Chapter Five: The First

Continued from Chapter Four: No Accidents

Dear Charlene:

You wanted to know:  What has my life been like?

For a long time I didn’t tell my story, my sense of grief and loss so profound that to put them in words and sentences would be to lessen them. So, now as I try to tell my story, I can’t decide whether to start with the best or the worst. Maybe the first.

The first year was the hardest because I lived beyond my own death, the death of the person who I’d been, who I had fought to become, and whom I really loved. (You would have to know my childhood to see why I had to fight to love myself.)Yet, I had no self to replace me with except this huge gaping, wounded darkness. My life had been a light; what was left was a shadow.

The first year was so bad because each calendar day I would look back at where I was a year before and weep for the loss. However, as soon as I passed the first anniversary I could say with relief: I am now much better than I was last year on this day. The first year all I felt was loss, even losses from before the accident which I had never felt as deeply conscious about. My losses are still hard to sort out coming out of my forties.

Many were subterranean; they felt mainly potential, barely articulated. That I would never cross my legs again, straddle a bike or a tree again, I’d never have a lap, I’d never sit with comfort, never run, never do a ballet fouete again or jette, never lose my virginity properly, all those things remained potential losses. For those first three months all I could think about was how I would never be “me” again.

For nine years after the first, I would honor the anniversary of my accident as not a second birthday, but a day of salvation and redemption. I’d lost life; indeed, I heard I was dead on arrival at Cooley Dickinson­ – and had a second chance. Once over the shock, it took about three years to feel like a whole person again, to integrate my old self into the new. I knew what life was worth, and I was always mindful of Mark.

He was his mother’s pride and joy, her eldest boy, her handsome high school hero.  Left with a daughter Wendy, whom Mark adored, and three other sons, Clyde, Dennis and Glen, his mother Dottie divorced her alcoholic husband and I think felt she was forging a new life.  

After Mark’s death I visited Dottie Robinson on May 24, from 1973. She took me to the gravesite in Danvers, Massachusetts, near the Liberty Tree mall.  A small tree by the grave was decorated with presents that his friends brought to him, and other ornaments were planted or hidden nearby, which inspired me to return many years later to place a kachina, an Indian spirit doll to honor his Native American heritage.  One year Dottie pulled out a box of items collected from his dorm room.  We each pulled forth items from it and remembered things in his life.  It included a motorcycle helmet and many pieces of leather which he used to make mocassins and belts.

After 1980, when Dottie moved to Florida with her new husband, who was a childhood flame rekindled, I marked the day by writing a bit of my memories. After I’d moved to Colorado, I asked myself what friends had always asked me, “Why not write about what happened,” and in 1982 I honored the day by beginning my research.

I descended to the bowels of MGH’s medical records library and went through my 11 and 12-year old records and copied all the notes from the first month. With my mother’s memory and these notes I was able to reconstruct the first three weeks, the amount of time it took before it was sure I would live.

So, now I will tell you the first, although it’s really not the hands-down worst.

They battled three days for my life at Cooley Dickinson Hospital in North Hampton. For three days my body lay hanging in a pelvic sling, with newly donated blood pouring in and then out of me. When they could not contain the spread of gangrene from my leg to my hip, Dr. Hinckley, who was in charge of my care, knew a surgeon who had great talent in amputating to contain cancer cells that had spread to women’s hips and pelvises.

His name was Dr. Hedberg, and was a god to me because when Cooley-Dickinson doctors could do no more for me, my mother told me, “There is a doctor at Mass General who can help us. Dr. Hedberg.” After I knew about Mark’s death, it became real to me that I also could die. I then repeated the doctor’s name; he became a mantra in my desperate state of survival. “Doctor Hedberg” were the last words on my mother’s lips as they loaded me into the ambulance for the risky transfer.

I don’t know all the names for the physical states of shock and breakdown I was in, but I do know the 90-minute trip only took an hour speeding down the Mass Pike, while I was in a state of siege. 

In the ambulance my lungs, kidneys and liver collapsed, and by the time I reached the emergency room, I heard voices talking urgently, “You better get that thing in her right now or she’s going to go on us.” Although I felt like I soared off the stretcher, I’m sure I couldn’t have moved more than a twitch. But I declared, “I am not going to die! Where’s Dr. Hedberg?!” My hope in Hedberg was one of two elements of my survival.

Many times I heard what was said between doctors and nurses over my body. Rarely was I able also to see them, but the one image I remember was like a person would peer at me through a fish eye lens. The ambulance arrived at the emergency room with sirens blaring, and into my distorted field of perception peered these doctor/nurse faces of incompetence. “You’re all a bunch of spics! Where’s Dr. Hedberg?” I screamed. I felt like I must meet him right then or I couldn’t hold on. And I called out for my mother. She was the other element.

