effect – not cause

effect - not cause 08.05.14

After spending a few weeks on vacation with the family, we returned to the JetBlue terminal at JFK. Caroline and I walked off the plane ahead of Cara and the boys to head straight for baggage claim. As a lengthy preliminary aside, I was anxious to see how quickly our bags came out. I have traveled JetBlue enough to gain preferred  (“Mosaic”) status, and had noticed the gate agent attaching colored stickers to our bags at check-in. When I asked what these were for, she informed me that Mosaic members get preferential luggage treatment. This caused me great – in fact, too much – excitement, because I don’t have preferred status on any other airline. As a result, this limited perk – especially given the fact that I only check bags once a year on our annual family vacation – took on far more significance than it deserved. Sadely, the system worked less well in practice than it did in theory. Caroline and I arrived at baggage claim to find 4 of our 5 bags already out. The 5th – green sticker and all – arrived after almost every other piece of luggage made it off the plane.

Anyway, before we ever found out the fate of our bags, Caroline and I walked together across the terminal. I wore shorts, exposing my prosthesis, as well as a hat bearing the Wounded Warrior Amputee Softball Team’s logo. Caroline held my hand and talked to me as we approached the escalators when a voice on my left interrupted our conversation.

I turned to see a middle-aged man in glasses and a beard with some family members next to him. “Did you serve in the military?” he asked. This is not unusual for me. Given my age, the prosthesis I’m wearing and – on this night – the hat with a large stars and stripes shield that’s part of the WWAST’s logo, it was entirely logical to assume that I’d lost my leg as a member of the military.

I smiled and said, “No, I’ve got the hardware and the haircut, but I’m not a veteran.”

He looked at me awkwardly for a second before saying, “Oh. I was going to thank you for your service.” I waited for the typical transitional sentence that invariably follows my clarification, usually something along the lines of, “Oh, I’m sorry to have bothered you,” or, “Well, either way, you look like you get around pretty well on that.” But this gentleman stared at me another awkward half second and then just peeled off with his family in another direction.

Caroline, who was standing on the opposite side of this conversation, queried, “What was he saying to you?”

“He thought I was in the military.”

“What did you tell him?”

I relayed my response to her.

“And what did he say?”

“He said that he was going to thank me for my service.” I paused and then continued. “I think he was a little upset with my answer.” Another pause. “Apparently, I’m a lower class of amputee than what he was hoping for,” I said with a smile. Caroline looked up at me, trying to figure out how serious I was. Seeing my face, she burst out laughing.

*   *   *

I should be clear: the point of this story isn’t to suggest either that those men and women who gave their bodies to serve their country shouldn’t be thanked for their service, or that civilian amputees deserve thanks from the public in the absence of such service. I’ve been fortunate enough to meet and spend time with many amputees from both Gulf Wars. When with them, I’ve had strangers come up and thank me, assuming (logically) that because I’m with veterans and I’m wearing a prosthesis that I too served. I always back out of those situations, correcting the misimpression and physically stepping away so that the actual veterans get properly recognized.

The concept of an amputee class system isn’t new. I’m generally the beneficiary of it. When people learn that I’m a traumatic amputee who lost his limb acting as a good Samaritan, I tend to get reactions that are as close to those of members of the military, police or fire departments as is possible in the civilian world. But other types of traumatic amputees – motorcyclists are a good example – can get more of an implicit, “you asked for it” reaction than I do. And if you venture into the world of disease, amputees who lose limbs to cancer or meningitis may sometimes be viewed more favorably than their peers who lost them to diabetes, the underlying subtext being that the former strike randomly and without warning while the latter often results from an individual’s behavior and habits.

My encounter with the stranger at JFK brought this to mind because it’s highly unusual for me to engage in a discussion about how I lost my limb without having to deflect away some form – either explicit or implicit – of the (at best), “No good deed goes unpunished,” reaction, or (at worst), “You’re a hero!” But because I blew up this guy’s assumptions about who he thought I was as a person, he just disconnected from the interaction, awkwardly and suddenly. And I acutely felt the absence of how I had expected him to respond.

But the cause of amputation really misses the broader point, it glosses over the power of the story that the amputee community as a whole has to tell. And that’s because the reason an individual has limb loss tells you less about who they are as a person than how they choose to respond to that event.

Who is the “better” amputee: the guy who loses his leg while trying to help someone who then falls into a life of bitterness and blame, lashing out at those around him, or the woman who loses her leg to diabetes, adopts an active, healthy lifestyle and volunteers to educate others with the disease about how to manage it?

