One of the things that drive me is seeing problems that seem insurmountable. Creating a practical electric light seemed that way at one time but then along came Edison. And his attempt to improve it created a device, the vacuum tube that grew to become the backbone of the electronics industry till it was replaced by the solid state device in the second half of the twentieth century. The backbone industry had only to adapt to the new device.

If we could find a substance that would allow human flesh to interface with some inanimate structure, like a plastic, or if we could find a way of picking up nerve impulses and insert them in the nerve at another place to in effect bypass a break in a nerve there are many advances we could make. Many think this is impossible. But many thought the incandescent light bulb was impossible and after Edison created it research into making it better resulted in the vacuum tube that kicked off the electronics industry. I believe out there somewhere is another Edison who will create another leap.

A substance that would connect with human flesh would revolutionize the care of a stoma. It would make long term care of a PEG tube easier. It would make some advances possible for amputees. Some things like what I describe are being tried without this and they provide significant enhancement, but they create infection risks because it is an opening in the skin.

Kathy’s Legs explores some of these issues, “what if they were possible” and how they might impact human lives. People sometimes ask about the themes I use. Some of it is because of my own life experiences. I faced a possible leg amputation in 1963 and have spent about six months on crutches because of several leg surgeries and injuries. I know I don’t know what any of these are like but I have seen the human spirit rise to the situation and thrive.

June 1

Kathy Cramer raised herself on her toes and clicked her heels together as soon as the elevator door closed and she was alone. It was something she unconsciously did when she was happy. And Kathy was very happy. Things she had only dreamed of and worked for years to make happen were falling into place, one by one. It was almost like they had been lined up like a row of dominoes. Finals were over last Friday ending her Junior Year in college. She had one year left to attain a BA in Computer Science. Saturday, Bill Jansen gave her a diamond. Although not a surprise, it was wonderful. She was now officially engaged to be married. Today, Dr. Dave Western, the director of a hospital research project hired her for the summer. The job would pay more than she had ever dreamed and it was fabulous training and experience in her field. It also looked very fulfilling and Dr. Western had hinted it could lead to a permanent job. She would be working on a project that would help people, one of her goals in life. She would be a participant in an exciting research project, not a spectator, but a doer and innovator, not a bureaucrat. She was to report to the doctor’s office Tuesday morning at eight AM for her first assignment.

At the ground floor the opening elevator door jarred her back to the present. She walked out of the lobby, looked both ways and stepped off the curb to cross the street. A car pulled from the parking garage so she stopped just off the curb, behind a parked car, ready to cross the street when it passed. Her mind wondered momentarily as she stood there.

A few minutes before Paul Baskins got into his car in the parking garage. He had just left a hospital room where a lifetime friend was wasting away. George Carver was dying of cancer. Tears welled up in Paul’s eyes as he took his change from the parking lot attendant and pulled away from the booth. He doubted he would see his friend again, George was so weak. He had prayed that he would not suffer and waste away as his friend was doing. As Paul turned on the street and accelerated his car pain stabbed into the right side of his head and his vision blurred. He collapsed over the wheel, turning it slightly to the right. He slumped forward and his foot pressed harder on the accelerator as the car traveled toward the place where Kathy was standing. She saw the car turn and accelerate toward her and stepped back toward the curb. Her reaction was much too late. Paul’s car hit her, traveled two more feet and impacted with a car parked along the street. Kathy’s legs were pinned between the bumpers of the two cars.

Had Paul been travelling at a higher rate of speed Kathy would have been killed, her body crushed between the two cars. At the speed he was travelling, the two bumpers hit and they absorbed most of the impact and prevented that. Had Kathy not been there the accident would have resulted in nothing more than some badly bent sheet metal. Unfortunately, Kathy’s knees were smashed between the bumpers when they met. Bone and flesh were crushed and torn. With the bones crushed her legs were no longer able to support her. She collapsed face down on the hood of Paul’s car. He was unaware of her. A major blood vessel exploded in his head as he turned out of the parking lot. Paul’s fear of dying slowly like his friend was unfounded. He was dead before he reached the hospital emergency room less then a hundred yards away. Kathy lay on the hood of his car, conscious and crying with pain. Her legs were crushed and pinned between the cars. She could do nothing to free herself.

