CHAPTER 25

Mad Dash

There are no limits. There are only plateaus, and you must not stay there, you must go beyond them.

BRUCE LEE

WHAT A MAD DASH THIS WAS GOING TO BE! FROM NEW YORK CITY TO Rockville, Maryland, to Denver, Colorado, to Miami, Florida—all in three days. But this was the life we’d chosen, I reminded myself. And I couldn’t see skipping any of it.

Daisy was recovering. Lu still felt sad about Orange Girl, but had reached a place where she could accept what had happened as the natural order of things. I still had no idea which of the other puppies would end up being my next service dog. One of the two girls, I assumed, but maybe not. Maybe I’d been too quick in thinking it should be a girl next time. Was gender really the best way to find the right match for me? Tuesday had worked out beautifully, and he was a boy. I didn’t resolve any of that. I didn’t have time to. Lu didn’t even know the personalities of the various puppies. Those personalities were only being formed. Plus, Tuesday and I had places to go and people to meet, actually a whole lot of them.

We had been asked to join a panel hosted by the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services, the SAMHSA/HHS. Yes, the federal government is justifiably renowned for its alphabet soup of departments and agencies. But this was an important gathering. The topic was recent developments in the field of PTSD. I believe they considered Tuesday and me a recent development and the expertise we possessed on the subject to be of value.

The logistics were, admittedly, a little tight. We’d have to check out of our hotel in Brooklyn and take an Uber car across the East River to New York’s Penn Station and then an Amtrak train to Washington, D.C., and then a taxi from Union Station to suburban Rockville. And that was just the first leg of our frantic cross-country jaunt. When we got done with the federal panel, we would grab a late-night flight to Denver, where we would see Bill-the-prosthetist at the Jewell Clinic, who was going to fit my final-final leg socket and a brand-new, high-tech, spring-loaded Ottobock foot. Then, as soon as we got the new gear fitted and attached, it was back East on an overnight flight to Miami, where we would finally catch our breath for a couple of weeks of hanging out with my parents. We hadn’t seen them since before the operation. They sounded excited to see us. I know I was looking forward to spending time with them. Tuesday was too. Oh, I forgot one thing. As soon as we landed in Florida, we had agreed to read Tuesday Takes Me There to a group of children at Books & Books, a beloved local book store in Coral Gables.

To make all this work, we would have to leave New York in the middle of the night. Our train to Washington was scheduled to depart at 3:25 A.M. At that hour, navigating the usually snarled New York traffic would be a breeze. So around 2 A.M., I climbed into my prosthetic leg. Tuesday and I ordered the Uber from Brooklyn, which delivered us and all our stuff to the sidewalk outside Penn Station a little before 3:00.

I should probably describe what I mean by “all our stuff.” My clothes and toiletries and Tuesday’s toys and snacks were jammed into one suitcase and a medium-size duffel bag. I hoisted the suitcase into my wheelchair, which I used as a makeshift luggage cart. Then, I plopped the duffel bag on top of the suitcase. I had my folding crutches in one hand and Tuesday’s leash in the other. Even though neither of my hands was empty, I still had to steer the wheelchair.

By my count, that was four assistive devises in all. The wheelchair. The crutches. The prosthetic leg. And Tuesday. Plus, all the normal stuff. No one could accuse us of traveling light.

The station was eerily empty at that time of the night. So when our train was called, we didn’t bother hunting for an elevator to the platform. I figured we could ride the handy escalator down.

Holding Tuesday’s leash, I collected all our stuff and gently pushed the wheelchair onto the moving escalator. That part was easy enough. Here is where the learning curve got really steep, as steep as a train station escalator, you might say: We were aboard the escalator. It was rolling down. Clearly, I should have given more thought to the physics of the situation. Even some thought. I didn’t think about physics at all. But in an instant, the weight of the load shifted downward on the wheelchair. I felt a sharp tug on my hands and arms. I held on as hard as I could and tried to pull the wheelchair back toward me. The pressure got intense quickly. I lost my grip and then lost my balance. The wheelchair toppled forward, down the escalator. Almost simultaneously, I fell headfirst, Tuesday’s leash still firmly in my right hand. He tried to hold both of us steady, but the weight of my tumble pulled him along with me.

