A young female athlete girl breaks her leg playing soccer. After treating the fracture the doctor sees the potential of a more serious condition and calls her back. While he is doing the tests she begins to study the diagnosis, treatment and outcome of the treatment and in doing so she encounters something disturbing. Are all the surgeries being done for this condition necessary?
After they left she pulled up www.alltheweb.com and started searching with the words “broken bone”. She looked at the first three of the nearly 98,000 hits. There was nothing interesting there. She added leg and the number of hits fell to just over 22,000. She added femur and trauma, the number was still over 2136, entirely too many to look at. Finally she dropped the word femur and added the word radiology and the number of hits was 487. She wrote down the key words in each group, there was no reason to repeat unproductive searches. She had to get a better search argument.
She picked up her crutches and headed to the bathroom. As she was sitting on the commode she thought of several other words. She went back to the computer and one by one she added, teen, female and pain. There were just over 150 hits! What a dramatic change! She started looking at the hits. The first one was about a bone disease called osteomylitis. She looked at it and shuddered. It was an infection in the bone that weakens the bone making it likely to breakage. It usually only followed an injury or surgery where the bone was exposed to allow a path for the infection. The second was about something called myeloma, a disease that destroyed the bone and made it weak, allowing it to fracture. There was osteoporosis which showed as more likely for an older person and rarely seen in a healthy teen. There was one called osteoid osteoma. It produced a benign growth in the bone that weakened it, there was pain and often the diagnosis was because of the pain or a break at the weakened spot. They were most likely between the age of twelve and twenty nine. But all had one contradicting feature. They were diagnosable by x-ray. In fact x-ray was the test that usually detected them. The hospital had x-rayed her leg. The doctor mentioned nothing but the break. Her broken leg was a fluke. She must get on with her schoolwork, allow her leg to heal and be ready for the basketball season in her Senior year. Although basket ball was her second sport, maybe she could get a scholarship.
About a half hour later her mom came in and asked if she wanted something. She plugged in a wireless intercom they had used between the basement and the kitchen. “Let’s put this here for a couple of weeks, till you get better. If you need something, you can call me.”
“But mom, I’m not a cripple.”
“I know you aren’t but this will save me steps too. If you need something you can tell me without my walking upstari. Maybe I should call my boss and get Monday off.”
“Don’t. I’ll be going back to school.”
“You can’t.”
“Guys on the football team break a leg in a game on Friday night or Saturday afternoon and they get to school on Monday. Unless I can’t get up I can’t stay at home. I can’t let them know we girls are soft.”
“You don’t have to prove anything to them.”
“I do to me.”
“OK, but if you need me during the day at the school, call.”
“I will. You’ll have to fix me with some medicine for the school nurse.”
“I’ve already written the note for you to go back. I’ll let you get back to your work and I’ll finish dinner. Your dad should be home soon with the boys.”
“Thanks mom, for being there.”
Her mom bent down and they hugged.
It was over an hour till her dad arrived with the boys and her car. Lem, the eighth grader bounded in, “Laur, let me see your cast.” He looked at it propped on the char, “Awesome,” was his only response.
Larry was a little more restrained. “Golly sis, that thing is big.”
Her dad was behind them. “Do you feel up to coming out to the car?”
“Sure, why?”
“Got something to show you.”
She picked up her crutches and headed to the driveway. Lem bounded past her and nearly knocked her right crutch from under her arm.
“Watch it,” she yelled.
“Sorry, Laur,” the properly chastised and contrite brother responded.
At the car he pulled open the door and pointed to the driver’s side floor. “See what dad got for you?”
She looked in. On the floor next to the door was a second gas pedal.
Her dad nodded, “See if you can get in and out.”
It was difficult to get in but once in her left foot was at the right place. She tried moving from the gas to the brake. She slid out, stood up and hugged her dad. “Thanks dad.”
Laura’s alarm woke her at 6:00 AM on Saturday. She did not change the time of the alarm for the weekends. She was about half way through getting her feet to the floor when she remembered that there was something on her right leg. She grabbed her crutches and moved to her exercise area. She picked up her weights and worked her arms. Then she sat on the bench and did leg lifts with both legs and worked her left leg. She could not allow any portion of her body to go soft.
She went to the bathroom and bathed in the basin. She wanted a shower but knew that was impossible with the cast. With her hair done she returned to her room and went back to her school work. After about an hour she broke off the schoolwork to read and answer some E-mail from some friends. It was nice to know that they were concerned about her. After a while she crutched over to her bed and propped her leg as high as possible on pillows. She picked up the remote control and browsed the channels, finally settling on the History Channel. She watched a program on the Civil War. It contained a segment on Daniel Sickels, an officer who was shot and lost his leg above the knee. The bone was shattered just below the knee and they could not manage the wound. After convalescence he returned to the battlefield. In a later battle when a shot shattered his artificial leg he quipped that it didn’t hurt to be shot in a wooden leg. She looked at the cast. Her leg was protected inside it to heal. Only the very top of her right leg was visible. At the end of the segment she turned off her TV and returned to the computer. She connected to the internet and brought up www.alltheweb.com. She typed in cast and fracture. The first entry was startling. She had never seen anything like it. There were pretty women in casts, being photographed and displayed like models. At first she did not realize that many of these casted women had no medical reason for the casting. Laura shook her head. How could someone want to have a cast for the fun of it?