The woman at the Hospital information desk saw Kathy cross the lobby and go to the street. She heard the impact, saw Kathy pinned between the cars and dialed the Emergency Room. Within seconds of her report two medical teams were headed to the site. Two men on the other side of the street saw the accident and ran over to help. One held Kathy while the other tried to help Paul. It took him only a few seconds to see that Paul was beyond any help he could give. The man eased him off the wheel and put the car in reverse. While the other man held Kathy he backed the car to free her. The man with Kathy called for the other man to help him. They slid her off the hood and placed a coat under her head. They took off their ties and tried to slow the bleeding from her crushed knees. As they did, they realized her right leg was totally severed from her body. The left was held on by only a thin piece of tissue.

The first trauma team arrived and took over Kathy’s care. A second team arrived and started to work on Paul. Kathy was placed on a litter and moved to the ER for evaluation. When they moved her from the litter to the table the left leg detached from her body. Her upper legs and body were X-rayed and examined. Her lower legs were taken and put in ice. Her parents were called and within fifteen minutes her mother arrived. Her father was just a few minutes behind her. The parents met with the doctor outside the room.

“Your daughter is very seriously injured but I don’t see the injuries as being life threatening at this time,” Dr. Runk began, “The most serious injury is to her legs which were severed from her body by the accident. Based on an initial evaluation her knees are crushed beyond any hope of reconstruction so the usual methods of reattachment are out of the question. Fortunately, the people who were at the accident were able to stop the bleeding quickly so she has lost very little blood. Her lower legs aren’t badly damaged, just a few minor cuts and bruises. Without her knees which are destroyed the only treatment we have is to complete the amputation of her legs unless you want to have your daughter participate in an experimental reattachment program. Actually, the amputation is complete; that is, her legs are already separated from her body. All we would do now with conventional treatment is to surgically prepare each of her stumps to accommodate a prosthetic. With both legs amputated above the knees her mobility will be very limited. There is an experimental program here which is an alternative to the conventional treatment.”

Mr. Cramer held her mom as she started to cry.

“One of our surgeons, Dr. Dave Western has a research project in the area of reconstruction of severed and crushed limbs. He has been looking for a suitable subject for that surgery. Based on what I know about the program and her condition, your daughter is a very likely to be a good candidate. She has only a few bruises and cuts other than the injury to her knees, is young, healthy, and strong, has no head or spine injuries and has lost very little blood. Her knees are so badly damaged that amputation is the only treatment we can offer. The only portions of her legs that have any serious injuries are her knees.”

“Can he help my daughter? Will she be better off in the program?” Mr. Cramer asked.

“As I said, your daughter’s legs are damaged far beyond being saved by any conventional treatment. His is the only treatment other than completing the amputation. We took the precaution of handling her legs as if she were in the program. We have a protocol in the ER to assume that unless we see something to totally contradict, for example serious head or body injuries. I had the nurse alert Dr. Western and he should be here in a few minutes to see her if you like.”

Kathy’s mother spoke up. “Did you say the program is headed by Dr. Western?”

“Yes, do you know him?”

“She was here to meet with him. He’s the Doctor Kathy was going to work for this summer. I think the decision should be hers if she’s awake. Can we see her and ask her?”

“Sure. That sounds good to me. The nurse will take you to your daughter.”

When they went in Kathy looked so small on the table. There was an IV in each arm. Her clothes were partially removed. A nurse was finishing the job. Her legs were wrapped at the knees. Her lower legs were obvious by their absence.

Her mother grabbed her hand and started to cry. Her father pushed back her hair and asked. “Did they tell you about your legs?”

She bit her lip, “Yes. I guess they’re pretty bad. I really can’t feel anything in my feet. My knees hurt really bad. Don’t bump them.” She wrinkled her nose as the nurse moved her slightly. It was obvious she was in pain and was not totally aware of the situation.