The whole thing lasted maybe three seconds… but bouncing down those rolling metal steps felt like a thirty-minute ride. With my first gasp of panic, my mind slowed immediately. I was absorbing every sight and sound.

I credit all my years of military training and experience for this. A lot of people who get forged in the fire of combat, dealing with crazy situations day after day, become adept at slowing their minds in moments of crisis. It is a skill, as learnable as shooting a rifle or marching in single file. It’s not a simple reflex. It isn’t fight-or-flight. It’s a matter of weighing relative options in real time, taking the time to strategize, making judgments as you go. Suddenly, it’s not a car crash you’re in the middle of. It’s a ballet.

I could have been Mikhail Baryshnikov, riding an escalator with a dog.

The wheelchair seemed to flip in exaggerated slow motion. The suitcase toppled over. The duffel bag rolled forward, and the crutches went flying, both momentarily suspended in midair above the rolling escalator. I tumbled behind the chair, trying to protect my good leg, trying to protect my prosthesis, trying to protect Tuesday, and trying to protect myself—all at once.

I was also eager to avoid getting jammed at the bottom of the escalator, where the steps were folding down and sliding into the metal teeth of the landing. To me, that seemed like a special danger zone. In my mind’s eye, I could see all our equipment landing there, then Tuesday and me colliding on top of all that, as the metal steps collapsed into the metal teeth of the landing.

Protect the prosthesis. Protect the good limb. You mess that up, and you’ll spend months not getting around. Minimize the blows on the way to the platform. Avoid those metal teeth if at all possible. All those thoughts were rushing through my head. In the swirl of the fall, my mind screamed. I didn’t hear Tuesday wail or whimper. I swear it was like watching a scene from a movie with highly detailed visuals—with the sound turned off.

Was it luck? Was it slow-mo strategy? Was it angels watching over us? I don’t know. The bad news was that we fell with such momentum that there was no stopping in midair. The good news? That the escalator stopped before we hit the bottom and two guys came to our rescue just as Tuesday and I came tumbling down.

I’m not sure whether one of them pushed an emergency button or the escalator stopped on its own. But one man caught the duffel bag and then the runaway wheelchair. I let go of Tuesday’s leash so he could jump clear of any obstructions. Meanwhile, the other man grabbed the suitcase and scrambled to get the crutches. Tuesday and I both got banged around a bit, but my new leg didn’t fall off. Both men helped me to my feet.

I know how badly I could have injured myself. People break their necks—even die that way. I know how Tuesday could have been hurt. A fall like that with so much equipment on a moving escalator—it truly could have been disastrous.

In fact, from what I could tell as I began to take stock of the situation, I didn’t break anything. As I hit the bottom, I guess I did get bitten on the ankle and calf of my good leg by those escalator teeth. My skin was nice and bloodied up. But I was on my two feet. Tuesday was on his four and wagged his tail in surprised excitement. Remarkably, considering the many moving parts here and all the unforgiving surfaces, I had a bleeding right shin, a scraped-up left elbow, and that was about it. Tuesday, thankfully, seemed entirely unscathed. I profusely thanked the two men who sprung up to help us. They acted like it was no big deal. They both petted Tuesday, and I told them again how grateful both of us were.

As quickly as the escalator incident had started, it was over. All of us boarded the train. We found our seats and got settled for a gentle predawn ride down the Eastern Seaboard, arriving in our nation’s capital a little after dawn.

We had to nix going to the PTSD conference. Despite our best intentions, the physical and emotional start to our trip took its toll. By the time Tuesday and I got to our hotel in Rockville, both of us were so exhausted we could barely stand, much less speak intelligently. So, we spent the rest of the day calming our nerves, resting our bodies, and getting the night of sleep we’d so dramatically been robbed of. After a quick hotel dinner, we headed to Dulles Airport for our late-night flight to Denver, where we were due at 9 A.M.

On the ride to Dulles, I felt angry with myself for missing the panel. We had promised to attend. I knew we had some useful insights to share. We had just wasted all that time and money and effort, rushing down from New York—for what? To sit in a hotel room and then fly out immediately to Denver? But the more I thought about it, the more I came to see that there was a life lesson in here that Tuesday and I needed to learn.

