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Amputation Isn’t the End: Disability Among the Boston Bombing Survivors

Posted on Monday, April 22nd, 2013 at 11:13 am

Author: s.e. smith

In the wake of the horrific bombings at the Boston Marathon, media commentary splintered in a thousand different directions in the United States, many of them terrifying and troubling. For example, in a highly racialised culture, speculation about the race and religious affiliation of the suspects began before they’d even been identified. This led eventually to the false identification of an utterly innocent man as people hastened to attribute the crimes to a non-Christian man of colour.

And speculation about the post-bombing lives of the surviving victims of the attack also began to run rampant.

Given the nature of bomb blasts and the kinds of injury profiles they tend to present, I knew almost immediately that some of the victims would be experiencing what is medically referred to as ‘traumatic amputation.’ In the media’s words, ‘having their limbs blown off.’ Once it became apparent that a bomb rather than an explosion was involved, I also assumed that many victims would be dealing with shrapnel, which is often included in improvised explosive devices (IEDs) to make their impact that much worse; for those who live through the blast and don’t lose limbs, shreds of metal, hardware, and other material can still cause blindness and severe injuries.

Medically, the bombings presented a very interesting situation. The victims benefited from a number of things not available to victims of prior bombings in the US like the Oklahoma City Bombing, or, for that matter, to the victims of the numerous bombings the US itself conducts overseas.

First and foremost, they had access to immediate medical attention through the first aid tent already staffed with responders prepared to deal with Marathon-related injuries. While they weren’t prepared for an explosion, they had the medical skills and training to give patients potentially life-saving medical attention very, very rapidly. Bystanders also acted quickly to save lives and help transport the most severely injured to safety.

And they benefited from the tremendous advances in medicine made in thanks to the Iraq and Afghan wars, where IED survivors experience some of the signature injuries of the wars. The classic injury, of course, is traumatic brain injury (TBI), which can be both cumulative (exposure on multiple occasions, as commonly seen with members of bomb squads) and single-incident (exposure to one massive explosion). But issues like traumatic amputation and shrapnel wounds are also a significant concern.

Through significant advances in military medicine, these injuries are more survivable for troops on the front line than they ever were before, meaning that more and more people are coming back on medical cots instead of in coffins. And those same advances are translating to the civilian world, where the skilled trauma surgeons and other medical personnel who flooded Boston hospitals to help provided rapid services to patients with serious injuries in the wake of the bombing.

Furthermore, once patients are stable, their long-term outcomes are much better than they were before. Surgeons have perfected the best amputation techniques and improved pain management, while there are better ways of dealing with phantom limb syndrome and the emotional trauma of amputation. Furthermore, protheses are substantially better than they were at any point in history, with some truly astounding and advanced technology for artificial knees and other joints.

Rather than hailing the fact that dozens of lives were probably saved by medical personnel, however, the US media chose to focus on a different narrative. They talked about how the lives of amputees were now ‘over’ because they’d lost limbs, airing things like a tearjerker narrative about how a little girl who’d lost a leg had always wanted to be a dancer. The message pounded into the head of viewers, over and over again, was that amputation means your life has effectively ended; you may be alive, you may have survived a horrendous and traumatic event, but these aren’t things to celebrate, because you lost a limb.

The suggestion seemed to be that people hadn’t survived at all, really. They’d just been handed disability as a life sentence.

This gross misrepresentation of life as an amputee was galling, and more than that, it did a profound disservice to victims of the attack. While everyone responds to traumatic amputation or any acquired disability differently, and there’s no right or wrong way to respond, it is safe to say that waking up and being told your life is over is not the greatest way to start your recovery. Especially when you hear that message on every channel of the television in your room.

Traumatic amputation can come with a rough recovery period. First, patients need to adjust to the loss of a limb and the selection of appropriate prostheses. They also may struggle with emotions related to the original trauma: surviving a bomb blast can cause depression, post-traumatic stress disorder, and other emotional issues like survivor’s guilt. It can be difficult to balance these with the life changes that come with losing one or more limbs, and at time people may feel deeply depressed, stressed out, and miserable. Some may indeed wonder why they survived and whether their lives are worth living.

Over time, however, most people adjust well to amputation. Like other disabilities, it becomes a fact of life and something you deal with when it comes up, rather than an all-consuming thing that limits your life at every turn. You work with occupational therapists, physical therapists, and others to learn to use your prosthetic limb(s) effectively, and you move forward with your life. You’re not going to forget what happened to you, and your recovery isn’t magically over in a day, but it does get better.

And amputations do not in any way shape or form limit your ability to engage with society and participate in a broad variety of activities. Double amputee and veteran Tammy Duckworth, who was recently elected to Congress from Illinois, is a stark example.

For that matter, so are the disabled runners who competed in the Boston Marathon, including not just wheelchair athletes but also amputees. Some of those same athletes came out for the London Marathon less than a week later, including Tatyana McFadden, a para-athlete to watch thanks to her blistering times on the course. She competed in honour of the city of Boston and the victims, but she’d have had fans out cheering for her anyway, because she’s a talented athlete.

Oscar Pistorious is not the only bladerunner out there. And amputees, along with other disabled people, participate in so many sporting events that the BBC has an entire section dedicated to disabled sport.

For that matter, amputees are also dancers, participating in both modern and classical dance. Some work with integrated dance troupes including nondisabled and disabled dancers, while others focus on performing with disabled dancers only. Amputees act in film, television, and stage performances—Robert David Hall, for example, is a high-profile double amputee.

These kinds of narratives, about amputee success and the fact that traumatic amputation is far from the end of the game, were few and far between in the major US media. In fact, only two-high profile examples arose last week: one in CNN, and the other in the New York Times. Both discussed recovery from amputation, prosthetics, and living a different, but not reduced or tragic, life after disability.

The CNN piece tended to focus, unfortunately, on a ‘supercrip’ recovery narrative, with a depiction of disability-as-inspiration (‘amputees never say can’t!’) intended to make viewers view disability in a specific way, but the underlying story was an important and solid one. It was a reminder that amputees don’t actually wither away and die, but rather live rich and full lives—unless, of course, they’re told time and again that they have no hope and no purpose in life after a major injury.

I want the victims of the Boston Marathon bombing to know that traumatic amputation and other injuries are scary, and they are a huge adjustment, and it’s important to get emotional and physical support during recovery, but you can recover. There are also people out there who are ready and willing to help you through it, including fellow amputees.

And in terms of the potential for the things you want to do with your new body and your new life? The sky is the limit—that and the nondisabled people around you.

The media don’t seem to want survivors to know that, raising the question: what’s so dangerous about this information?

 

Photo by phalinn, licensed under Creative Commons free for Commercial Use license.

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