“The doctor says your legs are gone and can’t be reattached unless you want to try Dr. Western’s treatment. It’s experimental so they can’t guarantee anything. Do you want to try it? We think you should be the one to decide. It is your life and you know more about his program than we do.”

She blinked back the tears. “I don’t have a choice. It’s either no legs or a chance at legs. His is the only game in town, dad, I want to play. I spent this whole morning seeing what he’s doing. I was going to work for him. I guess that’s out but I need what he’s doing. Please let me try. I want to walk again.”

“Do you know what he’ll do to you?”

“Yes. I had the tour today. It’s kind of weird and sounds a lot like Star Trek. Dad, please don’t say I can’t. I don’t want to spend my life in a wheelchair or on crutches.”

Ken Cramer nodded, “I’ll tell the doctor. Nan, you stay here with Kathy.” He turned and left the room.

In the hall he met Dr. Runk and another man. Dr. Runk took the initiative. “This is Dr. Western. We don’t have a lot of time till we have to get her into surgery so we have to decide what we’re doing. Do you have any questions?”

“A few, but I think my daughter should decide although I think she’s already made up her mind. Can we talk with her for a few minutes so she knows what to expect? As long as she’s awake, it’ll be her decision.”

“Sure. That’s a good idea. Let’s go in and talk to her. I need to see her legs and confirm Dr. Runk’s diagnosis before we can decide if we can do anything.” He pushed the door open and waited for them to go in, then followed them.

Dr. Western had only been told that a potential patient had been admitted. He had not been told her name. When he saw Kathy he stopped short and gasped. He looked at the chart he held in his hand. Less than a half hour ago this beautiful young woman had been in his office, excitedly describing what she wanted to do with her life. Much of that would not happen now unless he could in fact do what he had described to her this morning. He regained his composure and started to explain the treatment he was proposing.

When he stopped, Kathy looked up and said, “Let’s get going, I really wanted to work with you, I just hadn’t planned to do it this way. I believed in your project enough to want to work in it. I guess I should trust it for treatment.”

“I’ll have to get things ready for your surgery. Dr. Runk will get the papers and get you ready. I’ll see you in surgery in about twenty minutes.”

He made several measurements of her legs and asked her height. Then he left the room.

Dr. Runk came back and read a list of complications and problems that could result from the treatment. One of the problems mentioned was that the legs may have been damaged so badly that they could not be reattached in which case the normal procedure would be followed. There was also a statement about possible later attachment of the legs under some conditions and they signed that one too. The pile of signed documents grew while she was being prepped for surgery. A few minutes after the last form was signed she was headed for the operating room.

After she left, Ken and Nan went to the lounge to wait. A few minutes later the nurse found them. Kathy had been assigned to room 478. They could wait there if they liked. Ken called Bill to tell him about the accident. Bill was not at home but his mother took the call. He was being interviewed for a summer job and would be home soon. Mrs. Jansen took the information. Bill would call when he got home.

At about 7:30 P. M. a very sleepy Kathy was brought to room 478 in the hospital. They transferred her to the bed and hooked her to the traction equipment that had been brought in and set up earlier. Shortly after she was brought in Bill arrived. He spent the rest of the visiting time holding her hand and wiping her hair. He would spend his evenings next to her bed as much as possible.

On Tuesday morning Dr. Western came in to talk to Kathy. A nurse followed with a tray.

“How are you feeling?”

“I’d be better if you could get me out of this contraption. Every time I try to move, it pulls me back to this position. I can’t really seem to get comfortable.”

Kathy was on her back. Her legs were in traction, pulled up at a forty-five degree angle and slightly spread. The elevated portions of her legs were covered by a sheet. Early this morning she tried to uncover them but had been unable to do so.

“You’ll be out of the traction as soon as you’ve recovered enough,” he replied. “We need to talk some first about your injuries. Anything else you want to tell me?”

“I’m a little worried. I still can’t feel anything below my knees except an occasional pain in my foot. It’s like my legs aren’t there. Actually, I can’t feel my knees either. At least they quit hurting. Can I see what you did?”