We’re typically conditioned to focus on cause, first and foremost. But this is one instance where effect is more important.

growing a life

growing a life 06.17.14

Last Thursday I attended a retirement party for my father, who has spent most of the last 38 years as the Superintendent of three different public school districts. As I sat with my family at a dinner table watching school board members, principals, and teachers recount the impact he’d had on the district generally and them specifically, I thought back to how he treated me as a parent, and his role in helping me get to where I am today.

I don’t remember my father ever giving me a specific piece of career advice while growing up. Rather than point me towards careers or jobs, he instilled in me a single broader principle: our job – whatever it is – is to give back to others. He often talked about “fighting the good fight” and working “for the greater good.”

Shortly after my mother died of cancer, my father and I stopped having a productive relationship for nearly a decade. Fueled in roughly equal parts by the loss of a woman we both adored, complications in our relationship arising out of my accident just over a year later, and our temperamental disinclination to ever talk about how we felt, I largely disengaged from meaningful contact with him. These phrases that I’d heard so often growing up became punch lines, things to resist.

If I chose to attend law school because I didn’t know what I wanted to do with my life, I chose my first job out of a combination of desperation – it paid more than any other opportunities I had at the time – and my desire to stick it to my dad. It was, in retrospect, a pretty juvenile approach to career planning: “You want me to do something useful? You want me to help other people? You want me to give back? I’m going to take a job that pays me more than anything else I can find so that I can protect those poor, helpless insurance companies!” It was hard to argue that representing insurers in intellectual property disputes was either fighting the good fight or working for the greater good. And I didn’t even try. I had a job – nothing more.

My anti-paternalistic career plan – not the most well-thought out strategy to begin with – foundered after I lost my leg. Proving a point to my father no longer seemed so important. While I returned to the big law firm, I knew almost immediately that I wouldn’t be spending the rest of my career there. The work I did there truly had no meaning to me.

My next job at a medical malpractice defense firm represented an incremental improvement. I loved preparing doctors and nurses for depositions.  Despite my efforts to resist it, my father’s philosophy – work for the greater good, for others – gave me a sense of purpose. I enjoyed giving people the tools and skills they would need to navigate an unfamiliar and threatening system.

Realizing this and the associated reality that deposition preparation accounted for less than 5% of my time as a practicing attorney, I jumped at the opportunity to co-found a prosthetic facility. For the first time in my professional life, my job and my worldview clicked into alignment. A significant part of every day consisted of talking with amputees, learning from their experiences, and trying to help them get the tools they needed to achieve their goals. I was fighting the good fight, working for the greater good.

Today I work for a publicly-traded company that manufactures prosthetic components. I spend a significant portion of my time educating prosthetists and their staff about how to run their businesses effectively and build productive, positive relationships with their patients. My father’s original guidance plays a larger role in my life now than it ever has.

Happily, he and I stepped back from the estrangement abyss several years ago, primarily because of his efforts and secondarily because I grew up a little bit. All the stuff he told me that sounded pedantic and unrealistic to me 15-20 years ago now forms the foundation of my personal philosophy.

So I sat at a table with my family, my sister and her boyfriend, and my stepmother and father last Thursday night. I watched the accolades roll in for 16 years of service to Scarsdale. I listened to the people who had worked with him describe how he had made them better, how he had made an entire school district better. I looked at Max and Jackson, neither of whom have ever seen my father in a public setting, their jaws slightly agape at the disconnect between my father, the public figure, and the grandfather they’ve always associated with challenging discussions about school that they only partially understand.

My father closed the event with a lengthy speech. As he returned to the table, Caroline got up and gave him a big hug. I’m pretty certain she didn’t understand a lot of what he said, but she knew it was important, both to him and the audience that  was still on its feet, cheering. As he made his way back to his seat he had to walk past me. I followed Caroline’s lead, hugging him and saying, “Great job,” into his ear.

Michael McGill has spent his entire professional life – more than 40 years – fighting for the highest-quality education for his districts’ students. In an era where “teaching to the test” and “the common core” have become the status quo, he has forcefully and passionately stood up for principles that are decidedly less expedient (and popular) politically, but that, I suspect, will prove out in the long run.

He has fought the good fight. He has worked for the greater good. I’m proud to be my father’s son.

