after surgery, your life doesn’t stop: it bifurcates. You have an existence with all of your limbs, a line in the sand, and then a new, different way of learning to navigate the world.
And eventually – maybe weeks, maybe months, maybe years after your amputation – you wake up one morning saying to yourself, “Well, now what?”
This transition happens at different speeds for different people. I measured it in days. My sister reminds me of the exact moment she knew that I’d be ok. She remembers sitting in my hospital room with me, Cara and my father, the three of them wondering how (if?) I’d recover from my unsuccessful effort to dance with cars.
“You were lying around not saying much,” she said, “and somehow we’d gotten the numbers of several different rehabilitation facilities. Suddenly, you picked up the phone and started calling each one, and it was like a switch had been flipped. You might as well have been back in your office at the law firm speaking to a client. You were interviewing each facility, figuring out where you were going to go next. And I knew then that you were going to be ok.”
Now, having confidence that everything will turn out all right isn’t necessarily the same thing as deciding what The Next Step will be. But for me at least, the two were essentially one and the same. When I made the decision to actively move beyond where I was that day, I told myself that the life I’d carved before the accident would be the same life I’d reclaim afterwards. In other words, my answer to, “Now what?” was, “The same old thing.” So I began my rehabilitation, focusing with an almost unhealthy intensity on getting out of the hospital, out of rehab, and back into my office on the 10th floor of my firm’s office building. (Which, given how much I didn’t love what I was doing professionally, tells you how much I hated being “disabled.”)
But the answer to “Now what?” doesn’t – and shouldn’t – necessarily lead you to the same place you were before losing your limb. More important than how you answer that question is the fact that you choose to answer it at all.
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Making a conscious decision to do something – particularly when evaluating where you are in your life relative to where you want to be – stirs up feelings of vague anxiety in most people, including me. Perhaps I overcomplicate things in the maze of thoughts racing through my brain, but my hypothesis is that we struggle with this so much because making the decision to either do something new or stay “stuck” where we are defines us. We’re not always aware of it, but it does.
When I was a younger, dumber amputee, a friend who ran a church youth group asked me to speak to a group of teens at a retreat. I agonized about what to say to a group of high school seniors who attended church regularly. I wasn’t a normal (or church-going) teenager myself: never drank; never partied; never challenged authority. (This last one always irked my sister, who even though she was the second-born, got zero benefit from me “breaking in” our parents to the realities of how high school kids act.) After hours of thinking and jotting things down on random pieces of paper, I ended up with an extremely rough version of this post, minus a lot of self-awareness.
I argued to the teens that while my physical difference made me look different, it had the ironic effect of teaching me just how similar we all were. I contended that just as I had to make what appeared to be “huge” life decisions in the wake of my accident – “How will I respond to this?” – they made decisions every day that defined them just as strongly.
“Do I drink that beer?”
“Do I go to that party?”
“Do I ingest that drug?”
My point was that figuring out how to respond to my accident wasn’t all that different from deciding to say “yes” or “no” to any of these questions. And the decision – whatever it was – said something about the person making it.
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One obvious difference between the “teenage questions” and the big issue of how to reconstruct your life after losing a limb is that, societally speaking, the former have right and wrong answers while the latter doesn’t. The new amputee who decides to do nothing or who can’t make a decision due to their post-operative state of mind hasn’t transgressed some cultural (or legal) norm. In fact most people would probably conclude that the person who does nothing when asking herself the “Now what?” question immediately after surgery is acting in a totally acceptable, understandable manner.
But as the days bleed into weeks and the weeks into months, every amputee has to grapple with “What next?” I’m lucky – the majority of people I’ve met choose to answer the question in a way that’s somehow affirmative. After working through the mental issues and appropriate feelings of loss and depression, they reclaim their lives. But I suspect I’m also the victim of selection bias. The amputee who never emerges from that place of darkness isn’t out talking to me or, likely, anyone else.
All too often, we focus on the amputee’s access to the best possible prosthetic components as if they’re the most critical element of a patient’s rehabilitation. The tools we use can be critical but aren’t necessarily primary. Indeed, some amputees happily eschew prosthetic devices altogether, while others live productive lives using prostheses that are something less than perfect for their needs. I’m willing to bet these people remember exactly how and when they answered the question, “What’s next?” To give all amputees the best possible chance to do exactly what they want post-amputation, we need to do a better job of helping them answer that question also.