I am lucky to have our taped interview from 1981, with her colorful descriptions and dialogues. Still, she was not good with the details and dates, so I went to my MGH notes for those. In the tape, my mother free-associates unless I jump in and ask her questions. First, I ask her about when I arrived at MGH in the ambulance.

“You had a very high temperature, you were in shock, and they weren’t taking you at the emergency ward right away. They had me wait in emergency. Then Doctor Hedberg came. [I told him] I wanted to see the surgery.

“I went up to the anteroom, and there were all doctors there. These two men with their egos were arguing about one taking the other’s work and publishing it,” my mother scoffs.

“I don’t think they cut above the knee for weeks. You were yelling you wouldn’t let them do anything to you unless I came in. So Dr. Hedberg let me. I came in after the above-the-knee amputation (A-K) and held the stump while he hit it with an instrument, and he said, ‘There’s healthy tissue.’ And I was so happy, I said ‘Hallelujah!'”

When did I have a below the knee amputation? I wanted to know. My mother wasn’t sure. Looking for some progression of the amputations, I turned to the notes I had copied from Mass General. Though it was 10 years after the amputation, the notes had an immediacy, a vitality as I read them that I would not have expected. The very syntax of the doctor’s notes conveyed to me the emotion, or sometimes a seeming lack of it, these menders of people felt toward their subject.

I read that when I arrived at Mass General I was taken to surgery shortly after my ER admission. My ER notes read: “Severe pelvic fracture and severe laceration of the perineum.” The hospital nurse’s notes read that on May 25 at Cooley Dickinson they performed a left A-K amputation. [This must be wrong if I was at CDH for only three days, and if MGH received me on May 25 as the note implies.] There is no mention of a below-the-knee amputation in the Mass General notes.

The comment is made on the same date that, “her labia are cold, swollen, and blue.” That’s a sign they were dead. I am absolutely chilled reading this, not wanting to think about any of the further death to my most private parts, yet knowing I will experience much more if I am to follow this paper trail through the next month of the trauma at MGH. That this reading is re-traumatizing I do not consider, so intent am I on uncovering the truth about my unconscious past.

On 5/27/72, the notes reveal they removed the pelvic packs. On 5/29, ”She is a little agitated, keeps asking whether she is to be operated on tonight.” This is the evening of the day they informed me they were going to have to amputate further. “A little agitated.” I question how my mother could have kept track of what was going on at the time let alone recollect the details of the events now.

In my mother’s words:  “Everything happened so fast. They thought they had caught the gangrene. But then they had to do another amputation, this time of your hip and the [floater] rib.” That means they watched it for three days to see if they had caught the gangrene. I don’t wonder why they didn’t catch “not catching” it sooner. But I quickly check any of this kind of “what if” speculation. I recognize it is not healthy.

According to the next notes, on 5/30 Dr. Hedberg performed a hip disarticulation; the description of the operation is fascinating, but grim enough for me to turn the page and not look at it again.

On June 2 and 3, the nurses notes report, they performed debridement, but the gangrene they had tried to prevent from spreading to nearby flesh had outfoxed their antibiotics.

Doctor Hedberg’s sketchy notes report on the next few days briefly, but I find that in their sequence, even these are enough to raise concern in me, as though this report were today. It occurs to me I never saw him when he had a look of concern. My visual memories of Hedberg only begin after the first month.

Hedberg:  “June 1 – dressing changed. There has been considerable further necrosis of the skin. We will have to remove some more.

June 2 – Further extensive loss of tissue was debrided under anesthesia. We may have to do a hemipelvectomy to get ahead of this thing. disease – a real problem with sepsis and advancing gangrene. Please follow and advise.” He was evidently addressing Dr. Mollering.

The next notes were from Dr. Mollering, the internist and infectious disease doctor, who would not normally see me in the operating room. “6/4 Shaking chill with temp to 101+ this a.m. Unfortunately abundant pseudomonas of two types, not surprising, but a most disturbing development.” Pseudomonas is the fast spreading gas gangrene.

My mother recalls the next day was an ordeal for everyone concerned. “After the operation, we were very apprehensive. Before you went in to the next one Hedberg took me into his office and talked with me for a whole hour. He told me, ‘I don’t know how much we’re going to have to take.’ I said, ‘What do you mean how much?’ and he told me, ‘I may have to take the torso.’

“I told him very hesitantly, ‘That would be a terrible thing for her to handle. . .’ You had heard them say something about what they might do, and you let me know you didn’t want that. I didn’t even know what a torso was,” my mother admits, and I can’t help but laugh, but I sober quickly as she continues.