So Dad, fittingly only a few days after Father’s Day, let me wish you luck on the next stage of your life. As you’ve said to so many graduating seniors – including me, Cara, and Erin – over the years, as you walk down a new path for the first time since you were 28, Godspeed.

 

finding flow

Many lives are disrupted by tragic accidents, and even the most fortunate are subjected to stresses of various kinds. Yet such blows do not necessarily diminish happiness. It is how people respond to stress that determines whether they will profit from misfortune or be miserable.

— Mihaly Csikszentmihalyi, Flow

I rarely read something and think, “Hey, I could’ve written that.” But that was my immediate reaction upon reaching page 7 of  Flow. Csikszentmihalyi has spent much of his career exploring this concept, “the process of achieving happiness through control over one’s inner life.” A more mercenary author would have likely named this book 10 Steps to Happiness, creating a “how to” manual that (falsely) promised a roadmap to achieving flow. But Csikszentmihalyi rejects that approach, instead summarizing years of psychological research in a readable, entertaining format to explain the science behind why some people can find flow (and by extension, happiness) while others can’t.

As someone who survived a traumatic accident in my late 20’s, I found Chapter 9 – “Cheating Chaos” – particularly compelling. In it, he describes the reactions of people trying to rebound from life-altering disabilities like paraplegia and blindness. Again and again, the words on the page mapped so perfectly to my own experience that it felt like I was the one being described. For example, a man paralyzed from the waist down in a motorcycle accident describes the experience as “like being born again.”

I had to learn from scratch everything I used to know, but in a different way. I had to learn to dress myself, to use my head better. I had to become part of the environment and use it without trying to control it. … It took commitment, willpower, and patience.

A woman who lost her sight at age 12 states that “it made me mature in ways that I could never have become even with a college degree … for instance, problems no longer affect me with the pathos they used to, and the way that they affect so many of my peers.”

Csiksgentmihalyi asks, “[h]ow does it comes about that the same blow will destroy one person, while another will transform it into inner order?” The answer, he posits, is what psychologists call “coping ability” or “coping style.” He continues:

The ability to take misfortune and make something good come of it is a very rare gift. Those who possess it are called “survivors,” and are said to have “resilience,” or “courage.”

But why certain people can do this and others can’t isn’t widely understood. Csikszentmihalyi hypothesizes that positive transformations from negative events share three characteristics.

First, people in these situations believe that they can control their destiny. Interestingly, however, “they are not self-centered; their energy is typically not bent on dominating their environment as much as on finding a way to function within it harmoniously.”

Second, these individuals tend not to focus obsessively on themselves, but rather, direct their attention on the world around them. “They are not expending all their energy trying to satisfy what they believe to be their needs, or worrying about socially conditioned desires. Instead, their attention is alert, constantly processing information from their surroundings.”

Third, people who positively cope with life-changing events “focus on the entire situation, including oneself, to discover whether alternative goals may not be more appropriate, and thus different solutions possible.”

*   *   *

When I consider my rehabilitation from limb loss and the three characteristics described by Csikszentmihalyi, the parallels are startling.

1: belief that you can control your destiny

As I’ve written about before, when doctors told me post-surgically that I would be able to walk with a cane within 6 months of my amputation, I rejected their estimates out of hand. I didn’t do this because I believed I was better than other above-knee amputees or because I had a built-in sense of superiority. In fact, I had no frame of reference whatsoever for making any estimate about when I’d be able to walk independently.

But I did believe that I could directly influence that timeline by focusing intensely on each element of my rehabilitation in an aggressive, positive way. I set small goals – i.e., I’m going to be home before Christmas – that I could achieve, over and over. This mindset forced me to put questions like, “why me?” in the background – I had a deadline to beat.

2: focus on the world around you

While I was admittedly self-obsessed in many ways after my surgery – How do I look? What will others think about me? – navigating the world first with crutches and then with a prosthesis forced me to look at my immediate environment in a completely different way than I ever had before. On crutches, a wet tile floor meant something completely different than it had when I walked over it with two shoes. (As I found out, violently, upon my first trip outside my house after returning home post-accident.) On a prosthesis, a slight uphill or downhill completely changed my walking dynamics, forcing me to monitor what lay ahead of me with careful consideration.

The world around me necessarily narrowed to those things that could threaten my stability and gait.

3. find new solutions

Before I even left inpatient rehab, I learned that something as simple as making a sandwich while using crutches required a different way of thinking than two-legged sandwich making. I had to think strategically if I didn’t want to drop a jar of peanut butter or if I aspired to pull multiple items out of the refrigerator simultaneously.

