Notification of my husband’s injury came May 7, 2007, at Fort Riley, Kansas.
Early reports indicated both of his legs were severely damaged—the left more than the right. He was fighting for his life and would not be conscious and coherent for several more days.
I met Greg as he arrived at Walter Reed Army Medical Center in Washington, D.C., five days after his injury. He had metal external fixators attached like a set of Kinex keeping the bones of his legs aligned.
There were eight vacuum tubes coming from underneath different parts of his legs draining fluids into four wound vacuums on the floor beneath his bed.
The tops of his lifeless legs were very normal looking, but underneath large holes were filled with the dark sponges attached to the tubes draining the nastiest of fluids from his wounds. He had a feeding tube going through his nose and several fluids and medicines dripping into the IV attached to his arm. He was sedated, thin, still—quiet, but not peaceful. Looking at my husband that first day at Walter Reed—his only independent function at that moment was breathing—I knew I would forever be a caregiver.
His slow return to consciousness was scary. He recognized me and understood our relationship, but we endured several days of delusional outbursts before he realized what happened and could remember his circumstances from one day to the next. The medical staff assured me the behavior would likely subside in time. I remained unconvinced and struggled with providing emotional support to the irritated and annoyed. I was more afraid than I had ever been, for me and for our family.
Fortunately, the delusions subsided just in time for the arteries in each of his legs to fail and the discovery of significant damage to his right arm and elbow. The failures caused an immediate amputation of the left leg and, the very next day, an emergency surgery on the right leg that led doctors to take an extra vein from his left arm to save the leg.
As the surgeon explained the procedure to me afterward in the surgical waiting room, I said to him,
“Don’t do that again.”
“Do what?” he asked.
“Take a working part from a perfectly good limb and put into an area of known damage and destruction.”
He assured me it was standard procedure. My husband would be better off trying to salvage one leg and did not need the vein in his arm. This was a departure from my previously passive and appreciative attitude toward the medical staff. I knew we were getting the absolute best care in the world for his injuries. I merely had philosophical differences regarding limb salvage.
The procedure worked, but the leg still had significant tissue loss, likely nerve damage and an uncertain future.
My husband reached a sustainable level of coherence and, with the amputation of the left leg, made tremendous progress toward recovery in just a few short days. He was ready to get moving again, but the uselessness of his right leg held him back.
After in-depth consultation with numerous medical professionals he decided to have his right leg amputated. He wanted to keep moving forward, keep making positive progress and get on with his life.
That decision set the tone for his healing and the recovery of our entire family. We were all going to keep moving forward, make positive progress and get on with our lives together.
Two days after the right leg was amputated, Greg was moved out of the ICU and up to Ward 57 with the rest of the recovering amputees.
The move to Ward 57 brought increased responsibilities for me as a caregiver. Certainly, the nursing staff provided assistance as needed. We had been married for 20 years—I was there to assist and serve. The damage to his right arm was going to take a significant amount of effort on the part of everyone to fully recover.
Multiple surgeries, occupational therapy, time and more time were all needed to heal the arm.
Meanwhile, Greg was down to the use of one limb and his non-dominant hand. He needed help with virtually all of his activities of daily living—eating, using the bathroom, personal hygiene, getting dressed—even rolling-over while sleeping.
Our time on Ward 57 revolved around learning how to become independent enough to get released from the hospital. Our kids were 15 and 13 so they were part of Greg’s immediate team of caregivers. We learned how to transfer from the bed to a wheelchair, from the wheelchair to the car, from the wheelchair to the shower bench. We learned where and when to provide physical support and how to be encouraging.
We learned how to change bandages, remove a stray stitch and perform scar tissue therapy. Over time we gained skills in minor repair and maintenance of manual and automatic wheelchairs, hand cycles and prosthetic legs. Now we are expert pathfinders during travel, assessing slopes, grades, curbs, ramps, door widths and elevator locations with unmatched speed and precision.
We spent hours in occupational therapy as Greg learned how to become more and more independent with his one arm. He learned to cook, use the washer and dryer and put on his clothes. I learned not to slam on the brakes with a double amputee in the front seat.
That is a whole separate essay.
We spent more hours in physical therapy as Greg learned how to walk first on short legs without knees, then on legs with knees. As his health improved and our experience as caregivers progressed, he was released from the hospital six weeks after his initial arrival.