“He said, ‘We might have to take an awful lot of her body, her buttock and hip.’ I knew you’d feel terrible, they’d take a lot, and he’d feel terrible. After the operation he spoke with me an hour.”

On the tape she is silent for about 10 seconds. I ask her what they talked about, and I regret I didn’t press her further on this.

She sighs heavily. “Oh, he’d taken a terrible lot out of you, and he was pleased with the surgery.” I know she meant he was satisfied that he had gone far enough. But why hadn’t she asked him if I could still have sex? Had she admitted the whole thing to herself yet. Or was it not something she felt comfortable talking about.

At another time, my mother told me she and he had talked about “this generation,” with whom he expressed feeling great alienation. He told her about a young woman he had seen in Harvard Square, tall, blonde, handsome, “obviously from a good family,” unkempt and drugged out, who was carrying a ragged blanket she was obviously using to sleep “in the streets” on. I felt slightly irritated they didn’t talk about me the whole time.

My mother earnestly tried to make him see that the “tune-in, turn-on drop-out” mentality he saw was a healthy response to the world we were all living in. My mother had recently become an activist against the Vietnam War, and on the authority of her strong voice and her Motherhood got up and spoke at a huge rally in the Boston Common against the killing of America’s sons.

My mother goes on to describe Dr. Hedberg’s state of mind, which she considered inseparable with my survival. “The anesthesia man came up to see you afterwards, but Hedberg felt so bad, he couldn’t see you. You had a healthy, beautiful body, and it meant a lot to you. He knew because you had told him. When you did see him, you said, ‘I told you not to take my torso, now throw the rest of me away,’ and that’s when he told you it was his job to save you, and if you wanted to take your own life, you needed to do that for yourself. That seemed to satisfy you.”

Did I know during the last surgery what was happening? I ask. I realize writing this now that that was a foolish question. How can anyone know “what was happening” under anesthesia.

“You were quoting Camus and the existentialists, and he told you, ‘I like Sartre,’ and then you said Sartre was too cynical for you,” and my mother went on with uncharacteristic candor regarding my “vulgar” tongue to recreate the conversations I had in the operating room under a full general anesthetic.

“You said, ‘Who’s going to want me without my body?’ and several of the doctors – and that young, handsome, Dr. Ryan was there – said, ‘Well, I wouldn’t throw you out of bed!’”

I do recall, as her testimony reminds me, asking them how I was  going to be called a nice piece of ass any more. Of course, I didn’t have the mental acuity to get the joke the way it really was funny, which was, “Now they really can call me a nice piece of ass.” I don’t think I realized that this expression meant having had a girl, sexually. I thought when they boys said that to you it was a compliment based on how you looked in blue jeans. Hedberg was shocked a year later to hear that I had been a virgin, and I told him then, “You’re the one who took away my virginity.”

After my infamous line about piece of ass, my mother told me the doctors then said, “You still have beautiful breasts.” At that point, I’m sure it was a consolation only a man could appreciate, and one which my mother heard with mixed feelings, considering she disapproved of men talking about women’s bodies as objects even if as objects d’art. I remember her anger and shame when my father showed me a painting he’d done of her with her breasts bared.

Later, after the intern’s comments about my breasts, my mother said, “Don’t worry, dear, there are other kinds of love,” and then, in her words, “And then that young, handsome Dr. Ryan spoke up for you. ‘Don’t you ever say that to her. She can have intercourse.'” True. I still had 2 1/2 inches of vaginal canal left, and there was always the good old accommodating vagina at the cervix to make more room for a man. I got a kick out of one of my boyfriends who used to say, “Bob Geary, at your cervix.”

My mother’s testimony on the tape almost makes the operating room out to be a place of lighthearted banter, but my body’s memory is different. To this day I dream nightmares of physical annihilation, my body pulverized to ash. During the late 1980’s I didn’t sleep for four years after reconstructive surgery. My body’s memory had been triggered by the new pelvic surgery, and every time I was about to lose consciousness – even in a lying-down daydream – I would awake before I could fall into sleep, in terror that someone might do something to me in my sleep. 

Especially difficult was the debridement. They were afraid to give me too much Ketamine – there are today far better anesthesia – so they only gave me a local and debrided in my hospital room, and they were – plain and simple – digging the dead flesh out of the wound. The sensations would trigger any nerve in the pelvis, including my genitals, and I would remember the feeling of riding a boy’s bike and landing by mistake on the bar between my legs.

The Ketamine I’m told was responsible for the hallucinations. I felt monkeys crawling all over me, like snakes swirling around me, smothering me, and I would scream to get them off me.

According to the nurses’ notes, on June 5, two weeks after the accident, they performed the hemipelvectomy and on June 9-16, debridement of the wound. The notes reveal it would be another week, however, before they were sure the surgery was successful in saving my life.