“Yes, but I need to talk to you before I let you look. Your legs were damaged more at the knees than we even imagined. Not only were the bones crushed, the other tissues were totally destroyed. We couldn’t reattach your legs now like we had anticipated. I even considered making you shorter by four inches but there wasn’t enough good flesh to even attempt it. We just couldn’t reconstruct the nerves. That’s a crucial item in determining how we do the surgery. Without the nerves you have legs that don’t move and they have no feeling. They’re just dead weight.”

“But I’d still have legs. I’d look normal.”

“In a wheelchair, with full length braces you’d look normal. They wouldn’t be any good for walking, hiking or jogging. Worse yet, they could be damaged without your knowing it because you can’t feel anything.”

She turned her head and started to cry. “So the bottom line is you couldn’t put them back on, that’s what you’re saying? The treatment isn’t going to work for me. I’m going to be a cripple, a leg-less, helpless freak.”

“That’s not true. Sure, your knee joints were totally gone. The bones were in hundreds of pieces. We could have replaced them with metal joints but there wasn’t anything we could do to reattach the soft tissues of the legs now. The veins, arteries, tendons and nerves were just a mass of crushed and mangled flesh. In addition, the upper end of the lower legs had several fractures we felt we didn’t have time to work with now. On the plus side, you had no head or internal injuries.”

“Then I’ve lost my legs forever.” She bit her lip. “The reattachment has to be done right away to be successful.”

“In the traditional reattachment that’s right. Our procedure has several options. When we found we couldn’t do the reattachment now we put the limbs on an infusion device that will keep them supplied with blood. The other team set the lower leg fractures and prepared the top of the lower legs. They’re down in the lab and doing well. You’re just temporarily without them.”

“Temporarily? How long?” Her eyes widened. He had mentioned but hadn’t explained this phase of the program when he had interviewed her. Then it was discussed as a future possibility. Now, for her, it was for real.

“We could reattach as soon as a few months, maybe as long as ten. It depends on the progress the computer group makes in the nerve impulse program. We’ve already designed and built the computer and chips to bypass the nerves. We need to test the computer and write the programs for it. We guessed they’d take about a year with subjects with limbs. We hadn’t considered using a subject who was an amputee. With a good subject who is an amputee maybe it’ll not take so long. The tubing to bypass the blood vessels is available right now. So are the chips to pick up and retransmit the nerve impulses. We did as much of the work on your legs as we could so you wouldn’t need any more surgery after they are attached. For now you’ll have more mobility and freedom with a prosthetic. Do you still want to take a look at the ends of your legs now or would you want to wait? This could be a little frightening at first.”

She blinked back the tears and nodded.

The doctor turned and busied himself as the nurse arranged the sheet to protect her modesty and still allow them to examine her legs. She would soon start to call them “stumps” but for now these abbreviated appendages that were incapable of performing the functions of legs were to her still her legs.

The stumps were tightly wrapped with elastic bandages. A tear rolled down her cheek. They were so short. A rope came from the end of each of them and attached to the traction equipment.

“Wind her bed up some so she can see what we’re doing and take the weight off the left one,” he asked the nurse. She raised the bed and removed a twenty pound weight from the rope. He had held his hand under her leg and lowered it gently to a pillow on the bed. In spite of his care in handling the leg and the protection of the bandage, the change of position hurt. The end of the stump was very tender. He slowly unwound the elastic bandage and exposed her upper leg. It had a couple of bruises and several

cuts but was otherwise intact. She had done more damage to her hip in a fall while hiking.

“Don’t try to move it in any way when it’s unwrapped, let me do that. I don’t want you to strain any of the work we did. It hasn’t had time to heal yet.” He took the rope from her left leg and hooked it over a pulley directly above her chest. Then he turned to the nurse, “Put the weight back on and add

another twenty to hold it there.” He held the leg till the nurse added the weight.

Kathy felt her leg being pulled up toward her and for the first time she could see the end of the stump. A gasp came from her lips. She had never seen the end of an amputated limb before. Even if she had, hers was so different the experience would not have prepared her for it. A hollow steel shaft protruded about an inch from the end of her leg. The rope was attached to it by a clamp.