“Take it easy!”

It’s true. Too many people have far too sedentary lives, adversely affecting their health and welfare. I never wanted to fall into that trap. I would rather stay on the offensive, moving around, getting things done, taking on bigger and bigger challenges. But even for creatures like Tuesday and me, there are limits. And maybe we’d just come face-to-face with one of ours.

I also understand that the only way you know your limits is to push them and find your breaking point. We had certainly done that. As a new amputee, I am not saying what we did was smart. Clearly, we should have found the elevator instead of taking our escalator-wheelchair joyride. But that said, I would rather have an accident like this one happen three months in instead of two years post-op.

But yes, we do need to be a bit more cautious. Both the escalator tumble and the dog attack helped to remind me of that. Don’t be stupid, Luis! You need to protect your body! You especially don’t want to injure your good limbs! You need them, now more than ever! Be a little gentler on yourself, okay?

Before I get off this, let me give myself some credit for the level of mobility we had achieved in the first twenty-four hours of our continental dash. Talk about planes, trains, and automobiles! We pushed our limit. We found it. And we responded accordingly. Given what we were up against, that was its own kind of success. If we’d gone to the conference, who knows whether we’d have made the flight to Denver or our appointment at the clinic. That in turn might have affected our red-eye to Miami and the children’s event and seeing my parents—and, wow, who could say where and when those dominoes would stop falling!

We didn’t just show up in Denver. The appointment was carefully planned well in advance. A week before Tuesday and I left New York, Bill-the-prosthetist and I spoke on the phone. That way, he’d be ready when we got to the VA Eastern Colorado Health Care System’s Jewell Clinic.

“How many socks?” he asked me.

“Two,” I’d told him.

“Good to know,” Bill said. “That’s in the range of the shrinkage we would expect.”

These weren’t socks like the kind you buy in Walmart or the Gap. These were socks that could tell a story as well as a doctor’s medical chart. A newly amputated limb is something of a moving target. Everyone expected my stump to shrink. The swelling goes down. The muscles atrophy. A prosthetic leg has to accommodate for that. Making those adjustments is a big part of what a good prosthetist does.

When Bill first fitted me back in April, my residual limb fit snugly inside the poly-fiber socket that Bill had made for me. But over time, the socket had gotten looser and he suggested I wear a special sock around the residual limb. The sock would tighten the fit, he promised. And it did. For a while. But the stump kept shrinking, and pretty soon I needed two socks to fill the growing gap. That two-count gave Bill a rough estimate of how much my limb had shrunk—two socks’ worth.

“How else does it feel?” he had asked me on the phone.

It wasn’t easy to put into words, but I did the best I could. “It’s like the limb doesn’t quite reach to the top front of the socket,” I said. “I feel room up there. It’s definitely looser now than it was before.”

Bill assured me all this was normal, a predictable part of the fitting process. And he knew what do to about it. “You’ll leave Denver with a far better fit,” he promised. I liked his confidence.

Our late-night flight from Dulles landed in Denver just in time for us to flop into bed. The next morning brought one of those perfect Colorado summer days. Sunny. Crisp. Hardly any humidity in the air. The kind of weather that has drawn people to the Rockies since pioneer times. It was an air of optimism. Tuesday and I arrived at the Jewell Clinic a little before 9 A.M. and found Bill in an unusually talkative mood. Maybe the weather had affected him too. During our past visits, Bill had kept his thoughts mostly to himself. This time, with a little prodding, he was almost expansive—for Bill.

“How long have you been doing this?” I asked him, not at all sure he was eager for conversation.

“I’ve been a prosthetist for seventeen years,” he said.

I asked how many prostheses he figured he’d created. “It must be up in the thousands,” I offered.

“Yeah,” he answered. “For a number of years after 9/11, when the wars in Iraq and Afghanistan were heating up, I used to do a few hundred a year. Now, it is less than that. There aren’t as many wounded combat veterans coming home now, and there are also more prosthetists out there. But we still stay pretty busy.”