And I’ll never forget the afternoon when, unable to drag a large broken tree branch on my back lawn into the woods, I figured out a novel workaround that I never would have (had to) consider with two legs. I placed one end of the broken branch into the “V” formed by diverging branches of another tree and proceeded to step on it with all of my weight until it snapped into two smaller branches that I could more easily carry. The sense of achievement I felt from solving this combined mental/physical problem gave me as much pride as many key “professional” successes I’ve had over the last 17 years.

conclusion

In the end, what makes Flow such a compelling read is its hypothesis that we possess the capacity to actively control how we perceive and respond to events around us. Shortly after losing my leg, I spoke to a group of teenagers on a religious retreat, and I remember saying, “Life is going to kick you in the teeth eventually. You can’t prevent that. It’s how you respond to it that defines who you are.” That’s not a novel or earth shattering concept. But I find it somewhat ironic that it took me roughly 15 years to find an explanation of why I see the world that way.

 

fear (revisited)

Fear 04.22.14

Several weeks ago I authored a post on fear. I used Caroline’s anxiety about competitive cheerleading as an excuse to describe my formative battle with this emotion as a young boy. I wrapped the story up neatly, suggesting that my late-night intervention with my daughter would lead her to a life-changing realization about and positive attitude towards fear – and all before the age of 9. The words, “Aren’t I just the most incredible dad?” implicitly lurked just beneath the surface of the words on the screen.

As this week’s continuation of the story will reveal, I am not.

*   *   *

It’s evaluation month at Caroline’s gym. All the kids on the team (as well as new kids vying for a position on it) audition for placement based on the specific skills that they’ve mastered. What I’ve learned over the last two years is that the word “evaluation” short circuits the neurons responsible for rational thought in my daughter’s brain. If I told her that I’d be evaluating her ability to walk tomorrow, I’m reasonably certain that she’d be lying on the floor, dragging herself around with only her arms – her legs dangling uselessly behind her – inside of 8 hours.

Despite that, following my late night heart-to-heart with Caroline a few weeks ago, my alter ego – SuperDad – naively assumed that he had given her a strategy to successfully overcome her fear. After this, he could turn his attention to bigger problems, like fixing U.S. health care and creating a self-sustaining clean energy source that would reduce the planet’s reliance on fossil fuels.

Then came what will go down in the annals of McGill family history as The Ride.

*   *   *

Caroline’s gym is in Ronkonkoma, which is anywhere from 30-60 minutes from her house depending on traffic. This usually gives SuperDad time to engage in all kinds of entertaining activities with her: listening to music; hearing her interpretations of what shapes the clouds have chosen to take on that particular day; getting regaled with the ongoing saga that is the life of a third-grade student. But on this day, SuperDad seized the initiative, bypassing all these benign activities and replacing them with Project Elimination of Scary Thoughts. (SuperDad, in addition to solving familial and world problems, frequently spends valuable time devising acronyms that strike him as clever initially, then decidedly less so the more he thinks about them.)

PEST strategy number one? Visualization. SuperDad, as part of PEST, had encouraged his somewhat skeptical wife to engage the services of a sports therapist to help their 8 year-old work through this anxiety. (Yes, the words “sports therapist” and “8 year-old” in the same sentence should send alarm bells off in your head.) And the sports therapist had suggested that Caroline visualize herself performing the moves that she had “lost” since evaluations started as one way to help deal with her anxiety.

Since SuperDad had previously suggested this to Caroline himself before retaining the sports therapist, he wholeheartedly agreed with this component of PEST. And as Caroline started to express mild anxiety about going to cheer shortly after leaving their house, SuperDad encouraged her to try visualization.

That’s when the fun really started.

“Visualization is stupid. It doesn’t work,” said Caroline. SuperDad smiled benevolently from the front seat.

“Little child,” he thought to himself, “thinking so small. Allow SuperDad to open your eyes to the wonders of reality.”

He glanced at his daughter in the rearview mirror. “Caroline, how can you say it doesn’t work if you’ve only done it a few times last night? It’s one of those things that you have to do over and over again before you know if it’s working or not.

“I don’t waaaannnnnaaaaa,” his daughter responded, the whine factor rising exponentially. “It doesn’t woooorrrrrrrkkkkkk. It’s stuuuuuupid.”