She returned to the search list and found only a few of the sites had anything to do with broken bones but most of these were much too technical to be of any help to her. She remembered the Union Officer. Curiosity struck her, what would it be like to have a leg amputated? With the thought she was appalled that she would even consider that. The doctor had never mentioned this as a possible outcome. But she was concerned about her leg. She had not done anything she has not previously done a hundred times before and it broke. She did three more searches. None turned up anything worth reading.
She went back to the sites she was looking at the night before. One mentioned sarcoma, she had ignored it before, she assumed it was like one of the other bone diseases. She opened it. It was a story about a high school girl that had broken her leg cheering. The x-ray of her leg showed a spot, the diagnosis was sarcoma, the treatment, amputation of the leg just above the knee. She bit her lip as she looked at the picture of the girl in her cheerleader’s uniform before the surgery and in the same uniform on crutches after the surgery. The tip of what was left of her leg just showed below her skirt. There was another picture of her cheering without her leg and one more with her with an artificial leg. But this could not be true for her. The x-ray would have shown the tumor. She pushed it out of her mind. A few minutes later her mother called from the kitchen on the intercom. Did she want to do anything today?
She picked up her crutches and went to the kitchen. “What were you planning?”
“I was going to go to the mall for an hour or two.”
“I’ll get ready and go with you, can you wait fifteen minutes?”
“Are you sure you should?”
“Don’t you want me to go with you?”
“No, I was just afraid that it may be too much for you.”
“I have a broken leg. I’m not dying.”
“But I thought the cast is a lot to get around with, it is heavy.”
“If I get tired I sit down and wait for you to come back or I get a wheelchair and ride around. Are you ashamed of me?”
“Of course not. I don’t want you to be hurt more.”
“Then I’m going. I’ll be right there.”
Fifteen minutes later she was back wearing a pair of shorts and a frilly blouse. “Let’s go.” She crutched to her car and slid in before her mother could stop her.
“Let me drive,” her mother blurted out as she was closing the door.
“But mom, I need to know if I am going to be able to take us to school Monday. Wouldn’t it be better for me to see if it is going to work today when you can take over if I have problems?”
Her mom nodded and slid in on the other side. “You generally get your own way, don’t you.”
“I learned from you.”
“Touché.”
At the mall Laura parked the car as close as she could to the door. Her mother mentioned using a handicapped space. Laura glared, “I don’t have the papers to park there and even if I did, I’m not handicapped.”
“We are independent, aren’t we?”
Laura looked over and glared. They got out of the car and went to the entrance in silence.
They shopped through four stores, Laura bought a blouse; her mother looked at some clothes but found nothing she liked. Coming out of the fifth store Laura crutched to a bench in the mall and plopped down. “This is heavy.” She propped her foot up on the bench and looked at her toes. “I think they are swelling a little.”
“The doctor said they would if you were on your feet too long. Let me get you a wheelchair. There is an entrance over there.”
Laura started to protest that she didn’t need one and then looked up and smiled, “You’re right mom. It is really feeling tight and hurting. Guess the wheelchair is a good idea. But you have no idea how much I hate getting in it.”
“Oh, yes I do. I remember the day they made me ride in one when I went to the hospital to have you. I protested until the first contraction came, then sat down and was happy to ride.”
“Mom, go get it, but could you do one thing?”
“What?”
“Let me wheel myself if I can?”
“Sure. I understand. If you let me help you in some places.”
“Agreed.”
Laura was soon seated in the wheelchair, her crutches in the rack on the back and the right leg lifted to just level. As she wheeled down the mall her mom asked, “Does that help?”
“Some, I guess it takes some time to get the swelling to go down.”
“It will, just keep the leg up as much as possible.”
She was stopped three times by schoolmates. All had to sign her cast. She was treated like a hero. The last one was Brian Warner. He was a computer geek but a nice guy. They did things together. There were few guys she would even consider working with, most of them did not want to do school work. They had other ideas. He looked at her and took her hand. “Laur, please be careful. It hurts to see you like this.”
“I’ll be as good as new soon.”
“I wish you didn’t take so many chances. What if you got hurt bad? Laur, please be careful.” He held her hand and tears formed in his eyes. “Be careful, for me.”
Shortly after two PM Laura and her mom returned to the entrance near the car. As they approached the entrance Laura pulled the wheel chair off to the side of the mall, locked the brakes and stood up. She pulled her crutches out of the rack and slid them under her arms. Without any comment she started to the car. As they crossed the parking lot she said, “Mom.”