I was happy to hear him talk about himself at all. There’s a level of trust to be achieved in simple conversation. I like knowing about the mechanic who works on my car, and my leg is a whole lot more important to me than my car. I don’t want my leg to be the project of some anonymous toiler. I want to know there’s a real human putting his heart and his soul and all his talent into something as important as that.

“It is very rewarding,” Bill said of the responsibility. That was the mind-set of someone who cared, and I was reassured to hear him say it.

For a less experienced prosthetist, this visit could have been a lot more trial and error. But Bill had a clear idea what I needed. He brought out a test socket that he had fashioned for me. The Ottobock bionic leg would fit into that. This wasn’t my final socket. It was just to test the fit. But I could see immediately that the test socket was smaller and sleeker than the one I had been wearing for the past three months—and, I bet, far easier to slide over a pants leg.

I thought to myself: “So these are the advantages of limb shrinkage?”

He asked me to take off my leg. Then, like Geppetto in Pinocchio, headed back to his workshop, where he got busy with his Allen wrenches swapping out the old socket.

“Try this on,” he said when he returned. “We may still need to make a few adjustments. But let’s try the fit.”

I slipped on the test socket and immediately I could feel the difference. It was snug, even without the socks. Bill watched me walk to assess my gait. Then, he copped a feel. I don’t know how else to describe it. He slid his fingers into my buttocks so he could check how well the socket was resting against my ischial seat, that delicate area between the butt and groin. He came around the other side and did more pushing and poking. He was trying to gauge if the socket was too tight, too loose, or just right.

The new fit felt pretty good to me, though Bill noticed a few things he still wasn’t happy with. “I’ll keep this overnight,” he said. “I’ll use it as a guide to make your final socket.”

I removed the leg. He kept the tester and reconnected my old socket. I got ready to wobble out of there on my loose, two-sock fit.

“That’s all we need for now,” Bill said, seeming eager to return to Geppetto’s workshop. “See you tomorrow afternoon.”

I was equally eager. “Come on, Tuesday,” I said. “Let the man get to work.”

Ever since the Penn Station escalator fiasco, I’d been asking myself, “Do we really need to travel with all this stuff?” While we were in Denver, I vowed to cast off some of the things we really didn’t need any more and do a better job of organizing the rest. I bought a canvas bag to carry the crutches. I swapped the duffel bag for a laptop-friendly backpack. And here was the big one: We went to a self-storage facility, where we stowed the wheelchair and some smaller excess items. I know I said I would have the wheelchair with me forever. But with my soon-to-be refitted prosthesis, I didn’t think I’d be needing the chair on a regular basis anymore. Yes, it was one sleek chair. Yes, I’d had fun racing with Tuesday. And yes, I’d be happy if I never saw it again for as long as I live. This was a huge leap for me. I’d had a wheelchair, this one and the clunker that preceded it, since my operation, first as my primary means of mobility then as a ready fallback. Clearly, the escalator gods had other ideas. All I could think was good riddance!

With less stuff to carry and no wheelchair to push, I knew I would have a lot more balance. As we walked, my hands were free. That would help me stand straighter. When you are more than 6 feet tall and pushing a luggage-cart wheelchair, you can’t help but lean forward.

From now on, I told myself, I would be a “light fighter.” That was the term we used in the army for a foot soldier who carried everything on his back. No armored personnel carriers. No marching from the battlefield to the barracks every night. It was all in the rucksack, period. “Pack light, freeze at night,” we used to say in the infantry. Light fighters all the way! Now, I was returning to that light life.

We got all that done and still made our 1 P.M. appointment at the Jewell Clinic. I could hardly wait to check out the final-final socket Bill had created for me. I was literally grinning as we walked into the clinic. Tuesday could feel my excitement. He bounced through the door beside me. When Bill led us into the examining room, I know he could also feel the anticipation. He took my old leg and loose socket into Geppetto’s workshop, spending a full thirty minutes with his Allen wrenches and screwdrivers. I didn’t know exactly what he was doing, but when he returned, the top of the leg was attached to my brand-new socket. It was just as sleek and tapered as the test socket, but the real one was made from a different kind of plastic and it was a cool-looking black. It also had a thin layer of padding where the earlier model was just the hard plastic.