“I know that’s a shock to see. We fixed your stumps so we can reattach your legs later. In doing that, we also gave you a better platform to attach a prosthetic till your own legs can be attached. Do you want me to explain it now or do you want me to wait till your parents come in?”

“No, tell me now.” She really wasn’t sure she was ready for this but she needed to know now.

“Like I said, we found the damage to your knees was much greater than we expected. The nerves were just gone. The blood vessels were smashed. We couldn’t reattach with our new method. It replaces the crushed bone and blood vessels but doesn’t do anything about the nerves. There wasn’t even enough good skin to work with. We didn’t have enough good skin to cover the wound. We decided to do the first half of the operation we were planning to do sometime early next year. You had signed the authorization for either surgery, something we do as a matter of routine. There wasn’t anything else we could do except a traditional amputation and I knew you didn’t want that.”

“Will I ever be able to walk?”

“Sure. You will walk with artificial legs and in the next couple weeks. With your own legs, nearly for sure a little further out in the future. I don’t know if you will be able to run but you will be able to hike and maybe be able to jog. Let’s see what we did. Your legs were amputated about six inches above the knees. We made the stumps match at a level where we had good tissue on both of them. Your lower legs were done in another OR. The team there removed the damaged portion of the legs to about three inches below the knee, and prepared them for reattachment. Essentially they were prepared like your stumps. The top of your lower legs look like these stumps except they’re smaller. They were put on infusion to keep them till we were ready.”

“They’ll be OK, you’re sure?”

“Yes. Now, let’s look at what we did to you and to your legs.” He pointed to the end of the stump. “Up to now when we amputate we smoothed the bone and covered it with a flap of muscle and skin. We did almost everything different. We cut off the damaged portion of each of your femurs and attached a metal shaft to each of them. The upper end of the shaft has a pin that goes inside your femur and a sleeve that goes outside it. They’re cemented in place and pins through the femur provide additional stability. We want the shaft to be an extension of the femur. On the lower part of your leg the two bones are each attached in a similar manner to a “Y” shaped shaft. We connected the rod in the femur to this rope for the traction. The replacement knee joint will attach here with your legs attached to them but till we are ready to attach them you’ll be using prosthesis. It’ll attach there. This method of attachment of artificial limbs is experimental and if it proves out, it may be the greatest advances in artificial limbs in years, the ability to firmly attach and in most cases provide limited movement of the artificial joint below the amputation. While you’re waiting for reattachment of your legs you can help us evaluate this method and gain some mobility.”

“We attached a special plastic cord to the end of each muscle that was still intact. These cords were passed through boot holes in a plastic disk that was put over the metal shaft. These allow the muscles to pull the cords through seals the end of the stump. All of the nerves in the stump were found and driver chips were attached to them. The cable from the chips was brought through another hole in the disk. Several major blood vessels were located and tubes were placed in them and passed through the disk. The tubes from the arteries and veins were connected with a thin tube to allow a small blood flow to keep the channels open. The whole thing was sealed and the plastic disk was sutured to the skin line. This special plastic disk and your skin will begin to grow together. You have a solid mechanical connection for your legs, muscle ends to move the knee, a blood supply connection to support your legs and an electrical connection to pass the nerve impulses.”

“So you can attach my legs to that?”

“Later. The programming of the computer to attach the chips on the stump and the leg isn’t ready yet. Till then, you’ll have to do without them.”

“What’ll I do till then? Learn to use a wheelchair?” In the shock she was only comprehending a portion of what he was saying.

“You’ll have to use one some but I think we can do better for you with prosthetics. Would you be willing to try an artificial leg we’ve developed until we can reattach your legs? You’ll be more mobile than with the wheelchair.”

“Do you have two of them? I’d look kind of funny with only one peg leg.” She asked and smiled then a tear ran down her cheek.