“Yes.”
“Can you drive home?”
“Yes.”
“I’m getting into the back. I’m beat. If I go to sleep, don’t wake me till we get home. You were right about this being tough. I am tired.”
“No problem, I just want to take care of you so you get better.”
“Thanks mom, for everything. I needed this.” She climbed in the back of the car. Her mom had to shake her to wake her when they arrived at home.
Sunday involved a trip to church and the family spent the afternoon together. She discussed her hair with her mom. She could put up with the spit baths as she put it, but her hair absolutely needed washed. Her mom laughed. Soon Laura found herself on a chair leaning back into the bathroom sink. Her mom was washing her hair. She dried it and lay down. Within ten minutes she was asleep. She woke in time to eat supper with her family.
Laura’s alarm went off as usual on Monday morning at 6:00 AM. She went through the same exercise program she had for the previous two days and headed for the bathroom. She bathed, did her makeup and hair and returned to her room. As usual she dressed and turned on her computer to do some schoolwork that was due later in the week. She packed her books into a backpack, slipped it over her shoulders, hung her shoulder bag across her shoulder, picked up her crutches and headed for the kitchen.
Breakfast was ready. She ate less than usual. Her leg was hurting enough that she didn’t fell like eating. As soon as she was done she started pushing the boys toward the car. She dropped Lem at the junior high and then drove to the high school. She parked and she and Larry headed for the building. Everyone seemed interested in her. By the time she got to the school there were three boys competing to carry her books, help her and open the doors. She noticed that none of them were paying any attention to anything but her legs. “Why would someone want to look at a big white cast?” she thought as she opened her locker. She remembered the pictures on the web.
Between the first and second period she needed to go to the restroom. As she was about to leave Jackie King came in the door. “Well, I can see I need to have a doctor put a big cast on my leg.”
“You’re crazy. What for?”
“Didn’t you see the guys following you with their tongues hanging out?”
“So there were a couple of them being helpful.”
“There were about fifteen of them standing gawking at you. Only a few of them could get close. They think a girl on crutches is sexy. Maybe it’s because she can’t run away. Remember when I had my ankle sprained? I was on crutches with my foot wrapped. I never got that kind of attention before or since. Guys even asked if I wanted them to re-wrap my foot or massage my leg. One wanted to put nail polish on my nails. And that was for a little ace bandage. I should have had the doctor put a cast on for a couple of weeks.”
“You’re nuts. You would wear a cast to get boys to pay attention to you?”
“Is there any doubt in your mind, sure.”
“I don’t understand it.”
“Guys are shallow.”
“What do you call a girl that would put on a cast to get that kind of attention?”
“Smart.”
“Jackie. I’m surprised with you.”
“I’ve considered getting out my crutches and ace bandage about a month before prom and see if I can get a date.”
“How would you do that, what would your parents say?”
“I’d just tell them I sprained my ankle again. I could fake another injury. I had forgotten the attention until you crutched in here today. Now I’m almost jealous.”
“I’ll ask my doctor if he’ll put a full cast on your leg, let you try this for a while.”
“I understand it’s a pain, but there are plusses.”
“I’m not sure having guys that are hot to trot following you and trying to paint your toenails is a plus.”
“Well, I do. But then I’m not the blond bombshell that guys follow all the time. Now how’s the leg?”
“Broke.”
“I knew that, how long are they talking about you keeping this?”
“Probably six weeks or so. The break is above my knee.”
“Are you going to be playing soccer again?”
“Not this year. The season will be over before I can play. I’m hoping to be ready to play basketball. I need to get a scholarship to help my parents with college.”
“Have you thought if you will be able to play after you get the cast off?”
“They say I will need some therapy to get going but should be back to where I was before.”
“Physically, yes. But are you going to be able to mentally?”
“I don’t understand.”
“Let me explain it this way. The ankle sprain made a difference to me. When I go up for a rebound there is always a thought in my mind, “If I land like I did that time last year, there will be pain, intense pain.” So I don’t go as high, take the same chances, and my playing stinks. And it isn’t my ankle, it is the fear of getting hurt.”
“You’re not kidding.”
“I’m not, and look at you, you have kicked that goal a hundred times and this time you break your leg. Is that going to haunt you every time you kick a goal from now on?”
Laura looked at her friend. She was serious, dead serious. Her rebounding was not nearly as good as before her injury and it was because she did not press in and jump as high. Everyone had speculated that her foot was not fully healed. Now Laura knew the reason. It was only after Jackie was hurt that Laura won the title of the top re-bounder. Jackie’s injury was to her mind. Laura wondered, “Will I have the same problem?” Instead of voicing it she looked at her friend, “Let’s see if we can help each other not let this hurt our game.”
“I’m for that.”
“I have to go. The teacher will be wondering if I got lost.” She pushed the door open and crutched out into the hall. She headed to the classroom, entered and took her seat.
Chapter 1 also contains an index.
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