When the Boston Marathon was bombed last year, we had the TV on in the amputee clinic at Walter Reed National Military Medical Center. We rarely turned on the TV, but we had done so this day because a group of our patients were at the marathon, competing in wheelchairs and handcycles.
Initially, by the yelling and commotion, I thought there had been an altercation at the facility. Everyone was rushing somewhere. A group of patients immediately got into their wheelchairs and left the room. I stood in the middle of the emptying clinic and wondered what was going on.
Suddenly a patient who had lost both of his legs after stepping on a bomb in Afghanistan snapped me out of my confusion. “A bomb went off on TV!” he yelled at me.
When I didn’t react, he yelled again, “Shut the [expletive] TV off!”
I worked as a physical therapist at Walter Reed for nine years, seven of them in the amputee section. While I was there, the injuries steadily got worse. In 2011, the year our original hospital at Walter Reed Army Medical Center closed, we were seeing 150 amputees a day and our incoming medevac flights regularly contained soldiers who had lost three limbs. By 2013, we had rehabilitated five men who had lost all four limbs.
What Boston suddenly had to deal with, we dealt with every day at Walter Reed.
When I first started working there, I swore I’d stay for only a year. The hours were terrible. There was no parking. And the stress was incredible. “I’m going to leave soon” was my mantra to my friends. But slowly I began seeing my friends less and less and my co-workers more and more. And time slipped by.
In 2005, I was a young physical therapist. I had a baby face, liked to stay out late and could fit all my possessions into the trunk of my car. I had gone to PT school because I wanted a job with good hours, and I sent my résumé to Walter Reed because I wanted a short commute. So the joke was really on me, because the hours at Walter Reed were not good and, once I’d lost my apartment, neither was the commute. But, mostly, I was simply unprepared for what I was getting myself into.
I remember the first time I saw a patient with combat wounds. He had burns on his arms and his face was pocked from shrapnel and gunpowder. His broken legs were held together by external frames, and there were areas of missing skin, muscle and bone. I watched transfixed as he transferred himself out of his wheelchair and onto the therapy table by sliding his butt across, and then lifting his legs one at time by grabbing the metal scaffolding and hauling each leg over.
If this new patient recognized my inexperience, he didn’t show it. After he carefully arranged his shattered legs on the mat, he looked at me and asked: “When can I start running again?”
Gunshot wounds, traumatic brain injuries, mangled legs, missing eyes and lost flesh quickly became my new normal. And because I spent 10 hours a day in a place where everyone also had amputations, in my dreams, everyone was an amputee — even me.
By 2007, our clinic at Walter Reed Army Medical Center had become so crowded that, even though we were scheduled to close in four years, they built us a new facility. In the new building, the rehab gym was glassed in, like an aquarium, and several times a day guided tour groups shuffled by on the other side of the glass.
Where, under the gaping eyes of the tour groups, my co-workers, our patients and I all joked and laughed. Because what was an amputation at Walter Reed but something to tease each other about? Our soldiers and Marines regularly referred to each other as “Ugly Stump” and made fun of each other for being a “princess” if they admitted to any pain. Patients with below-the-knee amputations were made fun of by those whose legs were amputated at mid-thigh as having “paper cuts.” Arm amputees had the ultimate bad joke: “Can someone just give me a hand?”
One day we watched from inside the glass as a young couple came striding down the hallway toward us, pushing an old-fashioned baby carriage. They came around the perimeter of the aquarium and then inside, yanking back the sunshade and wriggling blanket to reveal eight puppies.
Another day a woman came staggering past the window, bent over under the weight of an orchestra-size harp. Without a word to anyone she spent the afternoon serenading us.
As the years went by, we adjusted to life under glass. One co-worker started baking cakes for each of the patients on their birthday. Hundreds of cakes — so many cakes that he ended up having to buy a new oven. Another co-worker disappeared into the delivery room twice, with two of the pregnant wives. She held their hands while they delivered in lieu of a husband who was still unconscious in the intensive care unit.
A common refrain heard in our ICU was the phrase, “You are okay. You are at Walter Reed, and you are okay.” But how okay were they really? After the marathon bombing, our patients discussed the new victims, concern wrinkling their faces, and then had a question for the staff: “When are they going to get here?”
When the bombs went off in Boston our busiest days were behind us. Our old hospital had been shut down. And my co-workers, our patients and myself had been swept out of our bowl and transported down the road to the National Naval Medical Center seven miles away.
There, the medevac flights slowed down until they rarely came. Our new clinic was practically empty. No incoming patients to agonize over. No tour groups. Just us and our remaining patients. After years of treating hundreds of combat amputees, it was hard to turn off that kind of adrenaline. We were used to being out-of-control busy. What kept us going through those days was knowing that it was temporary. It was going to end sometime.
Finally, the wars wound down. It was what we wanted all along, but instead of being glad, we panicked. We didn’t know how to not be busy.
But, slowly, we began to accept our new reality. We enjoyed our time with the remaining patients, and we began to look at life on the outside.
My co-worker with the new oven stopped baking cakes and started going on vacations.
The co-worker who had been so involved in her patients’ lives that she had attended the births of their children resigned and moved to a remote cabin in Vermont.
Even I had grown up. Somehow in the midst of the chaos of my days, my nights were calm. I had settled down. I had a long-term partner, a house and two small children. When each of them was born, I marveled wryly at their perfect legs.
And now it was time for me to leave. There is a job opening at a new hospital down the road from me. It promises good hours and an easy commute, but in the window of my heart I know I’ll never forget the hospital I came from. I was acutely aware of it on the anniversary of the Boston Marathon bombings, remembering the highs and the lows, and how small joys, like puppies sneaked into a hospital clinic, can briefly eclipse everything around you.
Adele Levine is the author of “Run, Don’t Walk: The Curious and Chaotic Life of a Physical Therapist Inside Walter Reed Army Medical Center.” She lives in Wheaton.