SuperDad didn’t miss a step. He re-presented his infallible logic, undercutting Caroline’s nonsensical reaction definitively and comprehensively. She responded with tears and the words, “I don’t wanna go I don’t wanna go I don’t wanna go.” The volume and speed of this mantra increased. SuperDad’s attempts to interject got cut off, dismissed, and drowned out.

In less than 10 minutes, SuperDad had abandoned PEST for an alternative strategy: “Shut UP! I don’t want to hear it.” He shouted at his windshield as he cranked the music up to jet engine levels in an effort to eliminate the sound of the screaming girl somewhere behind him.

By the time he exited the highway only 10 minutes from the gym, SuperDad was in bad shape. His hands on the steering wheel were shaking and white. He could feel the skin across his face, taut and rigid as his teeth ground together. His daughter’s histrionics overrode the nuclear explosion of sound through the car’s speakers, as if she’d tapped directly into his inner ear to broadcast her wails of anguish.

The moment required action. And the action SuperDad took was what he had previously warned his wife never to do under any circumstance when confronted with exactly this scenario. He turned on the left blinker. He pulled into an empty parking lot. He then turned on the right blinker, and pulled back onto the road headed in the opposite direction from which he had come. “There. Are you happy?” he shouted. “We’re going home. I’m not taking you to the gym like this. It’s a waste of everyone’s time.”

The sounds from the back of the car stopped. He turned off the music as he pulled back onto the LIE, retracing the path he had just carved out for the last 45 minutes. “I’m sorry,” said Caroline from the back seat, probably more shocked at SuperDad’s retreat than he was. “Whatever,” he snarled back. Just 30 minutes later, they were home.

*   *   *

I learned last week how much stronger fear is than SuperDad. If I were to create a word problem approximating this disparity, it would read something like this:

Fear is 3 trillion rabid jaguars with blood-flecked muzzles racing towards a tree in the desert. The antidote to fear is SuperDad, a single, one-legged human, tied to the tree they’re running towards, unable to move his arms or legs. What are the odds that the antidote to fear will defeat fear in this situation?

But while SuperDad can’t beat fear, perhaps his daughter can. On Sunday, Caroline came to me with her proposed solution. It involved her still going to cheer but eliminating the stressor that paralyzes her a full day before she even leaves the house for the gym. I spoke with her coaches last night, who agreed that Caroline’s approach made sense. We don’t know what this will mean in terms of Caroline’s placement on one or more teams next season, but we do know that her solution is better than the status quo.

I’m not SuperDad. I’m thinking, though, that my daughter could be SuperGirl. Or perhaps Dark Phoenix. Time will tell.

Monotasking

04.29.14 Monotasking

Before this week’s post, I just want to send congratulations and best wishes to my Amp’d co-host and fellow blogger Peggy Chenoweth (aka The Amputee Mommy) who, true to her blogging handle, has become a new mom for the second time. Peggy and I will continue to record Amp’d, though the early arrival of Timothy may delay future podcasts a bit. But never fear – having a second child should provide ample fodder for fascinating future discussions and Amputee Mommy blog posts (which, after all, was (I’m sure) the reason Peggy and Scott decided to have another kid in the first place.) Congratulations, Peggy and Scott!

*   *   *

My kids think that they can multitask. So do many of my friends and professional peers. Unfortunately (for them), they’re all wrong. The National Highway Traffic Safety Administration reports that driving while texting is 6 times more dangerous than driving drunk. Apparently, I could more safely hop on the PCH in a borrowed Porsche with a bottle of Grey Goose intravenously dripping into my femoral artery than if I tried to text Cara, “This car is wicked fast,” while shooting up the California coast.

I love my iPhone, use both an iPad and a Kindle Fire, have an Apple laptop for personal use and a work-issued PC: I’m a “tech guy.” But I don’t have any illusions about my ability to multitask.

I was in the midst of a lengthy phone call yesterday with a peer from work. Jackson entered the room and signaled that he wanted to ask me something. I held up one finger to stop him. His eyes grew wider, his eyebrows lifted up, and he gestured excitedly with his hands. He knows not to interrupt my work phone calls unless it’s important, so his insistence led me to conclude that something momentous had occurred. Had he accidentally discovered a portal to a new dimension while playing Titanfall? Had Max suddenly (and silently) been eaten by a pack of rabid raccoons while lying in his bed?