But that wasn’t all. At the other end of the leg, I also noticed, was a brand-new Ottobock 1C61 Triton VS foot. VS stands for vertical shock. It didn’t look too different from the old one, but I’d checked it out online and knew this one was far more advanced. This lightweight carbon foot boasted “enhanced shock absorption and torsion resistance.” It is suitable, the manufacturer says, for “a particularly broad range of applications from everyday use to recreational sports.” Unlike earlier models, the IC61 had a spring in the back toward the heel. That little spring was designed to change the whole kinesiology of walking—imitating the way the muscles, tendons, and ligaments in a real foot all work together in a smooth and efficient way. All this promised greater flexibility and much more functionality. It was, as the company advertised, more like a foot. I was certainly excited to take it for a test walk.

I gently shoved my limb into the socket. I know that sounds like an oxymoron, but a gentle shoving is what it takes. Then I depressed the valve to release the air inside the socket. Finally, I stood and slowly walked around.

Damn, that felt nice!

No more wiggle. No more wobble. No more socks.

I remembered back in April, when Bill explained to me the ins and outs of prostheses, I had said to him, “It should fit like a glove,” and he had said to me: “It needs to fit better than a glove.”

I started to understand what he meant. Forget gloves. A prosthesis has to fit like a transplanted heart. Maximum fit and maximum comfort. Everything in the spot it’s designed for, connected in the way it’s supposed to be. No wiggle room at all.

It was, at that moment, almost perfect. We were getting close. I could tell. This was like being in a shoe store and having the clerk hand you a perfect pair of Johnston & Murphy dress shoes. Whatever shoes you came in wearing, the Johnston & Murphy fit was so much better.

Oh, this is nice, I thought. Sleek and comfy!

I hadn’t even left the clinic, and already I could tell the new fit gave me an extra shot of confidence and support.

But as I paced around Bill’s examining room, I began to notice that something was amiss. The new foot seemed to have more bounce in it—which was good, right?—but the bionic leg didn’t have enough resistance anymore. The knee movement was off. I took a step, and the leg started to buckle. The swing was too quick. It was unnerving.

“The socket feels fine, much better,” I told Bill. “But we need to adjust the resistance.”

Like a NASCAR racer coming into a pit stop, these bionic legs need continual adjustment and tune-ups. That was becoming clear.

With his Allen wrench, Bill gave the screws connected to the pylons a couple of extra turns. I didn’t understand all the mechanical details. But those pylons tightened or loosened certain hinges, which altered various settings. He did this four or five times and made other adjustments. No doubt about it: You get a real appreciation for the amazing human body when you try to replicate the way it works. He shifted the height of the leg, making sure it matched the height of my good leg. He altered the resistance. He adjusted the ankle. He focused especially on the new foot. Was the toe at the correct angle? How was the connection with the foot? Each time, the leg got a little better. All these small adjustments were huge.

After the fifth or sixth modification, Bill went into the leg’s computer using a Bluetooth connection. He changed the settings on the microprocessors in there. I could see the little blue light blinking.

Then, there was the new foot.

That spring and whatever else was in there really made a difference. Neither the leg nor the foot had a propulsion system. It wasn’t robotic. It depended on me to move. But that spring supported and amplified my body’s natural effort. It made everything more efficient and put a little bounce in my step, easing the physical impact like a shock absorber. Now, when I took a step, my foot didn’t simply plop on the ground like a dead weight. Now, it landed gently and then sprung back up. The difference was truly noticeable. I didn’t feel flatfooted anymore.

This new version of the leg was an undeniable improvement. And with the thrill of that came an adrenaline rush. Clearly, I knew, I needed time to take the setup on some longer test walks to make sure I wasn’t missing anything. But for now, it was feeling pretty darn great. I had only one small, lingering complaint.

Up near the top, where the socket fit snug against my groin, I felt rubbing against my skin. Pinching, really. It wasn’t pressure on the bone or the tissue. It wasn’t internal. It was external.

I mentioned it to Bill.

He took the leg back and returned to his workshop, where he applied a layer of foam adhesive. “This should help,” he said. I tried it on. Once again Bill had done his magic.