He joined me and the kids at the Mologne House, a kind of hotel for recovering service members and their families on the grounds of Walter Reed. We lived—two teenagers, two adults, assorted handicap-accessible equipment, numerous care package items and the entire wardrobe of our teenage daughter—in the equivalent of a Holiday Inn hotel room. We were all on full-time caregiver duty as Greg still only had the use of one arm. The rollingover while sleeping problem started to become a real issue affecting my objectivity as a caregiver.
Nonetheless, we continued to move forward. The kids were sent to sports camps, summer camp and extended visits with relatives in an effort to simulate a real summer experience away from the severe wounds, amputations and disfigurements they were surrounded by at Walter Reed. Greg continued his recovery working very hard to reduce and eliminate the need for pain medication and continued his work with prosthetic legs. I began looking for a place to live and return our family to a quasi-normal environment before school started.
Our move to a handicap-accessible house on Fort Belvoir introduced a whole new set of challenges we were all too glad to tackle. The ability to spread out and gain some personal space made arranging the breakfast table, dining, living and bedrooms in a layout open for wheelchair movement and parking seem like an easy mission. Unfortunately, my designated side of the bed for the last 20 years happened to be located closest to the bedroom entrance in our house and Greg would need to negotiate a narrow path with his wheelchair to arrive at his side of the bed. I was willing to re-designate my side, but made it known that I didn’t want to.
As a caregiver, sometimes you have to set some boundaries. You must know and understand your personal needs as well as those for whom you provide care. Caregivers make tremendous sacrifices for the well-being of their wounded service members. Service members must recognize and acknowledge those sacrifices oftentimes by making sacrifices of their own. Negotiations were aided in this case through understanding that the extent of his sacrifice was properly maneuvering the joystick on his high-powered automatic wheelchair.
Other negotiations were not as calmly achieved.
Over the next year after our kids left for school I drove Greg to Walter Reed every day for therapy and we tried to get back home in time to support the kids’ after-school activities. Over the course of that year Greg learned to walk, weaned himself from pain medication, learned to drive a vehicle modified with hand controls, and regained some use of his right arm through surgery and therapy. He also increased his ability to function independently.
Functioning independently becomes a choice when you are surrounded by a team of highly trained, willing and obedient caregivers. Dads routinely tell their kids to do stuff like bring a glass of tea, heat up the leftovers or find the remote control.
Fewer dads tell their kids to change the shoes on their prosthetic feet, put more air in the wheelchair tires, or find their cane. As Greg’s arm improved it became clear he could do more tasks on his own, but he kept expecting assistance from others.
It is nobody’s fault. It is hard to know when and how to transition a recovering service member to caring for themselves—at least performing those tasks within their capability. Bringing the discussion to the wounded service member about the discrepancy between their capability and their willingness to perform a task, especially a former commander, is hard. It is difficult to know when to have the discussion and how to gently approach the subject. One thing is certain, avoiding the transition to independence puts undue strain on caregiver relationships. Two teenage caregivers also put undue strain on caregiver relationships.
Again, another essay.
Caregivers must exhibit patience not only with the patient but everyone else who is looking from the outside in.
During an out-of-town trip we went to eat at a restaurant before starting a three-hour drive back home.
Prior to stopping at the restaurant I was up early, exercised at the gym, repacked our suitcases, loaded suitcases, artificial legs, wheelchairs and backpacks into the car and checked out of the hotel. The restaurant was busy so we put our name on the list. I went outside to sit down and Greg rolled around the restaurant store looking at trinkets and talking to the locals.
A staff member came outside to offer mini snacks to the waiting crowd and noticed me on the bench.
“So, you are just gonna leave him by himself like that and come sit down,” she said.
“Yes, ma’am, I am,” I answered. “He’s been sittin’ down all day.”
She caught my hint.
“I didn’t think about that,” she said apologetically.
No one ever does. People only know what they see. I have long since given up justifying my behavior to others.
Five years later we are still moving forward thanks to the perpetual support provided by medical professionals, family, friends and countless complete strangers. The kids moved on to college and
Greg was able to stay in the Army and currently serves as the garrison commander at Fort Belvoir.
I returned to my former life as a teacher.
Though I still consider myself a caregiver—Greg requires some, but really very little, assistance as a result of his injuries—my duties primarily correspond to my roles as wife and mother.
It won’t always be this easy. As we get older his mobility challenges will likely increase and we will make the appropriate accommodations at the time, moving forward even if slowly.
Kim Gadson is a 1989 United States Military Academy graduate. She currently teaches Technology & Engineering Education at Mark Twain Middle School in Alexandria, Virginia.