I turned my attention to him, breathless with anticipation. Jackson proceeded to mime the act of buying a gyro and eating it. From this, I learned two important things: (1) my definition of important (wormholes into other dimensions; death of a child) and Jackson’s (“I’m hungry”) are not the same; and (2) I heard nothing my friend on the other end of the line was saying as soon as I started watching Jackson’s silent one-man show.

Research suggests that my experience is the rule, not the exception. Most disturbing, it suggests that people who believe they multitask the best are actually the worst at it. While I have a demonstrated (and near-pathological) need to be right and admit no weakness, I’ve never seriously contended that I could do more than one thing at a time. While I can’t definitively demonstrate that where this singular area of honesty about my limitations came from, I have a hypothesis: I believe it’s because I walk with a prosthesis.

*   *   *

When I owned a prosthetic facility, I constantly saw myself walking. We had mirrors everywhere so that patients could get immediate feedback about what they looked like. In this small world of reflections, the act of evaluating my gait to the exclusion of everything else became easy. If I saw something amiss – vaulting up on my sound foot, dropping my shoulder down and back at heel strike – I could immediately self-correct.

This kind of physical self-monitoring soon extended beyond the walls of my office. When walking down the street I’d pay close attention to the angle of my knee at heel strike – was it slightly bent or fully extended? – or the length of my stride on my prosthesis compared to my sound leg. Was I rigidly holding my shoulders in place or relaxing them? What was precisely the right moment to let my prosthetic heel hit the ground?

The act of walking, something I had taken for granted the first 27 years of my life, now required attention. My focus on the tiniest details of gait biomechanics left no room for other activities. I became a serial monotasker, at least when putting one front in front of the other.

When I moved to my current job and found myself in a largely mirrorless world, I found (and still find) myself slipping into multitask mode. Usually, my walking suffers at the expense of the other activity. In perhaps the best illustration of my stunning inability to do two things simultaneously, I face planted on Capitol Hill a few weeks ago while walking and trying to enter information to download a new app for my phone. Nothing reminds you that you can’t multitask like visiting congressional staffers with ripped pants and blood pouring out of your hand.

While I find myself slipping into multitasking mode occasionally, for the most part I resist its pull. I’ve made all kinds of decisions to remind myself that “the other thing” I could be doing should wait. I have no audible alerts on my computer or phone to notify me when a new email gets pushed to my Inbox. I’ve disabled all pop-up notifications on every device I own. On my phone, I’ve eliminated push capability entirely so that I don’t see the red number of unopened emails climb the longer I fail to visit Outlook. In meetings, I usually put my phone in airplane mode and close my laptop. And most recently, I’ve started to limit my email consumption to only two daily visits: once in the late morning and once in the late afternoon.

I’ll admit that these monotasking safeguards sometimes cause me to panic. What if Medicare publishes a new policy that adversely impacts my company? What if someone sends me an emergency email and I need to get working on it right away? I’ve learned that these “what ifs” are largely hypothetical scenarios. Out of the millions of pieces of information competing for my attention every year, fewer than 5 (maximum) ever fall into these buckets. My professional life doesn’t go sideways when I climb on a coast-to-coast flight without wifi access, despite the fact that I’m not responding to anyone (or anything) during that 6-hour period. You don’t get fired for being unreachable while in an all-day offsite business meeting. What we think will happen if we don’t multitask doesn’t happen.

Mindful of this reality, and remembering that I only walk well when I focus on the act of walking, I will continue to monotask while the world around me checks its email for the 99th time before noon. I’ll take my chances.

 

 

fear

Fear 04.22.14

There’s a one-legged man who authors a weekly blog. He has three kids: two boys and a girl. The daughter’s almost 9. She’s tough. Tougher than her brothers. She gets hit or knocked down in public and she doesn’t cry. Never. Has always been that way.

She’s the only one of the children who’s passionate about sports. She spends 4-5 days a week in a huge gym training for an elite competitive cheer team. Her time there consists of alternately getting thrown in the air and caught by others, throwing others in the air and catching them, or racing across the gym floor uncorking different combinations of flips and tumbles of increasing complexity the longer she’s there. She loves it.

But at the same time, she’s terrified.

After learning a new move and seemingly mastering it, she inexplicably (in her own words) “loses it.” The tuck that she had yesterday? Gone. The multiple back handsprings she threw casually last week? No mas.