“Sure, we can get two. You’ll find they don’t look much like your concept of peg legs. They’re sexy enough to fool most guys. Take it easy for a few days. We’ll get started as soon as the stumps have some time to heal. I’m sure they’re really tender right now. Let’s get you back in traction. I can’t let you move the muscles in your hips or pull on the boots in your stump till they start to knit to your skin but I need you to start to exercise. To keep you from moving those muscles too much I’ve put your hips in the elastic bandages so you can’t contract them more than a little. It has to be tight but it’ll not be for very long.” He started to wrap the left stump. “I’ve put you in traction, not to keep you immobile but to provide you a way to exercise in precise amounts. I want you to start to see how far you can pull that rope. To start with, pull your leg up toward your chest about five times every hour. Then have the nurse hook the rope to the pulley above your head to pull your leg up. Exercise by straightening the leg. Work up toward twenty times as you can. I need to look at the other leg, to see how it’s doing, so be still for now.” The nurse removed the weight from the rope. He hooked the rope to the other pulley and the nurse replaced the weight. He unwrapped the other stump while he talked, looked at it, and re-wrapped it. The nurse added another twenty pounds to that rope, too.

“Exercise as much as you can. I’ll see you tomorrow. I want to see you pull that rope and hold it for a full minute. When you do, we put those peg legs on you and get you out of bed.”

She nodded and responded, “A full minute of holding the rope for a minute coming up.”

He smiled and left.

That evening Bill and her family visited. She was down but not beaten. She would lick this. When visiting hours were almost over her parents went out and left her with Bill for a few minutes. Bill felt strange in the room. He had never slept with her, had never seen her with less on than her bathing suit. They had decided to wait to be intimate till they were married. She held his hand and then slipped off the engagement ring and handed it to him. “Here, take this. You can’t be held to an agreement that isn’t valid any more.”

“I want you.”

“Are you sure?”

“I’m sure.”

“Let me show you what I look like. I know you liked my legs. Well, I don’t have them any more.”

“You’ll get them back.”

“What if I don’t?”

“I’ll love you anyway.”

“Could you make love to a freak with steel pins sticking out of her legs?”

“Why wouldn’t I want to if I love her?”

“Turn around.”

He obeyed. She pulled the sheet off her legs and placed it over her lower body. “Take a look at me. Can you love this?”

He turned with tears in his eyes. He looked at her stumps and then put his face down to hers and kissed her. He slowly rubbed his hand over her upper leg, something he had never done before. He touched the metal pin and then her leg. After a few minutes he slipped the ring back on her hand, kissed her and turned and left without saying anything.

When the nurse came in a few minutes later to answer her light she was exercising. The nurse changed the traction for her. When she checked in later, Kathy was sound asleep.

Table of Chapters

Kathy’s Legs: Chapter One, The Accident

Kathys Legs 2: Kathy’s Recovery Begins

Kathy’s Legs: Chapter Three, Kathy Meets Her Legs

Kathys Legs: Chapter Four, Kathy Gets Back Her Legs

Kathy’s Legs: Chapter Five, Brad Becomes a Patient

Kathys Legs 6: Kathy Returns to College

Kathy’s Legs: Chapter Seven, Kathy is Without Her Legs Again

Kathys Legs 8: The Friends with SCI Have Surgery

Kathy’s Legs 9: Ken to the Rescue

Other Articles by Ralph Brandt

Churches That Get Government Money

Financial Help in These Trying Times

Anonymous and Irresponsible: the Radical Left

The Comparison of the Assassinations of Kennedy and Lincoln

Relationship of Church and State

An End to Complacency

I’m Going on
Compromise in the Church
Come Away My Beloved
Communion
Contradictions – Science and Religion

Christian Perspective On Hatred Feb 20, 2007

Noivels

Alpha Four Chapter 01: Two Autopsies

Denise Chapter 01: Success in Hollywood

Jan Chapter 01: School Days

Karen: Chapter One – The Attack

Kathy’s Legs: Chapter One, The Accident

Laura Chapter 1

Sandra Chapter 01: the Accident

The First Family: Chapter 1 – Introduction

The Handshue Sect 1

The Night Sniper Chapter One: On the Beat

World War II – a Novel Chapter One