This paralyzes the girl, envelops her in all-encompassing anxiety. It begins the night before practice with an innocuous question: “Who’s driving me tomorrow?” It escalates the next morning when she tries to pin down the exact time of departure for the gym. By the time she gets out of school, she’s in full-out battle mode, shouting, negotiating, pleading that she should be permitted to skip the mandated practice.

Watching the pattern not only repeat but intensify, the one-legged father sat down with his daughter on a Sunday night as the terror swept over her. He lay across her bed while she sat, hugging her knees with the sheets pulled over her, and admitted to him for the first time (ever) that she was scared.

“I don’t have it anymore. If I go to practice and I don’t have it the coaches will yell at me [not true] and I’ll feel bad [embarrassed].” As the conversation continued, she opened up a little more. “When I can’t do it I get disappointed with myself. I feel like there’s a spiky ball pressing on my brain because I’m disappointed.”

The one-legged father tried to listen without interrupting, a near-impossibility given his belief that he has All Answers to All Things. He remembered the time as an 8 year-old two-legged boy that he threw a rock at a neighbor who was taunting him. The rock missed the boy but hit the blue car behind him: Mr. Frank’s car. The neighbor immediately shouted, “I’m going to tell on you,” and raced to Mr. Frank’s front door to tell the old German. The two-legged boy ran into his house, up the stairs, and into the safety of his bedroom. He peeked out his window and saw the neighbor speaking to Mr. Frank and Mr. Frank walking over to his car to assess the effect of the battery committed against it. He imagined the awful consequences of his actions.

The boy’s mother quickly divined that something was amiss at dinner that night. The boy’s already failing facade crumbled completely, the words spilling out as he revealed The Tale of the Rock. His mother had him recount the story to his father when he returned home from work, leading to a prep session at the kitchen table for what was about to transpire next.

“I’m Mr. Frank,” his father said. “What are you going to tell me when you come over?”

Confused at first, then anxious as he realized what was about to happen, the boy stumbled through a brief statement with help from his father. He cobbled together a script of admission and penance while simultaneously (and unsuccessfully) trying to negotiate his way out of the face-to-face meeting.

And so it came to pass that at 7:30 in a summer evening, with dusk starting to fade into night, the boy found himself staring woodenly at Mr. Frank’s cheap metal screen door, his father’s hand on his shoulder both for support and to prevent his imminent flight. Mr. Frank, who looked 14 feet tall with yellow teeth and a wifebeater threatening to give way under the pressure of his gut, appeared before him.

“My son has something he’d like to say to you,” said the father. And the boy, looking squarely at the place that Mr. Frank’s belt presumably rested underneath all that flesh, unleashed a torrent of barely audible words. “Mr. Frank I’mverysorry I threw a rock and accidentallyhityourcar and if there’s any damage I’llpayforitmyself.”

Mr. Frank paused for a moment and the boy felt his entire life hanging in the balance. He was only 8, but he could feel the vast hole that would swallow his existence up yawing in front of him. Mr. Frank opened his mouth. And miraculously, the hole closed. Mr. Frank related that he had waddled out to his blue Oldsmobile Cutlass to check it for damage and had been unable to see anything – not a single scratch.

It didn’t compute. The boy couldn’t figure it out as he walked home, barely registering his father saying that he was proud of him for facing up to his responsibilities. How could all of the fear, all of the anxiety just … disappear?

The one-legged father shared The Tale of the Rock with his daughter. He said, “It’s ok to be scared. But you can’t let the fear prevent you from Doing What You Have to Do.” She would have to go to practice on Monday, but facing up to what terrified her, staring at it without running away was the only objective.

Like that night in the kitchen 37 years ago, he had his daughter rehearse speaking to her coach before practice about what was going on inside her head. She presented different response scenarios. They rehearsed those also. By the time they finished, it was 10 o’clock and she was yawning.

“What are the 2 things you’re going to do tomorrow that will make your day a success?” he asked her. She responded wearily from her pillow, “Going to practice without freaking out before.”

“Right,” he interjected, as she continued on: “And then I get an iPhone,” she finished with a grin. The one-legged father shot her a look and she sighed. “And talking to my coaches to tell them what I’m feeling.” He smiled. “And then I get an iPhone?” she queried.

The one-legged father picked up his crutches and hopped to his foot. “Goodnight, Caroline,” he said. And he lay in bed till midnight, thinking about Mr. Frank as a kid, losing his leg as an adult, and overcoming fear, one tiny step at a time.

the “after” life

the "after" life 03.11.14

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.

*   *   *

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.

 *   *   *

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.